Does children's fear matter? Evaluating children's positions in Finnish court decisions on stalking.

Children are at particular risk when one parent is targeted by the other parent's stalking behaviors post-separation. In this article, we explore how court decisions position children when assessing fear, distress, and unlawfulness in cases of parental stalking. The data comprised 127 court decisions on stalking that involved a relationship (dating, cohabitation, or marriage), separation/divorce, and one or more children. Using discourse analysis, we identified four categories in how children were positioned: (1) children relegated to the background, (2) children's involvement recounted as part of the facts, (3) children's involvement assessed as relevant because it affected the parent, and (4) children as agents or victims in their own right. The findings highlight a significant risk of losing sight of children when the focus is on parents, and our concern is that this may also contribute to children not receiving the support they need.

Children's Everyday Lives Shadowed by Stalking: Post separation Stalking Narratives of Finnish Children and Women.

This qualitative study discusses post separation stalking and its implications in children's everyday lives. Based on narratives of 13 Finnish children and 20 women, the research fills a gap in the knowledge regarding the psychosocial, emotional, and physical impacts of stalking on children when their mothers are stalked by a former partner. It identifies four forms of impact: (a) an atmosphere of fear and feelings of insecurity; (b) disguised acts of stalking and the father's performance of care, love, and longing; (c) exploitation of children in stalking; and (d) physical abuse, acts of violence, and threats of death. The findings indicate that stalking severely constrains children's everyday lives and strengthens, yet often distorts, the mother-child bond. The study concludes that in cases where mothers are stalked, professionals in the social and health services, law enforcement, and criminal justice should view the children, too, as victims and construct supportive social relationships for women and children facing threatening life situations.

Oxygenation and ventilation during prolonged experimental cardiopulmonary resuscitation with either continuous or 30:2 compression-to-ventilation ratios together with 10 cmH20 positive end-expiratory pressure.

BACKGROUND: In refractory out-of-hospital cardiac arrest, the patient is commonly transported to hospital with mechanical continuous chest compressions (CCC). Limited data are available on the optimal ventilation strategy. Accordingly, we compared arterial oxygenation and haemodynamics during manual asynchronous continuous ventilation and compressions with a 30:2 compression-to-ventilation ratio together with the use of 10 cmH2O positive end-expiratory pressure (PEEP). METHODS: Intubated and anaesthetized landrace pigs with electrically induced ventricular fibrillation were left untreated for 5 min (n = 31, weight ca. 55 kg), after which they were randomized to either the CCC group or the 30:2 group with the the LUCAS® 2 piston device and bag-valve ventilation with 100% oxygen targeting a tidal volume of 8 ml/kg with a PEEP of 10 cmH2O for 35 min. Arterial blood samples were analysed every 5 min, vital signs, near-infrared spectroscopy and electrical impedance tomography (EIT) were measured continuously, and post-mortem CT scans of the lungs were obtained. RESULTS: The arterial blood values (median + interquartile range) at the 30-min time point were as follows: PaO2: 180 (86-302) mmHg for the 30:2 group; 70 (49-358) mmHg for the CCC group; PaCO2: 41 (29-53) mmHg for the 30:2 group; 44 (21-67) mmHg for the CCC group; and lactate: 12.8 (10.4-15.5) mmol/l for the 30:2 group; 14.7 (11.8-16.1) mmol/l for the CCC group. The differences were not statistically significant. In linear mixed models, there were no significant differences between the groups. The mean arterial pressures from the femoral artery, end-tidal CO2, distributions of ventilation from EIT and mean aeration of lung tissue in post-mortem CTs were similar between the groups. Eight pneumothoraces occurred in the CCC group and 2 in the 30:2 group, a statistically significant difference (p = 0.04). CONCLUSIONS: The 30:2 and CCC protocols with a PEEP of 10 cmH2O resulted in similar gas exchange and vital sign outcomes in an experimental model of prolonged cardiac arrest with mechanical compressions, but the CCC protocol resulted in more post-mortem pneumothoraces.

Effect of MK-467 on organ blood flow parameters detected by contrast-enhanced ultrasound in dogs treated with dexmedetomidine.

OBJECTIVE: To evaluate the dexmedetomidine-induced reduction in organ blood flow with quantitative contrast-enhanced ultrasound (CEUS) method and to observe the influence of MK-467 on such reduction. STUDY DESIGN: Randomized cross-over study. ANIMALS: Six adult purpose-bred laboratory beagle dogs (mean body weight 15.3 ± 1.9 kg). METHODS: Contrast-enhanced ultrasound was performed on six conscious healthy laboratory beagles. The animals on separate occasions underwent three treatments: awake without any medication (CTRL), dexmedetomidine 10 µg kg(-1) (DEX) and DEX + MK-467 500 µg kg(-1) (DMK) intravenously (IV). The kidney (10-15 minutes post-treatment), spleen (25-30 minutes post-treatment), small intestine (40-45 minutes post-treatment) and liver (50-55 minutes post-treatment) were examined with CEUS. A time curve was generated and the following perfusion parameters were analysed: arrival time (AT), time to peak from injection (TTPinj), peak intensity (PI) and wash-in rate (Wi). In addition to CEUS, renal glomerular filtration rate was indirectly estimated by the rate of iohexol elimination. RESULTS: AT and TTPinj were significantly higher for DEX than for CTRL in all studied organs. The same parameters were significantly higher for DEX than for DMK in the kidney, spleen and small intestine. PI was significantly lower for DEX than for CTRL or DMK in the kidney. Wi was significantly lower for DEX than for CTRL or DMK in the kidney and significantly lower than for CTRL only in the small intestine. Plasma concentration of iohexol was significantly higher after DEX than CTRL administration. CONCLUSIONS: Contrast-enhanced ultrasound was effective in detecting DEX-induced changes in blood flow. MK-467 attenuated these changes. CLINICAL RELEVANCE: Clinicians should consider the effects of the sedation protocol when performing CEUS. Addition of MK-467 might beneficially impact the haemodynamic function of sedation with alpha-2 adrenoceptor agonists.

Qualities of Children's Fear in Therapeutic Action Groups Addressing Post-separation Parental Stalking.

This paper examines the way in which parental stalking - as a form of domestic abuse - raises fear in children and affects their sense of safety. The study draws on three therapeutic action groups involving 13 children who have experienced stalking by their fathers/stepfathers after the parents' separation. The research question is as follows: How does children's sense of fear manifest in therapeutic action groups? The qualitative analysis revealed three qualities of fear among the children: (1) internalised, (2) constant and (3) episodic. Internalised fear appeared as a child's mental state that materialised as an overwhelming sentiment in the group sessions and elsewhere. Constant fear activated at times, and the senses of fear and security alternated both in the sessions and elsewhere. Episodic fear related to the children's memories of violent events and father's stalking behaviour. The children were able to sense security in the group and in daily life owing to a temporal distance to their father's stalking. Our findings underscore the importance of professionals' awareness of the qualities of children's fear and the significance of assessing their fear and sense of safety in a child-centered manner in therapeutic practices.

Children's Sense of Belonging in the Context of Post-separation Parental Stalking: Finnish Children's Experiences of their Family Relations.

Drawing from previous research on domestic violence and stalking, this study addresses children's experiences of their family relations in post-separation parental stalking contexts from the perspective of stalking as a form of violence against women and children. Despite the fact that violence perpetrated by a parent fundamentally changes family dynamics and children's perceptions of family security, research on children's family relations in the course of domestic violence or stalking has rarely addressed children's sense of belonging. The aim of this paper is to augment our understanding of children's experiences of family relations in connection with parental stalking. The research question is: How do children experience their belonging in family relations in the context of post-separation parental stalking? A total of 31 children and young people aged 2-21 participated in the study. The data were collected through interviews and therapeutic action group sessions with the children. The qualitative data analysis was content-oriented. Four dimensions of children's sense of belonging were identified: (1) Varying belonging, (2) distancing belonging, (3) non-belonging and (4) holding belonging. The first three dimensions are constructed in relation to the child's stalking father, while the fourth one includes the mother, siblings and other relationships that provide safety and comfort. The dimensions are parallel and not mutually exclusive. The study indicates that a finer-grained understanding of children's sense of belonging in family relations is needed when social and health care and law enforcement professionals evaluate the child's safety and best interest.

Ventilation during continuous compressions or at 30:2 compression-to-ventilation ratio results in similar arterial oxygen and carbon dioxide levels in an experimental model of prolonged cardiac arrest.

BACKGROUND: In refractory out-of-hospital cardiac arrest, transportation to hospital with continuous chest compressions (CCC) from a chest compression device and ventilation with 100% oxygen through an advanced airway is common practice. Despite this, many patients are hypoxic and hypercapnic on arrival, possibly related to suboptimal ventilation due to the counterpressure caused by the CCC. We hypothesized that a compression/ventilation ratio of 30:2 would provide better ventilation and gas exchange compared to asynchronous CCC during prolonged experimental cardiopulmonary resuscitation (CPR). METHODS: We randomized 30 anaesthetized domestic swine (weight approximately 50 kg) with electrically induced ventricular fibrillation to the CCC or 30:2 group and bag-valve ventilation with a fraction of inspired oxygen (FiO2) of 100%. We started CPR after a 5-min no-flow period and continued until 40 min from the induction of ventricular fibrillation. Chest compressions were performed with a Stryker Medical LUCAS® 2 mechanical chest compression device. We collected arterial blood gas samples every 5 min during the CPR, measured ventilation distribution during the CPR using electrical impedance tomography (EIT) and analysed post-mortem computed tomography (CT) scans for differences in lung aeration status. RESULTS: The median (interquartile range [IQR]) partial pressure of oxygen (PaO2) at 30 min was 110 (52-117) mmHg for the 30:2 group and 70 (40-171) mmHg for the CCC group. The median (IQR) partial pressure of carbon dioxide (PaCO2) at 30 min was 70 (45-85) mmHg for the 30:2 group and 68 (42-84) mmHg for the CCC group. No statistically significant differences between the groups in PaO2 (p = 0.40), PaCO2 (p = 0.79), lactate (p = 0.37), mean arterial pressure (MAP) (p = 0.47) or EtCO2 (p = 0.19) analysed with a linear mixed model were found. We found a deteriorating trend in PaO2, EtCO2 and MAP and rising PaCO2 and lactate levels through the intervention. There were no differences between the groups in the distribution of ventilation in the EIT data or the post-mortem CT findings. CONCLUSIONS: The 30:2 and CCC protocols resulted in similar gas exchange and lung pathology in an experimental prolonged mechanical CPR model.