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This article illuminates how understandings of disability is negotiated through use of assistive activity technologies, when people with physical impairment use this kind of technology in their social and physical environment. A qualitative data design was adopted involving interviews with 44 adults with mobility impairments using assistive activity technology. The study was conducted in Mid-Norway. In analysing the findings, this study adopted the stepwise deductive-inductive approach with social constructivism as a theoretical basis. Furthermore, a relational understanding of disability and the cyborg metaphor are used to explain how disability and assistive activity technology are embodied, as well as social and material matters. The article shows how aspects in the social construction of disability are changed when people using assistive activity technology become subjects for new and positive interpretations. The understanding of disability changes meaning according to the use of different technologies, between different people and in different contexts. To understand disability, we need to explore how people ascribe meaning to both the material and the social aspects of disability. The use of assistive activity technology led to new opportunities to participate in valued physical activities, and to negotiate new perceptions of disability. The understanding of disability and assistive activity technology use is an intertwined interpretation of human bodies, technology, and activity. [ABSTRACT FROM AUTHOR]

This article explores the experiences of mobility-impaired individuals participating in leisure-time physical activities through the use of assistive activity technology (AAT). Its purpose is to highlight how these experiences affect participation in everyday life. This article provides new knowledge about the participation of this population in leisure-time physical activities. Qualitative, semi-structured interviews were analysed according to the stepwise-deductive–inductive approach. During the analysis, self-determination theory (SDT) emerged as a theoretical tool for understanding how social context affects motivation as an interacting concept in the participation of leisure-time physical activity (LTPA). Individuals with mobility impairments who use AAT for leisure-time physical activities experience opportunities to participate in ordinary and valued activities that allow them to improve their social positions. Further, use of AAT provided the informants with opportunities to alter their daily routines, enjoy time on their own and enhance their personal awareness. Having opportunities to use AAT independently is experienced as a recognition of their individuality. Thus, this article highlights a new aspect of participation as performing a socially valued activity in solitude. How technology provides opportunities for social interaction influences the informants' experiences and motivation to use technology. LTPA through the use of AAT promotes mastery and personal dignity, thereby revealing a new aspect of participation as being involved in an independent activity. The allocation system for assistive activity technology requires knowledge about personal motivation for assistive activity technology use and the connection between leisure-time physical activity and social participation. Additional education about and understanding of motivational factors for assistive technology use is needed. [ABSTRACT FROM AUTHOR]

In affluent societies how people use technology is symbolic of various values and identities. This article investigates the symbolic values and use of assistive technologies from the world of information and communication technology (ICT) in the daily lives of 11 visually impaired young Norwegians. The article draws on a qualitative interview study and employs an interactionist approach. While the use of ICT is found to symbolise competence, belonging and independence, the use of ICT assistive technologies is found to symbolise restriction, difference and dependency. Thus, ICT and ICT assistive technologies have inherently contradictory sets of associations. To fit in as ordinary young people the visually impaired participants reject ICT assistive technologies whenever possible. The partially sighted participants who are somehow capable of participating in online interactions with their peers without ICT assistive technologies reject them. The blind participants, however, do not have the option of participating online without ICT assistive technologies and, consequently, they accept ICT assistive technologies. [ABSTRACT FROM AUTHOR]

Background: Persistent pain is increasingly recognized as a growing issue among adolescents worldwide, with an estimated prevalence of 10-30%. Physical therapy is a recommended treatment modality for managing this kind of pain. Yet, there is still limited knowledge regarding how physiotherapists experience, manage, and follow up this patient population., Purpose: This qualitative study aimed to explore the experiences of physiotherapists in Norwegian primary healthcare working with adolescents experiencing persistent pain. The study examined the resources the therapists make use of, and the challenges they encounter., Method: Four focus group interviews were conducted with a total of 13 Norwegian physiotherapists experienced in treating adolescents with persistent pain. The interviews explored the physiotherapists' experiences of working with adolescents with persistent pain. A reflexive thematic analysis was conducted to analyze the data., Results: Three main themes were identified from the data analysis: (1) Relationship building as the foundation of the intervention. (2) Accompanying the adolescents into their everyday life. (3) Challenging cases that are also rewarding to work with., Conclusion: This study sheds light on the importance of sufficient and multifaceted clinical competence among physiotherapists to enable them to work effectively with adolescents experiencing persistent pain, and their families. The experiences of physiotherapists show the importance of a strong therapeutic alliance and individualized treatment approaches, based on shared decision-making and age-appropriate communication and interventions. The therapists in our study emphasized the need to integrate interventions into the adolescents' everyday lives, tailoring treatments to the unique life of each individual. Physiotherapists must navigate the complexities of meeting individual patient needs and adapting to challenges beyond traditional practice. To support this patient group effectively, ongoing professional development is recommended, either through continued education or colleague guidance from other experienced physiotherapists.

Background: Many post-myocardial infarction (MI) patients struggle with physical activity behavior change (BC) for life-long secondary prevention. There is limited knowledge about factors influencing long-term physical activity BC among post-MI patients. This qualitative study aimed to explore the beliefs and experiences related to post-MI patients' physical activity BC process following a year's participation in a supervised and self-monitored exercise program: the Norwegian Trial of Physical Exercise After MI (NorEx)., Methods: We conducted a qualitative study, performing in-depth semi-structured interviews with a randomly selected sample of NorEx participants when they were scheduled for cardiopulmonary exercise testing after one year of participation. Interviews were transcribed verbatim and the data was analyzed by applying reflexive thematic analysis., Results: Seventeen participants (n = 4 female [24%]; median age, 61 years; median time since index MI, 4 years) were recruited and interviewed once. Analysis resulted in four main themes (nine sub-themes): (1) Personal responsibility to exercise (Exercise is safe, Health benefits, Habitual exercise); (2) Peer social support for a sense of safety and belonging (Social exercise, Supervision is preferred); (3) Research participation transformed exercise beliefs (High-intensity exercise is superior, Personal Activity Intelligence (PAI) promotes exercise adherence); and (4) Mind the intention-behavior gap (Initial anxiety, Lack of continued follow-up)., Conclusions: Several participants reported that they were able to maintain exercise BC during a year's participation in NorEx. Nevertheless, a perceived lack of continued and individualized follow-up made some participants struggle with motivation and self-regulation, leading to an intention-behavior gap. Therefore, our findings suggest there is a need for individualized and continued social support and supervision from health and exercise professionals to maintain long-term exercise BC for secondary prevention among post-MI patients., Trial Registration: The NorEx study has been registered at ClinicalTrials.gov (NCT04617639, registration date 2020-10-21)., (© 2024. The Author(s).)

Materials and Methods: Thirteen parents (eight mothers and five fathers) of ten children participated in this qualitative study through individual in-depth interviews. Transcripts were analysed using reflexive thematic analysis., Results: The parents emphasized the advantage of having the intervention provided at home with coaching and flexible support from the interprofessional team of therapists. This assured the families and enhanced their capacity to provide the child with playful and enriched learning opportunities integrated in everyday life. However, identification of achievable goals and intervention delivery could be emotionally taxing for parents, especially in the early stages and if treatment effects were below hopes and expectations., Conclusions: Our findings provide insights into what kind of support parents prefer and dilemmas professionals should be aware of when providing early intervention to families of infants at high risk of CP. Parents appreciated being involved as equal partners and receiving home-based guidance. Acknowledging grief and sorrow as natural reactions and fostering open discussions about expectations seem essential in addressing families' individual needs.

Purpose: User participation is important in the delivery of health- and social services. Yet, our knowledge regarding how user participation is experienced from the perspective of those who use these services is limited. This study aims to develop knowledge regarding how young persons living with disabilities experience becoming independent in user participation., Materials and Methods: This qualitative study is inspired by Constructivist Grounded Theory. Nine young persons between 16 and 25 years of age and living with a disability, participated in the interviews., Results: The results revealed that user participation for young persons is a socially situated, relational, and skills-dependent process. User participation is characterized as a process, consisting of increasing skills , gradually reducing parental support, and responding to interactions with professionals . The three categories are strongly reciprocal and interrelated, forming the unifying core category of Striving towards independence in user participation ., Conclusion: We theorize about the Interrelated process of becoming independent in user participation for young persons with disabilities. This theory highlights the need to understand the interrelatedness of user participation, allowing for a recognition of the complexity of user participation, showing it as a process involving developing skills, and gradually becoming independent and skilled in user participation.Implications for rehabilitationYoung persons with disability rely on support from parents as well as professionals to become independent in user participationProfessionals should acknowledge that user participation is a learning process and allow for time and resources to aid this processFocusing on increasing health literacy alone is not sufficient to ensure user participation for young persons with disability.

Purpose: The use of Information and communications technologies (ICT) in the public sector is widespread and on the increase. There is a need to develop knowledge regarding the end users experiences of using ICT to engage with services. This study aims to provide knowledge regarding young persons with disabilities or chronic disease experience using ICT to engage with health- and social care services., Materials and Methods: Nine young persons between 16 and 25, living with chronic disease or physical disability, participated in this study. The data was collected using semi-structured interviews. The interviews were recorded, transcribed verbatim and analysed using Constructivist Grounded Theory., Results: Three categories were identified that reflected the young persons' experiences with using ICT to engage with health and social care services. (1) Navigating in an information overflow , (2) Experiencing disparate dialogues , (3) Utilising the potential of ICT . The young persons experienced that ICT used for engaging with health and social care services did not necessarily fit their need, yet, they saw how ICT had potential to increase engagement with services, especially with an increased focus on dialogue. The findings can be subsumed by the core category Inaccessible Possibilities , illustrating both the potentials and the challenges ICT presented., Conclusion: The study shows that although young persons are perceived as digitally native, they experienced challenges using ICT to engage with health- and social services. The poor fit of ICT combined with navigation- and accessibility issues, hinder engagement. However, ICT inhabit a potential to increase engagement, especially communication.IMPLICATIONS FOR REHABILITATIONYoung persons' experiences show that ICT can be useful for enhancing engagement with health and social care servicesICT provided by health and social services does not necessarily meet young persons need for dialogueAn increased focus on accessibility and design is necessary to ensure people with disabilities access to ICT used by health- and social care services.

The implementation of technology in home-based services takes place in contextualised socio-material practices negotiated through interactions between a diversity of actors. Prerequisites for succeeding in this process are time and competence, and that use of the technology is experienced as meaningful, for both the support staff and the resident. In this article, we investigate how implementation of cognitive assistive technology (CAT) in home-based services for young adults with intellectual disabilities influences the support staff`s professional practice. The participants are eight support staff members, five women and three men. Data were collected through two group interviews, the second one 8 months after the first one. The data were analysed according to a systematic text condensation (STC) approach. Implementation of CAT is a demanding process, revealing different perspectives on professionalism and changing power relations, and entails a new way of working for the support staff.

Purpose: This article critically examines user-involvement in the service delivery process for assistive activity technology., Methodology: Data were collected in semi-structured interviews with 44 end users of assistive activity technology and in focus group interviews with 11 professionals at Norway's Assistive Technology Centre. Data was analysed according to a stepwise deductive-inductive approach., Findings: Flawed organisational principles like division of responsibility, unclear regulations, and a lack of competence with assistive activity technology among service professionals have hindered user involvement in the service delivery process., Conclusion: A missing knowledge of assistive activity technology among professionals and the current organisation of services creates barriers for a positive collaboration with users in the service delivery process of assistive activity technology.IMPLICATIONS FOR REHABILITATIONThe spread of information among users and courses for professionals should be expanded to ensure the necessary competence with assistive activity technology within the service delivery process.In developing the service delivery process for assistive activity technology, professionals should act less as guardians of traditional functional requirements and more as active providers of different technological solutions.The service delivery process for assistive activity technology should allow long-term testing to identify relevant social and physical factors affecting the use of this type of technology, before delivery.Guarantees and complaint systems should be established in the service delivery process for assistive activity technology.

In Norway, where all citizens are entitled to live in their own homes in their local communities, people with intellectual disabilities receive community-based home care services that aim to promote their ability to live on their own. In our study, we investigated how using an assistive device for cognitive impairment - namely, a memo planner (MP) - in community-based home care services affected the everyday lives of people with intellectual developmental disabilities (IDD). Our sample consisted of seven young adults with IDD and their support staff. Data were collected during field observations and group interviews and analysed via systematic text condensation. The findings illuminate how using an MP can structure the daily lives of young adults with IDD and afford them opportunities to participate in everyday activities. In this article, we discuss how using an MP shapes interactions between people with IDD and their support staff.

Studies of secondary prevention for cardiovascular disease show low fulfilment of guideline-recommended targets. This study explored whether nurse-led follow-up could increase adherence to statins over time and reasons for discontinuation. All patients admitted for acute coronary syndrome at Östersund hospital between 2010-2014 were screened for the randomized controlled NAILED-ACS trial. The trial comprises two groups, one with nurse-led annual follow-up and medical titration by telephone to reach set intervention targets and one with usual care. All discontinuations of statins were recorded prospectively for at least 36 months and categorized as avoidable or unavoidable. Kaplan-Meier estimates were conducted for first and permanent discontinuations. Predictors for discontinuation were analysed using multivariate Cox regression, statin type and mean LDL-C at end of follow-up. Female gender was a predictor for discontinuation. Allocation in the intervention group predicted increased risk for a first but decreased risk for permanent discontinuation. A nurse-led telemedical secondary prevention programme in a relatively unselected ACS cohort leads to increased adherence to statins over time, greater percentage on potent treatment and lower LDL-C compared to usual care. An initially increased tendency toward early discontinuation in the intervention group stresses the importance of a longer duration of structured follow-up.

Current methods to measure cerebral blood flow (CBF) in the neuro critical care setting cannot monitor the CBF continuously. In contrast, continuous measurement of intracranial pressure (ICP) is readily accomplished, and there is a component of ICP that correlates with arterial inflow of blood into the cranial cavity. This property may have utility in using continuous ICP curve analysis to continuously estimate CBF. We examined the data from 13 patients, monitored with an intraventricular ICP device determining the pulsatile amplitude ICP amp as well as the area under the ICP curve (AUC ICP ). Using an elastance measurement, the ICP curve was converted to craniospinal volume (AUC ΔV ). The patients were examined with Phase Contrast Magnetic Resonance Imaging (MRI), measuring flow in the carotid and vertebral arteries. This made it possible to calculate CBF for one cardiac cycle (ccCBF MRtot ) and divide it into the pulsatile (ccCBF MRpuls ) and non-pulsatile (ccCBF MRconst ) flow. ICP derived data and MRI measurements were compared. Linear regression was used to establish wellness of fit and ANOVA was used to calculate the P value. No correlation was found between ICP amp and the ccICP MRpuls (P = 0.067). In contrast there was a correlation between the AUC ICP and ccCBF MRpuls (R 2  = 0.440 P = 0.013). The AUC ΔV correlated more appropriately with the ccCBF MRpuls . (R 2  = 0.688 P < 0.001). Our findings suggests that the pulsatile part of the intracranial pressure curve, especially when transformed into a volume curve, correlates to the pulsatile part of the CBF.

Objective: The objective of this study is to investigate the discriminative validity of neuropsychological tests and diagnostic assessment instruments in diagnosing adult ADHD in a clinical psychiatric population., Method: Of 108 patients, 60 were diagnosed with ADHD. The Diagnostic Interview for ADHD in adults (DIVA 2.0) and Adult ADHD Self-Report Scale (ASRS) v.1.1 together with eight neuropsychological tests were investigated., Results: All instruments showed poor discriminative ability except for the DIVA, which showed a relatively good ability to discriminate between the groups (sensitivity = 90.0; specificity = 72.9). A logistic regression analysis model with the DIVA and measures of inattention, impulsivity, and activity from continuous performance tests (CPTs) showed a sensitivity of 90.0 and a specificity of 83.3., Conclusion: Neuropsychological tests have a poor ability to discriminate between patients diagnosed with ADHD and patients not diagnosed with ADHD, but variables from CPT tests can contribute to increasing the specificity by 10% if used in combination with the DIVA.

Background: Active ageing reflects the message from World Health Organisation about addressing the challenge faced by the rapidly ageing population. Knowledge about barriers and facilitators to an active lifestyle must be given more attention. In addition, men seem to participate less in cultural activities and less in fall-prevention groups than women do. When mostly women work with the elderly in primary care, one might question whether the activities offered to older men meet their activity preferences. The aim of this study is to provide new knowledge about challenges and motivators encountered by retired men in maintaining physical activity when ageing., Methods: Nine retired men, aged between 66 and 83, wrote a Time Geographic Diary for 7 days each. Two focus group discussions with the men were held. A Systemic Text Condensation was used to analyse the data., Results: The analyses identified three categories to describe challenges in being physical active: differences between men and women; meaningful physical activity; and environmental - especially socio-cultural - constraints. Motivating conditions were seen as: new activities to get younger friends, and more information about how to cope., Conclusions: To achieve the aim of active ageing, service providers as well as local authorities need to have a better understanding of the challenges retired men encounter when ageing. This study highlights vital aspects of the challenges faced by retired men in maintaining their physical activity level.

Objective: The purpose of the study was to evaluate an Internet-based cognitive behavioral therapy (iCBT) program targeting difficulties and impairments associated with adult ADHD., Method: Forty-five adults diagnosed with ADHD were randomized to either self-help (iCBT self-help format [iCBT-S]), self-help with weekly group sessions (iCBT group-therapy format [iCBT-G]), or a waiting-list control group. Treatment efficacy was measured at pre- and posttreatment and at 6-month follow-up., Results: Intention-to-treat (ITT) analysis showed a significant reduction in ADHD symptoms for the iCBT-S group in comparison with the waiting-list controls at posttreatment, with a between-group effect size of d = 1.07. The result was maintained at 6-month follow-up. No significant difference was found at posttreatment or 6-month follow-up between the iCBT-S and iCBT-G groups., Conclusion: The findings show that a CBT treatment program administered through the Internet can be a promising treatment for adult ADHD. Limitations of the study design and directions for future research are discussed.