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Studies exploring the experiences of recovering from mental health difficulties show the significance of social and relational aspects. Dialogical practices operate within the realm of social relations; individual perspectives are not the primary focus of attention. The present study is part of a series of qualitative studies from southern Norway, exploring dialogical practices and change from the perspective of lived experience and in relationship with network meetings. Two co-researchers, who themselves had experienced mental health difficulties, were part of the research team. Material from qualitative interviews was analysed through a dialogical hermeneutical process where ideas from Emmanuel Levinas and Mikhail Bakhtin were used as analytical lenses. Six interdependent dimensions emerged from our interpretative analysis, comprising three temporal dimensions (1. Dialogues open the moment, 2. Dialogues open the past, and 3. Dialogues open the future) and three dimensions of speaking, which operated across the three temporal dimensions (4. Ethical: Dialogues open through inviting attentiveness and valuing, 5. Expressive: Dialogues open for new vitality, and 6. Hermeneutical: Dialogues open for new meaning). These dimensions were incorporated into one main theme: Dialogues – beginning by others being invitingly attentive – open for moving and living. The way the findings point to change events as an opening for movement – ‘moving in’ as if from the outside, and ‘moving on’ as opposed to being stuck – are discussed in relation to other studies. We conclude by suggesting that the salient point of change-generating conversations is in the ethics of being invitingly attentive, and such conversations should take into account multidimensionality, that relates to the past and the future.

Published version of an article in the journal: Contemporary Family Therapy. Also available from the publisher at: http://dx.doi.org/10.1007/s10591-014-9317-3 Within mental health research, the promise of exploring the lived experience of those affected is increasingly acknowledged. This research points to the significance of social aspects. The present study is part of a series of qualitative studies exploring network-oriented practices in southern Norway. The aim of this study was to explore the social dynamics of change related to adolescents in psychosocial crises. From the perspective of lived experience the study focused changes related to the adolescents’ ways of existing in various social arenas. Data from qualitative interviews with adolescents receiving help from a mental health service, persons in their social network, and the practitioners involved were explored through a dialogical phenomenological–hermeneutical process. Two co-researchers, on the basis of their own experience with mental health problems, participated throughout the research process. Concepts from the thinking of Mikhail Bakhtin, Françoise Dastur, and John Shotter were used as interpretative help. Main theme: change is the event of becoming through movement in Ethical Time and Space. Two dimensions, conceptualized as Ethical Space and Ethical Time, were identified: (1) “A place for me” or “No place for me” (Ethical Space), and (2) Before-Event of anticipation—Event of movement—After-Event of experience (Ethical Time). Four aspects within these dimensions emerged: (1) an opening Before-Event: offering space for my movement; (2) a closing Before-Event: not offering space for my movement; (3) a life-giving After-Event: the experience of being valued; and (4) a life-deteriorating After-Event: the experience of being devalued. The results are discussed in relation to other studies investigating how bodily responsiveness is at the core of human becoming.

The present study is part of a series of qualitative studies focusing on dialogic practice in southern Norway. In this article, we present a qualitative study of a network meeting focusing on the interplay between the participants' inner and outer dialogues. The network meeting is between an adolescent boy, his mother and two network therapists, the same adolescent case discussed previously in this journal by Boe et al. (2013). The aim of this study is to explore how the interplay between inner and outer dialogues contributes to significant and meaningful moments for the interlocutors. A multiperspective methodology is used that combines video recordings of a network meeting and participant interviews with text analysis. Our research found the interplay has an important role in understanding the emergence of significant and meaningful moments in therapy. A one-sided focus on participants' utterances or inner dialogues was insufficient to explain their significance and meaning to the interlocutors. A dialogical approach provides a theoretical frame and concepts that are useful in investigations of therapeutic conversations.

The aim of this study is to describe the experience of time as it presents itself at the place being situated when living with severe incurable disease and receiving palliative care. The empirical data consist of 26 open-ended interviews with 23 patients receiving palliative care at home, at a palliative day care; in a palliative bed unite in hospital or in a nursing home in Norway. A common meaning of a shifting space for living emerged from the analysis and was revealed through three different aspects: (i) Transition from a predictable to an unpredictable time: To live with severe incurable disease marks a transition to a changed life involving an ongoing weakened and altered body with bothersome symptoms making experience of time different and unpredictable. (ii) Transition between a safe and unsafe time: When time is unpredictable, feeling safe is revealed as essential to how time is experienced at the place being situated. (iii) To be in transition from a homely to a homeless existence. In a time of increased bodily weakness, unpredictable ailments and displacements the sense of belonging to the place is revealed as significant to the experience of time. Not knowing where to be in a time of change is like an existential cry of distress where the foothold in existence is lost. The findings are discussed and interpreted as an embodied experience originating from the passage of time continually affecting life sometimes so fundamentally that it marks a transition to a changed space of life that is reflected in the experience of time. acceptedVersion

A nursing home is a complex multifactorial environment that influences the decisions and actions of nursing staff. Many of the actions performed by nursing staff appear to be straightforward or simple because they are repetitive, encompassing everyday activities such as helping a resident to get up in the morning, shower or get dressed. These daily activities are usually performed smoothly as part of normal care. This article draws on ethnographic data from a study of caring practices in a nursing home with the aim of investigating how a seemingly ordinary, but unexpected, event can develop into a chaotic situation. Staff appeared to have difficulty managing the situation, and they seemed to be disorganized in the application of their skills. First, we describe the situation in detail before investigating and discussing the situation to provide a deeper understanding of the complexity of nursing home practice.

Why are bodily washing practices the way they are in nursing? Michel Foucault argues that modern democratic societies discipline human bodies in accordance with political interests. In the extension of that argumentation we will show that bodily cleanliness in modern nursing may have been used as a disciplining tool. The first part of our discussion takes as its point of departure the second half of the 19th/the beginning of the 20th centuries, the period in which modern nursing emerged. At that time scientific theories on hygiene seem to have legitimized the political effort to produce a clean, pleasant-smelling, decent, obedient, and productive population. Doctors, nurses and teachers played important roles in the implementation of hygienic bodily washing practices. The second part of the discussion focuses on the post-war period. At that time humanistic needs theories seem to have legitimized political argumentation for independent patients who washed themselves if possible. Those who could not manage on their own, should, as far as possible, be washed by cheaper staff, so that nurses could concentrate on medical treatment. Finally we argue that present day bodily washing practices in nursing are in accordance with the norms of appearance and smell that arose in the second half of the 19th and the first part of the 20th centuries. We further argue that staff with little or no education perform much of the bodily nursing work. Self-care seems to be of interest only when it reduces public expenses.

In this article, we use the intersubjective ethics of Bakhtin and Levinas and a case illustration to explore change in therapy as an ethical phenomenon. We follow Lakoff and Johnson in their emphasis on the way our conceptions of change seem permeated by metaphors. Bakhtin and Levinas both suggest through a language in which metaphors play a crucial role, that human existence—the consciousness and the subject—emerge within the dialogue of the encounter. They both describe the dynamics of human existence as ethical in their origin. Following this, we argue that change may be seen as an ongoing ethical event and that the dynamics of change are found in the ways we constantly become in this event. We investigate the ethical dynamics of this ongoing event through three themes illuminating the contributions of both Bakhtin and Levinas: (1) we become as responsible, (2) we become in speaking, (3) we become in answering the unknown. We explore these themes through a case illustration. Finally, we briefly point out some possible implications for mental health practice.

Published version of an article in the journal: Vård i Norden. Also available from the publisher at: http://www.artikel.nu/Bob/GetBob.aspx?bobID=3544 Purpose: The purpose of this study was to describe and illuminate the daily life of parents who have children with developmental disabilities. Background: Up to the 1980’s most children with disabilities were institutionalized. Today these children live with their families supported by public health care services and the family’s social network. Parents experience extreme strain due to unpredictability, sleep deprivation, multiple hospitalizations and demanding caregiving procedures. Method: Semi structured interviews of four couples of parents with children from age one to six years with developmental disabilities were conducted. The interviews were taped and transcribed verbatim. Data were analyzed using Systematic Text Condensation. Findings: Four main themes were identified, “different and unpredictable daily life”, “always in a state of preparedness”, “living right now” and “challenging encounters with health professionals“. Despite parents’ challenging daily life they emphasized their positive view of caring for a child with disabilities. Conclusion: To manage their daily life parents needed to be acknowledged as valuable collaborators and experts on their child’s condition. They expressed a need for information adjusted to their child’s illness trajectory. Training family, especially grandparents, to be confident performers of caring procedures may relieve parents’ caring load. Despite a challenging daily life the parents expressed a positive and healthful attitude. To improve parents’ coping it is crucial that health professionals support the parents’ health promoting strategies as well as their need for care. Further studies on grandparents’ contribution is needed, as well as parents’ experiences of early transfer to the child’s habilitation services.

Women ( n = 87) at women’s shelters in Norway, a country of high welfare and gender equality, reported a multitude of severe threats and actual acts of physical, sexual and psychological violence. An individual threatening to kill his partner represented a significant increased risk for experiencing serious acts of violence, especially when the threats were repeated. A self-administered questionnaire was sent to all the women’s shelters. Experiences of violence were measured by The Severity of Violence against Women Scale (SVAWS) and the Psychological Maltreatment of Women Index (PMWI).

This study was performed in order to develop a method for studying blood flow in the ophthalmic circulation. Using a pulsed doppler system utilizing an ultrasonic frequency of 10 MHz, blood flow velocities have been measured in the ophthalmic artery and in the arteries behind the eyeball (lateral posterior ciliary arteries) in 40 normal subjects. The mean of the peak systolic velocities were 34 +/- 6 cm/s in the ophthalmic artery, and 14 +/- 3 cm/s in the lateral posterior ciliary arteries. We conclude that blood flow velocities can be measured in defined vessel areas in the orbit.

The aim of the study was to identify and describe spouses'/cohabitants' experiences of living with a partner with bipolar affective disorder over time. Qualitative research interviews were conducted with eight spouses/cohabitants. Transcribed interviews were analysed structurally based on Ricoeur's phenomenological hermeneutics as described by Lindseth and Norberg. The participants' shared lives ranged from 6 to 51 years, and the study found three major aspects that characterized their experience along this time-dimension; experience formed part of a cumulative process containing up to 14 experiences. Each experience created a preunderstanding that affected how subsequent experiences were perceived, and mastered. These three major aspects had a reciprocal influence on the following 14 experiences over time: Fear and the incomprehensible. Accusations. Self-doubt and doubt about own powers of judgement. Care and information vs. being overlooked or turned away by health personnel. Stigmatization and loss of social network. Uncertainty, powerlessness and hope. Loneliness. Anger and despair. The persistent threat. Own health problems. Grief over loss. Dawning acceptance. Reconciliation. New hope. A theoretical understanding using gestalt therapy theory suggests that burdensome experience can be seen as an inner imbalance in the spouse/cohabitant when she/he cannot find meaning in their experiences. When only parts of the whole are perceived, an incomplete gestalt is formed in the person's lived-experience that counteracts the equilibrium of the organism. Insight and meaning can protect them against burdensome experiences and nurses can empower them through care, health-promoting education and guidance. Nursing research should develop methods of education and guidance sensitive enough to help each spouse/cohabitant, regardless of where they are in their cumulative process.

This is the first follow up study measuring quality of life among abused women who have left their abusive partner. The women (n = 22) answered a questionnaire while staying at women’s shelter and one year later. The aim was to examine long-term effects of intimate partner violence against women on health-related quality of life. Health-related quality of life was measured using the SF-36 Health Survey and the WHOQOL-BREF. The meantime for living in a violent partnership was 11 years, most of the women had children under 10 years living with them, low income and were on sickness absence or disability pension. About half of the women had experienced threats of violence and 6 had experienced violent acts after leaving their partner. SF-36 scores after one year were significantly better in vitality (t-test, P

The SF-36 Health Survey and the WHO Quality of Life Index—BREF (WHOQOL-BREF) were used to study quality of life among women who had experienced intimate partner violence (IPV). The aim was to determine how these instruments correlated with each other and with physical and psychological IPV, in order to find the best instrument to use. IPV was measured using the Severity of Violence against Women Scale (SVAWS) and the Psychological Maltreatment of Women Index (PMWI). A self-administrated questionnaire was given to women able to understand Norwegian who were staying at a women’s shelter in Norway for more than 1 week. 87 of 212 women asked to participate completed the questionnaire. The physical acts of violence in SVAWS correlated significantly (P

This article aims to illustrate how Antonovsky's salutogenic theory and its central concept of sense of coherence can be operationalized into salutogenic therapy principles and an intervention program for promoting a sense of coherence, coping, and mental health among people with mental health problems. The intervention is based on the following five basic components or therapy principles: (1) the health continuum model; (2) the story of the person; (3) health-promoting (salutary) factors; (4) the understanding of tension and strain as potentially health promoting, and (5) active adaptation. The program is a talk therapy group intervention and consists of 16 group meetings and homework. The intervention may serve as a guide to mental health nursing practice when coping is the main target.

Objective Although the theory of salutogenesis provides generic understanding of how coping may be created, this theoretical perspective has not been explored sufficiently within research among people suffering from mental health problems. The aim of this study is to investigate the effect of talk-therapy groups based on salutogenic treatment principles on coping with mental health problems. Method In an experimental design, the participants (residents in the community) were randomly allocated to a coping-enhancing experimental group (n = 59) and a control group (n = 47) receiving standard care. Coping was measured using the sense of coherence (SOC) questionnaire. Results Coping improved significantly in the experiment group (+6 points) compared with the control group (−2 points). The manageability component contributed most to this improvement. Conclusion Talk-therapy groups based on salutogenic treatment principles improve coping among people with mental health problems. Practice implications Talk-therapy groups based on salutogenic treatment principles may be helpful in increasing coping in the recovery process among people with mental health problems and seem to be applicable to people with various mental health problems.

Previous research has shown that movement quality may be described as offering a general impression of a whole unified person, understood as a relation between postural stability, free breathing and awareness, which combined produce a refinement of movement as well as enhancing well-being. The phenomenon could further be structured in terms of four movement dimensions: structural, physiological, psychological/relational and a purely human dimension. So far we have little knowledge about these dimensions. The aim of this study is to deepen the understanding of the phenomenon of movement quality through close observation of Greek sculpture, reflection and literature studies relating to Greek sculpture. The aim was to see if these methods could be a tool for achievement of a deeper understanding of movement quality, in clinical observation and reasoning. A phenomenological method was used to study the essence of the phenomenon of movement quality. A study of Greek sculpture was chosen because of the way ancient Greek sculptors sought to express several dimensions of human existence. The results show that close observation, reflection and literature studies of Greek sculptures deepened the knowledge of the four dimensions of movement quality and provided a way in which this knowledge could be expressed in words. These methods may represent a tool for achieving a deeper understanding of movement quality in clinical observation and reasoning.

Quality of movement is frequently referred to as a phenomenon in the European movement tradition, underlining the close connection between outer expression and inner, lived experience. Within physical therapy little is clarified about the phenomenon from the point of view of lived experience. A case study has been undertaken focusing on the lived experience of the phenomenon, searching for basic elements and dimensions. An interpretive phenomenological approach was the method chosen for research. A qualitative interview was conducted involving one movement expert with an understanding and knowledge of the phenomenon. Analysis of the data revealed three levels of views on the quality of movement: basic elements and dimensions, functional use and personal integration. The phenomenon could be understood by the relation between three key elements, postural stability, free breathing and awareness; all contributing to a refinement in movement as well as a greater experience of well-being. The key elements were considered prerequisites to a four-dimensional therapeutic approach involving personal integration of bodily and mental aspects in movement. The basic element and dimensions of the phenomenon of quality of movement can be regarded as a starting point for research in this area.

The main issue is the connection between physical outfit and meaning in life after treatment in a stroke unit. The purpose is to provide knowledge about patients in the first period after getting the disease. Such information can be valuable when it comes to understanding the situation of elderly patients with stroke after they have left the hospital or stroke unit. 70 woman and men — aged between 55 and 95 participated, interviews were carried out and the instruments Barthel Index (ADL), Purpose in Life (PIL), and research questions were used. The main variables are activities of daily living and purpose in life. (The connection between physical outfit and meaning in life). The patients show a weakening of physical outfit and altogether 43 patients had an unsure score or reduced meaning in life. The results show a positive connection between physical outfit and meaning in life. There are gender differences that are clear, more men get stroke and they are also clinically more vulnerable (stronger connecti...

The study was carried out at a surgery ward in Norway, November 1997 to January 1998. 12 patients were interviewed, 8 men and 4 women. The average age was 73,6 years. The study used a hermeneutical...

For ultrasound color flow images with high quality, it is important to suppress the clutter signals originating from stationary and slowly moving tissue sufficiently. Without sufficient clutter rejection, low velocity blood flow cannot be measured, and estimates of higher velocities will have a large bias. The small number of samples available (8 to 16) makes clutter filtering in color flow imaging a challenging problem. In this paper, we review and analyze three classes of filters: finite impulse response (FIR), infinite impulse response (IIR), and regression filters. The quality of the filters was assessed based on the frequency response, as well as on the bias and variance of a mean blood velocity estimator using an autocorrelation technique. For FIR filters, the frequency response was improved by allowing a non-linear phase response. By estimating the mean blood flow velocity from two vectors filtered in the forward and backward direction, respectively, the standard deviation was significantly lower with a minimum phase filter than with a linear phase filter. For IIR filters applied to short signals, the transient part of the output signal is important. We analyzed zero, step, and projection initialization, and found that projection initialization gave the best filters. For regression filters, polynomial basis functions provide effective clutter suppression. The best filters from each of the three classes gave comparable bias and variance of the mean blood velocity estimates. However, polynomial regression filters and projection-initialized IIR filters had a slightly better frequency response than could be obtained with FIR filters.

The aim of this study was to gain a deeper understanding of the experience of time when living with severe incurable disease. A phenomenological and philosophical approach of description and deciphering were used. In our modern health care system there is an on-going focus on utilizing and recording the use of time, but less focus on the patient's experience of time, which highlights the need to explore the patients' experiences, particularly when life is vulnerable and time is limited. The empirical data consisted of 26 open-ended interviews with 23 participants receiving palliative care at home, in hospital or in a nursing home in Norway. The theoretical frameworks used are mainly based upon K. Martinsens philosophy of care, K. E. Løgstrup phenomenological philosophy, in addition to C. Saunders' hospice philosophy, L. Feigenberg's thanatology and U. Qvarnström's research exploring patient's reactions to impending death. Experience of time is described as being a movement that moves the individual towards death in the field of opposites, and deciphered to be a universal, but a typical and unique experience emerging through three integrated levels: Sense of time; where time is described as a movement that is proceeding at varying speeds. Relate to time; where the awareness of limited life changes the understanding of time to be more existential. Being in time; where limited time seems to clarify the basic living conditions and phenomena of life. The existence of life when the prospect of death is present is characterized by emotional swings that move within polarizing dimensions which is reflected in the experience of time illustrated as the moves of the pendulum in a grandfather clock. The diversity of the experience of time is oscillating between going fast or slow, being busy or calm, being unpredictable but predictable, safe or unsafe and between being good or bad, depending on the embodied situation of the individual.

In this article the concept «mental suffering» is discussed as a possible anomaly from the point of view of nursing science. Based upon a review of central concepts common to nursing science the concept «suffering» is elucidated with regard to the concept's content, source, character and power. «Mental suffering» has been predominately used as a concept connected to disease. In such a context the concept may be regarded as reductionistic since «suffering» is perceived to be a comprehensive concept having spiritual, cultural, psychological, social and physical dimensions. It may seem unnecessary, and frankly even misleading, to couple the concepts «mental» and «suffering» since suffering, in itself, is predominately mental. The Health Service must surely meet suffering human beings by focusing on the uniqueness of each individual and not just on the diagnosis of the person involved.

A review of the different transducer array technologies is given, with emphasis on their ability to meet the most important clinical requirements. Spatial resolution, imaging artifacts, and sensitivity are discussed, both for tissue imaging and color flow imaging. The qualities of each array type, for example small footprint, narrow slice thickness, high resolution etc., are analyzed in relation to clinical applications.

This article presents findings from a phenomenological study exploring experience of time by patients living close to death. The empirical data consist of 26 open-ended interviews from 23 patients living with severe incurable disease receiving palliative care in Norway. Three aspects of experience of time were revealed as prominent: (i) Entering a world with no future; living close to death alters perception of and relationship to time. (ii) Listening to the rhythm of my body, not looking at the clock; embodied with severe illness, it is the body not the clock that structures and controls the activities of the day. (iii). Receiving time, taking time; being offered - not asked for - help is like receiving time that confirms humanity, in contrast to having to ask for help which is like taking others time and thereby revealing own helplessness. Experience of time close to death is discussed as an embodied experience of inner, contextual, relational dimensions in harmony and disharmony with the rhythm of nature, environment and others. Rhythms in harmony provide relief, while rhythms in disharmony confer weakness and limit time.

Published version of an article from the journal: BMC Nursing. Also available from Bio Med Central:http://dx.doi.org/10.1186/1472-6955-11-7 Open Access Background Western governments have initiated reforms to improve the quality of care for nursing home residents. Most of these reforms encompass the use of regulations and national quality indicators. In the Norwegian context, these regulations comprise two pages of text that are easy to read and understand. They focus particularly on residents’ rights to plan their day-to-day life in nursing homes. However, the research literature indicates that the implementation of the new regulations, particularly if they aim to change nursing practice, is extremely challenging. The aim of this study was to further explore and describe nursing practice to gain a deeper understanding of why it is so hard to implement the new regulations. Methods For this qualitative study, an ethnographic design was chosen to explore and describe nursing practice. Fieldwork was conducted in two nursing homes. In total, 45 nurses and nursing aides were included in participant observation, and 10 were interviewed at the end of the field study. Results Findings indicate that the staff knew little about the new quality regulations, and that the quality of their work was guided by other factors rooted in their nursing practice. Further analyses revealed that the staff appeared to be committed to daily routines and also that they always seemed to know what to do. Having routines and always knowing what to do mutually strengthen and enhance each other, and together they form a powerful force that makes daily nursing care a taken-for-granted activity. Conclusion New regulations are challenging to implement because nursing practices are so strongly embedded. Improving practice requires systematic and deeply rooted practical change in everyday action and thinking.

A review of the scattering theory for moving blood, and a model for the signal in a multigated pulsed wave Doppler system is presented. The model describes the relation between a general time-variable velocity field and the signal correlation in space and time, including the effect of movement of the ultrasonic beam for color flow imaging systems with mechanical scanning. In the case of a constant and rectilinear velocity field, a parametric model for the autocorrelation function is deduced. General formulas for a full second order characterization of the set of autocorrelation estimates, with arbitrary lags in the spatial and temporal directions, are developed. The formulas are applied to the parametric model, and numerical results for the estimator variance are presented. A qualitative evaluation of the theoretical results has been performed by offline-processing of 2-D Doppler signals from a color flow imaging scanner. The benefit of spatial and temporal averaging is demonstrated by using different averaging filters to the same set of recorded data. >

Background In recent years, physical therapists have paid greater attention to body awareness. Clinicians have witnessed the benefits of supporting their patients' learning of movement awareness through the promotion of their movement quality. Objective The aim of this study was to investigate how physical therapist experts promote movement quality in their usual clinical settings. Design A phenomenological research design that included a sampling strategy was devised. Using specific criteria, 6 lead physical therapists nominated a group of physical therapist experts from the fields of neurology, primary health care, and mental health. Fifteen informants, 5 from each field, agreed to participate. Methods In-depth interviews were conducted with a semistructured interview guide. The informants were invited to simply describe what they had experienced to be successful therapeutic processes for promoting movement quality. Each interview was audiotaped and transcribed. The data analysis was based on a multistep model. Results Three main themes emerged from the data. First, the physical therapists' embodied presence and movement awareness served as a precondition and an orientation for practice. Embodied presence is a bodily felt sense, a form of personal knowing that evokes understanding and fosters meaning. Second, creating a platform for promoting movement quality revealed implementation of psychological attitudes. Third, action strategies for promoting movement quality suggested a movement awareness learning cycle and components for clinical use. Conclusions This study demonstrated specific attitudes and skills used by physical therapist experts to promote movement quality in their clinical practice. These results may serve as a therapeutic framework for promoting movement quality in clinical physical therapy, although further research is needed.

In color flow imaging for medical diagnosis, the inherent trade-off between frame rate and image quality may often lead to suboptimal images. Parallel receive beamforming is used to help overcome this problem, but this introduces artifacts in the images. In addition to the parallel beamforming artifacts found in B-mode imaging, we have found that a difference in curvature of transmit and receive beams gives a bias in the Doppler velocity estimates. This bias causes a discontinuity in the velocity estimates in color flow images. In this work, we have shown that interpolation of the autocorrelation estimates obtained from overlapping receive beams can reduce these artifacts significantly. Because the autocorrelation function varies quite slowly, the beams can be acquired with a considerable time difference, for instance across interleaving groups or across scan planes in a 3-D scan. We have shown that a high frame rate of color flow images can be maintained with parallel beam acquisition with minimal deterioration of the image quality.

Artikkelen argumenterer for at sjukepleiefaget har vorte politisk styrt ved hjelp av koplingar mellom sjukepleiepraksis og ulike former for vitskapsbasert kunnskap.

Movement quality is a phenomenon frequently used by physiotherapists in oral language, written text, and clinical practice, with little clarification. The purpose was to investigate the lived experiences of a group of expert physiotherapists, searching for essential features and characteristics of the phenomenon. A phenomenological study, using in-depth interviews was chosen. Ten copies of Fine Art were used to stimulate the description of the phenomenon. The informants were 15 peer-designated physiotherapists, five from each field of neurology, psychosomatic/psychiatry and primary health care. They were nominated by physical therapist leaders in the region. The interviews were audiotaped and transcribed. Giorgis' recommendation concerning analysis of the interview data was followed. Four main themes were developed, seeing movement quality as biomechanical, physiological, psycho-socio-cultural, and existential, all interacting processes. Each theme includes preconditions to movement quality and movement characteristics. Movement quality in general was seen as a unifying phenomenon, representing a synthesis of the four themes. The outcome of the study is the Movement Quality Model (MQM) illuminating essential features and characteristics of the phenomenon. Further research is needed for clarification and application in clinical practice.

Parallel beamforming is frequently used to increase the acquisition rate of medical ultrasound imaging. However, such imaging systems will not be spatially shift invariant due to significant variation across adjacent beams. This paper investigates a few methods of parallel beamforming that aims at eliminating this flaw and restoring the shift invariance property. The beam-to-beam variations occur because the transmit and receive beams are not aligned. The underlying idea of the main method presented here is to generate additional synthetic transmit beams (STB) through interpolation of the received, unfocused signal at each array element prior to beamforming. Now each of the parallel receive beams can be aligned perfectly with a transmit beam - synthetic or real - thus eliminating the distortion caused by misalignment. The proposed method was compared to the other compensation methods through a simulation study based on the ultrasound simulation software Field II. The results have been verified with in vitro experiments. The simulations were done with parameters similar to a standard cardiac examination with two parallel receive beams and a transmit-line spacing corresponding to the Rayleigh criterion, wavelength times f-number (ulambdamiddotf#). From the results presented, it is clear that straightforward parallel beamforming reduces the spatial shift invariance property of an ultrasound imaging system. The proposed method of using synthetic transmit beams seems to restore this important property, enabling higher acquisition rates without loss of image quality

Objectives There is a call for a further investigation of Sense of Coherence (SOC), the central concept in salutogenesis, and its relation to health and life satisfaction. No previous studies have investigated the utility of SOC versus mental symptoms for the prediction of life satisfaction among people with chronic mental health problems (MHP). Methods The present study has a prospective design including a baseline assessment and a 1-year follow up. We recruited 107 adults from the community health care system. SOC was measured by the Sense of Coherence questionnaire, mental symptoms by the Symptom Checklist-90 revised and life satisfaction by The Quality of Life Scale (all Norwegian versions). Results The results show that while SOC predicts change in life satisfaction (standardized beta coefficient for SOC was 0.39, P = 0.014), mental symptoms did not (standardized beta coefficient 0.00, P = 1.0). Conclusions These findings emphasize the importance of assessing factors that may explain differences in life satisfaction over and above mental symptoms among people with MHP. The results indicate that improving SOC among people with MHP might provide important opportunities for improving their life satisfaction.

We propose a new algorithm for real-time, adaptive-clutter-rejection filtering in ultrasound color flow imaging (CFI) and related techniques. The algorithm is based on regression filtering using eigenvectors of the signal correlation matrix as a basis for representing clutter, a method that previously has been considered too computationally demanding for real-time processing in general CFI applications. The data acquisition and processing scheme introduced allows for a more localized sampling of the clutter statistics and, therefore, an improved clutter attenuation for lower filter orders. By using the iterative power method technique, the dominant eigenvalues and corresponding eigenvectors of the correlation matrix can be estimated efficiently, rendering real-time operation feasible on desktop computers. A new adaptive filter order algorithm is proposed that successfully estimates the proper dimension of the clutter basis, previously one of the major drawbacks of this clutter-rejection technique. The filter algorithm performance and computational demands has been compared to that of conventional clutter filters. Examples have been included which confirms that, by adapting the clutter-rejection filter to estimates of the clutter-signal statistics, improved attenuation of the clutter signal can be achieved in normal as well as more excessive cases of tissue movement and acceleration.

We used the Quality of Life Scale to assess quality of life among 107 Norwegians with chronic mental health problems (MHP) from the community health care system versus 1893 general population adults. The groups differed in quality of life, including broader life domains. Age and quality of life were more strongly positively correlated in the MHP group than in the general population. Mental symptoms (measured by the Symptom Checklist-90 Revised) and quality of life were strongly negatively correlated in the MHP group. Services for people with chronic MHP should focus on enhancing quality of life and on its role as an outcome variable.

The study addresses the following two questions: 1) Do the patients and staff at psychiatric hospitals hold similar or divergent views with regard to what is good care? 2) Does gender influence how patients and staff at psychiatric hospitals rank the importance of what is good care? The study was carried out by a survey design. Four hospitals in western Norway with a total of 65 patients and 79 staff took part. A revised version of the Care Q instrument was used. The results show that both groups rank human interaction between patients and staff as the most important care procedure. Physical nursing and monitoring functions were considered the least important care procedures by both groups. The results also show a statistically significant difference between patients and staff with regard to 15 out of 50 individual statements. As an example the statement «is honest about your mental problems», and «gets to know the patient as an individual person» was ranked as much more important by patients than by staff. The study also indicates that the gender of patients and staff may influence how they rank the importance of care procedures.

Although the theory of salutogenesis provides generic understanding of how coping may be created, this theoretical perspective has not been explored sufficiently within research among people suffering from mental health problems. The aim of this study is to investigate the effect of talk-therapy groups based on salutogenic treatment principles on coping with mental health problems.In an experimental design, the participants (residents in the community) were randomly allocated to a coping-enhancing experimental group (n=59) and a control group (n=47) receiving standard care. Coping was measured using the sense of coherence (SOC) questionnaire.Coping improved significantly in the experiment group (+6 points) compared with the control group (-2 points). The manageability component contributed most to this improvement.Talk-therapy groups based on salutogenic treatment principles improve coping among people with mental health problems.Talk-therapy groups based on salutogenic treatment principles may be helpful in increasing coping in the recovery process among people with mental health problems and seem to be applicable to people with various mental health problems.

In ultrasound Color Doppler imaging, a grayscale B-mode image and a Doppler image representing velocities are overlaid to produce a color coded image of e.g. blood flow or myocardial movement. Normally, the B-mode and Doppler images are acquired at the same rate, resulting in trade offs between B-mode image quality and Doppler frame rate. In this work, we present a new scan sequencing technique for Color Doppler imaging, where the B-mode image is acquired at a lower frame rate than the Doppler scan. This is achieved by splitting the B-mode image in subscans which are acquired in between multiple scans of the entire Doppler image. In this way, a full width B-mode image with high spatial resolution is kept while the temporal resolution of the velocity information is increased. In this paper, application of the new technique in Tissue Velocity Imaging (TVI), is discussed, showing the potential for improving lateral beam density or temporal resolution in Color Doppler imaging.

During the last years there has been a wide reduction in institution places in psychiatric health care. The purpose of this study was to present how psychiatric patients experience their situation at home, and in what situations they need help from the psychiatric community nurses. Data were gathered from eleven qualitative interviews with eight patients. A hermeneutical approach and method was used in the study. The main focus was on the quality of life of the patients. The patients expressed a need of having an informal contact with the nurses and that the nurses focused on motivation and practical action. Three main factors showed out to be the causes related to the need of help. The first factor was the experience of psychological pain. The second factor was the experience of loneliness, and the third factor was related to the tendency of passivity. The patients need for help and guidance was therefore often related to emotional support, social contact and activities.

In this study we present new signal processing algorithms for visualization of blood flow in ultrasound imaging systems. Color flow systems produce each image from packets of typically 5-15 pulses transmitted along each scan line in the image. The Doppler shift from moving blood is utilized to remove clutter noise, and for color coding of the blood velocity component along the ultrasound beam. Blood motion causes a corresponding movement in the speckle pattern of the received signal from pulse to pulse. In conventional color flow imaging, substantial temporal and spatial averaging is used in order to get reliable detection of blood vessels, and low variance in the velocity estimate. This averaging process suppresses the spatial speckle pattern in the signal amplitude. In our technique the speckle pattern from the moving blood cells is preserved and enhanced, enabling the user to visually track the blood motion from pulse to pulse. The speckle visualization is combined with conventional color flow color encoding. In addition to preserving the speckle pattern, several image frames per packet of pulse transmissions are computed. The perception of movement is further improved if the scatterers in a large spatial region are imaged almost simultaneously. This is obtained by increasing the time between pulse transmissions in the same beam direction, and using a technique called beam interleaving. After transmitting a pulse in a first direction, there is little available to acquire data in several other beam directions before transmitting the next pulse in the first direction. Visualization of the speckle pattern movement gives the user a correct perception of the blood flow direction and magnitude, and is also useful in separating true blood flow from wall motion artifacts.

The quality of ultrasound color flow images is highly dependent on sufficient attenuation of the clutter signals originating from stationary and slowly moving tissue. Without sufficient clutter rejection, the detection of low velocity blood flow will be poor, and the velocity estimates will have a large bias. In some situations, e.g., when imaging the coronary arteries or when the operator moves the probe in search for small vessels, there is considerable movement of tissue. It has been suggested that clutter rejection can be improved by mixing down the signal with an estimate of the mean frequency prior to high pass filtering. In this paper, we compare this algorithm with several other adaptive clutter filtering algorithms using both experimental data and simulations. We found that realistic accelerations of the tissue have a large effect on the clutter rejection. The best results were obtained by mixing down the signal with non-constant phase increments estimated from the signal. This adapted the filter to a possibly accelerated tissue motion and produced a significant improvement in clutter rejection.

The purpose of this study is to identify central aspects of feelings in relation to the experience of being a brother or sister of someone who suffers from schizophrenia. The study makes use of a hermeneutical method for the collection of data as well as for the systemizing and interpretation of data. The participants in the study were 16 siblings of persons with diagnosed schizophrenia. In total 80 interviews were done, with an average length of 50 min. A theory of interrupted feelings was developed within the tension between empirical data and preunderstanding. Mixed feelings of grief, hope, anger, guilt and shame are interrupted by four interrelated factors: ambiguous loss, the fluctuating nature of the illness, an inner prohibition of feelings and the tendency of others to invalidate the feelings. The interruption may lead to a lonely and painful experience which is difficult both to process for oneself and to share with others.

A new approach to spectrum analysis, which is capable of suppressing velocity ambiguity in pulsed-wave ultrasonic Doppler, is presented. By simultaneous processing of several data samples from a range in depth, the movement of the scatterers along the ultrasonic beam can be tracked from pulse to pulse for each velocity component in the spectrum. In this way the correlation length of the signal component arising from a specific velocity increases when that velocity matches the expected velocity. The resulting velocity/time spectral display shows a more clearly defined spectral envelope of the maximum velocity than with conventional methods based on the discrete Fourier transform of the Doppler signal. This makes it possible to delineate velocity waveforms with peak velocity up to several times the Nyquist limit. Experimental data from human subclavian and aortic arteries are presented, where the new method is compared to conventional spectrum analysis.

An ultrasound system comprises a probe including a two-dimensional (2D) array of transducer elements that form an aperture having a plurality of receive elements that are configured to receive ultrasound signals. The transducer elements form at least one transmit sub-aperture that is configured to be interconnected with a fixed group of the transducer elements within the aperture. Transmitters generate electrical transmit signals, and at least one transmit sub-aperture processor (tx SAP) maps the transducer elements within the fixed group of the transducer elements to the transmitters in a transmit configuration based on a beam steering direction.