Objective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH)...Show moreObjective. To determine the effectiveness of a rehabilitation program including physical exercise, in improving cognition, participation, and coping in patients with a subarachnoid hemorrhage (SAH). Secondary, it was aimed to identify the role of clinical characteristics in the effectiveness of the rehabilitation program. Methods. A longitudinal pilot intervention study was performed, with measurements before the start (T0), after three months (T1), and after six months (T2). Cognition was measured with the Montreal Cognitive Assessment, participation with the Impact on Participation and Autonomy questionnaire, and coping with the Utrecht Proactive Coping Competence Scale. Generalized Estimating Equation analyses were performed. Results. A total of 19 patients with SAH participated; 13 in the intervention group and 6 in the control group. For the intervention group, cognition improved between T0 and T2 and between T1 and T2. Participation declined between T0 and T1, but improved between T1 and T2. Proactive coping declined between T0 and T2 and between T1 and T2. Cognition of the control group did not change, but participation improved between T0 and T1 and proactive coping declined between T0 and T1. There was no significant difference between the control and intervention groups in improvements in cognition between T0 and T1 (p = 0.090). However, there was a significant difference between the control and intervention groups in changes in participation between T0 and T1 (p = 0.001) and in changes in coping between T0 and T1 (p < 0.001). The location of SAH played a role in the differences in participation, but not in cognition and coping. For treatment type and time since SAH, no significant effects were found. Conclusion. There was no effect of the rehabilitation program on cognition. The control group had a better participation level after three months and the intervention group worsened. The intervention group had a stable coping style after three months, whereas the control group declined in the use of proactive coping. Only the characteristic location of the aneurysm played a role in the participation level after three months, but not in cognition or coping. The other characteristics did not play a role in the changes. This study indicates that some long-term complaints can improve after the rehabilitation program, but more research is needed.Show less
Abstract Background: Stroke patients discharged home often experience emotional and cognitive problems, resulting in participation restrictions. The ECO-stroke intervention was designed to reduce...Show moreAbstract Background: Stroke patients discharged home often experience emotional and cognitive problems, resulting in participation restrictions. The ECO-stroke intervention was designed to reduce these restrictions. Effectiveness will be examined in a separate randomized controlled trial (RCT). The current process evaluation assesses the feasibility of the ECO-stroke intervention, examining implementation, mechanisms of impact and contextual factors. Implementation involves assessing who received the intervention (reach), the intervention quantity (dose), and adherence to the protocol (fidelity). Additionally, mechanisms of impact examined the relationship between intervention components and changes in participation restrictions. Contextual factors examined external barriers and facilitators affecting implementation. Methods: Data from 264 patients allocated to the intervention group of the RCT were used. Nurses collected data in electronic case reports at six weeks after stroke. Measures included timing of the intervention, intervention duration, whether questionnaires were completed, shared decision-making was used, and whether a companion was present. Participation restrictions was measured using the USER-P-R questionnaire at 6 and 12 weeks after stroke. These measures were used to assess the fidelity and to conduct a multiple regression analysis examining their predictive properties on change in participation restrictions. Additionally, qualitative data was collected through focus group interviews with nurses, which were transcribed and analysed using a thematic analysis to further analyse implementation, mechanisms of impact and contextual factors. Results: The intervention reached 262 of the patients (99.2%), and five of the nurses (83.3%). The median intervention duration was 60 minutes. Components of the intervention were performed according to protocol > 80% of the time, except for duration of the intervention (50.4%). Individual components of the intervention did not predict change in participation restrictions. The intervention duration was a barrier for implementation, as patients become fatigued during the intervention, and the workload for nurses is increased. Conclusions: The intervention was implemented successfully. Nurses were positive about the intervention. Due to methodological issues no firm conclusion can be drawn on the mechanisms of impact. If the intervention turns out to be (cost-) effective, there are no major barriers for implementation in clinical practice.Show less
After a brutal war, ISIS (Islamic State of Iraq and Syria) lost its significant territorial areas. How to deal with the organization’s members returning back to their home countries, has been...Show moreAfter a brutal war, ISIS (Islamic State of Iraq and Syria) lost its significant territorial areas. How to deal with the organization’s members returning back to their home countries, has been subject to heated debate. By focusing specifically on the role of the organization’s female members this paper explores the differences in the judicial approaches to the returning ISIS-women, through a case study analysis of Norway and Sweden. By discussing the differences in the expansion of national terror legislation, its implementation in relation to the women of ISIS, and the possible contributing factors to the different approaches, this paper answers the following research question: how do Norway and Sweden differ in their judicial approach to the Norwegian and Swedish women of ISIS returning back home between 2012-2022? Moreover, what are the main contributing factors leading to the differences in the approaches? The paper argues that Norway is more punitive towards returning women than Sweden. This is due to Norway’s legislation on terrorism participation, which allows for prosecution without classifying which actions count as participation. Furthermore, the paper argues that this differs from Sweden’s legislation on participation, which requires evidence of grave terrorist crimes committed in order to prosecute. This, the paper demonstrates, results in Sweden lacking the legal framework to prosecute its female nationals returning from ISIS. Lastly, the paper explores possible factors contributing to the different judicial approaches and highlights the Swedish legislative council, the effect of recent terrorist attacks, and loud critics as the most significant. Through the use of the case study, this paper contributes to knowledge on the implications domestic judicial differences can have in combatting transnational threats like terrorism.Show less
Fish-smoking is a popular post-harvest preservation method in Ghana, predominantly carried out by women in fishing communities. NGOs and researchers in Ghana in the 1950s identified a range of...Show moreFish-smoking is a popular post-harvest preservation method in Ghana, predominantly carried out by women in fishing communities. NGOs and researchers in Ghana in the 1950s identified a range of adverse health risks in local fish-smoking oven technologies that place fish-smokers at risk. The main approach that has been adopted to combat these risks has been through developing new fish-smoking oven technology, which is being distributed across Ghana by NGOs. This research paper aimed to contribute an alternative understanding of these NGO approaches in Ghana through investigating the level of participation within NGO interventions and by drawing attention to gender dynamics that frame fish-smoker’s agency. Through conducting research at fish-smoking sites in Jamestown, Greater Accra, this paper’s findings demonstrate how fish-smoker’s participation and inclusion in NGO interventions are limited, leaving fish smokers hesitant to adopt NGO distributed oven technologies. Drawing from key theory around participation and Gender and Development, this paper stresses the dynamic interplay between participation and gender within NGO fish-smoking oven interventions and the far-reaching implications for women’s collective success in the Ghanaian fish-smoking industry. This study’s conclusions suggest that alternative approaches, which consider the role of gender in the fisheries value chain more closely, could result in more transformative interventions for fish-smokers in Ghana.Show less
An elected representative has the obligation to make decisions based on how this affects the population. There are various organized groups which seek to actively influence politicians in the...Show moreAn elected representative has the obligation to make decisions based on how this affects the population. There are various organized groups which seek to actively influence politicians in the decision-making process. This raises the question how a representative should deal with these organized groups, which we normally call lobbyists. In this thesis I will look at lobbying from a philosophical perspective. I will answer the question how lobbying influences democracy and how it affects democratic legitimacy. This will be done based on three accusations, that lobbying can create imbalances in decision-making, that lobbying can lead to a lack of transparency, and the accusation that lobbyists use immoral practices. I will first discuss different types of democracy and what the important features and requirements of a democracy are, and what exactly we mean by lobbying. Following this I will discuss the second accusation as well as the positive aspects lobbying can have on democracy. Positive aspects include the fact that lobbying allows for an exchange of information between politicians and external parties, that lobbying can lead to better representation by politicians because citizens can contact government officials directly, and the fact that lobbying can lead to increased publicity. Following this I will discuss possible solutions to the problems of lobbying. The first solution we will discuss states that publicity in the government is a strong way to counter many of the problems of lobbying. The second way to solve the problems of lobbying is by turning towards a more deliberative mode of democracy.Show less
The aim of this thesis paper is to understand the change in the relationship between libraries and society as part of the effects of today’s changes in technology, to analyze how this change is a...Show moreThe aim of this thesis paper is to understand the change in the relationship between libraries and society as part of the effects of today’s changes in technology, to analyze how this change is a reflection of how the very structure of information is being altered by the ways it is conveyed through digital platforms, and to trace its social impact. We are a culture of the book, the way we perceive and interact with the world has been shaped by the implications of print culture, and now this way is being transformed by the implications of digital culture. The different properties attributed to digital technologies enable people to have a more active and significant role in the construction of knowledge in culture.Show less
When becoming a political party during the 1992 elections, Hizbullah decided to shelve their revolutionary ideals of the establishment of an Islamic state in Lebanon in favour of accommodation with...Show moreWhen becoming a political party during the 1992 elections, Hizbullah decided to shelve their revolutionary ideals of the establishment of an Islamic state in Lebanon in favour of accommodation with the current political system. This thesis examines how they communicated this change in position firstly to the wider multisectarian public and secondly to their hardcore followers.Show less
This Thesis is a defense for Compulsory Voting. I the light of reasonable pluralism, societies need a moral compromise. In order to faccilitate the forming of a moral compromise widespread...Show moreThis Thesis is a defense for Compulsory Voting. I the light of reasonable pluralism, societies need a moral compromise. In order to faccilitate the forming of a moral compromise widespread political participation is necessary. Compulsory voting faccilitates participation and is thus justifiable.Show less
