Når ulike habituser møtes. Oppsøkende arbeid med ungdom i Oslo

Denne litteraturstudien tematiserer sosiale forskjeller i oppsøkende sosialt arbeid med ungdom og diskuterer dette temaet med utgangspunkt i klasseteori. Oppgavens problemstilling er «Hvordan gjør sosiale forskjeller seg gjeldende i oppsøkende sosialt arbeid med ungdom i Oslo?». Oppsøkende arbeid har fokus på å bygge relasjoner og tillit til ungdommer og ungdomsmiljøer og fungerer som bindeledd mellom hjelpeapparatet og ungdom. Oslo er en by med sosiale ulikheter, også blant ungdom, der de ulike klassene bosetter seg på forskjellige deler av byen og har ulike utfordringer. Fordi vi tilbringer mest tid med mennesker fra samme klasse og ikke eksponeres for ulikheter, liker vi mennesker som ligner oss selv og reproduserer klasseskillene som finnes. Ved at mange utekontaktvirksomheter ansetter forskjellige persontyper, samt en vektlegging personlighet og tilnærming, tilrettelegges det for at ungdom skal finne en utekontakt de kan knytte seg til, og på denne måten omfavnes sosiale forskjeller i oppsøkende arbeid

Barn som pårørende. Hvordan kan sykepleier ivareta barn som pårørende av foreldre som er alvorlig psykisk syke?

Problemstilling: Hvordan kan sykepleier ivareta barn som pårørende av foreldre som er alvorlig psykisk syke? Metode: Litteraturstudie, som inkluderer fem forskningsartikler og relevant teori. Funn: Funnene viser at sykepleiere mangler kunnskap og kompetanse, samt tydelige retningslinjer og rammeverk. Barneansvarlige har utfordringer som mangel på tid og rutiner, som resulterer i at det er tilfeldig hvilken oppfølging barna får. Sykepleiere opplever det utfordrende å samarbeide med foreldrene, da de mangler forståelse for hvordan den psykiske lidelsen påvirker barnet. Drøfting: Funn i forskningsartikler og teori drøftes opp mot problemstillingen. Jeg tar for meg hvordan barneansvarliges funksjon fungerer i praksis, viktigheten av informasjon og åpenhet, og familiefokusert sykepleie. Konklusjon: Det er viktig at sykepleiere involverer barnet i forelderens sykdom, ved å gi tilpasset informasjon i forhold til alder, og bruke åpenhet som medisin. Det er viktig å skape en tillitsbasert relasjon, ha kunnskap om barnets utvikling og identifisere eventuelle risikofaktorer. Sykepleiere bør ta utgangspunkt i familiefokusert omsorg, og trenger tydeligere retningslinjer for en helhetlig ivaretakelse av barnet

Bioenergetic modulation with dichloroacetate reduces the growth of melanoma cells and potentiates their response to BRAF^V600E inhibition

BACKGROUND: Advances in melanoma treatment through targeted inhibition of oncogenic BRAF are limited owing to the development of acquired resistance. The involvement of BRAF(V600E) in metabolic reprogramming of melanoma cells provides a rationale for co-targeting metabolism as a therapeutic approach. METHODS: We examined the effects of dichloroacetate (DCA), an inhibitor of pyruvate dehydrogenase kinase, on the growth and metabolic activity of human melanoma cell lines. The combined effect of DCA and the BRAF inhibitor vemurafenib was investigated in BRAF(V600E) -mutated melanoma cell lines. Vemurafenib-resistant cell lines were established in vitro and their sensitivity to DCA was tested. RESULTS: DCA induced a reduction in glycolytic activity and intracellular ATP levels, and inhibited cellular growth. Co-treatment of BRAF(V600E)-mutant melanoma cells with DCA and vemurafenib induced a greater reduction in intracellular ATP levels and cellular growth than either compound alone. In addition, melanoma cells with in vitro acquired resistance to vemurafenib retained their sensitivity to DCA. CONCLUSIONS: These results suggest that DCA potentiates the effect of vemurafenib through a cooperative attenuation of energy production. Furthermore, the demonstration of retained sensitivity to DCA in melanoma cells with acquired resistance to vemurafenib could have implications for melanoma treatment. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12967-014-0247-5) contains supplementary material, which is available to authorized users

Environmental toxicants in breast milk of Norwegian mothers and gut bacteria composition and metabolites in their infants at 1 month.

BACKGROUND:Early disruption of the microbial community may influence life-long health. Environmental toxicants can contaminate breast milk and the developing infant gut microbiome is directly exposed. We investigated whether environmental toxicants in breastmilk affect the composition and function of the infant gut microbiome at 1 month. We measured environmental toxicants in breastmilk, fecal short-chain fatty acids (SCFAs), and gut microbial composition from 16S rRNA gene amplicon sequencing using samples from 267 mother-child pairs in the Norwegian Microbiota Cohort (NoMIC). We tested 28 chemical exposures: polychlorinated biphenyls (PCBs), polybrominated flame retardants (PBDEs), per- and polyfluoroalkyl substances (PFASs), and organochlorine pesticides. We assessed chemical exposure and alpha diversity/SCFAs using elastic net regression modeling and generalized linear models, adjusting for confounders, and variation in beta diversity (UniFrac), taxa abundance (ANCOM), and predicted metagenomes (PiCRUSt) in low, medium, and high exposed groups. RESULTS:PBDE-28 and the surfactant perfluorooctanesulfonic acid (PFOS) were associated with less microbiome diversity. Some sub-OTUs of Lactobacillus, an important genus in early life, were lower in abundance in samples from infants with relative "high" (> 80th percentile) vs. "low" (< 20th percentile) toxicant exposure in this cohort. Moreover, breast milk toxicants were associated with microbiome functionality, explaining up to 34% of variance in acetic and propionic SCFAs, essential signaling molecules. Per one standard deviation of exposure, PBDE-28 was associated with less propionic acid (- 24% [95% CI - 35% to - 14%] relative to the mean), and PCB-209 with less acetic acid (- 15% [95% CI - 29% to - 0.4%]). Conversely, PFOA and dioxin-like PCB-167 were associated with 61% (95% CI 35% to 87%) and 22% (95% CI 8% to 35%) more propionic and acetic acid, respectively. CONCLUSIONS:Environmental toxicant exposure may influence infant gut microbial function during a critical developmental window. Future studies are needed to replicate these novel findings and investigate whether this has any impact on child health

Økonomiske avvik i Helseetaten: En undersøkende studie om muligheter for læring ved bruk av RPA

Samfunnet stiller i dag høye krav til at offentlige virksomheter bruker deres ressurser på en kostnadseffektiv måte, som speiler samfunnets behov av offentlige tjenester. Den teknologiske omstillingen i samfunnet fører til et behov for nye og forbedrede styringsverktøy som kan effektivisere og forbedre tradisjonell rapportering, og potensielt bidra til ny læring i organisasjoner. I denne case-undersøkelsen ser vi nærmere på hvordan Robotic Process Automation (RPA) kan bidra til å skape læringsprosesser ved økonomiske avvik i Helseetaten. Basert på fem kvalitative intervjuer av nøkkelinformanter, og tidligere publisert teori har vi utarbeidet en egen læringsmodell for bruk av industri 4.0-teknologier. Modellen skal bidra med økt bevissthet til hvilket kunnskapsnivå organisasjonen har i dag, og hvordan kunnskapen om industri 4.0-teknologier bidrar til økt verdiskapning. Læringsmodellen kan også bidra til å bevisstgjøre hvordan virksomheten kan bruke ressurser effektivt ved hjelp av ny teknologi, og bevare kunnskap i virksomheten gjennom overordnede prioriteringer. Våre funn viser at Helseetaten har en etablert læringskultur tilknyttet deres kjernekompetanse, hvilket bidrar til forbedret styring i virksomheten. Selv om organisasjonen har et godt grunnlag for organisatorisk læring, viser våre funn at Helseetaten ikke har nok kunnskap om RPA for at det skal bidra til læring og økt virksomhetsytelse i dag. På bakgrunn av vår undersøkelse konkluderer vi med at RPA-teknologi kan bidra til læring ved økonomiske avvik, og dermed forbedret økonomisk styring. Vi fremhever til slutt områder for videre forskning.Society today places high demands on the Norwegian public sector to use their resources in a cost-effective manner, which reflects society's needs for public services. The technological development in society leads to a need for new and improved management tools that can enhance and improve traditional reporting, and potentially contribute to new learning in organizations. In this case study, we take a closer look at how Robotic Process Automation (RPA) can contribute to creating learning processes in the event of financial deviations in Oslo Local Authority, Agency for Health. Based on five qualitative interviews of key informants, and previously published theory, we have created our own learning model for the usage of industry 4.0 technologies. The model will contribute to increased awareness of the level of knowledge the organization has today, and how the knowledge of Industry 4.0 technologies contributes to increased value creation. The learning model can also help to raise awareness of how the business can use resources efficiently with the help of new technology and preserve knowledge in the business through overall priorities. Our findings show that the Oslo Local Authority, Agency for Health has an established learning culture linked to their core competence, which contributes to improved management in the business. Although the organization has a good foundation for organizational learning, our findings show that the Oslo Local Authority, Agency for Health does not have enough knowledge about RPA for it to contribute to learning and increased business performance today. On the basis of our investigation, we conclude that RPA technology can contribute to learning in the event of financial deviations, and thus improved financial management. Finally, we highlight areas for further research

Preferences for follow up in long-term survivors after cervical cancer

Introduction An increasing number of cervical cancer survivors combined with lack of data on the efficacy of long-term surveillance, challenges existing follow-up models. However, before introducing new follow-up models, cervical cancer survivors’ own views on follow up are important. We aimed to explore preferences for follow up in long-term cervical cancer survivors and their associations with self-reported late-effects. Material and methods In 2013, we mailed 974 Norwegian long-term cervical cancer survivors treated during 2000-2007 a questionnaire with items covering preferences for follow up after treatment, clinical variables and validated questionnaires covering anxiety, neuroticism and depression. Results We included 471 cervical cancer survivors (response rate 57%) with a median follow up of 11 years. In all, 77% had FIGO stage I disease, and 35% were attending a follow-up program at the time of survey. Of the patients, 55% preferred more than 5 years of follow up. This was also preferred by 57% of cervical cancer survivors who were treated with conization only. In multivariable analyses, chemo-radiotherapy or surgery with radiation and/or chemotherapy (heavy treatment) and younger age were significantly associated with a preference for more than 5 years’ follow up. Late effects were reported by more than 70% of the cervical cancer survivors who had undergone heavy treatment. Conclusions Our study reveals the need for targeted patient education about the benefits and limitations of follow up. To meet increasing costs of cancer care, individualized follow-up procedures adjusted to risk of recurrence and late-effects in cervical cancer survivors are warranted.publishedVersio

Screening of metabolic modulators identifies new strategies to target metabolic reprogramming in melanoma

The prognosis of metastatic melanoma remains poor due to de novo or acquired resistance to immune and targeted therapies. Previous studies have shown that melanoma cells have perturbed metabolism and that cellular metabolic pathways represent potential therapeutic targets. To support the discovery of new drug candidates for melanoma, we examined 180 metabolic modulators, including phytochemicals and anti-diabetic compounds, for their growth-inhibitory activities against melanoma cells, alone and in combination with the BRAF inhibitor vemurafenib. Two positive hits from this screen, 4-methylumbelliferone (4-MU) and ursolic acid (UA), were subjected to validation and further characterization. Metabolic analysis showed that 4-MU affected cellular metabolism through inhibition of glycolysis and enhanced the effect of vemurafenib to reduce the growth of melanoma cells. In contrast, UA reduced mitochondrial respiration, accompanied by an increase in the glycolytic rate. This metabolic switch potentiated the growth-inhibitory effect of the pyruvate dehydrogenase kinase inhibitor dichloroacetate. Both drug combinations led to increased production of reactive oxygen species, suggesting the involvement of oxidative stress in the cellular response. These results support the potential use of metabolic modulators for combination therapies in cancer and may encourage preclinical validation and clinical testing of such treatment strategies in patients with metastatic melanoma

Environmental toxicants in breast milk of Norwegian mothers and gut bacteria composition and metabolites in their infants at 1 month

Iszatt N, Janssen S, Lenters V, et al. Environmental toxicants in breast milk of Norwegian mothers and gut bacteria composition and metabolites in their infants at 1 month. Microbiome. 2019;7(1): 34

Use of non-governmental maternity services and pregnancy outcomes among undocumented women: a cohort study from Norway

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Background: In 2011 Norway granted undocumented women the right to antenatal care and to give birth at a hospital but did not include them in the general practitioner and reimbursement schemes. As a response to limited access to health care, Non-Governmental Organizations (NGO) have been running health clinics for undocumented migrants in Norway’s two largest cities. To further facilitate universal health coverage, there is a need to investigate how pregnant undocumented women use NGO clinics and how this afects their maternal health. We therefore investigated the care received, occurrence of pregnancy-related complications and pregnancy outcomes in women receiving antenatal care at these clinics. Methods: In this historic cohort study we included pregnant women aged 18–49 attending urban NGO clinics from 2009 to 2020 and retrieved their medical records from referral hospitals. We compared women based on region of origin using log-binominal regression to estimate relative risk of adverse pregnancy outcomes. Results: We identifed 582 pregnancies in 500 women during the study period. About half (46.5%) the women sought antenatal care after gestational week 12, and 25.7% after week 22. The women had median 1 (IQR 1–3) antenatal visit at the NGO clinics, which referred 77.7% of the women to public health care. A total of 28.4% of women were referred for induced abortion. In 205 retrieved deliveries in medical records, there was a 45.9% risk for any adverse pregnancy outcome. The risk of stillbirth was 1.0%, preterm birth 10.3%, and emergency caesarean section 19.3%. Conclusion: Pregnant undocumented women who use NGO clinics receive substandard antenatal care and have a high risk of adverse pregnancy outcomes despite low occurrence of comorbidities. To achieve universal health coverage, increased attention should be given to the structural vulnerabilities of undocumented women and to ensure that adequate antenatal care is accessible for them.publishedVersio