«Nå må jeg begynne å gjøre noe, jeg må ta et grep!» Samiske elevers erfaringer med overgangen ut av det samiske språkforvaltningsområdet

Denne avhandlingen handler om samiske elevers erfaringer med overgangen ut av samisk språkforvaltningsområde. Empirien i studien baserer seg på syv kvalitative forskningsintervjuer med en sammensatt gruppe elever på en videregående skole. Fem av elevene har samisk bakgrunn, hvorav fire av disse igjen har erfaringer med overgangen ut av forvaltningsområdet. Jeg har analysert de samiske elevenes erfaringer med denne overgangen knyttet til teoretiske begreper som muda, aktørskap, og identitet sett i sammenheng med språk, sted og tilhørighet. Funnene i analysen indikerer at de samiske elevene erfarer overgangen ut av forvaltningsområdet som biografiske krysningspunkter knyttet til ulike deler ved samisk identitet. Et sentralt aspekt ved overgangen er endringer i de språklige omgivelsene, både knyttet til språkbrukeres praksiser og semiotiske landskap i kommunene. Ungdommene tar også på ulike måter aktørskap over samisk språk og identitet i denne overgangen. Flere av elevene blir bevisste på at de i større grad må ta aktivt stilling til sine samiskspråklige praksiser eller samiske identitet. Ungdommenes aktørskap kan videre knyttes til en ansvarsfølelse for samisk språk og kulturs fremtid, der valgene de tar som enkeltindivider knyttet til samisk språk og identitet handler om dette ansvaret. Dette prosjektet peker også mot overordnede politiske strukturer og samfunnsstrukturelle rammer som berører de samiske språkene, språkforvaltningsområdet og politiske føringer for offentlig kommunal virksomhet. Hovedfokuset i denne avhandlingen er likevel på de samiske elevenes erfaringer med overgangen ut av forvaltningsområdet

Analgesic use in a Norwegian general population: Change over time and high-risk use - The Tromsø Study

Published version, also available at http://dx.doi.org/10.1186/s40360-015-0016-yBackground: Increased use of analgesics in the population is a cause for concern in terms of drug safety. There is a paucity of population-based studies monitoring the change in use over time of both non-prescription (OTC) analgesics and prescription (Rx) analgesics. Although much is known about the risks associated with analgesic use, we are lacking knowledge on high-risk use at a population level. The purpose of this study was to estimate the prevalence of non-prescription and prescription analgesic use, change over time and the prevalence in the presence of potential contraindications and drug interactions in a general population. Methods: A repeated cross-sectional study with data from participants (30–89 years) of the Tromsø Study in 2001–02 (Tromsø 5; N = 8039) and in 2007–08 (Tromsø 6; N = 12,981). Participants reported use of OTC and Rx analgesics and regular use of all drugs in the preceding four weeks. Change over the time period was analyzed with generalized estimating equations. The prevalence of regular analgesic use in persons with or without a clinically significant contraindication or drug interaction was determined in the Tromsø 6 population, and differences were tested with logistic regression. Results: Analgesic use increased from 54 to 60 % in women (OR = 1.24, 95 % CI 1.15–1.32) and from 29 to 37 % in men (OR = 1.39, 95 % CI 1.27–1.52) in the time period; the increase was due to sporadic use of OTC analgesics. There was substantial regular use of analgesics in several of the contraindication categories examined; the prevalence of non-steroidal anti-inflammatory drugs was more than eight per cent among persons with chronic kidney disease, gastrointestinal ulcers, or high primary cardiovascular risk. About four per cent of the study population demonstrated at least one potential drug interaction with an analgesic drug. Conclusions: The use of analgesics increased in the time period due to an increase in the use of OTC analgesics. Analgesic exposure in the presence of contraindications or drug interactions may put patients at risk. Public and prescriber awareness about clinically relevant contraindications and drug interactions with analgesics need to be increased

SARS-CoV-2 vaccines are not associated with hypercoagulability in apparently healthy people

Background: SARS-CoV-2 adenoviral vector DNA vaccines have been linked to the rare but serious thrombotic postvaccine complication vaccine-induced immune thrombotic thrombocytopenia. This has raised concerns regarding the possibility of increased thrombotic risk after any SARS-CoV-2 vaccines. Objectives: To investigate whether SARS-CoV-2 vaccines cause coagulation activation leading to a hypercoagulable state. Methods: This observational study included 567 health care personnel; 521 were recruited after the first dose of adenoviral vector ChAdOx1-S (Vaxzevria, AstraZeneca) vaccine and 46 were recruited prospectively before vaccination with a messenger RNA (mRNA) vaccine, either Spikevax (Moderna, n = 38) or Comirnaty (Pfizer-BioNTech, n = 8). In the mRNA group, samples were acquired before and 1 to 2 weeks after vaccination. In addition to the prevaccination samples, 56 unvaccinated blood donors were recruited as controls (total n = 102). Thrombin generation, D-dimer levels, and free tissue factor pathway inhibitor (TFPI) levels were analyzed. Results: No participant experienced thrombosis, vaccine-induced immune thrombotic thrombocytopenia, or thrombocytopenia (platelet count 9 /L) 1 week to 1 month postvaccination. There was no increase in thrombin generation, D-dimer level, or TFPI level in the ChAdOx1-S vaccine group compared with controls or after the mRNA vaccines compared with baseline values. Eleven of 513 (2.1%) participants vaccinated with ChAdOx1-S had anti-PF4/polyanion antibodies without a concomitant increase in thrombin generation. Conclusion: In this study, SARS-CoV-2 vaccines were not associated with thrombosis, thrombocytopenia, increased thrombin generation, D-dimer levels, or TFPI levels compared with baseline or unvaccinated controls. These findings argue against the subclinical activation of coagulation post-COVID-19 vaccination

Untreated PKU Patients without Intellectual Disability: What Do They Teach Us?

Phenylketonuria (PKU) management is aimed at preventing neurocognitive and psychosocial dysfunction by keeping plasma phenylalanine concentrations within the recommended target range. It can be questioned, however, whether universal plasma phenylalanine target levels would result in optimal neurocognitive outcomes for all patients, as similar plasma phenylalanine concentrations do not seem to have the same consequences to the brain for each PKU individual. To better understand the inter-individual differences in brain vulnerability to high plasma phenylalanine concentrations, we aimed to identify untreated and/or late-diagnosed PKU patients with near-normal outcome, despite high plasma phenylalanine concentrations, who are still alive. In total, we identified 16 such cases. While intellectual functioning in these patients was relatively unaffected, they often did present other neurological, psychological, and behavioral problems. Thereby, these "unusual" PKU patients show that the classical symptomatology of untreated or late-treated PKU may have to be rewritten. Moreover, these cases show that a lack of intellectual dysfunction despite high plasma phenylalanine concentrations does not necessarily imply that these high phenylalanine concentrations have not been toxic to the brain. Also, these cases may suggest that different mechanisms are involved in PKU pathophysiology, of which the relative importance seems to differ between patients and possibly also with increasing age. Further research should aim to better distinguish PKU patients with respect to their cerebral effects to high plasma phenylalanine concentrations

Molecular anatomy of adult mouse leptomeninges.

Leptomeninges, consisting of the pia mater and arachnoid, form a connective tissue investment and barrier enclosure of the brain. The exact nature of leptomeningeal cells has long been debated. In this study, we identify five molecularly distinct fibroblast-like transcriptomes in cerebral leptomeninges; link them to anatomically distinct cell types of the pia, inner arachnoid, outer arachnoid barrier, and dural border layer; and contrast them to a sixth fibroblast-like transcriptome present in the choroid plexus and median eminence. Newly identified transcriptional markers enabled molecular characterization of cell types responsible for adherence of arachnoid layers to one another and for the arachnoid barrier. These markers also proved useful in identifying the molecular features of leptomeningeal development, injury, and repair that were preserved or changed after traumatic brain injury. Together, the findings highlight the value of identifying fibroblast transcriptional subsets and their cellular locations toward advancing the understanding of leptomeningeal physiology and pathology

Brukermedvirkning i psykiatriske institusjoner. Praktisering av "brukermedvirkning" gjennom miljøterapeutiske aktiviteter

User participation in psychiatric institutions - Practicing of "user participation" through milieu therapeutic activities. The purpose of this article is to examine how user participation is enabled in practice. Fieldwork is conducted in three Norwegian District Psychiatric Centres (DPCs), with an emphasis on observations of staff working with patients and interviews. The theoretical framework is interactionism. The data analysis shows that efforts to involve patients in activities related to their own illness and their stay at the centres are integrated into the work. The findings show that much time is spent on motivating patients to want to live. Practicing of user participation in combination with milieu therapy creates dilemmas. The staff must balance between the various considerations in their work: to motivate individual patients to live and to ensure that daily routines and milieu therapeutic joint activities are implemented. Such dilemmas give the staff a feeling of inadequacy in the practice of user participation. Because, either they must pressure patients to do things against their will or reject individual wishes for adapted services to get the daily routines to go round

User participation in district psychiatry. The social construction of ‘users’ in handovers and meetings

An ideal in mental health care is user participation. This implies inclusion and facilitation by clinicians to enable users to participate in decisions about themselves and in the design of suitable treatment. However, much of the work of clinicians consists of handovers and other meetings where patients are not present. It is therefore interesting to study how the patient perspective is handled in such meetings and whether it forms a basis for user participation. We conducted fieldwork in three different inpatient wards in Norwegian District Psychiatric Centres. We used an interactional perspective in our analysis, where speech acts, framing and footing were key concepts. The findings show that the talk in the handovers and meetings contained five main themes and that there was a clear correlation between what was said and how it was said, and whether clinicians related to the content in a decisive, person-centred or indecisive manner. We discuss potential participation statuses for patients and their limited opportunity to influence the talk and possible decisions about themselves. Our conclusion is that handover meetings primarily function as an aid in organising clinicians' work and could ultimately be seen as counteracting user participation