Views of young people with chronic conditions on transition from pediatric to adult health services

PURPOSE: This study sought to identify and describe the views of young people with chronic conditions about the transition from pediatric to adult services. METHODS: Q methodology was used to identify young people’s views on transition. A set of 39 statements about transition was developed from an existing literature review and refined in consultation with local groups of young people. Statements were printed onto cards and a purposive sample of 44 young people with chronic health conditions was recruited, 41 remaining in the study. The young people were asked to sort the statement cards onto a Q-sort grid, according to their opinions from “strongly disagree” to “strongly agree.” Factor analysis was used to identify shared points of view (patterns of similarity between individual’s Q-sorts). RESULTS: Four distinct views on transition were identified from young people: (1) “a laid-back view of transition;” (2) “anxiety about transition;” (3) “wanting independence and autonomy during transition;” and (4) “valuing social interaction with family, peers, and professionals to assist transition.” CONCLUSIONS: Successful transition is likely to be influenced by how young people view the process. Discussing and understanding young people’s views and preferences about transition should help clinicians and young people develop personalized planning for transition as a whole, and more specifically the point of transfer, leading to effective and efficient engagement with adult care

DPA-Resistant ASIC implementation of AES

With the increased proliferation of small embedded systems connected to the internet and the internet-of-things, the security concerns becomes increasingly important. Encryption, and the protection of encrypted circuits can be of great importance. With this thesis the aim was to design an encryption chip that was able to operate without leaking sensitive information even in the presence of a malicious adversary, specifically to be able to withstand differential power analysis attacks. A masked 128-bit data-path AES encryption and decryption architecture is proposed, supporting AES-128, 192 and 256 using cipher-block chaining mode of operation. Synthesized to 65nm technology, the system achieves a keymode- dependent throughput of 0.99-1.32 Gb/s operating at 400MHz with an average power consumption of 167.9mW. Our masking approach should withstand second order DPA-attacks at an area cost of 486% compared to the unmasked equivalent circuit

From cars to bikes : the feasibility and effect of using e-bikes, longtail bikes and traditional bikes for transportation among parents of children attending kindergarten : design of a randomized cross-over trial

Background: The present study aims to increase bicycling and level of physical activity (PA), and thereby promote health in parents of toddlers, by giving access to different bicycle types. There is a need for greater understanding of e-bikes and their role in the transportation network, and further effects on PA levels and health. Moreover, longtail bikes could meet certain practical needs not fulfilled by e-bikes or traditional bikes, hence increased knowledge regarding their feasibility should be obtained. No previous studies have investigated whether providing an e-bike or a longtail bike over an extended period in a sample of parents of toddlers influence objectively assessed amount of bicycling and total PA level, transportation habits, cardiorespiratory fitness, body composition and blood pressure. Methods: A randomized cross-over trial will be performed, entailing that participants in the intervention group (n = 18) complete the following intervention arms in random order: (i) three months access to an e-bicycle with trailer for child transportation (n = 6), (ii) three months access to a longtail bicycle (n = 6), and (iii) three months access to a regular bicycle with trailer (n = 6), in total nine months. Also, a control group (n = 18) maintaining usual transportation and PA habits will be included. A convenience sample consisting of 36 parents of toddlers residing in Kristians and municipality, Southern Norway, will be recruited. Total amount of bicycling (distance and time), total level of PA, and transportation habits will be measured at baseline and in connection to each intervention arm. Cardiorespiratory fitness, body composition and blood pressure will be measured at baseline and post-intervention. Main outcome will be bicycling distance and time spent cycling. Discussion: New knowledge relevant for the timely issues of public health and environmental sustainability will be provided among parents of toddlers, representing a target group of greatest importance. There is a call for research on the influence of e-bikes and longtail bikes on travel behavior and PA levels, and whether voluntary cycling could improve health. If the present study reveals promising results, it should be replicated in larger and more representative samples. Eventually, inclusion in national public health policies should be considered

Gynecological cancer survivors' experiences with sexual health communication in nurse-led follow-up consultations

Introduction Gynecological cancer and its treatment may cause sexual difficulties in terms of physical and psychosocial health. Considering the essential role that nurses play in cancer care, they are well positioned to be ideal providers for addressing sexual health concerns in the follow-up phase of gynecological cancer. The aim of this study was to gain in-depth knowledge of how gynecological cancer survivors experience sexual health communication in nurse-led follow-up consultations. Material and methods Using a qualitative hermeneutic approach, we conducted individual semi-structured interviews with 17 women from five different hospitals in Norway between April 4, 2022, and June 2, 2022. The women participated in a large intervention study on cancer follow-up that included sexual health as one of several topics addressed by trained nurses in three consultations in the first year of follow-up. A five-stage Gadamerian-inspired research method was utilized for data collection and analysis. Results We identified three themes: (1) the importance of nurses listening to the women's own perceptions of sexuality, (2) post-treatment sexual challenges influence the women's need to communicate about sexual health, and (3) nursing communication can help women regain their sexual health. Conclusions Women who have undergone treatment for gynecological cancer find communication with trained nurses regarding sexual health beneficial. We recommend integration of trained nurses in the follow-up team. The nurses should adjust communication according to each gynecological cancer survivor's unique understanding of sexuality and inform women with sexual health concerns at that end of treatment, that sexual health can improve during follow-up.publishedVersio

Parents and nurses in a neonatal intensive care unit: the development of a mutual beneficial partnership in the care of the infant

Ph.D. Thesis, University of Oslo - Faculty of Medicine, Institute of Health and Society”Foreldre og sykepleiere på en nyfødtavdeling - utvikling av et likeverdig partnerskap i omsorgen for barnet” Studien viser hvor viktig det er umiddelbart å involvere foreldre i omsorgen for det premature barnet, og at ansvar avklares ved at sykepleier og foreldre i fellesskap blir enige om hvordan, på hvilke områder og i hvilken grad foreldre ønsker å delta. Etter fødselen og når barnet er akutt sykt vil sykepleier ta hovedansvaret mens foreldre oppfordres til å være til stede og gi barnet fysisk kontakt. Studien viser hvor krevende starten oppleves for foreldrene, og at sykepleiers tidlige involvering av far positivt påvirker både mor, barn og far. Etter hvert som barnet stabiliseres vil gradvis mer av ansvaret for pleien overføres til foreldrene. Denne prosessen med endrede ansvarsforhold oppleves som utfordrende for begge parter, og preges av spørsmål som ”hvem har ansvar for hva”, ”hvordan balansere mellom en profesjonell og en personlig relasjon”, og ”hvem bestemmer hvis foreldre og sykepleiere er uenige om hva som er best for barnet”. Nyfødtavdelingens åpenhet og gjennomsiktighet kan bidra til å skape trygghet og tillitt i denne prosessen. På den andre siden kan åpenhet være både avslørende og forpliktende og dermed øke belastningen for begge parter. Tidligere studier viser stor enighet om at familiesentrert tilnærming basert på likeverd og samarbeid er den beste tilnærming til foreldre på nyfødtavdelinger. På tross av dette er det et økende fokus på hvor komplekst dette samarbeidet kan være, og uklare roller og manglende samarbeid er ofte beskrevet. Hensikten med denne studien var å utforske hvordan foreldre og sykepleiere opplever samarbeidet, og hvordan dette utvikler seg i løpet av barnets innleggelse. Data ble innsamlet gjennom observasjoner og intervjuer av mødre, fedre og sykepleiere

Lived Experience of Caregivers of Family-Centered Care in the Neonatal Intensive Care Unit: “Evocation of Being at Home

Background: In recent decades, family-centered care (FCC) has come to be known, accepted, and reported as the best care strategy for admitted children and their families. However, in spite of the increasing application of this approach, the experiences of the caregivers have not yet been studied. Objectives: The present study aimed at the description and interpretation of the FCC experience in two neonatal intensive care units (NICU) at Shiraz University of Medical Sciences. Methods: This study was conducted through the hermeneutic phenomenological approach. Semi-structured interviews were conducted with 17 professional and familial caregivers, and their interactions were observed in three work shifts. The interviews were audiotaped and transcribed verbatim. After observations, field notes were also written. Finally, the data were analyzed through van Manen’s methodology. Results: One of the essential themes that emerged in this study was the “evocation of being at home” among familial and even professional caregivers. This theme had three subthemes: i.e., “meta-family interaction,” “comprehensive support,” and “reconstruction of a normal family.” Accordingly, FCC eliminated borders between professional and non-professional caregivers and built close relationships among them in the NICU. It also provided for the needs of neonates, their families, and even professional caregivers through perceived and received support. Conclusions: Parents of the neonates admitted to the NICU experience hard moments. They not only play the role of primary caregivers, but they also receive the care. Focusing on the different meanings of this care from the caregivers’ points of view and having managers provide certain requirements can guarantee the establishment of comprehensive care for clients and proper support for the staff in this uni

Nurse–patient sexual health communication in gynaecological cancer follow-up: A qualitative study from nurses' perspectives

Aim To explore nurse–patient sexual health communication from the perspectives of nurses trained to address sexual health in gynaecological cancer follow-up. Design A qualitative hermeneutic approach. Methods Individual semi-structured interviews with 10 nurses at five different hospitals in Norway were conducted in March and April 2021. A Gadamerian-inspired research method was used in the analysis. Results Three main themes with six sub-themes were identified. The three main themes were: (1) building relationships through communication, (2) practice makes perfect—the importance of experience and knowledge, and (3) personal attitudes as promoters or inhibiters of sexual health communication. Conclusion This study provides valuable insights into nurse–patient sexual health communication from the perspectives of nurses. The nurses in this study experienced the importance of having a good, respectful nurse–patient relationship as the foundation for sexual health communication. The professional confidence gained through experience and knowledge was emphasized, including the significance of how attitudes and taboos can influence sexual health communication. Impact The main findings of this study indicate that training in sexual health communication and the possibility of addressing sexual health repeatedly give nurses skills and professional confidence to address sexual health in cancer follow-up. Our study indicates that sexual health communication can be achieved in a clinical setting without being overly resource demanding. Our results may also motivate nurses to enhance their knowledge about sexual health in cancer follow-ups.publishedVersio

Self-reported Sexual Health-Related Outcomes in Gynecological Cancer Survivors: Results from a Quasi-experimental Multicenter Intervention Study on Follow-up after Gynecological Cancer Treatment

Background: Gynecological cancer survivors often face sexual health challenges posttreatment, making interventions to address these issues essential. Objective: The aim of this study was to investigate changes in sexual health–related outcomes among gynecological cancer survivors comparing 2 different follow-up models. Methods: This preplanned substudy utilized data from the Lifestyle and Empowerment Techniques in Survivorship of Gynecologic Oncology study. Participants were assigned to either the intervention or control group based on their treatment hospital. The control group received standard follow-up care, whereas the intervention group received shared follow-up care with sexual health communication. Analyses included 686 participants with sexual activity as the primary outcome. Secondary outcomes included feelings of reduced physical attractiveness for all, sexual enjoyment and vaginal dryness (sexually active participants), and reasons for sexual inactivity (sexually inactive participants). Assessments were conducted at the end of treatment and at 6 and 12 months posttreatment. Results: No statistically significant group differences were found in any of the outcomes at 12 months. The intervention group showed a more favorable trend in sexual activity at 6 months, not sustained at 12 months. Both groups experienced an increase in vaginal dryness. The absence of a partner was the most common reason for sexual inactivity. Conclusions: Findings suggest that nurse-led sexual health communication during routine follow-up consultations may have a limited impact on the sexual health–related outcomes measured in this study. Implications for Practice: More intensive and individualized interventions may be necessary for significant improvements in the outcomes of this study.publishedVersio

Barnehagebarns estetiske opplevelser

I denne oppgaven har jeg rettet søkelyset mot hvordan barnehagebarn har uttrykt sine estetiske opplevelser på Rockheim, det nasjonale museet for populærmusikk. Sentralt er barn, musikk og museum. Det teoretiske grunnlaget for oppgaven er basert på estetisk erfaring med særlig vekt på John Deweys arbeid. Jeg viser videre til begrep som affekter og affordanse. Gjennom barns lekne og kroppslige tilnærming til verden knytter jeg oppgaven til lek og kroppsfenomenologi. Barn utrykker seg med et mangfold av måter. Derfor understøttes den teoretiske delen også av multimodalitet. For å belyse problemstillingen har fire barnehagebarn og deres barnehagepedagog vært på omvisninger under tre ulike besøk på Rockheim. Kunnskap om barnas uttrykk er samlet gjennom videoobservasjon. Jeg har hatt et spesielt blikk på barnas uttalelser, verbale og nonverbale uttrykk og kroppsspråk som blikk, lyder, smil, latter og gester. I tillegg observert plassering av kroppen i forhold til rom, gjenstander og hverandre. Ved gjennomsyn av videoene har jeg tolket betydningen barna selv har lagt i sine handlinger. I analyseprosessen har jeg beskrevet deres opplevelser og hvordan det har kommet til uttrykk. Ut fra dette har jeg utviklet tema som beskriver barnas opplevelser i møte med utstillingene. De uttrykker seg gjennom undring, entusiasme, lek, musisering og har samforståelse da de viser et sterkt behov for å dele opplevelser. Barnas estetiske opplevelser bidrar til kunnskap om barns perspektiver i museumsbesøk. Min forskning vil forhåpentligvis spore til nye refleksjoner i utviklingsarbeidet for og med barn på museum.publishedVersio