Frivillighetsturisme: En kartlegging av motivasjonsfaktorer

I denne oppgaven har vi sett nærmere på fenomenet frivillighetsturisme. Fenomenet er lite forsket på i Norge, men likevel er det kjent blant nordmenn ettersom stadig flere velger å kombinere reising med frivillig arbeid. Basert på vår interesse for frivillighetsturisme har denne oppgaven som formål å se nærmere på motivasjonsfaktorer som ligger til grunn for å kombinere reising og frivillig arbeid. I en tidlig fase brukte vi mye tid på litteraturgjennomgang som ga oss god innsikt i temaet, og basert på arbeidet med prosjektskisse 2 kom vi frem til følgende problemstilling: “Hvilke motivasjonsfaktorer ligger til grunn ved valg av frivillig arbeid i utlandet”. For å kunne svare på vår problemstilling utviklet vi tre forskningsspørsmål basert på tre sentrale dimensjoner i henhold til fenomenet, som skulle hjelpe oss med å svare på problemstillingen: 1. Hva kjennetegner opplevelsesdimensjonen ved kombinering av reising og frivillig arbeid? 2. Foreligger det forskjeller på motivasjonsfaktorer blant norske ungdommer og internasjonale funn? 3. Er motivasjonsfaktorene for å arbeide frivillig i utlandet altruistiske, egoistiske eller en kombinasjon? Denne avhandlingen har et fenomenologisk forskningsdesign og vi har benyttet oss av åpne, individuelle intervjuer ved datainnsamlingen. Vi har intervjuet åtte informanter som tidligere har kombinert reising med frivillig arbeid. Med utgangspunkt i forskningsdesignet har vi gjort et detaljert analysearbeid med utgangspunkt i fenomenologisk analyse av meningsinnhold. Basert på analysearbeidet har drøftelsen av funn og resultater tatt utgangspunkt i følgende tre temaer som representer våre tre forskningsspørsmål; opplevelsesdimensjonen, våre funn sammenlignet med internasjonale funn, og forholdet mellom egoisme og altruisme. Forskningsspørsmålene har lagt et solid grunnlag for å kartlegge motivasjonsfaktorer, og vi har på grunnlag av disse funnet følgende sentrale faktorer; selvutvikling, kulturell neddykking, virkelighetsbilde, opplevelse og å hjelpe

RESEARCH TRENDS ON COMMUNITY-BASED TOURISM IN THE PERIOD 2013 - 2023

Community-based tourism (CBT) has been around since the 1970s and so far, has grown in popularity in most continents. This study systematically evaluates and generalizes theoretical and practical issues on CBT based on 87 related articles published in scientific journals under the Scopus system from 2013 to 2023 through the application of content analysis methods. The results also show that research in this area has different research areas and mainly uses qualitative methods. The literature review identified a number of key themes including: (1) benefits of CBT development, (2) community and stakeholder engagement, (3) advantages and barriers in CBT development, (4) community perceptions about CBT, and (5) sustainable CBT development. The article has analyzed research trends on CBT: theory and application.  Article visualizations

Safety and efficacy of fluoxetine on functional outcome after acute stroke (AFFINITY): a randomised, double-blind, placebo-controlled trial

Background Trials of fluoxetine for recovery after stroke report conflicting results. The Assessment oF FluoxetINe In sTroke recoverY (AFFINITY) trial aimed to show if daily oral fluoxetine for 6 months after stroke improves functional outcome in an ethnically diverse population. Methods AFFINITY was a randomised, parallel-group, double-blind, placebo-controlled trial done in 43 hospital stroke units in Australia (n=29), New Zealand (four), and Vietnam (ten). Eligible patients were adults (aged ≥18 years) with a clinical diagnosis of acute stroke in the previous 2–15 days, brain imaging consistent with ischaemic or haemorrhagic stroke, and a persisting neurological deficit that produced a modified Rankin Scale (mRS) score of 1 or more. Patients were randomly assigned 1:1 via a web-based system using a minimisation algorithm to once daily, oral fluoxetine 20 mg capsules or matching placebo for 6 months. Patients, carers, investigators, and outcome assessors were masked to the treatment allocation. The primary outcome was functional status, measured by the mRS, at 6 months. The primary analysis was an ordinal logistic regression of the mRS at 6 months, adjusted for minimisation variables. Primary and safety analyses were done according to the patient's treatment allocation. The trial is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12611000774921. Findings Between Jan 11, 2013, and June 30, 2019, 1280 patients were recruited in Australia (n=532), New Zealand (n=42), and Vietnam (n=706), of whom 642 were randomly assigned to fluoxetine and 638 were randomly assigned to placebo. Mean duration of trial treatment was 167 days (SD 48·1). At 6 months, mRS data were available in 624 (97%) patients in the fluoxetine group and 632 (99%) in the placebo group. The distribution of mRS categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio 0·94, 95% CI 0·76–1·15; p=0·53). Compared with patients in the placebo group, patients in the fluoxetine group had more falls (20 [3%] vs seven [1%]; p=0·018), bone fractures (19 [3%] vs six [1%]; p=0·014), and epileptic seizures (ten [2%] vs two [<1%]; p=0·038) at 6 months. Interpretation Oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and epileptic seizures. These results do not support the use of fluoxetine to improve functional outcome after stroke

Frivillighetsturisme: En kartlegging av motivasjonsfaktorer

I denne oppgaven har vi sett nærmere på fenomenet frivillighetsturisme. Fenomenet er lite forsket på i Norge, men likevel er det kjent blant nordmenn ettersom stadig flere velger å kombinere reising med frivillig arbeid. Basert på vår interesse for frivillighetsturisme har denne oppgaven som formål å se nærmere på motivasjonsfaktorer som ligger til grunn for å kombinere reising og frivillig arbeid. I en tidlig fase brukte vi mye tid på litteraturgjennomgang som ga oss god innsikt i temaet, og basert på arbeidet med prosjektskisse 2 kom vi frem til følgende problemstilling: “Hvilke motivasjonsfaktorer ligger til grunn ved valg av frivillig arbeid i utlandet”. For å kunne svare på vår problemstilling utviklet vi tre forskningsspørsmål basert på tre sentrale dimensjoner i henhold til fenomenet, som skulle hjelpe oss med å svare på problemstillingen: 1. Hva kjennetegner opplevelsesdimensjonen ved kombinering av reising og frivillig arbeid? 2. Foreligger det forskjeller på motivasjonsfaktorer blant norske ungdommer og internasjonale funn? 3. Er motivasjonsfaktorene for å arbeide frivillig i utlandet altruistiske, egoistiske eller en kombinasjon? Denne avhandlingen har et fenomenologisk forskningsdesign og vi har benyttet oss av åpne, individuelle intervjuer ved datainnsamlingen. Vi har intervjuet åtte informanter som tidligere har kombinert reising med frivillig arbeid. Med utgangspunkt i forskningsdesignet har vi gjort et detaljert analysearbeid med utgangspunkt i fenomenologisk analyse av meningsinnhold. Basert på analysearbeidet har drøftelsen av funn og resultater tatt utgangspunkt i følgende tre temaer som representer våre tre forskningsspørsmål; opplevelsesdimensjonen, våre funn sammenlignet med internasjonale funn, og forholdet mellom egoisme og altruisme. Forskningsspørsmålene har lagt et solid grunnlag for å kartlegge motivasjonsfaktorer, og vi har på grunnlag av disse funnet følgende sentrale faktorer; selvutvikling, kulturell neddykking, virkelighetsbilde, opplevelse og å hjelpe

Unexpected Role for Adaptive αβTh17 Cells in Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome (ARDS) is a devastating disorder characterized by increased alveolar permeability with no effective treatment beyond supportive care. Current mechanisms underlying ARDS focus on alveolar endothelial and epithelial injury caused by products of innate immune cells and platelets. However, the role of adaptive immune cells in ARDS remains largely unknown. In this study, we report that expansion of Ag-specific αβTh17 cells contributes to ARDS by local secretion of IL-17A, which in turn directly increases alveolar epithelial permeability. Mice with a highly restrictive defect in Ag-specific αβTh17 cells were protected from experimental ARDS induced by a single dose of endotracheal LPS. Loss of IL-17 receptor C or Ab blockade of IL-17A was similarly protective, further suggesting that IL-17A released by these cells was responsible for this effect. LPS induced a rapid and specific clonal expansion of αβTh17 cells in the lung, as determined by deep sequencing of the hypervariable CD3RβVJ region of the TCR. Our findings could be relevant to ARDS in humans, because we found significant elevation of IL-17A in bronchoalveolar lavage fluid from patients with ARDS, and rIL-17A directly increased permeability across cultured human alveolar epithelial monolayers. These results reveal a previously unexpected role for adaptive immune responses that increase alveolar permeability in ARDS and suggest that αβTh17 cells and IL-17A could be novel therapeutic targets for this currently untreatable disease

Unexpected Role for Adaptive αβTh17 Cells in Acute Respiratory Distress Syndrome.

Acute respiratory distress syndrome (ARDS) is a devastating disorder characterized by increased alveolar permeability with no effective treatment beyond supportive care. Current mechanisms underlying ARDS focus on alveolar endothelial and epithelial injury caused by products of innate immune cells and platelets. However, the role of adaptive immune cells in ARDS remains largely unknown. In this study, we report that expansion of Ag-specific αβTh17 cells contributes to ARDS by local secretion of IL-17A, which in turn directly increases alveolar epithelial permeability. Mice with a highly restrictive defect in Ag-specific αβTh17 cells were protected from experimental ARDS induced by a single dose of endotracheal LPS. Loss of IL-17 receptor C or Ab blockade of IL-17A was similarly protective, further suggesting that IL-17A released by these cells was responsible for this effect. LPS induced a rapid and specific clonal expansion of αβTh17 cells in the lung, as determined by deep sequencing of the hypervariable CD3RβVJ region of the TCR. Our findings could be relevant to ARDS in humans, because we found significant elevation of IL-17A in bronchoalveolar lavage fluid from patients with ARDS, and rIL-17A directly increased permeability across cultured human alveolar epithelial monolayers. These results reveal a previously unexpected role for adaptive immune responses that increase alveolar permeability in ARDS and suggest that αβTh17 cells and IL-17A could be novel therapeutic targets for this currently untreatable disease

Effect of the Optimize Heart Failure Care Program on clinical and patient outcomes – The pilot implementation in Vietnam

Background: The Ho-Chi-Minh-city Heart Institute in Vietnam took part in the Optimize Heart Failure (OHF) Care Program, designed to improve outcomes following heart failure (HF) hospitalization by increasing patient awareness and optimizing HF treatment. Methods: HF patients hospitalized with left ventricular ejection-fraction (LVEF) <50% were included. Patients received guideline-recommended HF treatment and education. Clinical signs, treatments and outcomes were assessed at admission, discharge, 2 and 6 months (M2, M6). Patients' knowledge and practice were assessed at M6 by telephone survey. Results: 257 patients were included. Between admission and M2 and M6, heart rate decreased significantly, and clinical symptoms improved significantly. LVEF increased significantly from admission to M6. 85% to 99% of patients received education. At M6, 45% to 78% of patients acquired knowledge and adhered to practice regarding diet, exercise, weight control, and detection of worsening symptoms. High use of renin-angiotensin-aldosterone-system inhibitors (91%), mineralocorticoid-receptor-antagonists (77%) and diuretics (85%) was noted at discharge. Beta-blocker and ivabradine use was less frequent at discharge but increased significantly at M6 (from 33% to 51% and from 9% to 20%, respectively, p < 0.001). There were no in-hospital deaths. Readmission rates at 30 and 60 days after discharge were 8.3% and 12.5%, respectively. Mortality rates at 30 days, 60 days and 6 months were 1.2%, 2.5% and 6.4%, respectively. Conclusions: The OHF Care Program could be implemented in Vietnam without difficulty and was associated with high usage of guideline-recommended drug therapy. Although education was delivered, patient knowledge and practice could be further improved at M6 after discharge. Keywords: Heart failure, Optimize, Education, Knowledge, Mortality, Readmissio

Twelve-Month Outcomes of the AFFINITY Trial of Fluoxetine for Functional Recovery After Acute Stroke: AFFINITY Trial Steering Committee on Behalf of the AFFINITY Trial Collaboration

Background and Purpose: The AFFINITY trial (Assessment of Fluoxetine in Stroke Recovery) reported that oral fluoxetine 20 mg daily for 6 months after acute stroke did not improve functional outcome and increased the risk of falls, bone fractures, and seizures. After trial medication was ceased at 6 months, survivors were followed to 12 months post-randomization. This preplanned secondary analysis aimed to determine any sustained or delayed effects of fluoxetine at 12 months post-randomization. Methods: AFFINITY was a randomized, parallel-group, double-blind, placebo-controlled trial in adults (n=1280) with a clinical diagnosis of stroke in the previous 2 to 15 days and persisting neurological deficit who were recruited at 43 hospital stroke units in Australia (n=29), New Zealand (4), and Vietnam (10) between 2013 and 2019. Participants were randomized to oral fluoxetine 20 mg once daily (n=642) or matching placebo (n=638) for 6 months and followed until 12 months after randomization. The primary outcome was function, measured by the modified Rankin Scale, at 6 months. Secondary outcomes for these analyses included measures of the modified Rankin Scale, mood, cognition, overall health status, fatigue, health-related quality of life, and safety at 12 months. Results: Adherence to trial medication was for a mean 167 (SD 48) days and similar between randomized groups. At 12 months, the distribution of modified Rankin Scale categories was similar in the fluoxetine and placebo groups (adjusted common odds ratio, 0.93 [95% CI, 0.76–1.14]; P =0.46). Compared with placebo, patients allocated fluoxetine had fewer recurrent ischemic strokes (14 [2.18%] versus 29 [4.55%]; P =0.02), and no longer had significantly more falls (27 [4.21%] versus 15 [2.35%]; P =0.08), bone fractures (23 [3.58%] versus 11 [1.72%]; P =0.05), or seizures (11 [1.71%] versus 8 [1.25%]; P =0.64) at 12 months. Conclusions: Fluoxetine 20 mg daily for 6 months after acute stroke had no delayed or sustained effect on functional outcome, falls, bone fractures, or seizures at 12 months poststroke. The lower rate of recurrent ischemic stroke in the fluoxetine group is most likely a chance finding. REGISTRATION: URL: http://www.anzctr.org.au/ ; Unique identifier: ACTRN12611000774921