Creating Conditions for Professional Development Through a Trauma-Informed and Restorative Practice

This is a pre-copyedited, author-produced version of an article accepted for publication in Social work following peer review. The version of record Lauridsen MB, Munkejord MC. Creating Conditions for Professional Development Through a Trauma-Informed and Restorative Practice. Social work. 2020, is available online at: https://doi.org/10.1093/sw/swac005.Professionals in social work and nursing meet people who, due to trauma, struggle with the self-regulation of emotions and social behavior. Caring for trauma survivors requires connection and compassion. Previous research has indicated that many professionals, some with their own trauma histories, do not feel sufficiently equipped to practice self-care or cope with challenging communication. To address how insecurity and trauma are rooted in deeper individual and structural causes of social injustice, social workers and nursing students (n=29) were invited to participate in action research and a restorative circle process. The aim was to provide professionals the opportunity to challenge and reflect upon their own practices by introducing them to a trauma-informed and restorative practice based on the importance of building emotional safety and connection. Our findings suggest that given time and space for reflection in a setting characterized by equality and safety, professionals can develop increased a) self-awareness and compassion; b) emotional safety and tolerance of stress in challenging communication; c) trauma understanding; and d) personal growth. A change to a more restorative and trauma-informed practice could lead to increased well-being among professionals and clients

Creating Conditions for Professional Development Through a Trauma-Informed and Restorative Practice

This is a pre-copyedited, author-produced version of an article accepted for publication in Social work following peer review. The version of record Lauridsen MB, Munkejord MC. Creating Conditions for Professional Development Through a Trauma-Informed and Restorative Practice. Social work. 2020, is available online at: https://doi.org/10.1093/sw/swac005.Professionals in social work and nursing meet people who, due to trauma, struggle with the self-regulation of emotions and social behavior. Caring for trauma survivors requires connection and compassion. Previous research has indicated that many professionals, some with their own trauma histories, do not feel sufficiently equipped to practice self-care or cope with challenging communication. To address how insecurity and trauma are rooted in deeper individual and structural causes of social injustice, social workers and nursing students (n=29) were invited to participate in action research and a restorative circle process. The aim was to provide professionals the opportunity to challenge and reflect upon their own practices by introducing them to a trauma-informed and restorative practice based on the importance of building emotional safety and connection. Our findings suggest that given time and space for reflection in a setting characterized by equality and safety, professionals can develop increased a) self-awareness and compassion; b) emotional safety and tolerance of stress in challenging communication; c) trauma understanding; and d) personal growth. A change to a more restorative and trauma-informed practice could lead to increased well-being among professionals and clients

Association of Klotho protein levels and KL-VS heterozygosity with Alzheimer disease and amyloid and tau burden

Importance Identification of proteins and genetic factors that reduce Alzheimer disease (AD) pathology is of importance when searching for novel AD treatments. Heterozygosity of the KL-VS haplotype has been associated with reduced amyloid and tau burden. Whether this association is mediated by the Klotho protein remains unclear. Objectives To assess concentrations of Klotho in cerebrospinal fluid (CSF) and plasma among cognitively healthy controls and patients with AD and to correlate these findings with KL-VS heterozygosity status and amyloid and tau burden. Design, Setting, and Participants This case-control study combined 2 independent case-control AD cohorts consisting of 243 referred patients with AD and volunteer controls recruited from January 1, 2009, to December 31, 2018. Klotho levels were measured in CSF and plasma and correlated with KL-VS heterozygosity status and levels of CSF amyloid-β 42 (Aβ42), total tau, and phosphorylated tau. Statistical analysis was performed from January 1, 2021, to March 1, 2022. Main Outcomes and Measures Associations of Klotho levels in CSF and plasma with levels of CSF biomarkers were analyzed using linear regression. Association analyses were stratified separately by clinical groups, APOE4 status, and KL-VS heterozygosity. Pearson correlation was used to assess the correlation between CSF and plasma Klotho levels. Results A total of 243 participants were included: 117 controls (45 men [38.5%]; median age, 65 years [range, 41-84 years]), 102 patients with mild cognitive impairment due to AD (AD-MCI; 59 men [57.8%]; median age, 66 years [range, 46-80 years]), and 24 patients with dementia due to AD (AD-dementia; 12 men [50.0%]; median age, 64.5 years [range, 54-75 years]). Median CSF Klotho levels were higher in controls (1236.4 pg/mL [range, 20.4-1726.3 pg/mL]; β = 0.103; 95% CI, 0.023-0.183; P = .01) and patients with AD-MCI (1188.1 pg/mL [range, 756.3-1810.3 pg/mL]; β = 0.095; 95% CI, 0.018-0.172; P = .02) compared with patients with AD-dementia (1073.3 pg/mL [range, 698.2-1661.4 pg/mL]). Higher levels of CSF Klotho were associated with lower CSF Aβ42 burden (β = 0.519; 95% CI, 0.201-0.836; P < .001) and tau burden (CSF total tau levels: β = −0.884; 95% CI, 0.223 to −0.395; P < .001; CSF phosphorylated tau levels: β = −0.672; 95% CI, −1.022 to −0.321; P < .001) independent of clinical, KL-VS heterozygosity, or APOE4 status. There was a weak correlation between Klotho CSF and plasma levels among the entire cohort (Pearson correlation r = 0.377; P < .001). Conclusions and Relevance The findings of this case-control study suggest that Klotho protein levels were associated with clinical stages of AD, cognitive decline, and amyloid and tau burden and that these outcomes were more clearly mediated by the protein directly rather than the KL-VS heterozygosity variant. When selecting individuals at risk for clinical trials, the Klotho protein level and not only the genetic profile should be considered

A baseline study of the occurrence of non-indigenous species in Danish harbours

Project Manager/Main Author Jesper H. AndersenWe report the first ever nation-wide study of the occurrence of non-indigenous species in Danish harbours. The sampling was car-ried out using both conventional and biomolecular methods (eDNA). In total, 16 harbours were covered – Esbjerg and Aarhus, the two largest harbours in Denmark, with intensive sampling and 14 harbours with a reduced programme. 26 non-indigenous species were recorded using conventional sampling and 13 species were recorded using eDNA-based methods. Excluding overlapping rec-ords, we have recorded a total of 34 non-indigenous species in the 16 harbours studied. Based on the results, we conclude the following: 1) more non-indigenous species are found in the western parts of Denmark (North Sea region) then in the eastern parts (Baltic Sea), and 2) a few species previously unseen in Danish marine waters were recorded, i.e. the two bristle worms Eteone het-eropoda (fam. Phyllodocidae) and Streblospio benedicti (fam. Spionidae). Further, we provide a proof-of-concept regarding the overarching objectives of the MONIS 1-3 projects and the eDNA-based test systems developed. The results constitute a baseline for future studies in Danish ports and other hotspot areas.publishedVersio

Arbeidsinkludering, læring og innovasjon i NAV

illustratorArbeidsinkludering, læring og innovasjon i NAV (ALIN) er et forskningssamarbeid mellom UiT Norges arktiske universitet og NAV Troms og Finnmark, hvor forskerne har undersøkt ulike sider ved NAVs arbeidsrettede innsats, herunder ulike arbeidsinkluderingsmetoder, NAV-ansattes handlingsrom, kompetanseutvikling og selvivaretakelse, digitale tjenesteverktøy samt overordnede politiske føringer og lovreguleringer. Denne boken samler noen av arbeidene som er utført i forskningsprosjektet ALIN. Boken retter seg mot ledere og ansatte i NAV og deres samarbeidspartnere, politiske beslutningstakere og studenter og ansatte i ulike utdanningsløp som NAV rekrutterer fra

Characterization of Diarrheagenic Enteroaggregative Escherichia coli in Danish Adults—Antibiotic Treatment Does Not Reduce Duration of Diarrhea

Enteroaggregative Escherichia coli (EAEC) is frequently isolated from sporadic cases of diarrhea and in outbreaks of gastroenteritis in several regions of the world. The pathophysiology of EAEC continues to be enigmatic, and the efficacy of antibiotic treatment in EAEC-associated diarrhea has been discussed. Since the level of antibiotic resistance is increasing, it is essential to restrict the use of antibiotics to prevent further resistance development. We aimed to investigate EAEC strains in adult Danish patients suffering from diarrhea and from healthy controls. We examined the antibiotic resistance in EAEC strains, the clinical response to antibiotic treatment in EAEC diarrheal cases, and the distribution of virulence genes in diarrheal cases. The EAEC strains were collected from patients suffering from diarrhea in a Danish multicenter study. A medical doctor interviewed the patients by using a questionnaire regarding gastrointestinal symptoms, exposures, and use of antibiotic and over-the-counter antidiarrheal drugs. Follow-up was performed after 3–5 months to inquire about differential diagnosis to gastrointestinal disease. A multiplex polymerase chain reaction characterized virulence genes in diarrheal cases. Finally, the level of antibiotic resistance was examined by using the disc diffusion method. Asymptomatic carriage of EAEC in the adult Danish population was rare, in contrast to findings in healthy Danish children. The duration of diarrhea was not shortened by antibiotic treatment, specifically ciprofloxacin treatment, or by over-the-counter antidiarrheal drugs. Follow-up revealed no pathology in diarrheal patients apart from irritable bowel syndrome in two patients. A high number of patients suffered from long-term diarrhea, which was associated with the enterotoxin EAST-1 and a high virulence factor score. A high level of antibiotic resistance was observed and 58% of the EAEC strains were multidrug resistant. Multidrug resistance was most pronounced in cases of travelers' diarrhea, and it was seen that antibiotic treatment did not reduce the duration of diarrhea

A study protocol of a randomised controlled trial incorporating a health economic analysis to investigate if additional allied health services for rehabilitation reduce length of stay without compromising patient outcomes

Background Reducing patient length of stay is a high priority for health service providers. Preliminary information suggests additional Saturday rehabilitation services could reduce the time a patient stays in hospital by three days. This large trial will examine if providing additional physiotherapy and occupational therapy services on a Saturday reduces health care costs, and improves the health of hospital inpatients receiving rehabilitation compared to the usual Monday to Friday service. We will also investigate the cost effectiveness and patient outcomes of such a service. Methods/Design A randomised controlled trial will evaluate the effect of providing additional physiotherapy and occupational therapy for rehabilitation. Seven hundred and twelve patients receiving inpatient rehabilitation at two metropolitan sites will be randomly allocated to the intervention group or control group. The control group will receive usual care physiotherapy and occupational therapy from Monday to Friday while the intervention group will receive the same amount of rehabilitation as the control group Monday to Friday plus a full physiotherapy and occupational therapy service on Saturday. The primary outcomes will be patient length of stay, quality of life (EuroQol questionnaire), the Functional Independence Measure (FIM), and health utilization and cost data. Secondary outcomes will assess clinical outcomes relevant to the goals of therapy: the 10 metre walk test, the timed up and go test, the Personal Care Participation Assessment and Resource Tool (PC PART), and the modified motor assessment scale. Blinded assessors will assess outcomes at admission and discharge, and follow up data on quality of life, function and health care costs will be collected at 6 and 12 months after discharge. Between group differences will be analysed with analysis of covariance using baseline measures as the covariate. A health economic analysis will be carried out alongside the randomised controlled trial. Discussion This paper outlines the study protocol for the first fully powered randomised controlled trial incorporating a health economic analysis to establish if additional Saturday allied health services for rehabilitation inpatients reduces length of stay without compromising discharge outcomes. If successful, this trial will have substantial health benefits for the patients and for organizations delivering rehabilitation services

A systematic review of progranulin concentrations in biofluids in over 7,000 people—assessing the pathogenicity of GRN mutations and other influencing factors

Background: Pathogenic heterozygous mutations in the progranulin gene (GRN) are a key cause of frontotemporal dementia (FTD), leading to significantly reduced biofluid concentrations of the progranulin protein (PGRN). This has led to a number of ongoing therapeutic trials aiming to treat this form of FTD by increasing PGRN levels in mutation carriers. However, we currently lack a complete understanding of factors that affect PGRN levels and potential variation in measurement methods. Here, we aimed to address this gap in knowledge by systematically reviewing published literature on biofluid PGRN concentrations. Methods: Published data including biofluid PGRN concentration, age, sex, diagnosis and GRN mutation were collected for 7071 individuals from 75 publications. The majority of analyses (72%) had focused on plasma PGRN concentrations, with many of these (56%) measured with a single assay type (Adipogen) and so the influence of mutation type, age at onset, sex, and diagnosis were investigated in this subset of the data. Results: We established a plasma PGRN concentration cut-off between pathogenic mutation carriers and non-carriers of 74.8 ng/mL using the Adipogen assay based on 3301 individuals, with a CSF concentration cut-off of 3.43 ng/mL. Plasma PGRN concentration varied by GRN mutation type as well as by clinical diagnosis in those without a GRN mutation. Plasma PGRN concentration was significantly higher in women than men in GRN mutation carriers (p = 0.007) with a trend in non-carriers (p = 0.062), and there was a significant but weak positive correlation with age in both GRN mutation carriers and non-carriers. No significant association was seen with weight or with TMEM106B rs1990622 genotype. However, higher plasma PGRN levels were seen in those with the GRN rs5848 CC genotype in both GRN mutation carriers and non-carriers. Conclusions: These results further support the usefulness of PGRN concentration for the identification of the large majority of pathogenic mutations in the GRN gene. Furthermore, these results highlight the importance of considering additional factors, such as mutation type, sex and age when interpreting PGRN concentrations. This will be particularly important as we enter the era of trials for progranulin-associated FTD.</p