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Ehrstedt F.,Kopenhamns University | Ammentorp J.,Lillebaelt hospital | Kofoed P.-E.,Kolding sygehus | Kofoed P.-E.,University of Southern Denmark
Lakartidningen | Year: 2014

This literature review presents results of research on communication skills training (CST) of medical staff and its effect on patients. The 27 studies identified by a search in PubMed and Cochrane databases showed considerable heterogeneity in interventions, methods and study length. Most studies found a positive effect on patient satisfaction after the staff had participated in CST. Furthermore, there are indications that CST has an effect on other patient outcomes. Increasing the patient-centeredness in the consultation results in improved patient satisfaction and moreover has positive effects on psychological and physiological factors, such as improved function status and reduction in pain and blood pressure. Overall, we conclude that CST for health staff tends to improve patient satisfaction and other patient outcomes. The results of the studies are ambiguous, however the majority show positive results. © 2014, Swedish Medical Association. All rights reserved.


Sand-Jensen K.,Kopenhamns University | Sand-Jensen K.,Universitetsparken 4 | Baastrup-Spohr L.,Kopenhamns University | Andersen M.R.,Kopenhamns University | And 5 more authors.
Svensk Botanisk Tidskrift | Year: 2015

The Great Alvar plain on the Swedish island of Öland is characterized by thin soils covering the hard limestone pavements. This results in widely fluctuating water levels between winter flooding and summer draught and strong hydrological gradients along small changes in elevation. The semi-natural grassland, the intermittent streams and the ponds are all strongly influenced by the fluctuating water levels and the extremely low phosphorus availability. These factors have selected for phototrophs with low metabolic rates and growth, and communities with low levels of photosynthesis and respiration. We here present some of the results of our recent studies. Plant species were distinctively distributed according to their characteristic plant traits along water gradients from ponds to dry alvar. High root porosity to ensure efficient oxygen transport was strongly selected for among species in wet soils, while small, thick leaves were strongly selected for on thin, dry soils. Overall, six plant traits could predict 66% of the variation in abundance of plant species in the communities along the gradient. The alvar streams had only modest biomasses during maximum development of benthic algae in May, and community photosynthesis was 5-10 times lower than corresponding levels in nutrient-rich streams in cultivated lowlands of Scandinavia. During June-September streams dried out and the re-establishment of flow in winter and spring led to an export of nutrients. Shallow ponds also dried out during summer and had low metabolic rates just like streams, while permanent ponds developed dense stands of charophytes, despite undetectable levels of N and P. Photosynthesis and community respiration were in approximate balance in permanent ponds. The maximum rates were comparable to those in eutrophic, phytoplankton-rich lakes.

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