Two variants of 'constrained participation' in the care of vulnerable adults: A proof-of-concept study.

There has been a radical turn towards ideals of patient autonomy and person-centred care, and away from historically entrenched forms of medical paternalism, in the last 50 years of nursing practice. However, along the way, some shades of grey between the areas of ideal patient participation and of outright patient non-participation have been missed. The current article constitutes an exploratory proof-of-concept study of the real-world traction of a distinction-straddling concept of 'constrained participation' and its two sub-concepts of 'fought-for participation' and 'forced-to participation'. In order to concretise these additions to the conceptual terrain of person-centred participation and its anti-theses, we apply them to themes in the care of vulnerable older adults. In the final section, we close by eliciting some characterological, educational and clinical implications of adding these new tools also to the conceptual repertoire of nursing practice and education.

Keeping the Connection Alive With Tender Care and Common Sense: A Phenomenological Study on Daughters' Experiences of Having a Mother in a Nursing Home.

The relationship between mother and daughter is exceptional when it comes to closeness and its impact on their whole life. Thus, a mother's move to a nursing home is pivotal for both of them. The aim of this interpretative phenomenological study, using the Vancouver School of Doing Phenomenology, was to explore daughters' experience of having a mother in a nursing home, its impact on the maternal relationship, and the daughters' need for education and support. Data were collected by 21 semi-structured interviews with 12 women who had mothers living in a nursing home. Keeping the connection alive with tender care and common sense encapsulates the interrelation between the daughters' urge to hold on to the mother-daughter relationship and the rare consideration of education and support from health professionals. Responsibility and sense of duty paired with relief because the mother is in a safe place were accompanied by the daughters' need for confirmation that the mother is well taken care of.

Exploring the Potential of Icelandic Seaweeds Extracts Produced by Aqueous Pulsed Electric Fields-Assisted Extraction for Cosmetic Applications.

A growing concern for overall health is driving a global market of natural ingredients not only in the food industry but also in the cosmetic field. In this study, a screening on potential cosmetic applications of aqueous extracts from three Icelandic seaweeds produced by pulsed electric fields (PEF) was performed. Produced extracts by PEF from Ulva lactuca, Alaria esculenta and Palmaria palmata were compared with the traditional hot water extraction in terms of polyphenol, flavonoid and carbohydrate content. Moreover, antioxidant properties and enzymatic inhibitory activities were evaluated by using in vitro assays. PEF exhibited similar results to the traditional method, showing several advantages such as its non-thermal nature and shorter extraction time. Amongst the three Icelandic species, Alaria esculenta showed the highest content of phenolic (mean value 8869.7 µg GAE/g dw) and flavonoid (mean value 12,098.7 µg QE/g dw) compounds, also exhibiting the highest antioxidant capacities. Moreover, Alaria esculenta extracts exhibited excellent anti-enzymatic activities (76.9, 72.8, 93.0 and 100% for collagenase, elastase, tyrosinase and hyaluronidase, respectively) for their use in skin whitening and anti-aging products. Thus, our preliminary study suggests that Icelandic Alaria esculenta-based extracts produced by PEF could be used as potential ingredients for natural cosmetic and cosmeceutical formulations.

Facilitation of a Person-Centered Approach in Health Assessment of patients with chronic pain: An Ethnographic Study.

A phenomenologically derived assessment tool, Hermes, was developed in a rehabilitation setting for adopting the central ideals of person-centered care and patient participation into health-assessment practices in nursing. This focused ethnographic study aimed at exploring the feasibility of using Hermes for enabling the application of these ideals into assessment of patients with chronic pain upon admission to a rehabilitation center. Participants were patients with chronic pain, enrolled in rehabilitation, and their nurses. Data were collected by participant observation and interviews, and analyzed by thematic analysis. By the use of Hermes, the impact of illness was explored through supportive connection and dialogue with open, reflective, and interpretative features; understanding of the illness situation was enhanced; and possibilities provided in adjusting to health issues of concern. In sum, Hermes facilitated person-centered participation of patients with chronic pain in their health assessment and made a phenomenological philosophy usable in nursing-assessment practices.

The Effects of Short-Time Temperature Abuse on the Microbial and Sensory Quality of Chilled Saithe (Pollachius virens) Fillets.

Chilled fish products are highly perishable with a limited shelf life (10 to 14 d). For this reason, the control of the cold chain for fish is essential. This study´s objective was to investigate the effects of short-time temperature abuse during processing on spoilage of chilled saithe (Pollachius virens) fillets. Analysis of microbial growth, freshness grades, and sensory score by Quality Index method, as well as pH, were carried out during a 10-d storage period at 2 ± 2 °C. Before storage, the fillets were kept at 16 °C for 0, 1, and 2 h. The results showed that spoilage of the fillets was accelerated with longer holding time at 16 °C. The 1- and 2-h holding before packing and storage caused a 22% (2 d) and 44% (4 d) loss of shelf life, respectively, compared to fillets that were packed immediately after processing. These findings indicate how bottlenecks and delays during processing may result in loss of microbial and sensory quality of chilled fish products. PRACTICAL APPLICATION: The observations show the importance of maintaining a low temperature in fish, even for a short period such as during processing. Any delays, such as due to buffering or mechanical failure, may accelerate spoilage of chilled products during subsequent storage. This effect is even more pronounced when products are packed in bulk volumes as the cooling rate is much slower than the piece-by-piece cooling rate.

Weakening Pin Bone Attachment in Fish Fillets Using High-Intensity Focused Ultrasound.

High Intensity Focused Ultrasound (HIFU) can be used for the localized heating of biological tissue through the conversion of sound waves into heat. Although originally developed for human medicine, HIFU may also be used to weaken the attachment of pin bones in fish fillets to enable easier removal of such bones. This was shown in the present study, where a series of experiments were performed on HIFU phantoms and fillets of cod and salmon. In thin objects such as fish fillets, the heat is mainly dissipated at the surfaces. However, bones inside the fillet absorb ultrasound energy more efficiently than the surrounding tissue, resulting in a "self-focusing" heating of the bones. Salmon skin was found to effectively block the ultrasound, resulting in a significantly lower heating effect in fillets with skin. Cod skin partly blocked the ultrasound, but only to a small degree, enabling HIFU treatment through the skin. The treatment of fillets to reduce the pin bone attachment yielded an average reduction in the required pulling force by 50% in cod fillets with skin, with little muscle denaturation, and 72% in skinned fillets, with significant muscle denaturation. Salmon fillets were treated from the muscle side of the fillet to circumvent the need for penetration through skin. The treatment resulted in a 30% reduction in the peak pulling force and 10% reduction in the total pulling work, with a slight denaturation of the fillet surface.

Development of Hermes, a New Person-Centered Assessment Tool in Nursing Rehabilitation, Through Action Research.

In this article, an action-research project has been outlined, aimed at exploring ways for developing an assessment tool, underpinned by phenomenology, which would enhance a person-centered approach to the participation of patients in nursing assessment and care planning in rehabilitation. Participants were nurses in physical rehabilitation and a consultant. Data were collected by interviews and observation of the documentation on the tool. The tool, Hermes, was adopted in practice. Through its use, important person-centered assessment practices were enhanced and several aspects of its phenomenological grounding were supported. Hermes has potential for facilitating the transfusion of phenomenology into nursing practice.

Patients' perspectives on person-centred participation in healthcare: a framework analysis.

The aim of this article was to critically analyse the concept of person-centred participation in healthcare from patients' perspectives through a review of qualitative research findings. In accordance with the integrative review method of Broom, data were retrieved from databases, but 60 studies were finally included in the study. The diverse attributes of person-centred participation in healthcare were identified and contrasted with participation that was not person-centred and analysed through framework analysis. Person-centred participation in healthcare was found to be based on patients' experiences, values, preferences and needs in which respect and equality were central. It manifested itself via three intertwined phases: the human-connection phase, the phase of information processing and the action phase. The results challenge in many aspects earlier concept analyses of patient participation in addition to illuminating patient participation that is not positively valued by patients.

Flavor and quality characteristics of salted and desalted cod (Gadus morhua) produced by different salting methods.

Flavor characterization and quality of salt-cured and desalted cod (Gadus morhua) products was studied using sensory analysis and gas chromatography techniques. The products were produced in Iceland using two different processing methods (filleting and splitting) and three different salting procedures, i.e., the old single-step kench salting or a multistep procedure, and presalting (injection and brine salting or only brine salting), which was followed by kench salting. The main difference observed was between fillets and split fish, where the split fish was darker and had stronger flavor characteristics. Comparison of different salting procedures showed that the use of presalting improved the appearance of the salted products, which can be described as increased lightness and reduced yellowness of the products. In the same products, the intensity of curing flavors was milder, as described by sensory analysis and key aroma compounds. Derivatives from lipid and protein degradation contribute to the characteristic flavor of the salted products.

The effects of presalting methods from injection to pickling, on the yields of heavily salted cod (Gadus morhua).

The production of heavy-salted cod (Bacalao) has changed from being a single-step process (kench) salting to a multistep procedure varying between producers and countries. Presalting by injection, brining, or pickling is increasingly applied prior to pile (dry) salting. This article describes the effects of different presalting methods (injection and brining, brining only, and pickling) on yield and chemical composition of salted cod fillets, in comparison to a single-kench salting step. The procedures used influenced the weight yields and chemical composition of the products. Injection was significantly different from other methods in increasing weight yields throughout brining, dry salting, and rehydration. The yield of nitrogenous compounds tended to be lower for injected and brine-salted fillets, mainly due to higher losses of nonprotein nitrogen. Practical Application: Salting procedures for cod have changed rapidly in recent years. Injection is increasingly used as a presalting method. It has been suggested to have strong effects on weight yields of salted cod products. This article describes the effects of injection on weight yields on products in salted, rehydrated, and cooked stage.

Mentorship: an international perspective.

This paper is an account of a project funded by the European Union as a Leonardo da Vinici pilot project which aimed to produce a framework for a programme which prepares qualified nurses for their role as mentor of the student nurse. Representatives from universities in Norway, Sweden, Iceland, Poland, Portugal and the United Kingdom were the partner countries. The project was developed through the establishment of a series of common meetings sequentially held in each of the partner countries. The aim of these meetings was to devise a common curriculum for the preparation of mentors of students, when in practice, thereby sharing views, experiences and expectations. Initially, the group established a common philosophy specifically theory and practice were seen as a single entity with theory being both related to and drawn from practice. Reflection and reflection on practice was also seen as important; an inductive model which emphasized the dialectical relationship between theory (abstract thinking), practice (concrete experiences), reflected observation (induction) and active experimentation (deduction) and serve to reduce the gap between theory and practice. The process evolved rather than was a predetermined plan but on reflection the process involved several stages: the first lay in the identification of a common understanding of terms and a shared common philosophy. A framework is then devised which allows the partner countries to develop their programme according to local and national needs.