Alt kan snu på et sekund : Mentaliseringssvikt under vold i nære relasjoner

Tittel: Alt kan snu på et sekund: Mentaliseringssvikt under vold i nære relasjoner Forfattere: Morten Hegdal og Marianne Heltne Lütchen-Lehn Veileder: Kirsten Benum Formålet med denne studien var å utforske hvorvidt mentaliseringsteori kan være et nyttig rammeverk for å forstå mekanismer knyttet til vold i nære relasjoner. Utvalget bestod av seks menn som har påbegynt behandling ved Stiftelsen Alternativ til Vold. En fenomenologisk og narrativ tilnærming ble lagt til grunn for studien. Et semistrukturert intervju ble benyttet for å utforske hvordan informantene erfarte seg selv og partner i løpet av en voldsepisode. Funnene indikerte at flere av informantenes subjektive beskrivelser kan ses i sammenheng med en svikt i mentalisering. En tentativ modell ble foreslått for å synliggjøre hvordan mentaliseringssvikt kan gjøre seg gjeldende under ulike faser av volden. Modellen tar for seg mentaliseringsprosesser, fysiologisk og emosjonell aktivering og korresponderende subjektive erfaringer langs en tidsakse. En implikasjon av studien er en anbefaling om økt bruk av mentaliseringsbaserte tilnærminger i behandling av voldsutøvere

Patterns of drug prescriptions in an orthogeriatric ward as compared to orthopaedic ward: results from the Trondheim Hip Fracture Trial - a randomised clinical trial

Purpose In the Trondheim Hip Fracture Trial, 397 home-dwelling patients with hip fractures were randomised to comprehensive geriatric care (CGC) in a geriatric ward or traditional orthopaedic care (OC). Patients in the CGC group had significantly better mobility and function 4 months after discharge. This study explores group differences in drug prescribing and possible associations with the outcomes in the main study. Methods Drugs prescribed at admission and discharge were registered from hospital records. Mobility, function, fear of falling and quality of life were assessed using specific rating scales. Linear regression was used to analyse association between drug changes and outcomes at 4 months. Results The mean age was 83 years, and 74% were females. The mean number (± SD) of drugs in the CGC and OC groups was 3.8 (2.8) and 3.9 (2.8) at inclusion and 7.1 (2.8) and 6.2 (3.0) at discharge, respectively (p = 0.003). The total number of withdrawals was 209 and 82 in the CGC and OC groups, respectively (p < 0.0001), and the number of starts was 844 and 526, respectively (p < 0.0001). A significant negative association was found between the number of drug changes during the hospital stay and mobility and function 4 months later in both groups. However, this association disappeared when adjusting for baseline function and comorbidities. Conclusion These secondary analyses suggest that there are significant differences in the pharmacological treatment between geriatric and orthopaedic wards, but these differences could not explain the beneficial effect of CGC in the Trondheim Hip Fracture Trial