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Copyright © 2021 Kristin Helstad, Per Arne Øiestad.This work is licensed under a Creative Commons Attribution 4.0 International License. Undervisning består av komplekse handlinger der lærere leder læringsprosesser og kontinuerlig må balansere ulike hensyn opp mot hverandre. Å tenke som en dramaturg kan bidra til å bevisstgjøre og profesjonalisere det didaktiske arbeidet i klasserommet. I denne artikkelen undersøker vi hva dramaturgisk didaktikk kan innebære, og vi ser nærmere på hvordan dramaturgiske begreper og verktøy kan stimulere og utvikle lærerens iscenesettelse av undervisning. Artikkelen er et teoretisk bidrag til klasseromforskning der et læringsperspektiv på undervisning koples med et dramaturgisk perspektiv. Til grunn ligger en praksisrettet forskningstilnærming, der en lærer i drama- og teaterfag i videregående skole har samarbeidet med en skoleforsker om å utvikle nye forståelser av didaktisk arbeid. Vi illustrerer tenkningen i form av en læringssirkel, der aristotelisk dramaturgi og begrepene entré og sorti rammer inn en begynnelse og en slutt i et undervisningsforløp. Dramaturgisk didaktikk forstås som virksomme handlinger som blir satt i spill i dette mellomrommet, der læreren tilrettelegger for læring i klassefellesskapet, og der elevene over tid får bryne seg på faglig og relasjonelt arbeid. Ved å hente inspirasjon fra regissørens arbeid i teatret, viser vi at en dramaturgisk tenkemåte kan ha sterk forklaringskraft for arbeid i klasserommet. Abstract: Teaching consists of complex actions where teachers lead processes of learning and continuously have to balance different considerations. Using dramaturgy as a tool helps raise awareness and professionalize teachers’ work in the classroom. In this article, we examine what dramaturgical didactics might entail, and how dramaturgical concepts and tools may stimulate and develop teaching. The point of departure is a practice-oriented research approach where a teacher in drama in upper secondary school collaborated with a school researcher on understandings of teaching. The article is a theoretical contribution to classroom research where we combine a learning perspective and a dramaturgical perspective. We illustrate the theory by presenting a dramaturgical learning circle that may serve as a tool for teaching. The concepts of ‘entrance’ and ‘exit’ frame a beginning and an end in a teaching process. Dramaturgical didactics involve active actions, where the teacher facilitates for a fruitful learning community and where the students, over time, work on the subjects and the resources at play with learning as the ultimate goal. Although the dramaturgical learning circle is developed in a specific context, the underlying thinking might be used in similar contexts. By drawing inspiration from the director’s work in the theater, the article illuminates that a dramaturgical way of thinking may have a strong explanatory power for teachers’ work on all educational levels.

There is limited knowledge on the association between lifestyle behaviour in adolescence and musculoskeletal pain in young adulthood. This study aimed to investigate whether an accumulation of adverse lifestyle behaviours in adolescents with and without musculoskeletal pain at baseline, was associated with persistent musculoskeletal pain (pain duration ≥3 consecutive months the last year) 11 years later.Longitudinal data from the Trøndelag Health Study in Norway including 1824 adolescents (13-19 years old) was analysed. The outcome was persistent musculoskeletal pain (≥3 months). The number of adverse lifestyle behaviours (low physical activity level, sleep problems, insufficient fruit/vegetables consumption, smoking, frequent alcohol intoxication [drunkenness] and/or illicit drug use) were summed up to comprise an ordinal variable and analysed with 0 or 1 adverse behaviours as the reference. Multiple logistic regression analyses, stratified by individuals with and without baseline musculoskeletal pain, were conducted. The results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs).In adolescents with musculoskeletal pain at baseline, reporting ≥ four adverse lifestyle behaviours increased the odds of persistent musculoskeletal pain (OR 2.23, 95% CI 1.36, 3.66) 11 years later. Two and three adverse behaviours were not associated with future persistent musculoskeletal pain. In adolescents without musculoskeletal pain at baseline, an accumulation of adverse lifestyle behaviours was not associated with future persistent musculoskeletal pain.An accumulation of adverse lifestyle behaviours in adolescents with musculoskeletal pain at baseline was associated with persistent musculoskeletal pain 11 years later, but not in adolescents without musculoskeletal pain at baseline.An accumulation of four or more adverse lifestyle behaviours in adolescents with musculoskeletal pain was associated with persistent musculoskeletal pain in young adulthood. In future health care of adolescents with musculoskeletal pain, lifestyle behaviours should be assessed, with emphasis on accumulation of multiple adverse lifestyle behaviours. Focusing on an accumulation of multiple adverse lifestyle behaviours, rather than each individual behaviour, might provide a potential area for future research and interventions targeting musculoskeletal pain in youth.

The highly potent opioid analgesic fentanyl and its analogues are involved in an increasing number of overdose deaths worldwide. New fentanyl analogues are continuously emerging, and there is a lack of knowledge concerning the metabolism of these compounds. The determination of fentanyl analogues can be challenging due to their low circulating concentrations and rapid and extensive metabolism, making metabolite identification necessary for confirming drug intake. The aim of this study was to discover and elucidate the structures of the major metabolites of the three novel fentanyl analogues 3-methylcrotonylfentanyl (3-MCF), furanylbenzylfentanyl (FBF), and 4-fluorocyclopropylbenzylfentanyl (4-FCBF), which were all seized at European borders in 2018. 3-MCF, FBF, or 4-FCBF was incubated with human liver microsomes and human hepatocytes for up to 4 h. The metabolites formed were separated by ultra-high-performance liquid chromatography using an octadecyl silica column employing solvent gradient elution with a mobile phase consisting of ammonium formate and methanol. The compounds were detected by quadrupole time-of-flight mass spectrometry. The major metabolites of 3-MCF were formed by N-dealkylation, carboxylation, oxidation, or hydroxylation of the 3-methyl-2-butene, and hydroxylation of both the 3-methyl-2-butene and the piperidine ring. FBF was metabolized through N-dealkylation, amide hydrolysis with/without subsequent hydroxylation at the N-phenyl, and dihydrodiol formation at the furan ring. 4-FCBF metabolism was dominated by N-dealkylation and N-oxidation at the piperidine ring. In the present study, we successfully discovered and elucidated the structures of the major metabolites of 3-MCF, FBF, and 4-FCBF which could be used as markers to confirm intake of these compounds in forensic case work.

ObjectivesTo critically appraise and summarise measurement properties of functional performance tests in individuals following anterior cruciate ligament (ACL) or meniscal injury.DesignSystematic review.Data sourcesSystematic searches were performed in Medline (Ovid), Embase (Ovid), CINAHL (EBSCO) and SPORTSDiscus (EBSCO) on 7 July 2021.Eligibility criteria for selecting studiesStudies evaluating at least one measurement property of a functional performance test including individuals following an ACL tear or meniscal injury with a mean injury age of ≤30 years. The COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias checklist was used to assess methodological quality. A modified Grading of Recommendations Assessment, Development and Evaluation assessed evidence quality.ResultsThirty studies evaluating 26 functional performance tests following ACL injury were included. No studies were found in individuals with an isolated meniscal injury. Included studies evaluated reliability (n=5), measurement error (n=3), construct validity (n=26), structural validity (n=1) and responsiveness (n=1). The Single Leg Hop and Crossover Hop tests showed sufficient intrarater reliability (high and moderate quality evidence, respectively), construct validity (low-quality and moderate-quality evidence, respectively) and responsiveness (low-quality evidence).ConclusionFrequently used functional performance tests for individuals with ACL or meniscal injury lack evidence supporting their measurement properties. The Single Leg Hop and Crossover Hop are currently the most promising tests following ACL injury. High-quality studies are required to facilitate stronger recommendations of performance-based outcomes following ACL or meniscal injury.

ObjectiveTo update a systematic review on the association between knee extensor muscle weakness and the risk of incident knee osteoarthritis in women and men.DesignSystematic review and meta-analysis.Data sourcesSystematic searches in PubMed, EMBASE, SPORTDiscus, CINAHL, AMED and CENTRAL in May 2021.Eligible criteria for selecting studiesLongitudinal studies with at least 2 years follow-up including baseline measure of knee extensor muscle strength, and follow-up measure of symptomatic or radiographic knee osteoarthritis. Studies including participants with known knee osteoarthritis at baseline were excluded. Risk of bias assessment was conducted using six criteria for study validity and bias. Grading of Recommendations Assessments, Development and Evaluation assessed overall quality of evidence. Meta-analysis estimated the OR for the association between knee extensor muscle weakness and incident knee osteoarthritis.ResultsWe included 11 studies with 46 819 participants. Low quality evidence indicated that knee extensor muscle weakness increased the odds of symptomatic knee osteoarthritis in women (OR 1.85, 95% CI 1.29 to 2.64) and in adult men (OR 1.43, 95% CI 1.14 to 1.78), and for radiographic knee osteoarthritis in women: OR 1.43 (95% CI 1.19 to 1.71) and in men: OR 1.39 (95% CI 1.07 to 1.82). No associations were identified for knee injured populations except for radiographic osteoarthritis in men.DiscussionThere is low quality evidence that knee extensor muscle weakness is associated with incident symptomatic and radiographic knee osteoarthritis in women and men. Optimising knee extensor muscle strength may help to prevent knee osteoarthritis.PROSPERO registration numberCRD42020214976.

Electromembrane extraction (EME) involves transfer of analyte ions from aqueous sample, through a supported liquid membrane (SLM), and into an aqueous acceptor solution under the influence of an external electrical field. In addition to target analyte ions, the sample also contains matrix ions, and both the sample and acceptor contains background buffer ions to control pH. The ratio between the total amount of ions in sample and acceptor defines the ion balance (χ). Previous publications have discussed the impact of ion balance, but conclusions are contradictory. Therefore, the current paper investigated the ion balance in more detail. From a theoretical point of view, low χ-values favor EME; buffer anions at high concentration in the acceptor migrate into the SLM, while target cations enters the SLM from the sample to maintain electroneutrality. A large number of experiments was performed in this paper to investigate the practical impact of ion balance. Twelve basic drugs were used as model analytes (0.0log P 5.0), and 2-nitrophenyl octyl ether (NPOE) and NPOE + 5% di(2-ethylhexyl) phosphate (DEHP) were used as SLM. With formate buffer pH 3.75 as sample and acceptor, the impact of χ in the range 0.01-10 was studied without bias from differences in pH. Here model analytes were unaffected by ion balance. Buffers containing propionic, butyric, and valeric acid were also tested. These buffer ions migrated more into the SLM, and affected recoveries in several cases. However, this was due to ion pairing rather than effects of ion balance. Similar behaviors from sodium chloride and urine samples were observed with different χ-values. Thus, in the systems tested, almost no impact of ion balance was found, and this was attributed to very low partition of background buffer and matrix ions into the SLM. On the other hand, extractions were in several cases influenced by ion pairing phenomena.

Similarly to many other sample extraction techniques, efficient extraction of very polar compounds with electromembrane extraction (EME) is difficult. To date, the best known strategy to improve the mass transfer of these compounds is the addition of an ionic carrier, often bis(2-ethylhexyl) phosphate (DEHP) to the supported liquid membrane (SLM). DEHP is known to work by providing ionic interactions with basic compounds, to improve the partitioning into the SLM. In this work, the behavior of DEHP during extractions was studied for the first time. Interestingly, substantial amounts of DEHP was found to leak from the SLM into the aqueous sample at pH 4. Due to this leakage, the ion-pair formation between analytes and DEHP was moved from the sample/SLM interface (interfacial complexation) to the bulk of the sample solution (bulk-sample complexation), which improved the mass transfer of polar bases considerably. Based on this, an extraction procedure for eight polar bases with log P values from +0.7 to -5.9 was developed and optimized. The optimization demonstrated that extraction of more polar analytes was favored by bulk-sample complexation. With optimized conditions, extraction from biological samples such as urine, protein-precipitated plasma, and raw plasma were performed with recoveries40%, except for a few analytes. In addition, the extraction system could be operated under robust conditions with relatively low current (70 μA for plasma), and provided low variability (16% RSD), as well as good clean-up efficiency. These findings are an important step in further scientific anchoring of EME, and development of the technique towards selective extraction of very polar substances from complex biological matrices.

The use of designer benzodiazepines appears to be increasing in many countries, but data concerning blood concentrations are scarce, making interpretation of concentrations difficult. The aim of this study was to report blood concentrations of clonazolam, diclazepam, etizolam, flualprazolam, flubromazepam, flubromazolam and phenazepam and to investigate the relationship between blood concentrations and impairment. The concentration data are from blood samples collected from living cases (apprehended drivers and other drug offences) and medico-legal autopsies. The blood samples were analysed for the seven designer benzodiazepines mentioned above by ultra high performance liquid chromatography–tandem mass spectrometry. Positive cases from between 1 June 2016 and 30 September 2019 were included. Blood concentrations and the conclusion from a clinical test of impairment (when available) are reported. The presented seven benzodiazepines were detected in a total of 575 cases, where 554 of these cases concerned apprehended drivers or other criminal offenders. The number of findings and the median (range) concentrations were as follows: clonazolam, n = 22, 0.0041 mg/L (0.0017–0.053 mg/L); diclazepam, n = 334, 0.0096 mg/L (0.0016–0.25 mg/L); etizolam, n = 40, 0.054 mg/L (0.015–0.30 mg/L); flualprazolam, n = 10, 0.0080 mg/L (0.0033–0.056 mg/L); flubromazepam, n = 5, 0.037 mg/L (0.0070–0.70 mg/L); flubromazolam, n = 20, 0.0056 mg/L (0.0004–0.036 mg/L); and phenazepam, n = 138, 0.022 mg/L (0.0018–0.85 mg/L). A designer benzodiazepine was the only drug detected with relevance for impairment in 25 of the 554 living cases. The physician concluded with impairment in 19 of the 25 cases. Most of the concentrations in these cases were relatively similar to or higher than the median reported concentrations. The most frequent other drugs detected were amphetamine, tetrahydrocannabinol, clonazepam and methamphetamine. The presented blood concentrations can be helpful with the interpretation of cases involving one or more of these seven benzodiazepines. The results indicate that concentrations commonly observed in forensic cases are associated with impairment.

In June 1986, 1600 pond-reared one-year old cod were released into a fjord after being conditioned with a pulsed 160 Hz sound signal to search for food at a feeding location. Echosounders, UW-video and ultrasonic transmitter tags were used to monitor the fish behaviour. The fish were fed four times a day (09:00, 12:00, 15:00 and 19:00) in the current lobe from a propeller. A majority of the trained fish returned to the stimulus loeation, and also some "wild" cod and other species adapted the same behaviour. The ultrasonic tagged fish were distributed within 400 m from the stimulus location between the feeding periods. The experiment was terminated after three months. In this period the mean daily length increment was 0.6 mm/day.

BSV5-300

The objective of this study was to conduct a fidelity evaluation of a motivational interviewing (MI) intervention delivered by social insurance caseworkers, in a three-arm randomized controlled trial (RCT) for improving return to work for people on sick leave with musculoskeletal disorders. The caseworkers received six days of MI training, including an intervention manual prior to the trial onset, as well as supervision throughout the trial. The caseworkers recorded 21 MI sessions at regular intervals during the trial. An independent MI analysis center scored the recordings using the MI treatment integrity code (MITI 4). In addition, three experienced MI trainers assessed the adherence to the MI intervention manual on a 1–4 Likert scale and MI competence. Total MITI 4 mean scores were at beginning proficiency levels for two components (global technical, mean 3.0, SD 0.6 and the reflections/questions ratio, mean 1.1, SD 0.2) and under beginning proficiency for two components (global relational, mean 3.2, SD 0.7 and complex question, mean 34.0, SD 21.2). The MI trainers’ assessment showed similar results. The mean adherence score for the MI sessions was 2.96 (SD 0.9). Despite delivering a thorough course and supervision package, most of the caseworkers did not reach proficiency levels of good MI competence during the study. The fidelity evaluation showed that a large amount of training, supervision and practice is needed for caseworkers to become competent MI providers. When planning to implement MI, it is important that thorough consideration is given regarding the resources and the time needed to train caseworkers to provide MI in a social insurance setting.

Cannabis is the most widely used illicit substance worldwide. A limited number of studies have investigated whether tetrahydrocannabinol (THC) and cannabidiol (CBD) can be detected in other postmortem matrices than blood and urine. The aim of this study was to investigate the distribution of THC and CBD in several different postmortem matrices. Concentrations in peripheral blood were compared to those in cardiac blood, pericardial fluid, psoas muscle, vastus lateralis muscle, and vitreous humor. A total of 39 postmortem forensic autopsy cases were included. THC and CBD were analyzed using gas chromatography-mass spectrometry. We were able to detect both THC and CBD in most of the analyzed matrices. For vitreous humor, however, only approximately 50% of the cases were available for analysis, and only two were found to be positive. Median concentrations in peripheral blood were 0.0040 (0.00042–0.056) mg/L for THC and 0.0013 (0–0.023) mg/L for CBD. The concentration ratios between pericardial fluid and cardiac blood compared to peripheral blood were< 1 for both THC and CBD for the majority of the cases. For THC, a median ratio of 0.60 (0.063–7.2) and 0.65 (0.068–4.8) were found for pericardial fluid and cardiac blood, respectively, compared to peripheral blood, whereas for CBD the corresponding median ratios were 0.40 (0.010–1.9) and 0.80 (0.017–2.4). The THC concentrations in psoas muscle and vastus lateralis muscle were high compared to those in peripheral blood in several cases, and large variations in the muscles to peripheral blood concentration ratios were seen. This was also the case for CBD. Our study shows that THC and CBD can be detected in postmortem matrices other than peripheral blood, and results from other matrices might provide important information in forensic cases where peripheral blood is not available. However, vitreous humor was not suitable for detecting neither THC nor CBD.

Based on the strong linear relationship between heart rate (HR) and oxygen consumption, the Astrand–Ryhming cycle ergometer test (Astrand and Ryhming in J Appl Physiol 7:218–221, 1954) is a widely used submaximal test to predict whole body maximal oxygen consumption ($$\dot{V}{\text{O}}_{2\!\max }$$). However, a similar test predicting peak oxygen consumption ($$\dot{V}{\text{O}}_{{2{\text{peak}}}}$$) in the upper extremities is not established, and may be very useful for individuals unable to use their lower extremities or/and if separation of upper extremity aerobic capacity is sought after. Thus, the aim of the current study was to develop a submaximal test predicting $$\dot{V}{\text{O}}_{{2{\text{peak}}}}$$ in arm-cycling. Forty-nine healthy volunteers (25 women: 38 ± 13 years; 24 men: 39 ± 12 years) tested arm-cycle $$\dot{V}{\text{O}}_{{2{\text{peak}}}}$$ on a protocol with 4-min, 21-W increments to exhaustion. The data were contrasted to treadmill $$\dot{V}{\text{O}}_{2\!\max }$$ values. Arm-cycle $$\dot{V}{\text{O}}_{{2{\text{peak}}}}$$ was 66 ± 8% of $$\dot{V}{\text{O}}_{2\!\max }$$ (r = 0.92, p

BackgroundThis updated systematic review reports data from 2009 on the prevalence, and risk factors, for knee osteoarthritis (OA) more than 10 years after anterior cruciate ligament (ACL) tear.MethodsWe systematically searched five databases (PubMed, EMBASE, AMED, Cinahl and SPORTDiscus) for prospective and retrospective studies published after 1 August 2008. Studies were included if they investigated participants with ACL tear (isolated or in combination with medial collateral ligament and/or meniscal injuries) and reported symptomatic and/or radiographic OA at a minimum of 10 years postinjury. We used a modified version of the Downs and Black checklist for methodological quality assessment and narrative synthesis to report results. The study protocol was registered in PROSPERO.ResultsForty-one studies were included. Low methodological quality was revealed in over half of the studies. At inclusion, age ranged from 23 to 38 years, and at follow-up from 31 to 51 years. Sample sizes ranged from 18 to 780 participants. The reported radiographic OA prevalence varied between 0% and 100% >10 years after injury, regardless of follow-up time. The studies with low and high methodological quality reported a prevalence of radiographic OA between 0%–100% and 1%–80%, respectively. One study reported symptomatic knee OA for the tibiofemoral (TF) joint (35%), and one study reported symptomatic knee OA for the patellofemoral (PF) joint (15%). Meniscectomy was the only consistent risk factor determined from the data synthesis.ConclusionRadiographic knee OA varied between 0% and 100% in line with our previous systematic review from 2009. Symptomatic and radiographic knee OA was differentiated in two studies only, with a reported symptomatic OA prevalence of 35% for the TF joint and 15% for PF joint. Future cohort studies need to include measurement of symptomatic knee OA in this patient group.PROSPERO registration numberCRD42016042693.

Data from previous experimental studies on the detection time of oxazepam and zopiclone in biological matrices are limited. The aim of this study was to examine the detection time in urine and oral fluid after single oral doses of oxazepam and zopiclone. Ten healthy volunteers received 25 mg of oxazepam in the evening of Day 1 and 7.5 mg of zopiclone in the evening of Day 3. Urine and oral fluid samples were collected twice daily for 9 days, with an additional sampling the day after ingestion of zopiclone. A total of 19 samples of both urine and oral fluid from each participant were analyzed using fully validated chromatographic methods. The median detection time for oxazepam was 91 h (range 73-108) in urine and 67 h (range 50-98) in oral fluid. The median detection time for zopiclone in urine was 49 h (range 25-98) and 59 h (range 48-146) in oral fluid. The metabolite zopiclone N-oxide showed a detection time of 36 h (range 25-84) in urine. The area under the concentration-time curve (AUCTotal) in urine corrected for creatinine was 150 μmol/L/mmol/L*h (range 105-216) for oxazepam and 1.60 μmol/L/mmol/L*h (range 0.79-4.53) for zopiclone. In oral fluid, the AUCtotal was 673 nmol/L*h (range 339-1,316) for oxazepam and 2,150 nmol/L*h (range 493-4,240) for zopiclone. In conclusion, oxazepam can be detected longer in urine than in oral fluid, while zopiclone can be detected longer in oral fluid than in urine. The high AUCTotal for zopiclone in oral fluid shows that the transfer into oral fluid is significant. In certain individuals the detection time of zopiclone in oral fluid is long. These results can be helpful when interpreting drug testing analyzes.

Background and Objectives: Even though nightlife studies with potentially intoxicated participants provide the much needed information on drug use, they face additional methodological challenges. This study aimed to explore the utility of such studies by (i) classifying nightlife attendees based on their self-reported drug use and by (ii) examining whether these classifications were meaningful when assessed against other sources of data, including oral fluid drug tests. Methods: Self-reported questionnaires, oral fluid samples and blood alcohol concentration readings were collected in a sample of 1,085 nightlife patrons recruited outside 12 popular nightclubs in Oslo, Norway, in 2014. Patrons were classified using multiple approaches, including latent class analysis. Group differences were examined by logistic regression models. Results: Participants were classified into 5 mutually exclusive groups: 2 among current non-users (“Never-users”; “Previous users”), 2 among current users (“Multiple drugs”; “Cannabis mainly”) and one “Incomplete information” group. Meaningful differences across these groups were observed. For instance, positive tests for any illicit drug were more common in “Multiple drugs” group than in “Cannabis mainly” (62.7 vs. 29.1%, adjusted OR [aOR] 3.77 [2.42–5.84]) or “Incomplete information” groups (62.7 vs. 34.4%, aOR 2.46 [1.26–4.79]). Despite their self-declared non-use, illicit substances were detected in oral fluids of “Never-users” (13.1%; 95% CI 9.9–17.2) and “Previous users” (7.9%; 95% CI 5.1–12.1). Conclusions: Despite some discrepancies between self-reports and biological tests, self-reports proved both suitable and useful in identification of substantively different drug-user typologies, potentially informing targeted policy responses. Still, methodological challenges associated with onsite studies of illicit drug use should be further explored.

Background: Fentanyl and fentanyl analogues (fentanyls) are very potent opioids posing a serious threat to the public health. Thousands of overdose deaths across the world are caused by fentanyls and the numbers are increasing. Rapid mapping of current trends in opioid abuse is necessary to accelerate preventive measures. To ensure this, there is a need for sensitive targeted multiplex MS/MS methods to pinpoint drugs of abuse. We present a fully validated UHPLC-MS/MS method for the determination of 26 fentanyls, including several structural isomers, and the opioid antagonist naloxone in human whole blood. Methods: Blood samples were prepared by liquid-liquid extraction with ethyl acetate and heptane. The fentanyls were separated with UHPLC, using a Kinetex biphenyl column (2.1 x 100 mm, 1.7 µm, Phenomenex, Verlose, Denmark) with an acidic mobile phase. Quantification was performed by MS/MS. The method was validated according to SWGTOX guidelines.37 Results: The developed method could successfully separate all 27 analytes, including 7 isomers, and was validated according to SWGTOX guidelines with very low limits of quantification (4-20 pg/mL). The applicability of the method was demonstrated by determination of fentanyls in post mortem blood samples from two cases. Conclusions: A selective, highly sensitive and robust method for determination of a large panel of fentanyls and naloxone in blood was developed and validated. Naloxone was included to monitor use and efficacy of the opioid antidote in cases of fentanyl overdoses. The method demonstrated good ability to separate structural isomers, which is important to differentiate between the numerous available fentanyls with variable potency, toxicity and legal status. The developed method can be used to identify fentanyls on the drug market to help combat the fentanyl crisis.

Førstehåndserfaringer er selve kjernen i bedringsperspektivet på alvorlige psykiske lidelser for å forstå hvordan mennesker kan oppleve å få det bedre i kontekst av å oppleve alvorlig psykisk lidelse. Som ledesnor for mentale helsetjenester, har denne orienteringen hatt økt innflytelse i senere år. Hensikten med denne hovedoppgaven er å bidra til denne utviklingen. Dette ved bruk av autoetnografi som metode for å dele egne erfaringer med alvorlig psykisk lidelse og bedring. Resultatet av å analysere erfaringene mine innenfor dette rammeverket er et narrativ i to deler: ‘tilintetgjørelsen’ og ‘tilhelningen’. Begge er forfattet fra to forskjellige posisjoneringer: ‘å være der’ og ‘å være her’. I sin helhet legger narrativet til rette for å diskutere flere temaer som er sentrale for en generell forståelse av bedring. Jeg har prioritert følgende: (1) Betydningen av et bedringsnarrativ; (2) Min fortelling i relasjon til eksisterende modeller for bedring; (3) Det handler om mennesker og livet. Deretter følger en diskusjon om prosjektets metode og metodologi. Oppgaven avrundes med en epilog som er dedikert til et tankeeksperiment (del 1) og refleksjoner rundt det å være i en bedringsprosess i løpet av dette prosjektet og det å skrive akkurat denne autoetnografien (del 2). First-person accounts are at the heart of the recovery-framework for understanding how people experience improved well-being and quality of life in the context of severe mental illness. As a guiding vision for mental health care, this paradigm has been growing in influence during the recent years. The aim of this thesis is to keep this evolution going by using autoethnography as a method for providing an in-depth personal account of my own experiences with severe mental illness and recovery. The result of analyzing my personal experiences within the recovery-framework, is a narrative which consists of two parts: ‘the annihilation’ and ‘the healing process.’ Both are written from two different positionings: ‘being here’ and ‘being there.’ In its entirety, the narrative sets the stage for discussing several themes that are central for a general understanding of recovery. I prioritized the following: (1) The meaning and importance of constructing a recovery-narrative; (2) My story in relation to extant models of recovery-processes; (3) It’s about life and people. Subsequently, I reflect on the project’s method and methodology. In closing, an epilogue is dedicated to a thought experiment (part 1) and reflections regarding me in recovery during this project and creating this specific autoethnography (part 2). Hovedoppgave psykologprogrammet PROPSY317 PRPSYK