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Building and sustaining therapeutic relationships across treatment settings: a qualitative study of how patients navigate the group dynamics of mental healthcare
Get PDFBackground - Therapeutic relationships are vital for patients with complex and long-term psychosocial needs, yet such patients often face fragmented and unstable relationships within mental healthcare. These patients are more often than others moved between treatment settings and caregiving teams. Statutory obligations strain the relationships with frequent hospitalizations adding to the burden This study explores how these patients perceive and navigate therapeutic relationships, highlighting both positive and negative experiences across various treatment settings.
Methods - This is a qualitative study with a narrative approach utilizing in-depth interviews focusing on participants personal experiences and perceptions. We utilized purposive sampling to recruit patients with extensive hospitalization experience, operationalized as more than four admissions within one year or more than four successive weeks of hospitalization. Our sample consisted of 16 participants, twelve women and four men. The interviews were analyzed using a holistic-content approach.
Results - We found that therapeutic relationships were built on healthcare professionals recognizing and addressing patients’ needs and advocating for their interests within the service system. Participants described therapeutic relationships as sources of collaboration, stability, and support but found them challenging to sustain due to fear of rejection and institutional barriers. Successful relationships worked as a vital buffer, offering protection against malpractices and depersonalized care.
Conclusion - Therapeutic relationships play a crucial role in supporting patients with complex needs, but relational dilemmas and malignant group dynamics often impede their development. Mental healthcare services have an ethical responsibility to foster and maintain therapeutic environments and professional cultures that enable personalized care, while maintaining boundaries through reflective practices
The influence of menstrual cycle phase on performance-determining variables, acute training responses and recovery in endurance-trained athletes
Get PDFAims: This thesis aimed to investigate the influence of MC phase on endurance performance-determining variables (Paper I), the acute responses to low- and high-intensity training sessions (LIT/HIT) (Paper II), and sleep and recovery following exercise (Paper III). It also aimed to assess the accuracy of a modified MC tracking system (2-step method) for detecting subtle menstrual disturbances (Paper IV).
Methods: Endurance-trained women participated in two separate multi-center data collections. In Data Collection I, a standardized test battery assessed key performance determining variables, across two MCs (Paper I). In Data Collection II, the physiological and perceptual responses to standardized LIT and/or HIT session were assessed during two MCs (Paper II). Following each LIT / HIT session, objective sleep and next day recovery status were recorded (Paper III). Testing occurred in the early follicular (EFP), ovulatory (OP), and mid luteal (MLP) phases. MC phases were determined and verified using calendar-based counting, ovulation testing and serum hormone blood sampling on each test day (i.e., the 3-step method). Only eumenorrheic MCs were included in Papers I-III. Paper IV assessed the agreement between the 2-step (no blood samples) and 3-step method for detecting subtle menstrual disturbances.
Results: MC phase had no effect on the main endurance performance-determining variables (Paper I). During the LIT and HIT sessions, small between-phase changes were observed in ventilation, blood lactate, and perceived effort (Paper II). Objective sleep quality was slightly reduced in MLP, but perceived recovery status was unaffected (Paper III). Menstrual disturbances were identified in 36% of the recorded MCs. Compared to the 3-step method, the 2-step method correctly classified 92% of MCs as having or not having a menstrual disturbance (Paper IV).
Conclusion: MC phase had minimal effects on performance-determining variables, acute training responses and post-exercise sleep and recovery. While some subtle phase-related effects were observed, the objective and perceptual findings were misaligned, and the between-phase differences were not substantial enough to warrant phase-specific group-level recommendations. A large portion of the recorded MCs had a menstrual disturbance, most of which were detectable using the 2-step method. Overall, a flexible, athlete-centered approach to managing the MC is recommended, rather than a “one-size-fits-all” phase-based model.Formål: Denne doktorgradsavhandlingen hadde til hensikt å undersøke effekten av MS-faser på prestasjonsbestemmende variabler innenfor utholdenhet (Studie I), de akutte responsene på lav- og høyintensiv trening (LIT/HIT) (Studie II), samt søvn og restitusjon i etterkant av utholdenhetstrening (Studie III). Avhandlingen hadde også som formål å vurdere nøyaktigheten til et forenklet MS sporingssystem (2-trinns metode) sammenlignet med «gullstandardmetoden» (3-trinnsmetode) for å oppdage eventuelle menstruasjonsforstyrrelser (Studie IV).
Metoder: Utholdenhetstrente kvinner ble rekruttert til to separate multisenter datainnsamlinger. For Studie I-III ble testing utført i tidlig follikulær fase (EFP), eggløsningsfasen (OP) og midt i lutealfasen (MLP). MS-faser ble fastslått ved hjelp av kalenderbasert telling, eggløsningstesting og hormonbaserte blodprøver på alle testdager (såkalt 3-trinnsmetode). Et standardisert testbatteri ble brukt for å måle underliggende prestasjonsvariabler for utholdenhet i hver MS-fase, og dette ble gjentatt i to MS-er (Studie I). Fysiologiske og perseptuelle responser på standardiserte LIT og/eller HIT-økter ble analysert i hver MS-fase (Studie II). Etter hver treningsøkt ble søvnkvalitet og restitusjonsstatus påfølgende dag analysert (Studie III). Studie IV sammenlignet 2- og 3-trinns metoden med tanke på å oppdage subtile forstyrrelser i MS.
Resultater: MS-fasen hadde ingen effekt på sentrale prestasjonsbestemmende faktorer for utholdenhetsprestasjon (Studie I). Under LIT- og HIT øktene ble det observert små forskjeller i ventilasjon (høyere i MLP), blodlaktat (høyere i EFP) og opplevd anstrengelse (høyere i EFP) mellom fasene (Studie II). Det ble også observert noe redusert søvnkvalitet etter trening i MLP, men opplevd restitusjonsstatus var upåvirket (Studie III). Det ble registrert forstyrrelser i 36% av de registrerte MS-ene, hvorav 2-trinnsmetoden klassifiserte 92% av syklusene nøyaktig sammenlignet med 3-trinnsmetoden (Studie IV).
Konklusjon: Avhandlingen viste at MS-fasen til forsøkspersonene hadde minimal innvirkning på prestasjonsbestemmende utholdenhetsvariabler, akutte responser på LIT- og HIT-økter, samt restitusjon etter trening. Selv om noen små faserelaterte forskjeller ble observert, var de ikke betydningsfulle nok til å rettferdiggjøre MS-baserte anbefalinger på gruppenivå. En stor andel av de registrerte MS-ene hadde en forstyrrelse, og de aller fleste av disse kunne påvises ved hjelp av 2-trinnsmetoden. Det anbefales derfor at kvinner benytter en fleksibel og individbasert modell fremfor en generell tilnærming i forbindelse med belastningsstyring av utholdenhetstrening
Experience-dependent neuroplasticity in the hippocampus of bilingual young adults
Get PDFModels of experience-dependent neuroplasticity predict that the acquisition and extensive use of a new skill trigger a nonlinear trajectory of neurostructural modifications, where initial expansion of relevant brain areas subsequently (once the skill is acquired) gives way to volumetric re-normalization. Such predictions also apply in the domain of language during learning and/or simultaneous management of two (or more) linguistic systems. In a sample of 69 young adult Russian-English bilinguals, we tested the hypothesis that individual differences in bilingual engagement non-linearly correlate with normalized volume of the hippocampus – a key learning-related brain region particularly amenable to experience-dependent plasticity. Results revealed an inverted-U shape association between second language engagement and left hippocampal gray matter volume. The present results replicate and expand the findings from aging populations, showing a non-linear pattern of structural hippocampal plasticity in healthy young adults. These findings support the role of bilingualism as a promoter of experience-dependent neuroplasticity
Christianity
Get PDFIn several Western European democracies, more than a third of the population believe in Heaven, as shown by the latest World Values Survey (WWS 2020), including Norway (34%), the United Kingdom (35.2%), and Finland (33.9%). The percentage is considerably higher in culturally Roman Catholic and Eastern Orthodox nations, as well as the United States (66.9%). Belief in Hell is almost as widespread in these countries as belief in Heaven. The lowest values in the West are reported in Denmark, where still 17.8% believe in Heaven and 9.4% in Hell. Moreover, although longitudinal data are sparse, they show varying trends but no overall decline since the 1980s. The persistence of afterlife beliefs after centuries of secularization suggests that belief in Hell and Heaven is firmly ingrained in Christian cultures. This chapter looks at the origins and history of postmortem rewards and punishments in Christianity, focusing especially on their connection with moral behavior
Arbeiderpartiets rolle i samepolitikken: Fra styringsparti til mellomstort parti
Get PDFFrom having been a significant force and the largest party in the Sami parliamentary election in 2009, the Labour Party (Arbeiderpartiet) slipped during the 2021 election from its position among the largest parties and now stands as a medium-sized party with 15 percent of the vote. This chapter employs a combination of qualitative interviews with politicians and a larger survey to elucidate this decline. The salience of Sami self-determination in Sami politics has increased over the last elections, which has placed the Labour Party in a challenging position, caught between the poles of NSR and the People of the North Party, with the latter in particular attracting many former Labour voters. The party has struggled to define its role in this political landscape, where its previous strength of participation across multiple levels has now become a growing source of conflict. The Labour Party’s Sami wing has limited influence on the party’s national politics, especially when Sami rights clash with substantial economic interests. The surge in rights-based politics associated with Sami self-determination, akin to the second dimension challenging the left-right spectrum in European politics, has become a more dominant force within Sami politics
Assessment of welfare aspects of stunning and killing of farmed fish in Norway
Get PDFNorwegian aquaculture involves stunning and killing millions of fish every year. Welfare of fish is protected by laws and regulations. According to the legislation, all farmed individuals must be unconscious before killing and kept unconscious until they are confirmed dead after exsanguination.
There is a lack of knowledge about to what extent different stunning and killing methods used in Norway fulfil the legislation for all relevant fish species. Farmed fish species have different anatomy, physiology, and behaviour, and there are individual differences regarding size and health status that need to be considered at slaughter. Consequently, the Norwegian Food Safety Authority commissioned VKM to assess which criteria for documentation of methods will secure animal welfare during slaughter and evaluate how differences between fish species may affect documentation and animal welfare. VKM was also asked to summarise the knowledge and hazards for animal welfare regarding the methods for stunning and killing of farmed fish in Norway
Design and Evaluation of Interference Handling Mechanisms in Flow-Level Simulators
Get PDFWireless distributed systems face significant challenges when multiple devices share limited spectrum resources, leading to signal interference that corrupts data and impacts system performance. Flow-level network simulators, while computationally efficient, typically struggle to accurately model wireless interference scenarios, requiring users to implement complex collision handling mechanisms themselves. This complexity creates a barrier for researchers seeking to use flow-level simulation for studying distributed systems in wireless environments.
This thesis addresses the challenge of simplifying interference management in the Extensible Simulator for Distributed Systems (ESDS), a flow-level simulator for wireless networks. A novel interference handler plugin is designed and implemented that abstracts away collision detection and management, incorporating core principles from the IEEE 802.11 MAC protocol including medium sensing, acknowledgment mechanisms, and exponential backoff schemes. The implementation adapts packet-level MAC concepts to the flow-level simulation environment while addressing the inherent abstraction gap between these two approaches.
The research reveals fundamental limitations when adapting packet-level MAC protocols to flow-level simulation environments. Key challenges include ESDS's inability to continuously sense the medium, which prevents direct implementation of priority access mechanisms and precise timing features found in the 802.11 protocol
«Minoritetsbarn i fosterhjem»
Get PDFSammendrag
Stadig flere minoritetsbarn plasseres i fosterhjem. Spørsmålet som er aktuelle å stille seg i den forbindelse er bør minoritetsbarn plasseres i majoritetsfosterhjem, eller bør barnet plasseres i ett hjem som har samme kulturelle bakgrunn.
Følgende problemstilling ligger til grunn for studiet:
Hvordan opplever minoritetsbarn at deres identitet og kultur ivaretas ved plassering i fosterhjem?
Formålet med denne studiet har vært å utforske betydningen av ivaretakelse av kultur og identitet når minoritetsbarn plasseres av barneverntjenesten i majoritetsfosterhjem, samtidig har og formålet vært å sette et større fokus på ivaretakelsen av minoritetsbarn i barnevernet.
Dataene ble samlet inn gjennom semistrukturerte intervjuer med tre informanter. Intervjuene ble analysert ved bruk av tematisk analyse. Analysen avdekket tre hovedkategorier knyttet til ivaretakelsen av kulturen til minoritetsbarna. 1) Manglende fokus på opprinnelseskulturen) 2) Identitetsendring 3) Medvirkning.
Informantene beskrev en manglende oppfølgning fra barneverntjenestens knyttet til ivaretakelse av opprinnelseskulturen deres. Det kom frem at det var delte opplevelser knyttet til medvirkning. Videre påpekte samtlige informanter at det ikke var et alternativ for dem å bli plassert i et fosterhjem med samme opprinnelse ettersom de knyttet opplevelsene fra foreldrehjemmene til kulturen.
Studien viser et kompleks og sammensatt område hvor det fremkommer manglende oppfølgning fra barnevern og fosterhjem.Summary
An increasing number of minority children are placed in foster homes. The question that is relevant to ask in this connection is should minority children be placed in a majority foster home, or should the child be placed in a home that has the same cultural background.
The following research question forms the basis of the study:
How do minority children feel that their identity and culture are safeguarded when placed in foster care?
The purpose of this study has been to explore the importance of safeguarding culture and identity when minority children are placed by the child welfare service in majority foster homes, at the same time as the purpose has been to put a greater focus on the care of minority children in the child welfare service.
The purpose of this study has been to explore the importance of safeguarding culture and identity when minority children are placed by the child welfare service in majority foster homes, at the same time as the purpose has been to put a greater focus on the care of minority children in the child welfare service.
The data were collected through semi-structured interviews with three informants. The interviews were analysed using thematic analysis. The analysis revealed three main categories related to safeguarding the culture of minority children. 1) Lack of focus on the culture of origin) 2) Identity change 3) Participation
The informants described a lack of follow-up from the child welfare services related to safeguarding their culture of origin. It emerged that there were shared experiences related to participation. Furthermore, all the informants pointed out that it was not an option for them to be placed in a foster home with the same origin, as they linked their experiences from their parents' homes to the culture.
The study shows a complex and complex area. There is a lack of follow-up from child welfare and foster homes, which affects minority children after the placement
Impacts of Pink Salmon on the Social-Ecological System: The Tana River Community Survey
Get PDFInvasive alien species are major drivers of change in social-ecological systems in the world, causing changes not only in ecosystems but also affecting human systems and ecosystem services. In recent years, the Pacific pink salmon (Oncorhynchus gorbuscha) have invaded Norwegian rivers in numbers of thousands, increasing the concerns among managers regarding the impact on Norwegian ecosystems and biodiversity. Pink salmon as an invasive species has the potential to cause serious changes for both people and nature within the social-ecological system. Exploring insights from the community closest to these changes is essential for a complete understanding of this footprint. This study, based on an online survey in the Tana River community in Northern Norway, has collected knowledge and opinions of people in the community regarding impacts of pink salmon in the large Tana River and pink salmon management. Using a systems thinking approach, methods of visualizing the respondents’ answers in a cognitive map, and applying the concept of social-ecological systems, this work showcases nuanced concerns related to how pink salmon and pink salmon management may impact both ecosystems and human systems in the Tana River social-ecological system. The survey responses reveal concerns related to how Atlantic salmon may be negatively affected by the invasion of pink salmon, such as increased. competition for resources and spawning grounds, and how this can cause cascading effect on the human systems, considering the importance of the Atlantic salmon for cultures and human well-being along the Tana River. In contrast, the results also show how the respondents think of pink salmon as a possible food source, further underscoring the multifaceted impact of this invasive species on the social ecological system. The study demonstrates involvement of communities and system thinking can create a more holistic understanding of the complexity regarding invasive species impacting social-ecological systems. Future studies and management are therefore encouraged to engage the local communities and promote system thinking when addressing the impacts of pink salmon and pink salmon management in the Tana River and Norway in general.
Keywords:
Invasive alien species, pink salmon, social-ecological system, system thinking, citizen science, cognitive mappin
Can Patients with Lipedema Lose Weight?
Get PDFLipedema is a medical condition effecting women. The condition affects the fat tissue in the legs, and in some cases the arms. One distinct symptom is symmetrical disproportionality in subcutaneous fat distribution, in addition to pain in the affected areas. Patients report difficulty accomplishing weight loss, which also has been reported in some studies. This has led to a myth that lipedema patients are not able to achieve weight loss. The primary aim of this study was to assess if lipedema patients can achieve weight loss. In addition, this study aims to evaluate if guidance from a dietitian helped patients to achieve weight loss and if there are any differences between the patients that achieved weight loss, and those who did not. Data were collected through a questionnaire answered by individuals who got their diagnosis from a physician at the University Hospital of North Norway. In total 103 individuals answered the questionnaire, and 97 individuals were included in the analysis. The findings of the present study indicate that it is possible for lipedema patients to achieve weight loss. There was no significant association between achieved weight loss and nutritional guidance, but an association between achieved weight loss and medication use, time since diagnosis, and a general good condition was observed. The findings from the present study support the fact that more research is necessary to map the mechanisms behind weight loss in lipedema