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Cerebral venous sinus thrombosis in traumatic brain injury: A systematic review of its complications, effect on mortality, diagnostic and therapeutic management, and follow-up
Get PDFThis is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Objective: Cerebral venous sinus thrombosis (CVST) is increasingly being recognized in the setting of traumatic brain injury (TBI), but its effect on TBI patients and its management remains uncertain. Here, we systematically review the currently available evidence on the complications, effect on mortality and the diagnostic and therapeutic management and follow-up of CVST in the setting of TBI.
Methods: Key clinical questions were posed and used to define the scope of the review within the following topics of complications; effect on mortality; diagnostics; therapeutics; recanalization and follow-up of CVST in TBI. We searched relevant databases using a structured search strategy. We screened identified records according to eligibility criteria and for information regarding the posed key clinical questions within the defined topics of the review.
Results: From 679 identified records, 21 studies met the eligibility criteria and were included, all of which were observational in nature. Data was deemed insufficiently homogenous to perform meta-analysis and was narratively synthesized. Reported rates of venous infarctions ranged between 7 and 38%. One large registry study reported increased in-hospital mortality in CVSP and TBI compared to a control group with TBI alone in adjusted analyses. Another two studies found midline CVST to be associated with increased risk of mortality in adjusted analyses. Direct data to inform the optimum diagnostic and therapeutic management of the condition was limited, but some data on the safety, and effect of anticoagulation treatment of CVST in TBI was identified. Systematic data on recanalization rates to guide follow-up was also limited, and reported complete recanalization rates ranged between 41 and 86%. In the context of the identified data, we discuss the diagnostic and therapeutic management and follow-up of the condition.
Conclusion: Currently, the available evidence is insufficient for evidence-based treatment of CVST in the setting of TBI. However, there are clear indications in the presently available literature that CVST in TBI is associated with complications and increased mortality, and this indicates that management options for the condition must be considered. Further studies are needed to confirm the effects of CVST on TBI patients and to provide evidence to support management decisions.publishedVersio
As beings, children need to be at home. Chapter 8
No full textThis work is licensed under a Creative Commons Attribution 4.0 International License.Building upon the philosophical insights of Martin Heidegger and Gaston Bachelard, this chapter delves into the essence of what it truly means for human beings to have a home and inhabit it. It explores how this understanding can shed light on the experiences of children who are removed from their homes and transferred between various child welfare institutions. In conclusion, the chapter advocates for a humanistic approach that recognises the existential meaning of having a home. By embracing this perspective, the author argues, we can develop a practice that is better suited to providing the necessary support for children who can no longer live in their childhood homes.publishedVersio
First-time parents’ support needs and perceived support from a child health service with the integrated New Families home visiting programme
Get PDFPrint version: 2024. 34, (1-2), 20–32The transition to parenthood is complex and influenced by interacting factors related to society, the parents and the child. Professional support is considered to be one of the societal factors affecting this transition by facilitating parents’ sense of confidence and their competence as parents. In this study, we aimed to explore first-time parents’ support needs and experiences of support from a child health service with the integrated New Families home visiting programme, in the context of their transition to parenthood in the first year postnatally. Interpretive description guided this qualitative study. Six couples and one mother, all well-educated and employed, were interviewed individually (N = 13). The parents were recruited from the research project ‘New Families – Innovation and Development of the Child Health Service in Oslo’. We found that being a first-time parent is perceived as overwhelming and that defining support needs may be challenging, particularly in the first period postnatally. In addition, the support needs are constantly changing due to the complexity of interacting factors and the ongoing development of confidence in the parental role. Retrospectively, the parents were satisfied overall with the support from the child health service. The home visit during pregnancy facilitated management and relational and informational continuity. However, we identified a need for even more proactive information provision and communication to optimise the service’s availability and efficiency postnatally. In addition, the importance of peers and of approaching both mothers and fathers must be acknowledged in facilitating parental confidence.publishedVersio
Cultures shaped by elements of ideological totalism – Experiences of misuse of power in some pentecostal christian fellowships
Get PDFOpen access publication licensed under a CC-BY-NC-ND 4.0 International LicenseThis article presents a qualitative study about perceived demanding and hurtful experiences communicated by 16 informants from some Pentecostal fellowships in Norway. The inclusion criterion was that they had experienced what they thought could relate to the misuse of spiritual power. The study analyzes the informants’ perceptions of their interaction with the leaders in some Pentecostal fellowships. Two empirical patterns emerged in the material: 1) the dynamics of destabilization and 2) the dynamics of programming. The dynamics of destabilization created insecurity, and the informants expressed a) fear of the leaders, b) experiences of double-layered behavior, and c) difficult experiences with the leaders’ communication of “messages from God.” The dynamics of programming refers to experiences of legitimated logic in the fellowship, such as a) a dichotomy between evil and good and b) submission to the mission and loyalty to the leaders. We discuss the findings with the help of the theoretical concept of “ideological totalism”, power theory, perspectives on Pentecostal leadership and theological perspectives from the field of diaconia. We found that the two dynamics provided a base for exploitive power and the weakening of an empowered agency. A diaconal focus suggests the need for an intervening power against this perceived misuse.publishedVersio
Strengths and challenges with spiritual care: Student feedback from the EPICC Spiritual Care Self-Assessment Tool
Get PDFThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Aim: To explore qualitative data from students' self- reported competencies in spiritual care gathered during testing of a student self-assessment tool based on the EPICC Spiritual Care Education Standard.
Design: Reflexive thematic analysis of qualitative data from a multinational study on validating a new self-assessment tool.
Methods: The EPICC Spiritual Care Education Standard for competency in spiritual care was developed to enhance nurses' and midwives' ability to provide spiritual care by creating a baccalaureate education standard for spiritual care competencies. Spiritual care researchers then developed a self-assessment tool to raise student awareness of spirituality and track personal and professional growth in spiritual care competency. The EPICC Spiritual Care Competency Self-Assessment Tool, tested at eight universities in five countries, provided many opportunities for student comments, resulting in rich qualitative data presented here.
Results: Themes related to strengths, weaknesses and areas for improvement. Identified strengths were similar across countries: caring attitudes, general knowledge of caring and compassion and good communication skills. Weaknesses/challenges touched on spirituality as overlooked in some cultures but part of life for others, complex questions were hard to understand, and self-assessment tools are common for some and rare for others. Areas for improvement included need for knowledge of religious and other deeply held beliefs and for greater spiritual assessment skills. Similarities across countries related to basic training in communication and compassionate care for nurses globally. Differences lay in the challenges and/or barriers for spiritual care and may relate to cultures within countries and/or university test sites.
Relevance to clinical practice: The Tool raises awareness of spirituality among students and working nurses, providing an accessible way to self-check personal and professional growth in spiritual care competencies, which increases student and nurse capacity to become more knowledgeable and skilled in facilitating spiritual care, thus be role models for students at the intersection of spirituality and health.publishedVersio
Dobbel nedstengning: Beboeres erfaringer med rehabilitering av en kommunal bygård under koronapandemien
Get PDFI denne artikkelen undersøker vi beboeres erfaringer med en omfattende rehabiliteringsprosess i en kommunal leiegård under koronapandemien. Gjennom kvalitative intervjuer med beboerne utforsker vi hvordan de har opplevd denne tiden, og hvordan det å være leieboer kan ha påvirket opplevelser og tolkningen av prosessen. Ved hjelp av symbolsk antropologi fokuserer analysen på forskjellige grenser som ble utfordret, og hvordan opprettholdelsen av disse grensene påvirket beboernes livskvalitet, trygghet og verdighet under rehabiliteringsprosessen. Beboerne opplevde prosessen som særlig utfordrende under den sosiale nedstengningen. De levde uten dagslys i flere måneder, og de opplevde at de ble frarøvet trygghet og kontroll over sitt hjem og privatliv. Kaos trengte inn i hjemmene i form av støy, støv og arbeidere. Beboernes sosioøkonomiske situasjon gjorde at det var ekstra utfordrende å skjerme seg fra situasjonen. Beboerne var i liten grad involvert i prosessen, noe som bidro til en opplevelse av mindreverdighet, fremmedgjøring og avmakt. Analysen viser at bolig og hjem ikke kan sees uavhengig av materielle, sosiale, symbolske og følelsesmessige relasjoner.publishedVersio
BTI som modell for samhandling : En kvalitativ studie av barn, unge og familiers erfaringer med Stafettloggen som redskap for medvirkning og samhandling
Get PDFMaster i medborgerskap og samhandling. VID vitenskapelige høgskole, november 2023Denne studien omhandler barn, unge og familier bruk av stafettloggen i forbindelse med bedre tverrfaglig innsats (BTI). Målet med denne oppgaven er å sette søkelys på barn, unge og familier og de erfaringene de har ved bruk av stafettloggen som et redskap for medvirkning og samhandling. Problemstillingen for studien er:
Hvilke erfaringer har barn, unge og familier ved bruk av stafettloggen som redskap for medvirkning og samhandling?
For å finne svar på denne problemstillingen er det benyttet kvalitativ metode, der forskningsdesignet har vært semistrukturerte intervju. Det er blitt gjennomført 10 intervjuer med 11 voksne og 2 barn fra kommunene Eigersund og Sokndal. Analysen av dataene ble gjennomført ved bruk av temasentrert analyse inspirert av systematisk tekstkondensering.
Under analysen ble det identifisert fire hovedtema: potensialet for medvirkning og deltakelse, forutsetning for samhandling er strukturer, styrker ved bruk av stafettloggen og barrierer for medvirkning og samhandling.
Resultatene er drøftet opp mot den teoretiske rammen for medborgerskap, samhandling og folkehelse. Barn, unge og familiers erfaringer med bruk av stafettloggen setter søkelys på hvordan dette er redskap for å fremme deltakelse på like vilkår og for å ivareta rettigheter. Ved å få strukturene i BTI modellen og stafettloggen tydelig og avklart, vil dette kunne danne grunnlag for bedre medvirkning og samhandling for barn, unge og foreldre. Å gi mulighet for medvirkning og samhandling kan bidra til å styrke den enkeltes forhold til den relasjonelle velferden og bidra til videre utviklingen av velferdsstaten.This study concerns children, youth and parents and their use of the relay log associated with better interdisciplinary interventions model (BIDI). The aim of the study is to highlight the experience children, youth and families have with the use of the relay log as a tool for participation and interaction. The thesis of the study is:
Which experieces do children, youth and families have with the use of the relay log as a tool for participation and interaction?
To answer this thesis the qualitative method of semi-structured interview was used as the research design. A total of ten interviews with two children/youth and eleven parents from the municipalities of Eigersund and Sokndal was conducted. A theme-based analysis inspired by systematic text condensation was applied as analysis method, and four themes were identified: Participation and interaction, structure is a prerequisite for interaction, strengths with use of the relay log and barriers to participation and interaction.
The results are discussed using the theoretical frame of citizenship, interaction and public health. Children, youth and families experience from the use of relay log highlights how this is a tool for Justice as parity of participation and to take care of ones rights. By having the structure the BIDI model and relay log clearly clarified, this can make the basis for better participation and interaction for children, youth and families. By giving them the possibility of participation and interaction it can contribute to strengthen ones relation to relational welfare og contribute to the ongoing development of the welfare state.submittedVersio
Gynecological cancer survivors’ experiences and desire for follow-up after recent treatment: A phenomenological hermeneutic study
Get PDFThis is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBYNC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.Background: Gynecological cancer survivors experience a variety of challenges after discharge from hospital treatment. Cancer support and rehabilitation are recognized as significant facilitators for quality of life in survivorship but are reported to be insufficient by gynecological cancer survivors.
Objective: To describe the lived experiences of gynecological cancer survivors and how their needs for follow-up should be met following recently completed treatment.
Method: This study used a phenomenological hermeneutic design with individual in-depth interviews with 20 women after recently completed cancer treatment. Transcribed interviews were analyzed with the Lindseth and Norberg phenomenological hermeneutic method.
Results: Four themes were identified: “a brutal transition to life after cancer,” “fear of recurrence overshadowing the existence,” “a need for professional support,” and “information is not given unless asked for.”
Conclusion: After completing gynecological cancer treatment, the fear of cancer recurrence is dominating, regardless of prognosis and diagnosis. At the same time, information and support from healthcare professionals are described as lacking. Participants expressed a need to be contacted directly as a formal routine by healthcare professionals after cancer treatment with cancer-specific information as this may alleviate the existential suffering that the cancer experience brings.
Implications for clinical practice: A person-centered, systematic follow-up rehabilitation is needed as a continuation of the care provided during cancer treatment. Future research is needed to explore the impact on women’s quality of life when gynecologic-specific information is given in advance of hospital discharge after completing treatmentpublishedVersio
Investigation of the challenges Ukrainian, Afghan, and Somali refugees and immigrants face in accessing the labour market in Norway
Get PDFMaster's thesis in Community Development and Social Innovation, VID Specialized University Stavanger, May , 2023(1) Background: In recent times, there has been increased attention on issues faced by refugees and immigrants in accessing the labour markets of their host countries. Most of these people face numerous challenges. The current study sought to examine the experiences refugees and immigrants face in interacting with Norway’s labour market; with the aim of identifying the main barriers that hinder their access to this market. The study used a sample of Ukrainian, Afghan, and Somali refugees to compare their experiences with regard to interaction with the Norwegian labour sector. (2) Methods: data for the study was collected through qualitative semi-structured interviews with 15 respondents residing in Bergen, Norway. Five respondents from each country: Afghanistan, Somalia, and Ukraine. Data was analysed using the Interpretive Phenomenological Analysis (IPA) methodology which aims to examine how individuals make sense of important experiences in their lives. (3) Findings/ Results: The findings showed that refugees and immigrants from the three countries faced discrimination in accessing the labour market based on factors such as language proficiency, accent, name, appearance, religion/culture, nationality, education, gender, age, and family status. While all groups experienced discrimination based on education, language proficiency, accent, nationality, gender, and age; Ukrainians fared better in terms of appearance, name, religion/culture, and family status than Afghans and Somalis. Language proficiency and education were perceived as crucial factors in accessing the Norwegian labour market. Programs and activities run by the government and other humanitarian organizations are also shown to be crucial in helping immigrants and refugees integrate into Norway’s labour market. (4) Conclusions: The findings of the study highlight that there are structural and institutional factors that result in refugees and immigrants being discriminated against in their interaction with Norway’s labour market. From this and based on the institutional theory, the study recommends that it is necessary to disrupt the existing practices and norms and in so doing establish new institutional logics that are more welcoming and accepting for the immigrants and refugees. The specific recommendations are: Enhance language training efforts for refugees and immigrants; offer refugees and immigrants formal education; educate the general public on the importance of diversity and inclusivity; and introduce pertinent integration policy reforms Keywords: refugees and immigrants; integration, Norwegian labour market; interpretative phenomenological analysis; subjective experiences.submittedVersio
Narrowing deacons’ professional identity? Educational and institutional changes at Diakonhjemmet in Norway in the 1970s
Get PDFOpen access publication licensed under a CC-BY-NC-ND 4.0 International LicenseNorwegian deacon education in the Evangelical-Lutheran tradition underwent significant changes around 1970 to adapt to developments within the Church of Norway (CoN), the welfare professions, and the Norwegian higher education system. This article explores how a new ordination practice, a more diverse study course, and discussions about diaconia affected deacons’ professional identity. The study builds on archival source material from Diakonhjemmet (The Deacon’s Home), an educational institution for deacons founded in 1890, and uses theories of professions as a discussion partner. Based on archival sources, the article suggests that the professional identity of deacons was narrowed in this transition period. The article finds that, while the professional role of deacons as congregational workers in the CoN was strengthened, most students going through the education program identified more with the professional roles as nurses or social workers than as deacons.publishedVersio