"Karrierekompetanse, er det det vi har fått nå?" Karriereveiledning i gruppe på 10. trinn

Masteroppgaven handler om utvikling av karrierekompetanse gjennom veiledning i gruppe. Veiledningen har fokus på å styrke elevene i prosessen fram mot søknad til videregående opplæring. Empirien er fra en gruppe på seks elever i samme klasse på 10. trinn. Problemstillingen er: «Hvordan kan karriereveiledning i gruppe bidra til å utvikle karrierekompetanse hos elever på 10. trinn?» Aksjonsforskning er brukt som metode for å finne svar på problemstillingen, der SØT-modellen fungerer som en overordnet ramme for gjennomføringen. Jeg hadde et ønske om å utvikle egen praksis sammen med elevene, og det har vært et praktisk fokus på veiledningene. Det har vært gjennomført ulike karrierelæringsaktiviteter som utgangspunkt for samtale og refleksjon. Prosjektet ble avsluttet med et fokusgruppe-intervju, for at elevenes stemme skulle komme godt fram. I lys av karrierelæringsteori har jeg analysert og drøftet innsamlet materiale. Ut fra dette har jeg tre hovedfunn som bidrar til å belyse problemstillingen. Funnene viser at karriereveiledning i gruppe bidrar til kunnskap om muligheter i videregående skole, bedre kjennskap til seg selv og sine medelever, samt at gruppa påvirker elevenes valg. Videre har jeg to hovedfunn som viser at trygg atmosfære og tydelig ledelse er forutsetninger for at veiledning i gruppe skal fungere.My master thesis is about the development of career management skills through guidance in groups. The guidance has focused on empowering the pupils in the process of applying for upper secondary education and training. My empiric data is from a group of six pupils in the same class in the last year of lower secondary school. My problem statement is: “How can career guidance in groups contribute to developing career management skills for pupils in the last year of lower secondary school?” Action research is used as a method to answer the problem statement, and the Norwegian SØT-model has been used as a frame for the process. I wanted to develop my own practice together with the students, and I have kept a practical perspective during our guidance sessions. I have carried out various career learning activities, followed by discussion and reflection in the group. At the end of the project, I conducted a focus group interview, to make sure the pupils’ voices came through. I have used career learning theory to analyze and discuss the collected data. My project has led to three main findings that relates to the problem statement. The findings are that career guidance in groups increases the pupils’ knowledge about the possibilities in upper secondary school. Furthermore, they get more knowledge about themselves and their fellow pupils. The last main finding is that the group itself affects the pupils’ decisions. In addition, I have two findings that show that it is necessary to establish a safe environment and have a clear management of the group for group guidance to be successful

Vurdering av smerte hos pasienter med kognitiv svikt på postoperativ avdeling -en forenklet kunnskapsoppsummering

Bakgrunn: Verdens befolkning blir eldre og stadig flere eldre mottar ulik form for kirurgi. Risikoen for at disse pasientene har en form for kognitiv svikt, er større enn hos yngre pasientgrupper. Fare for utvikling av postoperativ delir øker også med pasientens alder. Ved kognitiv svikt er ikke alltid pasienten i stand til å uttrykke at de er smertepåvirket. Hensikt: Å bidra til økt kunnskap om tema ved å gjøre en forenklet kunnskapsoppsummering om smertevurdering av pasienter med kognitiv svikt på postoperativ avdeling. Det er og et mål å kunne anbefale ett smertevurderingsverktøy til bruk i denne settingen. Metode: Vi har gjennomført en forenklet kunnskapsoppsummering i form av Restricted review. Søk ble gjennomført i Embase, CINAHL, Ovid MEDLINE (R) ALL og British Nursing Index. Søkene resulterte i 789 antall artikler og 10 kvantitative studier ble inkludert. Resultat: Smertevurdering hos pasienter med kognitiv svikt på en postoperativ avdeling kan beskrives som en vanskelig oppgave. Selvrapportering av smerte er den sikreste metoden når smerte skal vurderes, også hos pasienter med kognitiv svikt. Når pasienten ikke er i stand til å selvrapportere smerte brukes observasjon. Det finnes flere smertevurderingsverktøy som brukes både ved selvrapportering og observasjon, disse verktøyene har ulike svakheter. Utilstrekkelig smertevurdering kan gi ulike konsekvenser. Konklusjon: Når smerte skal vurderes hos pasienter med kognitiv svikt bør det alltid forsøkes selvrapportering. Dersom selvrapportering ikke er mulig, kan ett observasjonsverktøy tas i bruk. Det er behov for ytterligere forskning på effekt og pålitelighet av disse for å kunne gi anbefaling om ett konkret smertevurderingsverktøy som vil være til støtte for intensivsykepleier i arbeidet.Bacground: The world's population is aging, and an increasing number of older individuals are undergoing surgery. The risk of these patients having a cognitive impairment is greater than in younger patients. The risk of developing postoperative delirium also increases with the patient's age. In cases of cognitive impairment, the patient may not always be able to express their experiencing pain. Purpose: To provide a simplified summary of knowledge about pain assessment of patients with cognitive impairment in a postoperative setting, contribute to increase awareness of the topic. And give a recommendation on a pain assessment tool for use in this setting. Method: We conducted a simplified knowledge summary in the form of a restricted review. Searches were conducted in Embase, CINAHL, Ovid MEDLINE (R) ALL, and British Nursing Index. The searches resulted in 789 articles, and 10 quantitative studies were included. Results: Pain assessment in patients with cognitive impairment in a postoperative setting can be a challenging task. Self-reporting of pain is the most reliable method when assessing pain, even in patients with cognitive impairment. When the patient is unable to self-report pain, an observation tool is used. There are several pain assessment tools used for both self-reporting and observation, these tools present different challenges. Inadequate pain assessment can result in different consequences. Conclusion: When assessing pain in patients with cognitive impairment, self-reporting should always be attempted first. If self-reporting is not possible, an observational tool can be used. Further research is needed on the effectiveness and reliability of these tools. So that it is possible to provide a recommendation for a specific pain assessment tool that will support the intensive care nurse in their work

The deleterious effect of crossfostering in rat pups on hypoxic-ischemic injury tolerance and hypothermic neuroprotection

We study the effect of hypothermia (HT) following hypoxic-ischemic (HI) brain injury in postnatal day 7 (P7) rats. In 2015, new European Union animal transport regulations prompted a change in practice at the breeding facility, which henceforth crossfostered P3 litters to P8 older lactating dam prior to transportation. It is generally assumed that crossfostering does not significantly affect the experimental results. The aim of this study was to examine whether crossfostering affects our model consistency by modifying injury susceptibility and hypothermic neuroprotection. We analysed 219 pups (56 litters) from 11 experiments conducted between 2013 and 2015: 73 non-crossfostered and 146 crossfostered pups. At P7, all pups underwent unilateral common carotid artery ligation followed by 50min of hypoxia (8% O2, 36°C). Immediately after this mild insult, the pups were randomised to post-insult normothermia (NT) or HT treatment. Pups were culled at P14. Injury was assessed by area loss of the ipsilateral hemisphere and histopathology scoring of hippocampus, cortex, thalamus, and basal ganglia. Crossfostered pups had double the injury compared to non-crossfostered pups irrespective of treatment group. Hypothermic neuroprotection was statistically significant, but with a smaller and less consistent effect in crossfostered pups (relative neuroprotection 16% vs. 31% in non-crossfostered). These results demonstrate hypothermic neuroprotection following a mild HI insult. A representative subset of 41 animals were also assessed for evidence of microglial reactivity, however no detectable difference in microglial reactivity was observed between any of the groups. In conclusion, crossfostering alters outcomes in our established model through reduced insult tolerance and variable neuroprotection. Crossfostering as a common breeding practice is a largely unexplored variable in animal research that may result in invalid research conclusions if inadequately adjusted for by larger group sizes. As a result, crossfostering is likely to be inconsistent with the principles of replacement, reduction, and refinement

Xenon depresses aEEG background voltage activity whilst maintaining cardiovascular stability in sedated healthy newborn pigs

Changes in electroencephalography (EEG) voltage range are used to monitor the depth of anaesthesia, as well as predict outcome after hypoxia-ischaemia in neonates. Xenon is being investigated as a potential neuroprotectant after hypoxic-ischaemic brain injury, but the effect of Xenon on EEG parameters in children or neonates is not known. This study aimed to examine the effect of 50% inhaled Xenon on background amplitude-integrated EEG (aEEG) activity in sedated healthy newborn pigs.Five healthy newborn pigs, receiving intravenous fentanyl sedation, were ventilated for 24 h with 50%Xenon, 30%O2 and 20%N2 at normothermia. The upper and lower voltage-range of the aEEG was continuously monitored together with cardiovascular parameters throughout a 1 h baseline period with fentanyl sedation only, followed by 24 h of Xenon administration.The median (IQR) upper and lower aEEG voltage during 1 h baseline was 48.0 μV (46.0-50.0) and 25.0 μV (23.0-26.0), respectively. The median (IQR) aEEG upper and lower voltage ranges were significantly depressed to 21.5 μV (20.0-26.5) and 12.0 μV (12.0-16.5) from 10 min after the onset of 50% Xenon administration (p=0.002). After the initial Xenon induced depression in background aEEG voltage, no further aEEG changes were seen over the following 24h of ventilation with 50% xenon under fentanyl sedation. Mean arterial blood pressure and heart rate remained stable.Mean arterial blood pressure and heart rate were not significantly influenced by 24h Xenon ventilation. 50% Xenon rapidly depresses background aEEG voltage to a steady ~50% lower level in sedated healthy newborn pigs. Therefore, care must be taken when interpreting the background voltage in neonates also receiving Xenon

Xenon combined with therapeutic hypothermia is not neuroprotective after severe hypoxia-ischemia in neonatal rats

Therapeutic hypothermia (TH) is standard treatment following perinatal asphyxia in newborn infants. Experimentally, TH is neuroprotective after moderate hypoxia-ischemia (HI) in seven-day-old (P7) rats. However, TH is not neuroprotective after severe HI. After a moderate HI insult in newborn brain injury models, the anesthetic gas xenon (Xe) doubles TH neuroprotection. The aim of this study was to examine whether combining Xe and TH is neuroprotective as applied in a P7 rat model of severe HI.120 P7 rat pups underwent a severe HI insult; unilateral carotid artery ligation followed by hypoxia (8% O2 for 150min at experimental normothermia (NT-37: Trectal 37°C). Surviving pups were randomised to immediate NT-37 for 5h (n = 36), immediate TH-32: Trectal 32°C for 5h (n = 25) or immediate TH-32 plus 50% inhaled Xe for 5h (n = 24). Pups were sacrificed after one week of survival. Relative area loss of the ligated hemisphere was measured, and neurons in the subventricular zone of this injured hemisphere were counted, to quantify brain damage.Following the HI insult, median (interquartile range, IQR) hemispheric brain area loss was similar in all groups: 63.5% (55.5-75.0) for NT-37 group, 65.0% (57.0-65.0) for TH-32 group, and 66.5% (59.0-72.0) for TH-32+Xe50% group (not significant). Correspondingly, there was no difference in neuronal cell count (NeuN marker) in the subventricular zone across the three treatment groups.Immediate therapeutic hypothermia with or without additional 50% inhaled Xe, does not provide neuroprotection one week after severe HI brain injury in the P7 neonatal rat. This model aims to mimic the clinical situation in severely asphyxiated neonates and treatment these newborns remains an ongoing challenge

Significance of progesterone receptors (PR-A and PR-B) expression as predictors for relapse after successful therapy of endometrial hyperplasia: a retrospective cohort study

This is the peer reviewed version of the following article: Sletten, E.T., Arnes, M., Lyså, L.M., Larsen, M. & Ørbo, A. (2019). Significance of progesterone receptors (PR-A and PR-B) expression as predictors for relapse after successful therapy of endometrial hyperplasia: a retrospective cohort study. BJOG: an International Journal of Obstetrics and Gynaecology, 126(7), 936-943, which has been published in final form at https://doi.org/10.1111/1471-0528.15579. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Objective - After successful progestin therapy for endometrial hyperplasia (EH), the risk of relapse remains. We aimed to assess if immunohistochemical (IHC) expression of progesterone receptor isoforms, PR‐A and PR‐B, in endometrial glands and stroma in pre‐treatment endometrial biopsies was related to relapse of EH. Design and setting - Biopsy material originated from women with low‐risk and medium‐risk EH recruited to a recent Norwegian multicentre randomised trial. Participants (n = 153) had been treated for 6 months with three different progestin regimens. Population - One hundred and thirty‐five of the 153 women achieved therapy response and underwent follow up for 24 months after therapy withdrawal. Fifty‐five women relapsed during follow up. Pre‐treatment endometrial biopsies from 94 of the 135 responding women were available for IHC staining. Methods - Immunohistochemical staining was performed separately for PR‐A and PR‐B and IHC expression was evaluated in endometrial glands and stroma by a histological score (H‐score) using light microscopy. Main outcome measure - Immunohistochemical expression of PR‐A and PR‐B in endometrial glands and stroma in women with or without relapse of EH. Results - Low PR‐A in endometrial glands (P = 0.013) and stroma (P 1 (19%; P < 0.001). Conclusion - Immunohistochemical expression of PR‐A and PR‐B in pre‐treatment endometrial biopsy proves valuable as a predictor of relapse in EH