Ala Bassam Qadan, Mohammad Ibrahim Zafar, Mohammed Anass Tanveer
et al.
Abstract Background Idiopathic retinal vasculitis, aneurysms and neuroretinitis (IRVAN) is a rare ocular condition with an unresolved aetiology, different treatment practices and a risk of severe vision loss in refractory cases. There is sparse literature on the use of biologics, specifically TNF- α inhibitors, in the management of IRVAN, emphasising the need for additional evidence in this therapeutic area. Case presentation We present a 49-year-old otherwise healthy Norwegian woman who experienced gradual bilateral visual deterioration and was diagnosed with IRVAN syndrome following extensive systemic and ophthalmological evaluation. Despite treatment with monthly bilateral intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections, which were initially combined with systemic corticosteroids and later with peripheral scatter laser photocoagulation, disease control was not achieved. At nadir, the best-corrected visual acuity (BCVA) was 0.4 in OD and 0.3 in OS. Eight months after treatment initiation, the TNF-α inhibitor adalimumab was introduced in combination with methotrexate, and the subsequent clinical course was characterised by substantial and sustained improvement. The macroaneurysms regressed and the vasculitis subsided, leading to complete resolution of the peripapillary oedema and improvement of visual acuity to 0.9–1.0 bilaterally. At two years, the patient remained stable on adalimumab monotherapy without further intervention. Conclusions Adalimumab may represent a safe and effective option for managing refractory IRVAN syndrome and could address the underlying pathology. Our findings underscore the importance of individualised therapeutic approaches and advocate further investigation of TNF-α inhibitors as a viable treatment option for IRVAN.
Ingvild Brenna, Bente Prytz Mjølstad, Ingrid Baasland
et al.
Background A gradual transition from cytology-based screening to Human Papillomavirus (HPV) testing within the cervical cancer screening program has resulted in new routines for follow-up, and new challenges for communication of abnormal test results. General practitioners (GPs) have an important role in the screening program, as they are the primary performers of the screening test, they communicate test results to patients and refer them to a specialist if necessary.Objective The study explores what consequences the introduction of HPV testing in the cervical cancer screening programme has for GPs’ professional practice and communication with patients.Design, setting and subjects Qualitative focus group study including 32 GPs in Central Norway who conduct screening tests within the cervical cancer screening programme.Results The overall concern of the GPs was to communicate abnormal test results in a way that ensured appropriate follow-up, without causing unnecessary worry. Staying updated on revised screening guidelines and maintaining their role as medical experts when communicating results to patients could be challenging. GPs shared the responsibility for follow-up after an abnormal result between themselves, the women, and the screening programme. Reciprocal familiarity between GP and patient guided decisions about what and how to communicate, and how to balance the shared responsibility. GPs used their professional judgement to assess patients’ informational needs and tailored information accordingly.Conclusion GPs manage the challenges of communicating abnormal screening results by sharing responsibility and using their professional judgement. Strengthening support and communication tools may enhance their role in the screening programme.
Mille Sofie Stenmarck, David GT Whitehurst, Hilde Lurås
et al.
Abstract Background Demand for healthcare outweighs available resources, making priority setting a critical issue. ‘Severity’ is a priority-setting criterion in many healthcare systems, including in Norway, Sweden, the Netherlands, and the United Kingdom. However, there is a lack of consensus on what severity means in a healthcare context, both in the academic literature and in policy. Further, while public preference elicitation studies demonstrate support for severity as a relevant concern in priority setting, there is a paucity of research on what severity is taken to mean for the public. The purpose of this study is to explore how severity is conceptualised by members of the general public. Methods Semi-structured group interviews were conducted from February to July 2021 with members of the Norwegian adult public (n = 59). These were transcribed verbatim and subjected to thematic analysis, incorporating inductive and deductive elements. Results Through the analysis we arrived at three interrelated main themes. Severity as subjective experience included perceptions of severity as inherently subjective and personal. Emphasis was on the individual’s unique insight into their illness, and there was a concern that the assessment of severity should be fair for the individual. The second theme, Severity as objective fact, included perceptions of severity as something determined by objective criteria, so that a severe condition is equally severe for any person. Here, there was a concern for determining severity fairly within and across patient groups. The third theme, Severity as situation dependent, included perceptions of severity centered on second-order effects of illness. These included effects on the individual, such as their ability to work and enjoy their hobbies, effects on those surrounding the patient, such as next of kin, and effects at a societal level, such as production loss. We also identified a concern for determining severity fairly at a societal level. Conclusions Our findings suggest that severity is a polyvalent notion with different meanings attached to it. There seems to be a dissonance between lay conceptualisations of severity and policy operationalisations of the term, which may lead to miscommunications between members of the public and policymakers.
Ylva Ran, Pierre Van Rysselberge, Biljana Macura
et al.
Abstract Background The global food system is inflicting substantial environmental harm, necessitating a shift towards more environmentally sustainable food consumption practices. Policy interventions, for example, information campaigns, taxes and subsidies and changes in the choice context are essential to stimulate sustainable change, but their effectiveness in achieving environmental goals remains inadequately understood. Existing literature lacks a comprehensive synthesis of evidence on the role of public policies in promoting sustainable food consumption. Our systematic map addressed this gap by collecting and categorising research evidence on public policy interventions aimed at establishing environmentally sustainable food consumption patterns, in order to answer the primary research question: What evidence exists on the effects of public policy interventions for achieving environmentally sustainable food consumption? Methods Searches for relevant records (in English) were performed in WoS, Scopus, ASSIA, ProQuest Dissertation and Theses, EconLit, Google Scholar and in bibliographies of relevant reviews. A grey literature search was also performed on 28 specialist websites (searches were made in the original language of the webpages and publications in English, Swedish, Danish and Norwegian were eligible) and Google Scholar (search in English). Screening was performed at title/abstract and full-text levels, with machine learning-aided priority screening at title/abstract level. Eligibility criteria encompassed settings, interventions (public policies on sustainable food consumption), target groups and outcomes. No critical appraisal of study validity was conducted. Data coding covered bibliographic details, study characteristics, intervention types and outcomes. Evidence was categorised into intervention types and subcategories. Visual representation utilised bar plots, diagrams, heatmaps and an evidence atlas. This produced a comprehensive overview of effects of public policy interventions on sustainable food consumption patterns. Review findings The evidence base included 227 articles (267 interventions), with 92% of studies in high-income countries and only 4% in low-income countries. Quantitative studies dominated (83%), followed by mixed methods (16%) and qualitative studies (1%). Most interventions were information-based and 50% of reviewed studies looked at labels. Information campaigns/education interventions constituted 10% of the sample, and menu design changes and restriction/editing of choice context 8% each. Market-based interventions represented 13% of total interventions, of which two-thirds were taxes. Administrative interventions were rare (< 1%). Proxies for environmental impact (85%) were more frequent outcome measures than direct impacts (15%). Animal-source food consumption was commonly used (19%) for effects of interventions on, for example, greenhouse gas emissions. Most studies used stated preferences (61%) to evaluate interventions. Conclusions The literature assessing policies for sustainable food consumption is dominated by studies on non-intrusive policy instruments; labels, information campaigns, menu design changes and editing choice contexts. There is a strong need for research on sustainable food policies to leave the lab and enter the real world, which will require support and cooperation of public and private sector stakeholders. Impact evaluations of large-scale interventions require scaling-up of available research funding and stronger multidisciplinary research, including collaborations with industry and other societal actors. Future research in this field should also go beyond the European and North American context, to obtain evidence on how to counteract increasing environmental pressures from food consumption worldwide.
Bianca Kronlöf debuterade nyligen som författare med ett feministiskt manifest mot mäns våld. Även om hennes verk är ett bidrag till samhällsdebatten, visar det tydligt fram drag av Kronlöfs humor. Liv Strömquist är känd för sin feministiska satir i form av grafiska romaner, i vilka hon sammanställer humor och bitande feministisk kritik med historiska, filosofiska och sociologiska teorier. I min artikel undersöker jag det specifikt feministiska i deras humor och hur de använder sig av den för att främja sina (feministiska) mål. Jag kommer även att besvara frågan om humor är ett adekvat verktyg för feministisk aktivism.
Medan nya studier i feministisk teori uppmärksammar vikten av feministisk humor i skämt, stand-up och i litterära verk, finns det ännu inte många studier av grafiska romaner. Genom att särskilt fokusera på sådana mindre utforskade medier och aktivisters kombination av olika medier, kommer jag att visa hur dessa kulturella praktiker är särskilt lämpliga för mångtydiga artikulationer och mångbottnade uttryck av feministiska idéer.
The volume Rewriting Norse Mythology in Contemporary Norwegian Literature. The Search for Identity in a Multicultural World by Cristina Vișovan appeared at the publishing house Casa Cărții de Știință from Cluj-Napoca, Romania, in the collection "Nordica”, the only one of its kind dedicated entirely to Nordic literature at a national level, and has at its basis Mrs. Vișovan’s doctoral thesis that was successfully defended in 2019 at Babeș-Bolyai University under the supervision of the esteemed Professor Sanda Tomescu Baciu. Mrs. Vișovan is a graduate of the program English language and literature and Norwegian language and literature from the same university. Later, she continued her studies at the University of Oslo, where Mrs. Vișovan is a graduate of Viking and Medieval Studies.
The main aim of this empirical study is to examine short and long run volatility movements based on a case study for Norwegian Stock Market, i.e. Oslo Stock Exchange. The econometric framework includes a series of statistical tests, ARIMA models and GARCH family models for the sample period from March 2013 to October 2021. The empirical results were influenced by the impact of COVID19 pandemic. This research paper also contributes to the existing literature regarding the influence of extreme events, such as COVID-19 pandemic on the behavior of developed stock markets, like Norwegian Stock Market.
On 28-29 May 2020 in full Coronavirus pandemic upsurge and lockdown conditions the Eleventh Conference on Baltic and Nordic Studies gathered on Zoom instead of The Palace of Culture and The Middle Age Citadel of Târgu Mureș as initially planned. The meeting was summoned in partnership with Rethinking Europe in order to reflect, from the perspective of the Baltic Sea Region, upon the Old Continent in the context of Brexit and the pandemic. Questions on the impact of the recent evolutions on Baltic and Scandinavian states have been raised, but the perspective was much wider looking on how the countries of this region responded to structural changes or alterations of the international environment over time.
The two plenary sessions on the EU after Brexit: Perspectives on the Future of Europe and Constructions of Christian Identity and the Idea of the Holy Land in the Northern Periphery: The Sawley World Map in Twelfth-Century England appropriately mirrored the sequential diversity of the conference. Panels have been devoted to Encounters, fantasies and perceptions in shaping Europe, Rethinking Europe in Nordic and Baltic cultures, Rethinking the Baltic Sea Region in Europe during the interwar period, Rethinking Scandinavia and the Baltic Sea Region in Europe during the two world wars, Intercultural relations in the Nordic and Baltic countries, Reception of Nordic literature, New perspectives on Norwegian literature, Teaching and use of Nordic languages. The main theories, concepts and ideas presented are resumed in the Book of Abstracts published before the conference, while the full papers are assembled in volume 12, issues 1 and 2 of our biannual peer review journal.
In 2016, the Norwegian government announced that public health and life mastery would be an overarching topic in all the subjects in high schools. Empathy may predict mental health issues, and fiction can encourage empathy. This article illustrates narrative empathy through the Norwegian novel Begynnelser (Beginnings) (2017) by Carl Frode Tiller. The aim is, to give a theoretical account of combined methods and insights from literary studies and narrative medicine in order to investigate how narrative empathy can emphasize mental health and life mastery in Norwegian literature when taught in high school. The article draws upon the thoughts of Bloom, Nussbaum, van Lissa et al. and Bryant on empathy and its meaning, Suzanne Keen’s theory of narrative empathy and pedagogical perspectives from the field of narrative medicine, represented by Rita Charon. Begynnelser connects to the concept of life mastery and through a close reading of the novel in a sociocultural context, students can learn to recognize important details in the text. Character identification and narrative situation are two main techniques in narrative empathy and in the novel by Tiller. This article reflects upon, how students can identify with the main character, in terms of both categorical and situational empathy, and how the narrative situation can show the reader why the character’s life unfolded as it did. The teacher must adjust the texts and the tasks to the particular group of students, and remember that teaching should not be a therapy session.
Public aspects of medicine, Social sciences (General)
Silje Langseth Dahl, Rebekka Hylland Vaksdal, Mathias Barra
et al.
De siste årene har fosterreduksjon i økende grad vært gjenstand for debatt i Norge, og intensiteten nådde et foreløpig maksimum da Lovavdelingen leverte tolknings-uttalelsen § 2 - Tolkning av abortloven i 2016 som svar på at Helse- og omsorgs-departementet (i 2014) ba Lovavdelingen om å vurdere hvorvidt Lov om svangers-kapsavbrudd åpner for fosterreduksjon av friske fostre ved flerlings-vangerskap. Lovavdelingen konkluderte med at abortloven åpner for fosterreduksjon ved flerlingsvangerskap innenfor de rammene som loven ellers oppstiller. Debatten har ikke stilnet, og utover høsten 2018 ble den ytterligere tilspisset i forbindelse med KrFs veivalg og signaler fra Høyre om å vurdere å fjerne § 2.3c, samt å forby fosterreduksjon.
Mange av argumentene i fosterreduksjonsdebatten fremstår tilsynelatende like de argumentene som verserer i abortdebatten, og det mangler en analyse av hva som stiller seg annerledes ved fosterreduksjon. Målet med denne artikkelen er følgelig å undersøke hvorvidt det finnes en moralsk relevant forskjell mellom abort og fosterreduksjon av friske fostre. Vi tar for oss typiske argumenter fra den norske debatten, og belyser dem med fagartikler fra forskningslitteraturen. De mest sentrale argumentene mot fosterreduksjon har vi identifisert som skadeargumentet, skråplansargumentet, intensjonsargumentet, sorgargumentet, psykologiske langtids-effekter for kvinnen og sorteringsargumentet. Vi kommer frem til at motargumentene ikke holder mål hva gjelder å påvise en moralsk relevant forskjell mellom abort og fosterreduksjon av friske fostre. Konklusjonen vår er derfor at det – på tross av hva flere debattanter synes å mene - ikke finnes en moralsk relevant forskjell mellom de to. Når vi derfor tillater abort, så bør vi også tillate fosterreduksjon.
Nøkkelord: Abort, etikk, fosterreduksjon, medisinsk etikk, selektiv fosterreduksjon
English summary: Abortion and multifetal pregnancy reduction: An ethical comparison
During recent years, multifetal pregnancy reduction has increasingly been subject to debate in Norway, and this debate reached an apex when the Legislation Department delivered the interpretation statement § 2 - Interpretation of the Abortion Act in 2016 in response to the Ministry of Health and Care Services, who had (in 2014) requested the Legislation Department to assess whether the Abortion Act allowed for multifetal pregnancy reductions of healthy fetuses. The Legislation Department concluded that the Abortion Act does regulate and permit multifetal pregnancy reductions within the framework that the law otherwise stipulates. The debate has not subsided, and in the autumn of 2018, it was further intensified in connection with the Norwegian Christian Democratic Party´s (KrF) "crossroads choice" and the signals from the Norwegian Conservative Party that they would consider reverting the Abortion Act’s section 2.3c [regulating second trimester abortions due to fetal anomalies], as well as a ban on multifetal pregnancy reduction.
Many of the arguments in the multifetal pregnancy reduction debate appear very similar to the arguments pending in the general abortion debate, and an analysis of what makes multifetal pregnancy reduction significantly different from abortion is wanting. The aim of this article is, accordingly, to investigate to what extent there is a morally relevant distinction between abortion and multifetal pregnancy reduction of healthy fetuses. We take on board typical arguments from the Norwegian debate and consider them in light of the scholarly literature. We have identified the most central arguments against multifetal pregnancy reduction as the harm argument, the slippery slope argument, the intent argument, the grief argument, the regret argument (concerning long-term psychological effects for the woman), and the sorting argument. We argue that these counter-arguments do not succeed in establishing a morally relevant difference between abortion and multifetal pregnancy reduction of healthy fetuses. Our conclusion is, therefore – that despite what is often held – there is no morally significant difference between the two. Therefore, when we allow abortion, we should also allow multifetal pregnancy reductions.
Keywords: Abortion, ethics, fetal reduction, medical ethics, multifetal pregnancy reduction
The literature on successful schools has revealed that a school culture of high expectations is beneficial for student achievement and that leaders may exercise significant influence on their school’s success trajectory. However, less information is known about how leaders at different levels interact to build such cultures in local schools or how standards of professional work and new demands interact to support teachers’ com-mitment to quality education for a diverse student population. This study aimed to examine the interplay between district and school leadership in creating cultures of equity and high expectations for all students in a Norwegian low-performing school. Methods included interviews with the principal and the superin-tendent, focus group interviews with deputies, teachers and students, and a survey among all students in grade 10 at the selected school. The study demonstrated how leading teachers’ effort to raise academic and social standards among students was a complex endeavour and how a productive interplay between district level leadership and school-level leadership became one of the key enabling factors. A main argument is that promoting quality education for all begins with the question of purpose and requires understanding how principals’ and teachers’ work is embedded in broader social structures of power.
Decadent authors writing about the past share a common artistic practice: revisionist creativity. I argue in my Zoom sur les décadents that this particular type of creativity uses as its main device recombination of legends, myths, and historical events. Historical, cultural or religious figures are reexamined and shown in a new unexpected light. I show in my book how Villiers de Isle-Adam conflates two crucial battles of the Ancient world: Marathon (490 BC) and Thermopiles (480 BC) in a
short story called "Impatience de la foule." The final result of Villiers's telescoping of separate historical events is a seamless narrative. In Hugues Rebell's "Une Saison à Baia," Saint Paul attempts to convert Roman patricians who mock his incoherent speeches. In "La Gloire de Judas," Bernard Lazare departs from the Gospels and tells the tragic story of Judas whose betrayal made the salvation of the human race possible. In Lazare's short story, Judas is a self-effacing figure who doesn't act on his own but on Jesus Christ's specific order, who sworns him into secrecy.
Common in French decadent fiction, religious revisionism was largely tolerated in the secular Third Republic. Whereas censorship was quick to punish naturalist authors writing about debauched clergy in contemporary France (e.g. Louis Deprez and Henry Fèvre's Autour d'un clocher) decadent authors reinventing ancient religious stories and retelling the life of catholic saints enjoyed a relative freedom of
expression.
It is my hypothesis that taken out of its secular context, religious revisionism of the kind practiced by French decadents may be seen as shocking transgression in a fiercely catholic country like Poland. In the country that lost its independence in 1794 and was ever since seeking to regain it, Catholic Church was perceived as an essential ally in the struggle against main occupying powers: Orthodox Russia, and Protestant Prussia. In the course of the 19th century Catholicism and patriotism had been effectively fused in Polish national conscience. In this charged political context a Polish author revisiting Church dogma or tradition was at risk of being perceived not only as a religious outcast but also as a traitor to the cause of Polish independence.
To test my hypothesis I propose to examine Igrzysko (Game), a forgotten play by Leopold Staff. Admired today chiefly as a poet, the young Staff wrote Igrzysko in Poland after a long sojourn in Paris where he had lived among the international crowd of fin de siècle writers and artists. The play was first produced in Lemberg in 1909 and after a few performances vanished forever from Polish theatrical repertoire.
Leopold Staff's play is set in ancient Rome and depicts tribulations of an actor who, while impersonating a Christian awaiting crucifixion, converts to Christianity. In his play, Staff revives the legend of Saint Genesius, an actor in Arles who died a martyr's death in 286 under Diocletian. In Spain, Saint Genesius's legend inspired Lope de Vega who wrote Acting is Believing (Lo fingido verdadero, 1607). In France, it was the source for Jean Rotrou's Saint Genest (1646). All told, the legend of Genesius is a popular theme for artists who wish to explore the distinction between art and life. An important addition to this old tradition, Staff's play contains, however, a decadent and potentially scandalous twist. Unlike in Acting is Believing and Saint Genest, the protagonist's conversion is very short lived in Igrzysko. Fearing pain, Staff's character commits suicide and is, therefore, condemned for eternity. In my paper, I will discuss the significance of Staff's religious transgression in the context of the turn of the century arch-catholic and patriotic Poland.