Western Norway University of Applied Sciences
Recent publications
Childhood trauma is associated with lower school performance and decreased grade point averages. Also, many traumatized children in need of help does not receive it, which again may cause additional challenges for schools in supporting them. Schools may provide an optimal arena for interventions because they provide access to all children on a regular basis and over time. In this chapter, we first discuss some of the underlying concepts related to school-based interventions, before considering the particular challenges schools address in meeting the needs of children who have experienced traumatic events. We highlight the importance of a general foundation of empathy and support, crisis management plans, and procedures for traumatic incidents. We also touch upon the newly emerging concept of trauma-informed schools. We then provide an example of effective trauma-informed practice by introducing “Teaching Recovery Techniques,” a procedure that was developed by the Children and War Foundation in which one of the authors (AD) took part. Finally, we give a brief overview of the evidence base for interventions.
To protect healthcare workforce during the COVID-19 pandemic, rigorous efforts were made to reduce infection rates among healthcare workers (HCWs), especially prior to vaccine availability. This study aimed to investigate the prevalence of SARS-CoV-2 infections among HCWs and identify potential risk factors associated with transmission. We searched MEDLINE, Embase, and Google Scholar from 1 December 2019 to 5 February 2024. From 498 initial records, 190 articles were reviewed, and 63 studies were eligible. ROBINS-E tool revealed a lower risk of bias in several domains; however, some concerns related to confounding and exposure measurement were identified. Globally, 11% (95% confidence interval (CI) 9–13) of 283,932 HCWs were infected with SARS-CoV-2. Infection rates were associated with a constellation of risk factors and major circulating SARS-CoV-2 variants. Household exposure (odds ratio (OR) 7.07; 95% CI 3.93–12.73), working as a cleaner (OR 2.72; 95% CI 1.39–5.32), occupational exposure (OR 1.79; 95% CI 1.49–2.14), inadequate training on infection prevention and control (OR 1.46; 95% CI 1.14–1.87), insufficient use of personal protective equipment (OR 1.45; 95% CI 1.14–1.84), performing aerosol generating procedures (OR 1.36; 95% CI 1.21–1.52) and inadequate hand hygiene (OR 1.17; 95% CI 0.79–1.73) were associated with an increased SARS-CoV-2 infection. Conversely, history of quarantine (OR 0.23; 95% CI 0.08–0.60) and frequent decontamination of high touch areas (OR 0.52; 95% CI 0.42–0.64) were protective factors against SARS-CoV-2 infection. This study quantifies the substantial global burden of SARS-CoV-2 infection among HCWs. We underscore the urgent need for effective infection prevention and control measures, particularly addressing factors such as household exposure and occupational practices by HCWs, including cleaning staff.
Background Patients undergoing surgery and anaesthesia are in a vulnerable situation, requiring advanced treatment and care. Nurse anaesthetists are specially trained to meet their needs when administering and monitoring anaesthesia, ensuring patient safety and comfort throughout the entire perioperative care. However, there is a growing concern that efficiency requirements might take precedence over humanistic care when having to prioritize. Most people have a limited understanding of the extended role of nurse anaesthetists in maintaining quality and safety in anaesthesia services. This study aimed to explore how nurse anaesthetists describe their practice as being nursing when caring for surgical patients. Methods We applied a qualitative inductive design. Twenty nurse anaesthetists working in small or large hospitals in different regions of Norway were recruited. Semi-structured individual interviews were carried out. Data were analysed using qualitative content analysis. This study was conducted and reported in accordance with the Consolidated Criteria for Reporting Qualitative Research Checklist. Results We identified three categories and eight subcategories. The category Continuously attending to physical and psychological needs involved reading the patient and responding accordingly and the ethical and moral obligation to maintain patients’ well-being and dignity. The category Providing a concerned presence involved the importance of the nursing process and nurse anaesthetists’ self-confidence in their professional abilities and readiness to act when caring for the surgical patient. The category Aspiring towards excellence involved expectations towards nurse anaesthetists as professionals who display professional courage and undertake professional development through continuous learning. Conclusion Nurse anaesthetists experience themselves as being highly qualified to address the needs of surgical patients. Their nursing background and extensive training have prepared them to know how and argue why. Knowledge from this study could be expected to add to the field of describing and understanding nurse anaesthetists’ practice in the perioperative context and support supervision in postgraduate education.
Aims and Objectives To explore the professional practice of transferring patients with lung cancer from hospitals to their homes through the experiences of healthcare professionals (HCPs) working in hospitals. Background Hospital‐to‐home transitions are particularly challenging for vulnerable patients, including lung cancer patients, and could threaten patient safety. There is a need to improve coordination between specialised and community care and to develop knowledge on the practice of transferring patients with lung cancer. Design A descriptive qualitative design was used. Consolidated criteria for reporting qualitative research (COREQ) were followed for reporting. Methods Six focus group interviews with nurses and two focus group interviews with physicians at pulmonary medicine units in two hospitals in Norway were conducted. Qualitative content analysis was used to analyse the focus group interviews. Results Patients' vulnerability and gratitude motivated HCPs to ensure that patients experienced the best hospital‐to‐home transition. The following obstacles made it challenging to plan for a good hospital‐to‐home transition and to transfer the responsibility for the patient to the municipality: lack of time and routines to attend to the patient's individual needs, lack of established standards for patient information, absence of resources and predictability, and inadequate communication tools for collaborating with the primary healthcare services. Conclusion The healthcare system does not provide hospital units and HCPs with adequate resources to accommodate the individual needs of lung cancer patients in hospital‐to‐home transitions. HCPs compensate with supplementary initiatives to secure patient safety, but the additional responsibility and tasks leave them overworked. Relevance to Clinical Practice The study provides knowledge on lung cancer patients' needs in hospital‐to‐home transitions and how HCPs try to ensure patient safety by compensating for the healthcare system's deficiencies. Public Contribution A reference group comprising one patient representative from the Norwegian Cancer Society and five HCPs with varied relevant backgrounds contributed to the overall design, recruited participants, and provided feedback on the interview guide.
The translation of the highly effective Environmental Enrichment (EE) paradigm from preclinical animal models to human clinical settings has been slow and showed inconsistent results. The primary translational challenge lies in defining what constitutes an EE for humans. To tackle this challenge, this study conducted a scoping review of preclinical EE protocols to explore what constitutes EE for animal models of stroke, laying the foundation for the translation of EE to human application. A systematic search was conducted in the MEDLINE, PsycINFO, and Web of Science databases to identify studies that conducted an EE intervention in the post-stroke animal model. A total of 116 studies were included in the review. A critical reflection of the characteristics of the included studies revealed that EE for post-stroke is a strategy that frequently modifies the animals’ daily environment to create a richness of spatial, structural, and/or social opportunities to engage in a variety of daily life-related motor, cognitive, and social exploratory activities. These activities are relevant to the inhabiting individual and involve the activation of the body function(s) affected by the stroke. This review also identified six principles that underpinned the EE protocols: complexity (spatial and social), variety, novelty, targeting needs, scaffolding, and integration of rehabilitation tasks. These findings can be used as steppingstones to define what constitutes EE in human clinical applications and to develop a set of principles that can inform the design of EE protocols for patients after a stroke.
Background Ankle fracture patients are a heterogenous group with differences in age, sex, fracture morphology, and treatment provided. With the increased focus on patient-centered treatment, patient-reported outcome measures (PROMs) are increasingly adopted by clinicians to facilitate best clinical practice. The Manchester Oxford Foot Questionnaire (MOXFQ) has demonstrated good measurement properties when used in patients with foot or ankle disease. The PROM has three domains: (1) Pain; (2) Walking/Standing; and (3) Social Interaction. One study found sufficient content validity for the Pain and Walking/Standing domains when used in the evaluation of ankle fracture patients. Another validation study demonstrated acceptable structural validity and reliability for the MOXFQ in ankle fracture patients 12 weeks after injury. The aim of this study is to assess the structural validity and reliability of the Norwegian version of the MOXFQ in the context of an ankle fracture patients one year after surgery and provide patient acceptable symptom state (PASS) estimates. Methods A pragmatic cross-sectional study design was used to collect the one-year MOXFQ follow-up data from patients surgically treated for an ankle fracture in the period 2017 to 2020 at (Stavanger University Hospital). The structural validity and internal consistency were assessed using confirmatory factor analysis. A separate test-retest study including patients at least one year since ankle surgery was used in the assessment of reliability and measurement error. Results A confirmatory factor analysis of the three-factor model of the MOXFQ had a good model fit (TLI 0.94; CFI 0.95; RMSEA 0.094; SRMR 0.039). However, the measurement model demonstrated poor discriminant validity of the three factors. A unidimensional model of the 16 items had worse model fit, while a second-order factor model demonstrated strong factor loadings for a second-order factor. A bi-factor model also revealed a strong general factor but also unique variance in the Pain and Social Interaction domain. The domains had good internal consistency (McDonald’s omega 0.80 to 0.95) and test-retest reliability (ICC 0.80 to 0.92). The standard errors of measurements for the three domains were between 6.5 and 7.5, and 5.5 for the MOXFQ-Index (scale 0 to 100). PASS estimates for the (sub)scales were: Pain 45; Walking/Standing 39; Social Interaction 19; and MOXFQ-Index 34. Conclusion The MOXFQ with three domains demonstrated sufficient structural validity and reliability when used in the evaluation of a one-year postoperative ankle fracture population. Reporting the scores of the Pain and Walking/Standing domains was best supported.
Aim To assess the prevalence and severity of periodontitis in an older adult population in Western Norway using the periodontitis definition by the recently published ACES 2018 Classification Framework. Materials and Methods In the present study, 1298 70‐year‐old subjects answered a questionnaire and underwent a full‐mouth periodontal examination. The prevalence of periodontitis, stages, extents and grades was presented according to the Framework applying the 2018 periodontal classification scheme in epidemiological survey (ACES). Descriptive analyses were used, and results were expressed as percentages of the total number of observations. Results According to ACES, periodontitis was detected in 100% of the study population, and Stage II, Stage III and Stage IV were present in 21%, 75% and 4% of the individuals, respectively. The majority of periodontitis cases demonstrated generalised periodontitis and Grade B was the predominant grade in the periodontitis cases. The mean number of teeth in the study population was 25.3. Conclusion There is a high burden of periodontitis in the present population of old individuals, and the majority of participants were classified as Stage III periodontitis. The cut‐offs for interdental clinical attachment loss in the definition of periodontitis affect the estimate of cases, stages and extent of periodontitis in older age groups.
Oral dryness is common in persons with untreated obstructive sleep apnoea (OSA) as well as in those using positive airway pressure (PAP). OSA with or without PAP treatment could therefore be a risk factor of dental caries. Objectives To describe and compare the prevalence of dental caries among persons with or without PAP‐treated OSA. Methods Cross‐sectional data derived from a clinical examination of 121 adults without OSA, and with or without long‐time experience of PAP treated OSA (> 10 years) were used. The participants responded to a questionnaire and were clinically and radiographically examined. Decayed, missing, and filled teeth, decayed surfaces, gingivitis and presence of dental plaque were registered. Descriptive analyses were performed to describe dental caries prevalence among groups. To compare groups, one‐way ANOVA and Kruskal–Wallis tests was conducted. Results Participants (52% females, mean age 69.5 ± 5.8 years) were categorised into groups based on OSA status; non‐OSA ( n = 49), non‐PAP‐treated OSA ( n = 38), and PAP‐treated OSA ( n = 34). Dental caries prevalence showed no statistically significant differences among groups, except for occlusal caries, where the PAP‐treated OSA group had a higher mean compared to the non‐OSA group ( p = 0.033). Most participants did not report xerostomia, but the highest prevalence was found in the non‐PAP‐treated OSA group (31.6%). Conclusions The prevalence of dental caries was slightly higher in persons with PAP treated OSA compared to non‐PAP‐treated OSA and persons without OSA, but the results were not statistically significant.
Purpose The purpose of this study was to explore experiences with an interdisciplinary micro-choice-based concentrated group intervention for people with type 2 diabetes. Methods A qualitative study with individual semistructured interviews were conducted with 14 adults (8 women, ages 45-74 years) with type 2 diabetes. Purposive sampling was used, and participants from 3 different intervention groups in the micro-choice-based concentrated group intervention were recruited. Thematic analysis was used for the data analysis. Results Three main themes were identified: (1) group intervention tailored to individual needs through friendly and skilled professionals, (2) valuable social interactions and an experience of fellowship, and (3) commitment to change through goal setting and conscious micro-choices. The participants described a readiness for change that was met by important knowledge from skilled professionals in the concentrated intervention. They reported that new knowledge, particularly about micro-choices and the focus on how insulin works in the body, led to change in their awareness and self-management. The concentrated group intervention was a preferred setting that contained a sense of community without compromising on meeting individual needs. Participants described internalized changes after the intervention and a willingness to adhere to changes necessary for their self-management. Conclusion Study findings showed that a micro-choice-based concentrated group intervention for people with type 2 diabetes can be a valuable approach contributing to improved patient activation and diabetes self-management. The findings underpin the importance of increased diabetes knowledge and support from an interprofessional team to bring about significant changes in everyday life.
Aim To systematically identify, evaluate and synthesise the research literature about (a) the roles and responsibilities of advanced practice nurses (APNs) in the context of advance care planning (ACP) for older persons, (b) the characteristics of APNs' ACP practices and (c) the facilitators and barriers influencing APNs' involvement in ACP. Design Mixed‐methods systematic review. Methods Followed the mixed methods systematic review guidelines outlined by the Joanna Briggs Institute. Three researchers independently screened studies for eligibility using the Covidence Screening Application. The screening involved two stages: titles and abstracts, followed by full‐text evaluation. The Mixed Methods Appraisal Tool was used for quality assessment. A convergent integrated synthesis combined quantitative and qualitative data by ‘qualitising’ quantitative findings into text, enabling integration and thematic analysis to synthesise the results. Data Sources Medline, CINAHL and Embase were searched from 2012 to 2024 for original research in English, focusing on APNs involved in ACP for individuals aged 65 or older, using qualitative, quantitative or mixed method designs. Results The review included 19 studies: seven qualitative, nine quantitative and three mixed method designs. Thematic analysis revealed that APNs play a key role in ACP, aligning care with patient preferences through discussions and documentation. Studies from the United States (12), United Kingdom (4), Canada (2) and Australia (1) show varying APN roles and responsibilities. Conclusion APNs are crucial to ACP, but barriers limit their impact. Overcoming these is key to improving outcomes. Implications for the Profession and Patient Care APNs clinical expertise and close patient relationships are crucial for aligning care with patient preferences and needs in ACP. However, to fully maximise their contribution, it is essential to overcome barriers such as time constraints, lack of role recognition and insufficient training. Addressing these challenges will enhance the effectiveness of APNs in providing person‐centred care. Reporting Method This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Patient or Public Contribution No patient or public contribution.
We aimed to investigate the effects of preschool staff physical activity (PA) professional development on self-regulation, executive function and early academic learning in 3–5-year-old children. A total of 1265 children from 46 preschools in Norway were randomized to a 7-month intervention or control. Main analyses included 816 3–4-year-olds who provided data at baseline, 7- and 18-month follow-ups. We measured children’s self-regulation (Head-Toes-Knees-Shoulders task), inhibition, cognitive flexibility, working memory, early expressive vocabulary, early mathematical skills (Early Years Toolbox) and physical activity (accelerometry). Linear mixed models were used to analyze the data. Results showed no effect of the intervention on cognitive or learning outcomes in the primary analyses. We found small positive effects on sedentary time (standardized effect size (ES)=-0.17, p = 0.014) and moderate to vigorous-intensity PA (ES = 0.15, p = 0.048) at 7 months, and a negative effect on low-intensity PA at 18 months (EF = −0.15, p = 0.021). Boys had a small positive effect on vocabulary at 7 months (ES = 0.23, p = 0.006), and girls a small negative effect at 18 months (ES = −0.23, p = 0.004). This cluster RCT in preschoolers supports the notion that pragmatic trials within educational settings have difficulties in providing changes to the PA practice and to impact young children’s cognitive development and learning.
It is well-known that functions over finite fields play a crucial role in designing substitution boxes (S-boxes) in modern block ciphers. In order to analyze the security of an S-box, recently, three new tables have been introduced: the Extended Boomerang Connectivity Table (EBCT), the Lower Boomerang Connectivity Table (LBCT), and the Upper Boomerang Connectivity Table (UBCT). In fact, these tables offer improved methods over the usual Boomerang Connectivity Table (BCT) for analyzing the security of S-boxes against boomerang-style attacks. Here, we put in context these new EBCT, LBCT, and UBCT concepts by connecting them to the DDT for a differentially δ\delta -uniform function and also determine the EBCT, LBCT, and UBCT entries of three classes of differentially 4-uniform power permutations, namely, Gold, Kasami and Bracken–Leander. We also determine the Double Boomerang Connectivity Table (DBCT) entries of the Gold function. As byproducts of our approach, we obtain some previously published results quite easily.
Restless Legs Syndrome (RLS) affects 3% of the world's population, causing tingling sensations primarily in the legs. Incorporating self-care activities could improve the management of RLS symptoms, yet knowledge about effective self-care actions is limited. This study employs the Capability, Opportunity, and Motivation-Behaviour (COM-B) model to explore self-care behaviours in individuals with RLS, as research in this area is sparse. Qualitative content analysis of interviews with 28 participants with RLS, 26 subcategories emerged, aligning with the COMB model's components. The first part, Capability, highlighted the importance of being able to be in motion, while the second, Opportunity referred to situations where there was a lack of trust and guidance for self-care. The third part, Motivation, emphasised the importance of fixed routines of sleep, rest, and activity. These identified prerequisites can inform the development of screening instruments and patient-reported outcome measures to evaluate self-care needs and interventions for individuals with RLS.
In 1971, the Danish author Thorkild Hansen was awarded the Nordic Council Literature Prize for his trilogy of books exploring Danish colonialism and slave trade. Hansen’s books were the first widely read and critically acclaimed accounts of Denmark’s history of slavery. Hansen started writing the books after a visit to Auschwitz in 1965. In this article, we explore the genesis of these books, and the impact of holocaust memory on Hansen’s narrative of slavery in the Danish West Indies. We argue that the trilogy’s portrayal of slavery can be understood by employing the framework of multidirectional memory, particularly the idea of anachronistic aesthetics.
Multivariate pattern analysis was recently extended with covariate projections to solve the challenging task of modelling and interpreting associations in the presence of linear dependent multivariate covari�ates. Within a joint model, this approach allows quantification of the net association pattern between the outcome and the explanatory variables and between the individual covariates and these variables. The aim of this paper is to apply this methodology to establish the net multivariate association pattern between cardiorespiratory fitness (CRF) and a high-resolution linear dependent physical activity (PA) intensity descriptor derived from accelerometry in children and to validate the crucial sub-regions in the PA spectrum predicting CRF. We applied the Andersen test as a measure of CRF, a PA descriptor with 23 PA intensities, and included age, sex, and three nearly linear dependent measures of adiposity as covariates. Net predictive association patterns are calculated for unadjusted and adjusted data. The explained variance in CRF was reduced from 25% for unadjusted data to 7.2% for adjusted data, but the association pattern was robust and dominated by vigorous PA across models. Models of sub-regions of the PA spectrum validated the association pattern for the full model and the crucial influence of vigorous PA.
Aim. The aim was to investigate the attitudes of men who plan to become fathers or not, and who either attend antenatal classes with their wife/partner or do not. Material and methods. The study included three groups of 200 men: I – those who did not plan to become a father within the next year, II – those who were going to become fathers within the next year but did not attend antenatal classes, III – those who were gping to become fathers within the next year and attended antenatal classes. The original questionnaires were used. Results. Pregnancy should be planned according to 81.8% of respondents. When it comes to 87.2% of men, they reported that man should support pregnant wife/partner, while 65.5% believed that joint visits to the doctor were pointless. Respondents most often preferred interactions between mother and father with the future child in her womb, such as stroking the belly (43% vs. 29.8%) and talking to the baby (31% vs. 19.8%). Conclusions. Most men reported pregnancy should be planned. Men had problems with declaring whether the father should be on paternity leave after the birth, and there was no infl uence of the duration of the marriage, the fact of having children, the age of the respondents and education, and the place of residence had infl uence on the above. Key words: pregnancy, attitudes, men
Indigenous and local knowledge (ILK) is increasingly used along with scientific knowledge (SK) to understand climate change. The multi evidence base (MEB) offers ways of combining knowledge systems together. Nonetheless, there is little guidance on how to use MEB approaches in research. Our aim is to systematically evaluate empirical cases using MEB approaches in Arctic climate change research; and explore ILK inclusion in research stages. The mapping followed the ROSES protocol, which provides a checklist of details to be included in the review. The literature search identified 1483 records referring to MEB approaches. We identified seven papers applying the cross-fertilization and nine applying the coproduction approach to combine ILK with SK. The theory of change framework was used to evaluate participation, revealing a distinct difference between the approaches in participant involvement in the research stages. Regardless of MEB approach, the output and outcome of the cases were less clear.
Institution pages aggregate content on ResearchGate related to an institution. The members listed on this page have self-identified as being affiliated with this institution. Publications listed on this page were identified by our algorithms as relating to this institution. This page was not created or approved by the institution. If you represent an institution and have questions about these pages or wish to report inaccurate content, you can contact us here.
3,624 members
Djenana Jalovcic
  • Health and Functioning
Tosin Daniel Oyetoyan
  • Software Engineering, Sensor Networks and Engineering Computing
Erik Bohemia
  • Centre for Educational Research
Coral Falco
  • Department of Sport, Food and Natural Sciences
Reza Arghandeh
  • Department of Computing, Mathematics and Physics
Information
Address
Bergen, Norway
Head of institution
Berit Rokne