Avoidant and borderline personality disorder patients during the first Covid-19 wave in Norway – a survey-based comparison of therapy changes and patients’ accommodations

Background Patients with personality disorders (PDs) often have insecure attachment patterns and may be especially vulnerable to abrupt treatment changes. Patients with borderline PD (BPD) are often considered vulnerable to treatment interruption due to chronic fear of abandonment. Nonetheless, other PDs are poorly investigated. In the first Covid-19 wave in Norway, in-person treatment facilities and group treatments were strongly restricted from March 12th until May/June 2020. Objectives To examine and compare changes in outpatient treatment for patients with avoidant (AvPD) and BPD during the first Covid-19 wave in Norway, and patients’ reactions to these changes. Methods The study is based on a cross-sectional survey distributed to 1120 patients referred to 12 different PD treatment units on a specialist mental health service level within the Norwegian Network for Personality Disorders. The survey included questions on treatment situation, immediate reactions, and changes during the crisis. From 133 responders (response rate 12%), 40 patients reported BPD and 30 AvPD as diagnosis. Results All patients were followed up from their therapist after March 12th. Almost all patients in both groups expressed satisfaction under the new circumstances. Both groups experienced the same regularity as before, but more AvPD patients reported less than weekly consultations. AvPD patients reported more negative feelings about changes in therapy, and missed the therapy and group members more than the BPD group. Conclusion After the lockdown, BPD patients received a closer follow-up than AvPD patients, and the latter reported more negative feelings related to change in their treatment situation

Development of a brief multidisciplinary education programme for patients with osteoarthritis

Background Osteoarthritis (OA) is a prevalent progressive musculoskeletal disorder, leading to pain and disability. Patient information and education are considered core elements in treatment guidelines for OA; however, there is to our knowledge no evidence-based recommendation on the best approach, content or length on educational programmes in OA. Objective: to develop a brief, patient oriented disease specific multidisciplinary education programme (MEP) to enhance self-management in patients with OA. Method Twelve persons (80% female mean age 59 years) diagnosed with hand, hip or knee OA participated in focus group interviews. In the first focus group, six participants were interviewed about their educational needs, attitudes and expectations for the MEP. The interviews were transcribed verbatim and thereafter condensed. Based on results from focus group interviews, current research evidence, clinical knowledge and patients' experience, a multidisciplinary OA team (dietist, nurse, occupational therapist, pharmacist, physical therapist and rheumatologist) and a patient representative developed a pilot-MEP after having attended a work-shop in health pedagogics. Finally, the pilot-MEP was evaluated by a second focus group consisting of four members from the first focus group and six other experienced patients, before final adjustments were made. Results The focus group interviews revealed four important themes: what is OA, treatment options, barriers and coping strategies in performing daily activities, and how to live with osteoarthritis. Identified gaps between patient expectations and experience with the pilot-programme were discussed and adapted into a final MEP. The final MEP was developed as a 3.5 hour educational programme provided in groups of 6-9 patients. All members from the multidisciplinary team are involved in the education programme, including a facilitator who during the provision of the programme ensures that the individual questions are addressed. As part of an ongoing process, a patient representative regularly attends the MEP and gives feedback concerning content and perceived value. Conclusion A MEP has been developed to enhance self-management in patients with OA attending a multidisciplinary OA outpatient clinic. The effectiveness of the MEP followed by individual consultations with members of the multidisciplinary team is currently evaluated in a randomised controlled trial with respect to patient satisfaction and functioning

Comparison of organic and conventional food and food production. Part II: Animal health and welfare in Norway

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Does politics matter? Explaining swings in wind power installations

This is a social science article on the politics of wind power, and on whether or not politics actually matters. While it may seem obvious that politics actually does, I argue that the arguments that we encounter about wind power very often are about economics, technology or geography, arguments that have something deterministic to them, and which leaves politics a lesser factor. Against this, I argue that while these arguments may go a long way toward explaining the general upward trajectory of wind power, they do a bad job of explaining swings in wind power installations, why some countries are more successful at wind power in general, and why within countries, you typically have periods of both stops and starts. For this, we need a political explanation. Of these, there are many, but from the vantage point of political economy, I suggest a focus on vested interests, among other reasons because this is an explanation that can be used to analyze both democracies and non-democracies, and both presidential and parliamentarian systems. Methodologically, the study is a qualitative comparative case-study of five countries (US, Denmark, Japan, Germany, China) employing a combination of John Stuart Mill’s comparative methods and process-tracing. The main finding is that if you want to explain swings in wind power installations, you need to focus on the political system, and in particular on the interest politics that goes on behind the scenes. While economic, technological, or geographic explanations all provide useful amounts of understanding, neither explanation can explain swings. There is only one explanation that remains constant and important in every one of the five cases. Economics, technology and geography play different roles in different contexts to different extents. Politics on the other hand always plays a role

Renewable energy expansion or the preservation of national energy sovereignty? Norwegian renewable energy policy meets resource nationalism

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A green maritime shift: Lessons from the electrification of ferries in Norway

Norway is at the forefront of a transition toward cleaner solutions in the maritime sector. In 2015, the first fully electric ferry, the MF Ampere, started operating in Western Norway. Since then, 60 electric or hybrid-electric ferries are in operation or scheduled to be by the end of 2021. With a few exceptions the literature on energy transitions sees transitions as disjointed and slow. Through this case study—based on 13 semi-structured interviews, two focus groups, as well as seminars, conferences and workshops with industry experts, public sector stakeholders, and project managers—we show how the Norwegian ferry case is an example showing that, under the right circumstances, energy transitions can however be politically accelerated, even in what is widely deemed a hard-to-decarbonize sector. This is one of the first attempts at analyzing the politics of accelerated transitions within the maritime sector. It is also one of few studies of the electrification of ferries, and at the end of which we suggest a set of success criteria for accelerated transitions. We propose four main explanatory factors: First, what we label the Norwegian ferry innovation system was instrumental in providing an environment conducive to electrification. Second, the Norwegian state acted entrepreneurially, by moving beyond merely being a de-risker through playing an active role in market creation and transformation through public agencies and support schemes. Third and fourth, we argue that the relative lack of strong opposing vested interests combined with an oil shock to create favorable conditions for structural change