Newborn respiratory support using distending pressure : the effect of interfaces and system design on performance and outcome

Preterm infants often require respiratory support after birth due to lung immaturity. The preferred method of providing respiratory support to breathing infants in respiratory distress is non-invasively with continuous positive airway pressure (CPAP). This has been associated with less mortality and morbidity compared to invasive mechanical ventilation. The continuous distending pressure that improves lung aeration and gas exchange can be generated with different CPAP systems and is usually applied through either nasal mask or prongs in the neonatal intensive care unit while face mask has been the most used interface in the delivery room. The overall aim of this thesis was to evaluate how different interfaces and system design affect the quality and outcome of CPAP respiratory support for neonates in the delivery room and neonatal intensive care unit. In study I the literature was reviewed regarding differences in bubble CPAP systems intended for use in low-resource settings. Tests in a mechanical lung model showed how using an interface with high resistance or expiratory tubing with a narrow diameter can lead to increased imposed work of breathing and higher delivered mean airway pressure. Study II was a randomised clinical cross-over study with the aim of measuring leakage during CPAP treatment in newborn infants with nasal mask versus nasal prongs. Measurements revealed a greater leakage for nasal mask compared with prongs. Although some leakage was common with both interfaces it could often be reduced with simple care adjustments. Study III was a follow up study of extremely preterm infants included in the randomised CORSAD study in Stockholm. Medical records of the infants that had been randomised to initial respiratory support with either rPAP using nasal prongs or T-piece with face mask were reviewed up to 36 weeks of postmenstrual age. Infants in the rPAP group were less likely to be intubated and receive mechanical ventilation during the first week of life. At 36 weeks of postmenstrual age there was no statistically significant difference found in mortality or bronchopulmonary dysplasia. Study IV was a feasibility study evaluating a simplified version of the rPAP system for delivery room stabilisation and continued support during transportation and after arrival in the neonatal unit. The system could be used for stabilisation both skin-to-skin and on a resuscitation table as well as for continued support the first hours after birth. The study did not reveal problems with the system or safety

"THIS ROT SPREADS LIKE AN EPIDEMIC" POLICING ADOLESCENT FEMALE SEXUALITY IN ICELAND DURING WORLD WAR II

The thesis examines events, perspectives and prevailing discourses that led to the criminalization of adolescent female sexuality in Iceland during World War II. Provisionary law was passed that became the foundation to submit young women to the mercy of special Juvenile Court, which tried girls for real or suspected sexual relationships with British and American servicemen, and sentenced them to rural homes or to a reformatory. Through the critical theory of Nira Juval-Davis, I have demonstrated that in the national discourse, Icelandic women who dated the foreign troops, stepped over the line that signified the nation 's boundaries and failed to become the bearers of the collectivity's identity. Their lack of Icelandicness turned them into the threatening "other". They were placed on the margin of society, as legal actions were taken to protect and police their sexuality

How Much Information Do Icelandic Men Receive on Pros and Cons of Prostate-Specific Antigen Testing Prior to Undergoing Testing?

Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Traditional Chinese Medical Science and Technology Project of Zhejiang Province (Grant No. 2022ZB130), and the National Famous Old Chinese Medicine Experts SONG Xinwei Inheritance Studio Project (G.TCM.R.J.H.[2018]134). Funding Information: The authors acknowledge the important work done at the Icelandic Cancer Registry that made this study possible and thank their staff for invaluable guidance. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Icelandic Center for Research (grant no. 141490) and the Research Fund of the Icelandic Cancer Society (grant no. 2017-05). Publisher Copyright: © The Author(s) 2022.Prostate-specific antigen (PSA) testing for asymptomatic men is neither encouraged nor discouraged in most countries; however, shared decision-making is emphasized prior to PSA testing. The objective of this study was to examine to what extent Icelandic men receive information about the pros and cons of PSA testing. Furthermore, to explore if patient–provider communication about pros and cons of PSA testing has improved in the last decade during which time more emphasis has been placed on shared decision-making. All Icelandic men diagnosed with prostate cancer in the years 2015 to 2020 were invited to participate, and a total of 471 out of 1002 men participated (response rate 47.0%). Participants’ age ranged from 51 to 95 years (M = 71.9, SD = 7.3). Only half of the men received information about the pros and cons of PSA testing, a third did not receive any information prior to testing and, alarmingly, 22.2% of the men did not even know that they were being tested. A majority of the participants lacked knowledge about the testing with half of the men reporting that they had no knowledge about pros and cons of PSA testing prior to testing. The findings have major public health relevance as they indicate that information provided prior to PSA testing continue to be deficient and that there is a pressing need for interventions that educate men about the benefits and limitations of PSA testing before men undergo medical procedures that can seriously affect their quality of life.Peer reviewe

Respiratory outcomes after delivery room stabilisation with a new respiratory support system using nasal prongs

Funding Information: The study was funded by H.K.H. Kronprinsessan Lovisas Förening för Barnasjukvård, Sällskapet Barnavård Research Fund, Region Stockholm and the Swedish Heart‐Lung Fund. Publisher Copyright: © 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.Aim: To study if stabilisation using a new respiratory support system with nasal prongs compared to T-piece with a face mask is associated with less need for mechanical ventilation and bronchopulmonary dysplasia. Methods: A single-centre follow-up study of neonates born <28 weeks gestation at Karolinska University Hospital, Stockholm included in the multicentre Comparison of Respiratory Support after Delivery (CORSAD) trial and randomised to initial respiratory support with the new system versus T-piece. Data on respiratory support, neonatal morbidities and mortality were collected up to 36 weeks post-menstrual age. Results: Ninety-four infants, 51 female, with a median (range) gestational age of 25 + 2 (23 + 0, 27 + 6) weeks and days, were included. Significantly fewer infants in the new system group received mechanical ventilation during the first 72 h, 24 (52.2%) compared with 35 (72.9%) (p = 0.034) and during the first 7 days, 29 (63.0%) compared with 39 (81.3%) (p = 0.045) in the T-piece group. At 36 weeks post-menstrual age, 13 (28.3%) in the new system and 13 (27.1%) in the T-piece group were diagnosed with bronchopulmonary dysplasia. Conclusion: Stabilisation with the new system was associated with less need for mechanical ventilation during the first week of life. No significant difference was seen in the outcome of bronchopulmonary dysplasia.Peer reviewe

Gas/particle Interaction in Ultrasound Agitated Gas Flow

AbstractAcoustic waves imply specific force and stress distributions onto particles in a gaseous environment. In this paper time-dependent and time-averaged acoustic forces of resonant standing ultrasound waves on rigid particles and agglomerates in gaseous environment are investigated by numerical simulation. The calculated resonant standing wave field is validated using experimental data. Acoustic forces are calculated for cylindrical and spherical particle geometries and the resulting values are compared with analytic correlations from literature. The position of the bodies in respect to the sound source was varied to study the local dependence of the acoustic force. Characteristics of gas/particle interaction in ultrasound agitated gas flow are discussed

Physical activity and well-being among adolescents: A public health perspective

Background: Physical activity among adolescents is diminishing and worldwide about 80% of 13–15-year-old adolescents do not meet the public health guidelines of minimum 60 minutes of daily physical activity of at least moderate intensity. This decline in physical activity has serious consequences as lack of physical activity adversely affects physical and mental health. As physical activity patterns develop during childhood/adolescence and are tracked into adulthood, diminished physical activity during adolescence can negatively influence health and well-being later in life. Aims: The specific aims of this Thesis were to 1) Examine age-related differences in physical activity and depressive symptoms among 10–19-year-old adolescents; 2) Explore potential effects of a pedometer- and diary-based physical activity intervention on 15–16-year-old adolescents’ physical activity and subjective sleep quality; and 3) Investigate the effects of a pedometer- and diary-based physical activity intervention on physical activity among 15–16-year-old adolescents. Methods: Cross-sectional, semi-longitudinal population-based data from Iceland were used to examine differences in age-related physical activity and depressive symptoms. In a pilot-study, a 2-x-2 factorial design was applied to test the effects of a pedometer- and diary-based intervention. Finally, a randomized controlled trial (RCT) with 4-x-4 factorial design was applied to test the effectiveness of using pedometers, diaries or combination of both in a physical activity intervention. Results: A decrease occurred in physical activity from the age of 15 with an increase in depressive symptoms during the age from 10 to 19 in Icelandic adolescents. Gender differences were apparent with girls being less active and having higher levels of depressive symptoms than boys. The intervention in the pilot-study was effective in increasing physical activity among 15–16-year-old adolescents as the intervention group had significantly higher step-count compared to the control group at follow-up. Additionally, subjective sleep quality improved over time in the intervention group. The RCT demonstrated further the effectiveness of the intervention with pedometers alone being equally effective in increasing physical activity as pedometers in combination with diaries. Conclusion: This Thesis provides important information about when to tailor public health efforts to enhance physical activity and well-being among adolescents. Brief physical activity interventions based on pedometers were effective in increasing daily steps and improving sleep quality among adolescents. This has important public health relevance as the intervention is cost-effective and can easily be disseminated and incorporated into schools’ curricula

Jafnvægisstjórnun og áhrif skynþjálfunar: óstöðugt eldra fólk og einstaklingar sem hlotið hafa úlnliðsbrot við byltu

Aims: The aim of this thesis was to evaluate the effects of a new multi-sensory balance training program: the “Reykjavik Model” among unsteady older adults as well as middle aged and elderly people with wrist fractures. Additionally, to explore the characteristics of the people with wrist fractures. Three papers are included in this thesis. The more specific aims were: Paper I: To evaluate the effects of the “Reykjavik Model” on postural control, functional abilities, confidence in activities of daily living and falls among unsteady older adults. Paper II: To investigate vestibular function, mechanoreceptive sensation in lower limbs, postural control, functional abilities, perceived dizziness and confidence in individuals between 50 and 75 years of age with and without fall-related wrist fractures and to evaluate whether these variables are independently associated with having sustained a fall-related wrist fracture. Paper III: To investigate whether “the Reykjavik Model” improves postural control, vestibular function, foot sensation and functional abilities among people with fall-related wrist fractures compared with wrist stabilization training. Methods: Paper I was a quasi-experimental intervention study with pre- and post-test design. Participants were 37 unsteady older adults with a history of falls. Treatment consisted of eighteen multi-sensory balance training sessions (MST) supervised by a physiotherapist. Measurements before and after training were: The Sensory Organization Test (SOT) to assess postural control, the Five-Times-Sit-to-Stand Test (FTSTS) to measure lower limb strength, 30-m normal and fast walk with a turn to measure walking speed, Ascending-Descending 11 steps to assess proficiency in stairs and the Activities-specific Balance Confidence Scale (ABC) to assess confidence during daily activities. Information was gathered about number of falls one year prior to training, during training and six months after completion of training. Paper II was a case-control study with 98 persons aged 50-75 years, having sustained a fall-related wrist fracture. Forty-eight sex, age and physical activity matched individuals, without previous history of wrist fractures, served as controls. Measurements included: Head-Shake test (HST) to measure function of the vestibular system, Tuning fork, Biothesiometer (BT) and Semmes-Weinstein monofilaments (SWM), to measure sensation in feet, SOT to assess postural control, FTSTS to assess lower limb strength, 10-meter-walk test (10MWT) to measure walking speed, the ABC and the Dizziness Handicap Inventory (DHI) scales to assess self perceived confidence and dizziness during daily activities. Paper III was a randomized controlled intervention study. Ninety-eight participants, age 50-75 years, were randomized to multi-sensory (MST) or wrist stabilization training (WT). Treatment consisted of six training sessions supervised by a physiotherapist and daily home exercises for both groups. Results from: HST, video-Head Impulse Test (vHIT), SWM, BT, SOT, 10 MWT, FTSTS, ABC and DHI were compared before and after training. Results: In Paper I significant improvement was observed in all measured parameters (p<0.001) post-training. The people aged between 70 and 92 years (mean age 80.8 years), had several comorbidities. Thirty-four of them reported 159 falls in the year prior to the study. Six persons reported 7 falls during the training period and seven reported 17 falls in the six months follow-up period. In Paper II The wrist fracture people had sustained a significantly higher number of previous falls (p<0.001) and fractures (p<0.001) than controls. Vestibular asymmetry was apparent in 82% of wrist fracture people and 63% of controls (p=0.012). Plantar pressure sensation (p<0.001), SOT composite scores (p<0.001), 10MWT (p<0.001), FTSTS (p<0.001), ABC (p<0.001) and DHI (p=0.005) were significantly poorer among cases than controls. The strongest predictors of a fall-related wrist fracture were a positive HST (OR: 5.424; p=0.008) and SWF sensation (OR: 3.886; p=0.014). In Paper III there was a 16% non-significant (p=0.058) reduction in asymmetric vestibular function (HST) in the MST group but no change in the WT group. There were significant endpoint differences in SOT (p=0.01) between the two groups, in favour of the MST group, but no changes were seen in other outcome variables. Subgroup analysis with participants below normal baseline SOT composite scores indicated that the MST was more effective in improving 10MWT fast (p=0.04), FTSTS (p=0.04), SWM (p=0.04) and SOT scores (p=0.04) than the WT. Conclusions: The multi-sensory balance training program, the “Reykjavik Model”, improves postural control, functional ability and confidence in ADL among unsteady older people. The results suggest that this multi-sensory balance training program can reduce the rate of falls among older unsteady individuals. The program improves postural control among people age 50-75 years who have sustained a fall-related wrist fracture, especially those with balance scores below age related norms on the sensory organization test. People with wrist fracture have a higher incidence of asymmetric vestibular function, reduced plantar pressure sensation and poorer standing and dynamic postural control compared with matched controls. Asymmetric vestibular function and reduced plantar pressure sensation are strongly associated with a fall-related wrist fracture and could be important contributing factors to falls and subsequent wrist fractures among the ageing population. People who sustain a wrist fracture should be screened for fall and fracture risk besides fracture treatment and education regarding fall-prevention should be provided to all persons who fracture their wrist.Markmið: Markmið þessarar doktorsrannsóknar var að rannsaka áhrif skynörvandi jafnvægisþjálfunar fyrir óstöðugt eldra fólk og miðaldra einstaklinga sem höfðu úlnliðsbrotnað, ásamt að rannsaka hvað einkenndi þátttakendur sem höfðu brotnað á úlnlið. Ritgerðin byggir á þremur vísindagreinum. Nánari markmið voru: Vísindagrein I: Að kanna áhrif skynörvandi jafnvægisþjálfunar á jafnvægi, starfræna færni, öryggi við daglegar athafnir og byltur á meðal eldra fólks með óstöðugleika. Vísindagrein II: Að rannsaka starfsemi jafnvægiskerfis innra eyra, skyn í fótum, jafnvægi, gönguhraða, vöðvastyrk og upplifun á svima og öryggi við daglegar athafnir einstaklinga 50-75 ára sem hlotið höfðu úlnliðsbrot við byltu. Einnig að kanna hvort einhver þessara breyta tengdist því marktækt að hafa úlnliðsbrotnað. Vísindagrein III: Að kanna hvort skynörvandi jafnvægisþjálfun bæti jafnvægisstjórnun, starfsemi jafnvægiskerfis í innra eyra, skyn í fótum og starfræna færni hjá einstaklingum sem hlotið hafa úlnliðsbrot við byltu, samanborið við stöðugleikaþjálfun fyrir úlnlið eingöngu. Aðferðir: Vísindagrein I lýsir hálf-staðlaðri tilraunameðferð með fyrir og eftir-prófi. Þátttakendur (meðalaldur: 80,8 ár±7,1ár; spönn 70-92) voru 37 óstöðugir eldri einstaklingar með sögu um byltur. Þjálfunartímar voru átján undir handleiðslu sjúkraþjálfara. Mælingar voru gerðar fyrir og eftir skynörvandi jafnvægisþjálfun. Jafnvægisstjórnun var metin með skynúrvinnsluprófi, gönguhraði var metinn með 30 metra göngu með snúningi, starfrænn styrkur í neðri útlimum var metinn með fimm sinnum standa-sitja prófi, stigafærni með tímatöku við að ganga upp og niður 11 þrep og öryggi við daglegar athafnir var metið með ABC sjálfsmatskvarða jafnvægis. Fjöldi byltna var skráður tólf mánuðum fyrir þjálfun, á þjálfunartímabilinu og sex mánuðum eftir að því lauk. Vísindagrein II var samanburðarrannsókn með 98 þátttakendum, 50-75 ára, sem leituðu á bráðamóttöku Landspítala í kjölfar byltu og greindust með úlnliðsbrot. Í samanburðarhópi voru 48 heilbrigðir einstaklingar án sögu um úlnliðsbrot. Pörun var gerð m.t.t. aldurs, kyns og hreyfingar síðastliðna tólf mánuði. Starfsemi jafnvægiskerfis innra eyra var metin með höfuð-skak prófi (Head-Shake Test). Þrýstingsskyn undir iljum var metið með Semmes-Weinstein einþráðum (Semmes-Weinstein monofilaments), titringsskyn í fótum var metið með titringsskynmæli (biothesiometer) og tónkvísl. Jafnvægisstjórnun var metin með skynúrvinnsluprófi. Starfrænn styrkur í neðri útlimum var metinn með fimm sinnum standa-sitja prófi og gönguhraði með 10 metra gönguprófi. ABC sjálfsmatskvarði jafnvægis og DHI svimakvarði voru notaðir til að meta eigin upplifun þátttakenda á öryggi og svima í daglegu lífi. Vísindagrein III var slembuð samanburðarrannsókn. Níutíu og átta einstaklingar (meðalaldur: 61,9 ár±7,1ár; spönn 50-75) sem hlotið höfðu úlnliðsbrot við byltu, tóku þátt í rannsókninni, tveimur til fimm mánuðum eftir brotið. Þeim var slembiraðað í annað hvort skynörvandi jafnvægisþjálfun eða stöðugleikaþjálfun fyrir úlnlið, til viðbótar við hefðbundna brotameðferð. Mælingar voru gerðar fyrir og eftir þjálfun. Starfsemi jafnvægiskerfis innra eyra var metin með höfuð-skak prófi og höfuð-rykkja prófi (video-Head Impuls Test). Skyn í fótum var metið með Semmes-Weinstein einþráðum og titringsskynmæli. Jafnvægisstjórnun var metin með skynúrvinnsluprófi, gönguhraði með 10 metra gönguprófi og starfrænn styrkur í neðri útlimum með fimm sinnum standa-sitja prófi. ABC sjálfsmatskvarði jafnvægis og DHI svimakvarði voru notaðir til að meta eigin upplifun þátttakenda á öryggi og svima í daglegu lífi. Þátttakendur í báðum hópum, fengu skriflegar heimaæfingar og mættu í sex þjálfunartíma undir handleiðslu sjúkraþjálfara í þrjá mánuði. Niðurstöður: Vísindagrein I: Marktækar framfarir komu fram í öllum mældum breytum eftir skynörvandi jafnvægisþjálfunina (p<0.001). Þrjátíu og fjórir þátttakendur höfðu hlotið 159 byltur síðustu tólf mánuði fyrir upphaf þjálfunar, sex tilkynntu 7 byltur á þjálfunartímabilinu og sjö tilkynntu 17 byltur hálfu ári eftir að þjálfun lauk. Vísindagrein II: Þeir sem höfðu dottið og úlnliðsbrotnað voru með marktækt fleiri byltur (p<0.001) og beinbrot (p<0.001) að baki en þeir sem ekki höfðu hlotið úlnliðsbrot við byltu. Tíðni ósamhverfrar starfsemi í jafnvægiskerfi innra eyra (p=0.012), þrýstingsskyn undir iljum (p<0.001), jafnvægisstjórnun (p<0.001), gönguhraði (p<0.001) og styrkur í fótum (p<0.001) var jafnframt marktækt verri hjá fólki með úlnliðsbrot. Einnig upplifðu þeir sem höfðu úlnliðsbrotnað marktækt meiri svima (p=0.005), óstöðugleika og óöryggi (p<0.001) við daglegar athafnir. Þeir þættir sem spáðu sterkast fyrir um líkur þess að tilheyra hópnum sem hafði úlnliðsbrotnað, voru ósamhverf starfsemi í jafnvægiskerfi innra eyra (OR: 5.424; p=0.008) og skerðing á þrýstingsskyni undir iljum (OR: 3.886; p=0.014). Vísindagrein III: Í skynþjálfunarhópnum minnkaði ósamhverf starfsemi í jafnvægiskerfi innra eyra um 16% en náði ekki marktækni (p=0.058). Engin breyting kom fram hjá þeim sem tóku þátt í stöðugleikaþjálfun fyrir úlnlið. Eftir að leiðrétt hafði verið fyrir upphafsmælingum, aldri og kyni með línulegri aðhvarfgreiningu, kom í ljós marktækur munur á milli þjálfunarhópanna á skynúrvinnsluprófi (p=0.01), skynþjálfunarhópnum í vil, en ekki í öðrum breytum. Undirgreining gagna meðal þátttakenda sem skoruðu undir aldurstengdum viðmiðunarmörkum á skynúrvinnsluprófi við upphaf þjálfunar, gaf til kynna að skynþjálfunin bætti meira 10 metra göngupróf, (p=0.04), fimm sinnum standa-sitja próf (p=0.04), þrýstingsskyn undir iljum (Semmes-Weinstein einþræðir) (p=0.04) og skynúrvinnslupróf (p=0.04) heldur en úlnliðsþjálfunin. Ályktanir: Skynörvandi jafnvægisþjálfun bætir jafnvægi, starfræna færni, og öryggi við daglegar athafnir á meðal óstöðugra aldraðra einstaklinga. Niðurstöður gefa til kynna að skynþjálfunin geti fækkað byltum hjá óstöðugum eldri einstaklingum. Þjálfunin bætir jafnvægisstjórnun hjá 50-75 ára einstaklingum sem hlotið hafa úlnliðsbrot við byltu, sérstaklega hjá þeim sem eru með jafnvægisstjórnun undir aldurstengdum viðmiðunarmörkum á skynúrvinnsluprófi við upphaf þjálfunar. Fólk sem hefur úlnliðsbrotnað við byltu er með hærri tíðni ósamhverfrar starfsemi í jafnvægiskerfi innra eyra, minnkað þrýstingsskyn undir iljum og verri jafnvægisstjórnun, samanborið við jafnaldra sem ekki hafa dottið og úlnliðsbrotnað. Ósamhverf starfsemi jafnvægiskerfis innra eyra og skerðing á þrýstingsskyni undir iljum geta verið mikilvægir undirliggjandi orsakaþættir byltna sem leiða af sér úlnliðsbrot. Meta ætti áhættu fyrir frekari byltum og brotum hjá einstaklingum sem hlotið hafa úlnliðsbrot við byltu og fræðsla um byltuvarnir ætti að standa þeim til boða.St. Josef’s Hospital Fund, Reykjavik, Iceland. The Icelandic Physiotherapy Association Research Fund. The Landspitali University Hospital Research Fund. The Icelandic Gerontological Society Research Fund. Helga Jónsdóttir and Sigurlidi Kristjánsson Geriatric Research Fund

«Det er alltid catwalk ... uansett hvor du går» Foreldreperspektiv, delaktighet, følelser og reaksjoner når barnet deres lærer å bruke den hvite stokken

For mange mennesker med nedsatt syn eller blindhet er den hvite stokken en av de viktigste ressursene for å kunne leve et selvstendig liv, hvor de kan mobilisere og orientere seg i omgivelsene. Dette er ikke minst viktig for barn med alvorlig synshemming, som de første årene trenger å lære seg å bruke den hvite stokken samt spesielle teknikker, for etter hvert å kunne bevege seg og orientere seg selvstendig. Ofte når vi fagfolk snakker om barn og hvordan de lærer å bruke den hvite stokken, er fokus kun på barna selv. I barnets læringsprosess spiller imidlertid foreldre en stor rolle. Foreldrene må samarbeide med ulike fagpersoner og institusjoner, og i mange tilfeller er foreldre de viktigste lærerne i barnets liv. Hovedspørsmålet som ble besvart: Hvordan opplever foreldrene sin rolle og følelser i barnets læreprosess av den hvite stokken? Dette spørsmålet ble delt inn i følgende delspørsmål: Hva føler foreldrene og hvilke er deres reaksjoner når barnet skal lære seg å bruke den hvite stokken? Hvordan beskriver foreldrene sin erfaring og sitt samarbeid med de fagpersonene som lærer barnet å bruke den hvite stokken? Hvordan opplever foreldrene sin delaktighet i opplæringen? Hvilke utfordringer i læringsprosessen opplever foreldrene? Dette er en kvalitativ studie med semistrukturert intervjuteknikk. Totalt ble det gjennomført fire intervjuer via videosamtaler, med siv foreldre til fire barn i alderen to til ni år. Alle var født blinde og alle hadde begynt å lære å bruke stokken i tidlig alder. Intervjuene ble transkribert og analysert med kvalitativ innholdsanalyse. Resultatene viser at alle foreldreparenes reaksjoner og følelser var positiv til den hvite stokken. Foreldrene opplevde den som et viktig hjelpemiddel og merka økt selvstendighet og selvtillit hos barna når de brukte den. Foreldrene opplevde sin erfaring og samarbeid med fagpersoner først og fremst som god. De opplevde seg delaktig i prosessen og hadde mye ansvar. Noen utfordringer med læringsprosessen var blant annet at foreldrene opplever for mye oppmerksomhet når de var ute og gikk med barna med den hvite stokken. Noen dager avsto de til og med fra å ta med den hvite stokken ut på tur med barnet fordi de ikke orket å få denne oppmerksomheten. Konklusjonen er at det svært viktig at vi fagfolk fokuser ennå mer på foreldrene i fremtidige læringsprosesser, at vi skaper godt samarbeid og motiverer foreldrenes til å delaktighet i barnets læring