Nothing to complain about? Residents’ and relatives’ views on a “good life” and ethical challenges in nursing homes

Background: Nursing home residents are a vulnerable population. Most of them suffer from multi-morbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature. Most studies have used staff members as informants, some have focused on the relatives’ view, but substantial knowledge about the residents’ perspective is lacking. Objective: To study what nursing home residents and their relatives perceive as ethical challenges in Norwegian nursing homes. Research design: A qualitative design with in-depth interviews with nursing home residents, and focus-group interviews with relatives of nursing home residents. The digitally recorded interviews were transcribed verbatim. Analysis was based on Interpretive Description. Participants and research context: A total of 25 nursing home residents from nine nursing homes in Norway, and 18 relatives of nursing home residents from three of these nursing homes. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Oslo, Norway. Findings and discussion: The main ethical challenges in Norwegian nursing homes from the residents’ and relatives’ perspective were as follows: (a) acceptance and adaptation, (b) well-being and a good life, (c) autonomy and self-determination, and (d) lack of resources. The relationship with the staff was of outmost importance and was experienced as both rewarding and problematic. None of the residents in our study mentioned ethical challenges connected to end-of-life care. Conclusion: Residents and relatives experience ethical challenges in Norwegian nursing homes, mostly connected to “everyday ethical issues.

Valideringsrapport – tilleggsrapport: Analyse av cystein/cystin (BIOLAB A99) ved bruk av Büchi Multivapor™ og Waters ACQUITY UPLC/Waters AccQ•Tag Ultra

Det ble validert nytt inndampingsutstyr (Büchi MultivaporTM) og nytt instrument (Waters ACQUITY UPLC) for metoden BIOLAB A99 Cystein/cystin. Selektivitet, linearitet, robusthet, presisjon og riktighet ble validert, måleområde ble vurdert, og måleusikkerhet ble beregnet. Valideringen demonstrerte at ytelsen til metoden er god og som forventet.Valideringsrapport – tilleggsrapport: Analyse av cystein/cystin (BIOLAB A99) ved bruk av Büchi Multivapor™ og Waters ACQUITY UPLC/Waters AccQ•Tag UltrapublishedVersio

Nothing to complain about? : residents’ and relatives’ viewson a "good life" and ethical challenges in nursing homes

Background: Nursing home residents are a vulnerable population. Most of them suffer from multimorbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature. Most studies have used staff members as informants, some have focused on the relatives’ view, but substantial knowledge about the residents’ perspective is lacking. Objective: To study what nursing home residents and their relatives perceive as ethical challenges in Norwegian nursing homes. Research design: A qualitative design with in-depth interviews with nursing home residents, and focusgroup interviews with relatives of nursing home residents. The digitally recorded interviews were transcribed verbatim. Analysis was based on Interpretive Description. Participants and research context: A total of 25 nursing home residents from nine nursing homes in Norway, and 18 relatives of nursing home residents from three of these nursing homes. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Oslo, Norway. Findings and discussion: The main ethical challenges in Norwegian nursing homes from the residents’ and relatives’ perspective were as follows: (a) acceptance and adaptation, (b) well-being and a good life, (c) autonomy and self-determination, and (d) lack of resources. The relationship with the staff was of outmost importance and was experienced as both rewarding and problematic. None of the residents in our study mentioned ethical challenges connected to end-of-life care. Conclusion: Residents and relatives experience ethical challenges in Norwegian nursing homes, mostly connected to "everyday ethical issues.

Nothing to complain about? Residents’ and relatives’ views on a “good life” and ethical challenges in nursing homes

Background: Nursing home residents are a vulnerable population. Most of them suffer from multi-morbidity, while many have cognitive impairment or dementia and need care around the clock. Several ethical challenges in nursing homes have been described in the scientific literature. Most studies have used staff members as informants, some have focused on the relatives’ view, but substantial knowledge about the residents’ perspective is lacking. Objective: To study what nursing home residents and their relatives perceive as ethical challenges in Norwegian nursing homes. Research design: A qualitative design with in-depth interviews with nursing home residents, and focus-group interviews with relatives of nursing home residents. The digitally recorded interviews were transcribed verbatim. Analysis was based on Interpretive Description. Participants and research context: A total of 25 nursing home residents from nine nursing homes in Norway, and 18 relatives of nursing home residents from three of these nursing homes. Ethical considerations: This study was reported to and approved by the Regional Ethics Committee in Oslo, Norway. Findings and discussion: The main ethical challenges in Norwegian nursing homes from the residents’ and relatives’ perspective were as follows: (a) acceptance and adaptation, (b) well-being and a good life, (c) autonomy and self-determination, and (d) lack of resources. The relationship with the staff was of outmost importance and was experienced as both rewarding and problematic. None of the residents in our study mentioned ethical challenges connected to end-of-life care. Conclusion: Residents and relatives experience ethical challenges in Norwegian nursing homes, mostly connected to “everyday ethical issues.

Life cycle analysis (LCA) and costs for energy storage in piles

This report is a part of the research project Sustainable energy from soils (BEAR). The BEAR project is a collaboration project between the industry, municipality and research institutions in mid Norway, funded by the regional research fund of Trøndelag (grant number 32116). The BEAR project involves designing and testing an energy concept that utilize the soil as a stable source of thermal energy for buildings, meanwhile also working as an integrated part of the building foundation, so called “energy piles”. The hypothesis is that integrating heat exchangers within the building foundations will enable and reduce the investment cost for the establishment of ground source heating systems in buildings that are situated on soils. The BEAR consortium consists of Malvik Municipality (project owner), NGI (project lead), Winns AS, Fundamentering AS, Noranergy AS and NTNU. BEAR comprises of four working packages, where this report summarizes the results and findings of work package 3 (WP3 - Evaluation)

A qualitative study of five teachers` perceptions of academic conversations in Norwegian with newly arrived multilingual young people

Mastergradsoppgave i kultur- og språkfagenes didaktikk, Høgskolen i Innlandet, 2021.Norsk: Denne oppgaven hører inn under feltet norsk fagdidaktikk, og er rettet mot norsk som andrespråk. Fokus i oppgaven er på læreren som underviser i norskfaget for flerspråklige ungdommer som kommer til Norge sent i opplæringsløpet. Oppgaven undersøker hva som kjennetegner fem læreres oppfatninger og bruk av faglige samtaler i norsk, når elevene er nyankomne til Norge. Informantene er lærere som jobber på tre forskjellige skoler; to videregående skoler og en ungdomsskole. Prosjektet baserer seg på kvalitativ metode med ca. 45 minutters dybdeintervju av hver lærer. Intervjuguiden ble utformet i tråd med fenomenologisk tilnærming der formålet er få tak i informantenes forståelse av et tema. Det er ikke foretatt observasjoner av undervisningssituasjoner, derfor er analyse og fortolkninger basert på meningsfortolkning av lærernes subjektive beskrivelser etter hermeneutiske prinsipper. Hovedfunnene i oppgaven er at selv om faglig samtaler er nevnt på alle nivå i de ulike norsklæreplanene, har ikke lærerne en enhetlig forståelse av selve begrepet faglig samtale eller hva som er faglige samtaler formål og funksjon. Likevel gjennomførte lærerne det de selv definerte som faglige samtaler på ganske like måter. Gjennomføringen var styrt av oppfatninger som til en viss grad kan sies å bryte med læreplanens intensjon, om at faglige samtaler skal foregå i interaksjon med andre. Et viktig funn som kan belyse hvorfor dette skjer, har sammenheng med at flere faktorer virker inn på lærernes oppfatninger. En viktig faktor var lærernes erfaringer med at nyankomne elever ble tause i klassesituasjoner. Det ledet som regel til at lærerne valgte å ta ut eleven for å gjennomføre faglige samtaler med elever alene. Det ble begrunnet med at elevene skulle få bruke språket i trygge omgivelser med lærer til stede. Da fikk lærerne også en anledning til å vurdere elevenes faglige kunnskaper og språklige ferdigheter. Fagsamtalen fikk dermed både en kommunikativ/ sosial funksjon og en vurderingssituasjon der elevene skulle «bli hørt» i dobbel forstand. En konsekvens av dette er at nyankomne elever antakelig får færre anledninger til å tilegne seg skolens sekundærdiskurs i fellesskap med medelever. Lærerens gode intensjoner om å skape en trygg samtalesituasjon, kan i ytterste konsekvens forsinke elevenes tilegnelse av skolespråket.English: The thesis falls within Norwegian academic didactics and Norwegian as a second language. The theme is teaching Norwegian to multilingual young people. The thesis examines the characteristics of five teachers' perceptions and their use of academic conversations in Norwegian with newly arrived pupils. The informants are teachers at three different schools; two high schools and one junior high school. The project is based on a qualitative method and includes approximately 45-minute in-depth interviews with each teacher. The interview guide was designed in line with a phenomenological approach, where the purpose is to gain insight into the informants' understanding of a topic. No observations were made during teaching itself, therefore the analyze is based on meaning interpretations of the teachers' subjective descriptions according to hermeneutic principles. A main finding is that teachers neither have a uniform understanding of the very concept of academic conversation, nor what it`s purpose and functions are. This is despite the fact that academic conversations are covered at all levels in the various Norwegian curricula. Nevertheless, the teachers conducted what they themselves defined as academic conversations in fairly similar ways. Their implementation did not, however, fully comply with the curriculas intentions of academic conversations taking place in interaction with others. An important and clarifying finding is that teachers' perceptions are affected by several factors. An important factor is the teachers` experiencesthat newly arrived pupils tend to become silent in the class situations. This usually leads to taking the pupils out of class to conduct one-toone conversations, and thus make it possible to use Norwegian in a safe environment with the teacher present. In this way the teachers also get an opportunity to assess academic knowledge and language skills. The conversation gets in other words both a communicative/social function and an assessment function, and the pupils are “heard" in a double sense. An assumed consequence is that newly arrived young people therefore have fewer opportunities to acquire the secondary discourses of the school together with fellow pupils. The good intentions of the teachers to ensure a safe frame around the conversations can thus ultimately delay students' acquisition of school language

“I smile, but Without Showing My Teeth”: The Lived Experience of Cleft, Lip, and Palate in Adults

Objective: To explore and describe the experience of growing up with unilateral cleft lip and palate (CLP) in adults. Design: Face-to-face interviews. Giorgi’s phenomenological method was used for analysis. Participants: Twenty-one (mean age: 40.8 years) adults treated for unilateral CLP during childhood and adolescence participated in the study. Results: Growing up with CLP meant to become aware of bodily otherness. The possible reactions from peers early in life complicated the striving for inclusion outside the close family. Being self-confident, clever in school, physically fit, and having trusted friends represented barriers against teasing and bullying. Nevertheless, the reflected image, in mirrors, windows, and photos, reminded the participants of the objectifying looks from others and often led to bodily adjustments that persisted into adulthood. The trajectory of treatment was not questioned during childhood, and the participants accepted the decisions on care made by experts and parents. Although problems related to the cleft could persist or return after the termination of ordinary treatment, a more hesitant view on the possible benefits of additional surgery was typical in adulthood. Conclusions: In retrospect, growing up with a unilateral CLP was found to have been an unquestioned part of the adult participants’ childhood, a burden that they feared would, to some extent, also be passed to their own children. However, the CLP had not prevented them from achieving goals and satisfaction in life. The occurrence of persisting psychological, functional, and esthetic challenges in adults suggests the need for an individualized, lifelong, and multidisciplinary perspective on CLP follow-up.publishedVersio

Kan degradering i mRNA predikere alder på biologiske spor?

DNA-analyser er et viktig verktøy for å knytte et individ til et biologisk spor funnet på et åsted. DNA gir i hovedsak kun informasjon om identitet, og sier ikke noe om når eller hvordan et spor ble avsatt. RNA har tidligere blitt ansett som for følsomt for bruk i rettsgenetiske analyser. Senere studier har dokumentert at RNA er mer stabilt enn først antatt. Foreløpig er RNA forbundet med identifisering av celletype, men forskning på tidsbestemmelse foregår på området. Målet er at RNA kan supplere DNA-analyser ved å gi informasjon om celletype og til hvilken tid det biologiske materialet ble avsatt. Per dags dato er det ikke funnet en pålitelig metode for å predikere alder på et biologisk spor, men det er gjort flere lovende analyser på området. Målet med studien har vært å undersøke om det er sammenheng mellom tid og degraderingsrate i spesifikke mRNA-markører for spytt og blod. Det var også ønsket å undersøke om degraderingsraten mellom ulike mRNA varierte, samt om 5’- enden degraderte raskere enn 3’- enden. I denne studien ble det samlet inn spytt- og blodprøver fra 16 frivillige deltakere. Det var til sammen 80 prøver som bestod av 35 spyttprøver og 45 blodprøver. Prøvene ble deretter plassert til lagring over en tidsperiode på 0 til 143 dager. RNA-ekstraksjon med fenol-kloroform ble utført med korte - og lengre tidsintervall for å observere endringer over tid. RNA-konsentrasjonen ble målt i hver prøve med Qubit™ Fluorometer. Videre ble 48 prøver inkludert for videre analyse. Det ble valgt ut 28 spesifikke mRNA-markører for spytt og blod. Deretter ble det forberedt et cDNA-bibliotek ved bruk av TruSeq® Targeted Expression kit. Avslutningsvis ble prøvene sekvensert på Illumina MiSeq® ved bruk av målrettet RNA-sekvensering. Sekvenseringsdataene ble benyttet for å undersøke antall «reads» for hver mRNA-markør og hvordan antallet forandret seg etter antall dager. Programvare for primær - og sekundær analyse av sekvenseringsdataene var forhåndsinstallert på maskinen, og ble benyttet for kvalitetskontroll og sammenstilling av sekvenser. Videre ble programvarene R og RStudio anvendt for datavisualisering og statistiske beregninger. Statistiske metoder som regresjonsanalyse og variansanalyse (ANOVA) ble benyttet i studien. Resultatene for spyttprøvene viste en signifikant degradering over tid, som prinsipielt betyr at markørene i studien kan benyttes for å predikere tid. Markørene viste lignende degraderingsmønster, samt hastighet over tid. Dermed kunne det ikke utføres en normalisering, som er nødvendig for å kunne benyttes i rutinemessig arbeid. Det ble ikke funnet en forskjell i degraderingsrate mellom 3’- og 5’ - enden som kunne benyttes for å predikere tid. For blodprøvene var genet hemoglobin-beta (HBB) den eneste markøren som viste degradering over tid. Resterende blodmarkører i studien var for stabile. Det ble observert forskjell i degradering mellom to gen, hemoglobin-beta (HBB) og hemoglobin-delta (HBD), hvor ratioen korrelerte med tid. Dermed kan denne ratioen anvendes for å predikere tid. Det ble ikke observert ulik degraderingsrate mellom 3’- og 5’- enden for blodmarkørene. Konklusjonen i denne studien ble at ratioen mellom to gener (HBB og HBD) som degraderer jevnt, men ulikt, kan benyttes for prediksjon av tid. Det var en signifikant degradering over tid for spyttmarkørene, men ettersom normalisering ikke ble foretatt, kan ikke modellen benyttes for andre datasett. Markørene bør evalueres i videre studier med andre primere, kortere tidsintervall og flere paralleller for hver deltaker. Det var ingen forskjell i degraderingsrate mellom 3’- og 5’- enden for markørene.DNA-analysis is a valuable tool to link an individual to a biological stain detected at a crime scene. DNA provide information about identity and say nothing about when or how a stain was deposited. Previously, it has been assumed that RNA is too unstable to be used in forensic genetic analysis. More recently, it has been shown that RNA is more stable than initially thought. Currently, RNA is associated with body fluid identification, but research on estimation time since deposition is ongoing. The goal is to use RNA as a supplement for DNA analysis by providing information about cellular origin and at what time the biological material was deposited. To date, no reliable method has been found for predicting age on a biological stain, but several promising methods has been reported in this area. The aim of the study has been to demonstrate whether there is a relationship between time and degradation rate in specific salivary and blood mRNA-markers. The study will also examine whether the degradation rate between different mRNAs varied, as well as whether the 5’ - end of a transcript degrade faster than the 3’ - end.M-BIOTE

Monolithic zirconia crowns in the aesthetic zone in heavy grinders with severe tooth wear – An observational case-series

Objectives The aim of this study was to assess the clinical outcomes and patient satisfaction with monolithic zirconia crowns in patients with severe tooth wear (≥1/3 of the tooth crown) in the aesthetic zone. Methods The historical prospective study sample consisted of 13 patients previously treated with a total of 84 monolithic zirconia crowns. The patients had been treated in a private clinic in Bergen, Norway, in the period 2012 to 2014. All patients were men, aged 35–67 years (mean age 56.3 years) and had been in need of prosthetic rehabilitation because of severe tooth wear in the aesthetic zone. Technical complications as well as biologic findings were registered when the crowns had been in function one to three years (mean 20 months). The patients completed a self-administered questionnaire regarding satisfaction with aesthetic and function. Results No biological complications were registered in 79 of the crowns (94%), and technical complications were registered in only two patients. All patients were satisfied with the aesthetic and function of the monolithic zirconia crowns and would choose the same treatment modality if they were to be treated again. Conclusions Within the limitations of this study, we conclude that the rate of clinical complications was low and that the patients were satisfied with the aesthetic as well as the function of the monolithic zirconia crowns. Clinical significance Monolithic zirconia crowns may provide a valid treatment modality in the aesthetic zone in patients with severe tooth wear.publishedVersio