Klientar si oppleving av kontakten med sosialarbeidarar på sosialkontor

Rapporten er basert på omfattande intervju med 14 sosialklientar i fem kommunar i Sogn og Fjordane. Klientane vart spurde om korleis dei opplever møte med eller relasjonen til sosialarbeidaren og korleis det var å møta sosialarbeidaren på fritida. Empirien syner at alle klientane opplevde skam før møtet med sosialkontoret, ingen tenker på seg sjølve som sosialklientar og dei opplever kontakten med sosialkontoret som mellombels. I møte med sosialarbeidaren deler klientane seg i to typologiar, konflikt – og konsensutypologi. Alle klientane er opptekne av relasjonen til sosialarbeidaren og oppfattar den som avgjerande for korleis samhandlinga skal utvikla seg og om dei vil få hjelp. Menn og kvinner opplever møtet med sosialarbeidaren på fritida ulikt. Til skilnad frå mennene var kvinnene opptekne av kva sosialarbeidarane tenkte om dei, og dei hadde ulike opplevingar knytt til dette. Dei kvinnelege klientane var òg opptekne av om teieplikta vert halden

Steinalderen i Sørøst-Norge

The Stone Age in Southeastern Norway. The Academic Program for Stone Age Research at the Museum of Cultural History comprises a general overview of excavations, carried out between 2000–2017, of 430 sites, graves, depots, hunting pits and other sites, and presents a broad and updated report on the status of research relating to the Stone Age (c. 9500–1700 BC) in the region.Insufficient knowledge has been the impetus for identification of four main areas for concerted prospective effort:• Technology• Settlement and land use• Subsistence and economy• Rituals and their practiceAlso presented in this program for Stone Age research are concrete strategies and initiatives that will contribute to filling in these knowledge gaps, advancing the field, and laying foundations for further research.The Stone Age in Southeastern Norway has been written with researchers, managers of cultural heritage and students in mind, as well as all others interested in a deep dive into our earliest history. This book will be an important reference for planning and carrying out future Stone Age excavations under the museum’s aegis. It will also serve as a foundation for guidelines the museum provides regarding conservation of our oldest cultural heritage.; Steinalderen i Sørøst-Norge. Faglig program for steinalderundersøkelser ved Kulturhistorisk museum inneholder en helhetlig oversikt over utgravinger av 430 boplasser, begravelser, depoter, fangstanlegg m.m. fra år 2000 til 2017, og presenterer en bred og oppdatert redegjørelse for forskningsstatus knyttet til steinalderen (ca. 9500–1700 f.Kr.) i regionen.I presentasjonen av forskningsstatus synliggjøres ikke bare det vi vet per i dag, men også betydelige kunnskapshull. Den manglede kunnskapen har dannet utgangspunkt for formuleringen av fire framtidige satsingsområder:- Teknologi- Bosetning og landskapsbruk- Ressursgrunnlag og økonomi- Ritualer og ritualisert praksisI dette faglige programmet for steinalderundersøkelser presenteres konkrete forslag til strategier og tiltak som vil bidra til å tette disse kunnskapshullene, skape faglig utvikling og danne grunnlag for videre forskning.Steinalderen i Sørøst-Norge er skrevet for forskere, forvaltere, studenter og andre som vil gjøre dypdykk i vår eldste forhistorie. Boken vil være et viktig verktøy for planlegging og gjennomføring av kommende steinalderutgravninger ved Kulturhistorisk museum. Den vil også danne et grunnlag for de rådene museet gir i forbindelse med forvaltningen av våre eldste kulturminner

TPS-grupper i praksis (Tverrprofesjonell samarbeidslæring i praksisstudier) Delprosjekt 1b i OPERASJON BACHELORPRAKSIS, FHS

I denne rapporten presenteres modeller for tverrprofesjonell praksis-læring som benyttes både i primærhelsetjenester (TVEPS) og i spesialisthelsetjenesten (TPS i sykehuspraksis). I tillegg presenteres en mal for informasjonsskriv til ledere og veiledere i helseforetak og kommuner, der det oppfordres til å legge til rette for tverrprofesjonelt studentsamarbeid når studenter fra flere profesjonsutdanninger har samtidig praksis i samme institusjon. Utvikling av modellene som beskrives har pågått gjennom flere år. Som del av prosjekt Operasjon Bachelorpraksis er modellene presentert samlet og er prøvd ut på nye praksis-arenaer og på flere HVL-campus. Modeller og mal for informasjonsskriv er også presentert i «Ressursemne for TPS i teori og praksis, opprettet i læringsplattformen Canvas (se rapport fra TPSgruppens oppdrag fra punktene 1 og 3)

Physical function endpoints in cancer cachexia clinical trials: Systematic Review 1 of the cachexia endpoints series

In cancer cachexia trials, measures of physical function are commonly used as endpoints. For drug trials to obtain regulatory approval, efficacy in physical function endpoints may be needed alongside other measures. However, it is not clear which physical function endpoints should be used. The aim of this systematic review was to assess the frequency and diversity of physical function endpoints in cancer cachexia trials. Following a comprehensive electronic literature search of MEDLINE, Embase and Cochrane (1990-2021), records were retrieved. Eligible trials met the following criteria: adults (≥18 years), controlled design, more than 40 participants, use of a cachexia intervention for more than 14 days and use of a physical function endpoint. Physical function measures were classified as an objective measure (hand grip strength [HGS], stair climb power [SCP], timed up and go [TUG] test, 6-min walking test [6MWT] and short physical performance battery [SPPB]), clinician assessment of function (Karnofsky Performance Status [KPS] or Eastern Cooperative Oncology Group-Performance Status [ECOG-PS]) or patient-reported outcomes (physical function subscale of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaires [EORTC QLQ-C30 or C15]). Data extraction was performed using Covidence and followed PRISMA guidance (PROSPERO registration: CRD42022276710). A total of 5975 potential studies were examined and 71 were eligible. Pharmacological interventions were assessed in 38 trials (54%). Of these, 11 (29%, n = 1184) examined megestrol and 5 (13%, n = 1928) examined anamorelin; nutritional interventions were assessed in 21 trials (30%); and exercise-based interventions were assessed in 6 trials (8%). The remaining six trials (8%) assessed multimodal interventions. Among the objective measures of physical function (assessed as primary or secondary endpoints), HGS was most commonly examined (33 trials, n = 5081) and demonstrated a statistically significant finding in 12 (36%) trials (n = 2091). The 6MWT was assessed in 12 trials (n = 1074) and was statistically significant in 4 (33%) trials (n = 403), whereas SCP, TUG and SPPB were each assessed in 3 trials. KPS was more commonly assessed than the newer ECOG-PS (16 vs. 9 trials), and patient-reported EORTC QLQ-C30 physical function was reported in 25 trials. HGS is the most commonly used physical function endpoint in cancer cachexia clinical trials. However, heterogeneity in study design, populations, intervention and endpoint selection make it difficult to comment on the optimal endpoint and how to measure this. We offer several recommendations/considerations to improve the design of future clinical trials in cancer cachexia

Physical Function Endpoints in Cancer Cachexia Trials; Systematic Review 1 of the Cachexia Endpoints Series

Abstract In cancer cachexia trials, measures of physical function are commonly used as endpoints. For drug trials to obtain regulatory approval, efficacy in physical function endpoints may be needed alongside other measures. However, it is not clear which physical function endpoints should be used. The aim of this systematic review was to assess the frequency and diversity of physical function endpoints in cancer cachexia trials. Following a comprehensive electronic literature search of MEDLINE, Embase and Cochrane (1990–2021), records were retrieved. Eligible trials met the following criteria: adults (≥18 years), controlled design, more than 40 participants, use of a cachexia intervention for more than 14 days and use of a physical function endpoint. Physical function measures were classified as an objective measure (hand grip strength [HGS], stair climb power [SCP], timed up and go [TUG] test, 6‐min walking test [6MWT] and short physical performance battery [SPPB]), clinician assessment of function (Karnofsky Performance Status [KPS] or Eastern Cooperative Oncology Group‐Performance Status [ECOG‐PS]) or patient‐reported outcomes (physical function subscale of the European Organisation for the Research and Treatment of Cancer Quality of Life Questionnaires [EORTC QLQ‐C30 or C15]). Data extraction was performed using Covidence and followed PRISMA guidance (PROSPERO registration: CRD42022276710). A total of 5975 potential studies were examined and 71 were eligible. Pharmacological interventions were assessed in 38 trials (54%). Of these, 11 (29%, n = 1184) examined megestrol and 5 (13%, n = 1928) examined anamorelin; nutritional interventions were assessed in 21 trials (30%); and exercise‐based interventions were assessed in 6 trials (8%). The remaining six trials (8%) assessed multimodal interventions. Among the objective measures of physical function (assessed as primary or secondary endpoints), HGS was most commonly examined (33 trials, n = 5081) and demonstrated a statistically significant finding in 12 (36%) trials (n = 2091). The 6MWT was assessed in 12 trials (n = 1074) and was statistically significant in 4 (33%) trials (n = 403), whereas SCP, TUG and SPPB were each assessed in 3 trials. KPS was more commonly assessed than the newer ECOG‐PS (16 vs. 9 trials), and patient‐reported EORTC QLQ‐C30 physical function was reported in 25 trials. HGS is the most commonly used physical function endpoint in cancer cachexia clinical trials. However, heterogeneity in study design, populations, intervention and endpoint selection make it difficult to comment on the optimal endpoint and how to measure this. We offer several recommendations/considerations to improve the design of future clinical trials in cancer cachexia

Skogens helsetilstand i Norge. Resultater fra skogskadeovervåkingen i 2020

Skogens helsetilstand påvirkes i stor grad av klima og værforhold, enten direkte ved tørke, frost og vind, eller indirekte ved at klimaet påvirker omfanget av soppsykdommer og insektangrep. Klimaendringene og den forventede økningen i klimarelaterte skogskader gir store utfordringer for forvaltningen av framtidas skogressurser. Det samme gjør invaderende skadegjørere, både allerede etablerte arter og nye som kan komme til Norge i nær framtid. I denne rapporten presenteres resultater fra skogskadeovervåkingen i Norge i 2020 og trender over tid

Brukarens roll i välfärdsforskning och utvecklingsarbete

Tekstene er fra forelesninger samt fra doktorantkurset "Brukarmedverkan i forskning och utvecklingsarbete inom hälso- och sjukvård, socialt arbete och omsorg". Kurset ble avholdt våren 2009.Fra omslag: På 1980-talet blev ”brukare” ett modeord i offentlig förvaltning och förvaltningsforskning. Termen betecknar den som använder sig av välfärdsservice (jfr. engelskans service user), eller ”slutmottagare” av offentlig nyttighet eller åtgärd. Brukare av välfärdstjänster vet hur hjälp och service fungerar i praktiken och kan därför ge synnerligen viktig återkoppling enligt devisen: ”Den som har skorna på fötterna vet var de skaver”. Välfärdsorganisationer har all anledning att involvera brukare i planering och policyarbete i syfte att utveckla förmågan att göra rätt saker. Det finns inte mycket dokumentation och forskning kring brukarmedverkan i utvecklingsarbete och forskning på välfärdsområdet. I synnerhet saknas kunskap om hur välfärdstjänster tas emot och realiseras i brukarens livssammanhang. En ambition i doktorandkursen ”brukarmedverkan i forskning och utvecklingsarbete inom hälso- och sjukvård, socialt arbete och omsorg” var att samla och presentera kunskaper på området. Kursen genomfördes våren 2009 i ett unikt samarbete mellan Karlstads Universitet, Sheffield University i England, Högskolan i Hedmark i Norge, Hälsohögskolan i Jönköping och Högskolan i Borås/FoU Sjuhärad Välfärd. Texterna i denna bok härrör från kursens föreläsningar och paperarbeten. De ger många exempel på hur brukare kan involveras i forskning och utvecklingsarbete, och presenterar en rad praktiska metoder för brukarsamverkan. Boken rekommenderas till välfärdens politiker och yrkespersoner, till studenter som förbereder sig för välfärdens yrken liksom till forskare och utvecklingsarbetare som vill utveckla samarbete med brukare och brukarorganisationer. Den vänder sig givetvis även till brukare och brukarorganisationer som vill engagera sig i forskning och utvecklingsarbete

Appetite and dietary intake endpoints in cancer cachexia clinical trials: Systematic Review 2 of the cachexia endpoints series

There is no consensus on the optimal endpoint(s) in cancer cachexia trials. Endpoint variation is an obstacle when comparing interventions and their clinical value. The aim of this systematic review was to summarize and evaluate endpoints used to assess appetite and dietary intake in cancer cachexia clinical trials. A search for studies published from 1 January 1990 until 2 June 2021 was conducted using MEDLINE, Embase and Cochrane Central Register of Controlled Trials. Eligible studies examined cancer cachexia treatment versus a comparator in adults with assessments of appetite and/or dietary intake as study endpoints, a sample size ≥40 and an intervention lasting ≥14 days. Reporting was in line with PRISMA guidance, and a protocol was published in PROSPERO (2022 CRD42022276710). This review is part of a series of systematic reviews examining cachexia endpoints. Of the 5975 articles identified, 116 were eligible for the wider review series and 80 specifically examined endpoints of appetite (65 studies) and/or dietary intake (21 studies). Six trials assessed both appetite and dietary intake. Appetite was the primary outcome in 15 trials and dietary intake in 7 trials. Median sample size was 101 patients (range 40–628). Forty-nine studies included multiple primary tumour sites, while 31 studies involved single primary tumour sites (15 gastrointestinal, 7 lung, 7 head and neck and 2 female reproductive organs). The most frequently reported appetite endpoints were visual analogue scale (VAS) and numerical rating scale (NRS) (40%). The appetite item from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30/C15 PAL (38%) and the appetite question from North Central Cancer Treatment Group anorexia questionnaire (17%) were also frequently applied. Of the studies that assessed dietary intake, 13 (62%) used food records (prospective registrations) and 10 (48%) used retrospective methods (24-h recall or dietary history). For VAS/NRS, a mean change of 1.3 corresponded to Hedge's g of 0.5 and can be considered a moderate change. For food records, a mean change of 231 kcal/day or 11 g of protein/day corresponded to a moderate change. Choice of endpoint in cachexia trials will depend on factors pertinent to the trial to be conducted. Nevertheless, from trials assessed and available literature, NRS or EORTC QLQ C30/C15 PAL seems suitable for appetite assessments. Appetite and dietary intake endpoints are rarely used as primary outcomes in cancer cachexia. Dietary intake assessments were used mainly to monitor compliance and are not validated in cachexia populations. Given the importance to cachexia studies, dietary intake endpoints must be validated before they are used as endpoints in clinical trials

Quality of life endpoints in cancer cachexia clinical trials: systematic review 3 of the cachexia endpoints series

The use of patient‐reported outcomes (PROMs) of quality of life (QOL) is common in cachexia trials. Patients' self‐report on health, functioning, wellbeing, and perceptions of care, represent important measures of efficacy. This review describes the frequency, variety, and reporting of QOL endpoints used in cancer cachexia clinical trials. Electronic literature searches were performed in Medline, Embase, and Cochrane (1990–2023). Seven thousand four hundred thirty‐five papers were retained for evaluation. Eligibility criteria included QOL as a study endpoint using validated measures, controlled design, adults (>18 years), ≥40 participants randomized, and intervention exceeding 2 weeks. The Covidence software was used for review procedures and data extractions. Four independent authors screened all records for consensus. Papers were screened by titles and abstracts, prior to full‐text reading. PRISMA guidance for systematic reviews was followed. The protocol was prospectively registered via PROSPERO (CRD42022276710). Fifty papers focused on QOL. Twenty‐four (48%) were double‐blind randomized controlled trials. Sample sizes varied considerably (n = 42 to 469). Thirty‐nine trials (78%) included multiple cancer types. Twenty‐seven trials (54%) featured multimodal interventions with various drugs and dietary supplements, 11 (22%) used nutritional interventions alone and 12 (24%) used a single pharmacological intervention only. The median duration of the interventions was 12 weeks (4–96). The most frequent QOL measure was the EORTC QLQ‐C30 (60%), followed by different FACIT questionnaires (34%). QOL was a primary, secondary, or exploratory endpoint in 15, 31 and 4 trials respectively, being the single primary in six. Statistically significant results on one or more QOL items favouring the intervention group were found in 18 trials. Eleven of these used a complete multidimensional measure. Adjustments for multiple testing when using multicomponent QOL measures were not reported. Nine trials (18%) defined a statistically or clinically significant difference for QOL, five with QOL as a primary outcome, and four with QOL as a secondary outcome. Correlation statistics with other study outcomes were rarely performed. PROMs including QOL are important endpoints in cachexia trials. We recommend using well‐validated QOL measures, including cachexia‐specific items such as weight history, appetite loss, and nutritional intake. Appropriate statistical methods with definitions of clinical significance, adjustment for multiple testing and few co‐primary endpoints are encouraged, as is an understanding of how interventions may relate to changes in QOL endpoints. A strategic and scientific‐based approach to PROM research in cachexia trials is warranted, to improve the research base in this field and avoid the use of QOL as supplementary measures

"Integrering er ikke bare å sitte i samme rom, altså". En studie av lærernes erfaringer med integrering av fysisk funksjonshemmede elever i grunnskolen

Integration of children with disabilities is regulated through legislation aiming at normalising and improving children's quality of life. School is an important arena for realisation. The aim of the study is to examine how school implements the law and what experiences and reflections the teachers have made in order to develop a well functioning integration. The study included children who were totally or partly dependent on a wheel chair, but without cognitive impairment. No overview of children belonging to the relevant category exists. These data were, thus, collected in the county of Hordaland. 28 of 34 municipalities responded. 54 pupils belonged to the defined category. 10 teachers, 2 assistants and 1 pupil were interviewed. There was an obvious lack of planning in the implementation. It seems that children with physical impairment are anonymous at the community level and that no one had responsibility to follow up before or during school-time. Praxis in schools varied from total integration to segregation and special treatment. Integration was especially difficult in the activity based school agenda (e.g. breaks). The teacher/assistant had in several schools sole responsibility for interpreting and accomplishing the integration, without training or extra time for planning. Data indicates that a management taking responsibility, co-operation between professions and support from colleagues are important in developing a well-functioning integration. The data suggests that the national aim of integration has not been fulfilled, and there is a lack of method and a need to develop knowledge through research and praxis