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A negative relationship between mathematics anxiety (MA) and mathematics performance is well documented. One suggested explanation for this relationship is that MA interferes with the cognitive processes needed when solving mathematics problems. A demand for using more cognitive effort (e.g., when performing harder mathematics problems), can be traced as an increase in pupil dilation during the performance. However, we lack knowledge of how MA affects this relationship between the problem difficulty and cognitive effort. This study investigated, for the first time, if MA moderates the effect of arithmetic (i.e., multiplication) problem difficulty on cognitive effort. Thirty‐four university students from Norway completed multiplication tasks, including three difficulty levels of problems, while their cognitive effort was also measured by means of pupil dilation using an eye tracker. Further, the participants reported their MA using a questionnaire, and arithmetic competence, general intelligence, and working memory were measured with paper‐pencil tasks. A linear mixed model analysis showed that the difficulty level of the multiplication problems affected the cognitive effort so that the pupil dilated more with harder multiplication problems. However, we did not find a moderating effect of MA on cognitive effort, when controlling for arithmetic competence, general intelligence, and working memory. This suggests that MA does not contribute to cognitive effort when solving multiplication problems. [ABSTRACT FROM AUTHOR]

BACKGROUND: Schools are important arenas for the promotion of critical health literacy (CHL) among adolescents. Key domains of CHL are information appraisal, understanding social determinants of health, and abilities to act on determinants of health. In this paper, we examine the psychometric properties of the Critical Health Literacy for Adolescents Questionnaire (CHLA‐Q). METHODS: A cross‐sectional survey study was performed at 5 schools in Norway. Respondents included 522 pupils aged 13‐15 years old. Confirmatory factor analysis (CFA) was conducted to examine the structural validity. Internal reliability was assessed using ordinal Cronbach's alpha. RESULTS: The estimated model had acceptable closeness of fit. Five of 6 scales displayed adequate internal reliability. CONCLUSION: The results indicate acceptable fit of the CHLA‐Q framework and that 5 of the 6 scales are applicable to inform future research and interventions. More research is needed on measurement of the second domain of CHL. [ABSTRACT FROM AUTHOR]

Introduction: People should have access to healthcare services that are effective, safe and secure, patient‐centred, and coordinated and continuous. One group that has consistently reported negative experiences and feels dissatisfied with services are patients with Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS). The objective of this study was to develop a deeper understanding of the experiences of dissatisfaction among ME/CFS patients and explore the reasons for such dissatisfaction. Methods: We conducted in‐depth interviews with 48 people from 24 households (comprising patients and family members), providing insight into the experiences of 37 ME/CFS sufferers in Norway. The participants were purposively sampled and included persons of different ages, genders, time since having the condition (3–30 years), and severity. Results: Four main themes were developed: (1) 'Nonexistent services' cover patients' experience that healthcare services had nothing to offer them after receiving their ME/CFS‐diagnosis. (2) 'Nonpersonalised services' documents experiences where patients did receive services, which in theory was appropriate for relieving a specific health problem, but in practice were experienced as inappropriate because they were not adapted to the patient's need. (3) 'Slow services' address patients' experience of getting services too late (or too little) to be useful. (4) 'Wrong services' comprise patients' experiences of being offered and/or 'forced' to accept services that they felt were inappropriate for their health problems. Conclusions: Providers' lacking knowledge of the condition and lack of precise recommendations for follow up may partly explain unsatisfactory experiences. Providers' belief (or disbelief) in the condition could furthermore influence caregiving. Also, systemic issues in the healthcare sector, like high workloads and bureaucracy, can negatively affect care provision. Finally, users' unsatisfactory experiences may also be due to a lack of patient involvement in the design of such services. Further research should investigate how patients can be involved in service design, and also providers' perspectives on caregiving and the barriers they experience for providing high‐quality care. Patient or Public Contribution: The ME‐patient organisation suggested research topics to the call from which this study got funding. Patients and caregivers provided feedback during analysis and interpretation of data. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to assess the paediatric and adult diabetes care provided to adolescents and young adults with childhood‐onset type 1 diabetes during the transition. Methods: This nationwide population‐based cohort study included 776 individuals with type 1 diabetes who were last registered in the Norwegian Childhood Diabetes Registry (NCDR) between 2009 and 2012 and had received adult health care for at least 2 years. The patients' experiences were reported in a validated questionnaire. Clinical data from the annual registrations in the NCDR were coupled with data from the medical records in adult diabetes care. The longitudinal measures of glycaemic control were analysed using a growth mixture model. Results: A total of 321 young people answered the questionnaire and provided written informed consent for the collection of their data from their medical records. The mean age at transfer was 18.0 years (range = 15.0–23.5 years), and the mean age at participation was 22.7 years (range = 20.9–26.7 years). Significant differences (p < 0.001) in patient experiences were found between paediatric and adult diabetes care in several areas: contact with health‐care personnel, continuity of care, interval between consultations and overall satisfaction. Registry and medical records data confirmed the patient‐reported experiences. The longitudinal analyses identified two groups with distinctly different trajectories of glycaemic outcome over time. Patient–provider continuity and perceived preparedness for transfer were the most influential predictors. Conclusions: This study highlights several areas to be addressed for improving health care and the transition to adult diabetes care in adolescents and young adults with type 1 diabetes, including provider continuity, individualised care and involvement of multidisciplinary teams. [ABSTRACT FROM AUTHOR]

Adolescents with a visible difference to the face or body (e.g., due to a congenital condition, illness, or injury), may be at risk of elevated psychological distress. Young Person's Face IT (YPF), a web‐based psychosocial intervention, has displayed effectiveness, but no previous study has specifically evaluated its cost‐effectiveness. The aim of our study was to investigate whether YPF could be a cost‐effective alternative for psychosocial support to adolescents distressed by a visible difference, relative to care‐as‐usual (CAU). Within the context of a randomized controlled trial in Norway, 102 participants (43% boys) were allocated to intervention (n = 55) or waiting list control group (n = 47). Mean age was 13.9 years (SD = 1.71; range 11–18), and all self‐identified as experiencing distress related to a visible difference. Participants answered questionnaires including measures of health‐related quality of life and social anxiety at baseline and 3‐month follow‐up. A health economic evaluation using the method of cost‐utility analysis was performed, including quality‐adjusted life‐years (QALYs). Results indicated that the incremental cost‐effectiveness of YPF was 63,641 Norwegian kroner per QALYs gained, which is well within the acceptability threshold in the Norwegian healthcare sector. Hence, YPF could potentially be considered a cost‐effective intervention for adolescents experiencing distress related to a visible difference, but more research is needed that includes comparisons of YPF to other health‐ and societal resources and long‐term follow‐ups. Our study also constitutes an addition to research as, compared to interventions for somatic diseases, there is a lack of studies exploring the cost‐effectiveness of psychological interventions. [ABSTRACT FROM AUTHOR]

In child welfare policies, as in contemporary society in general, great attention has been given to parenting roles and investing in 'positive' parenting practices. Several studies have suggested that socio‐economic factors frame parenting practices. There is broad evidence of a significant correlation between socio‐economic inequalities and child welfare intervention rates. Nevertheless, few studies have investigated parenting practices in a child welfare population. The aim of the present study was to investigate the association between socio‐economic status (SES) and parenting practices in a Norwegian child welfare population. The study was based on a cross‐sectional survey conducted in 2018–2019. The sample consisted of 256 parents (71.5% females). Linear regression analysis, adjusting for potential confounding and intermediate factors, was conducted. Lower SES was associated with higher levels of positive parenting/involvement practices (b = 0.146, CI: 0.026–0.266, P = 0.018), indicating an inverse pattern compared with the general population. When adjusting for symptoms of anxiety and depression, the association was slightly attenuated but remained statistically significant. No significant association was found between SES and inconsistent discipline/other disciplinary practices. The present study offers insights that should be useful in practice and further large‐scale studies. [ABSTRACT FROM AUTHOR]

Background: People with Parkinson's disease (PD) often experience symptoms that affect their ability to eat. This may contribute to weight loss and increased risk of malnutrition. The present study aimed to quantify the extent of nutrition impact symptoms (NIS) in the population and a scoring system of NIS was incorporated in the tool used to identify malnutrition. Methods: In this cross‐sectional study, members of the Norwegian Parkinson's Association, with any PD diagnosis and stage of illness, were invited to respond to an online 24‐item questionnaire. Questions from two validated questionnaires, comprising the abridged Patient‐Generated Subjective Global Assessment (aPG‐SGA) and the Radboud Oral Motor Inventory for Parkinson's disease (ROMP), were adapted to an online format. Results: The questionnaire was sent to 3047 members, of which 508 persons (17%) responded (61% men). In total, 59% were categorised as well‐nourished, 34% at risk of malnutrition and 6.5% as malnourished. One quarter of all participants reported symptoms that affected food intake. The most frequent symptoms were constipation (14.2%) and dry mouth (13.4%). Malnourished participants reported a mean ± SD of 3.4 ± 1.4 symptoms versus 0.1 ± 0.3 per well‐nourished participant. Malnourished participants had more swallowing problems than well‐nourished participants, with a mean ± SD total ROMP score of 15.5 ± 6.0 versus 9.0 ± 2.9 (p < 0.001). As the number of points in the ROMP score increased by one, the points in the aPG‐SGA score increased with 37% (95% confidence interval = 0.309–0.428). Conclusions: Risk of malnutrition was largely related to NIS, especially dysphagia in people with PD. Symptoms affecting food intake should be systematically mapped and treated in conjunction with PD to prevent malnutrition. Highlights: Symptoms affecting the food intake, malnutrition risk and malnutrition are commonly seen in patients with Parkinson's disease (PD).The present study highlights the fact that, despite being common, malnutrition may be unrecognised, under‐reported and untreated in PD patients.The results suggest that swallowing problems in PD are important for the development of malnutrition risk and malnutrition.Nutrition impact symptoms and weight loss should be systematically assessed in patients with PD.There is a need for more research investigating the relationship between malnutrition and nutritional impact symptoms in PD patients. [ABSTRACT FROM AUTHOR]

Background: Norwegian social educator students' attitudes towards addressing sexual health are unknown, even if their future clients often have needs related to sexual issues. Purpose: To investigate social educator students' readiness to address sexual health in their future profession. Methods: In 2019, 213 social educator students (response rate 34%) responded to the Students' Attitudes towards addressing Sexual Health Extended online questionnaire. Results: Most of the social educator students felt comfortable and ready to address sexual health in their future profession, but thought they had insufficient competence and education concerning sexual health. There were gender and age differences when discussing sexual health among persons with intellectual disabilities. Conclusion: Despite most Norwegian social educator students feeling ready to address sexual health, they needed additional competences and education. Further research is needed concerning the effectiveness of educational interventions targeting competence in sexual health, to ensure sufficient support for clients in this field. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the recovery of physical function, health related quality of life (HRQoL), and pain for people following hip fracture for the initial 12 months, and to examine whether postoperative outcome measures of physical function, HRQoL, and pain can predict physical function at 3 and 12 months. Design: A prospective single‐center observational study, as part of the HIPFRAC trial. Settings: One hospital with two associated municipalities in Norway. Subjects: 207 participants with hip fracture included in the study (140 participants transferred to a short‐term nursing home placement and 67 transferred directly home at discharge from hospital). Method: Outcome measures were Short Physical Performance Battery (SPPB), Timed Up & Go (TUG), Stair climbing test (SC), Numeric Rating Scale (NRS) for pain at rest and in activity, and EQ‐5D‐5L index and health score. Data were analysed by repeated measures of variance and multivariate regression analyses. Results: There were statistically significant improvements in physical function (SPPB total score and TUG), NRS‐pain in activity, and HRQoL (EQ‐5D‐5L) from hospital discharge to 3‐month follow‐up for the whole cohort and the two groups (p < 0.001). However, the largest improvements occurred within the first 3 months. Further statistically significant improvements occurred between 3 and 12 months (p < 0.05). The strongest predictors of physical function at 3 and 12 months post‐fracture were physical function (SPPB) at hospital discharge and pre‐fracture requirement of a walking aid. Conclusion: The recovery of physical function, HRQoL, and pain in participants after hip fracture indicates gradual improvements during the initial 12‐month follow‐up, with the largest improvements within the first 3 months. [ABSTRACT FROM AUTHOR]

This study aims to test the nomological validity of the People Performance Scales (PPS) using the job demands‐resources (JD‐R) model. All employees at two large companies in Norway (a governmental agency and a worker's union) were invited to complete the PPS questionnaire electronically. A total of 2,469 respondents completed the questionnaire, resulting in an 87 percent response rate. Data was analyzed Structural Equation Modelling. First, all 15 scales included in the PPS showed excellent internal and construct validity. PPS was also found to have configural‐, construct‐level metric‐ and scale‐level metric invariance across age groups and genders. Second, findings indicate that the PPS can be used for both research and consultancy based upon the JD‐R model, while simultaneously assessing constructs of particular importance in Norwegian and Scandinavian legislation. The PPS represents a short and efficient questionnaire which measures the most relevant working environment constructs in a reliable and distinct way. The questionnaire has great psychometric characteristics and is well suited for use in organizations to measure employees' experience of working environment factors, allowing organizations to identify areas of improvement and to support organizational development. [ABSTRACT FROM AUTHOR]

Aim: To estimate the prevalence of sexual dysfunction in women with type 1 diabetes (T1D) compared with women without diabetes and to analyse associations between sexual dysfunction and the presence of chronic physical diabetes complications, diabetes distress and depression in women with T1D. Methods: This cross‐sectional study was conducted in Norway, and 171 women with T1D and 60 controls completed the Female Sexual Function Index (FSFI) and the Hospital Anxiety and Depression Scale (HADS). Diabetes distress was assessed with the Problem Areas in Diabetes (PAID) scale. Data on diabetes complications were retrieved from medical records. We performed logistic regression to estimate differences in the prevalence of sexual dysfunction (defined as FSFI ≤26.55) between women with T1D and women without diabetes and to examine associations of sexual dysfunction with chronic diabetes complications, diabetes distress and depression in women with T1D. Results: The prevalence of sexual dysfunction was higher in women with T1D (50.3%) compared with the controls (35.0%; unadjusted odds ratio [OR] 1.89 [95% confidence interval (CI) 1.06–3.37]; adjusted OR 1.93 [1.05–3.56]). In women with T1D, sexual dysfunction was associated with both diabetes distress (adjusted OR 1.03 [1.01–1.05]) and depression (adjusted OR 1.28 [1.12–1.46]), but there were no clear associations with chronic diabetes complications (adjusted OR 1.46 [0.67–3.19]). Conclusions: This study suggests that sexual dysfunction is more prevalent in women with T1D compared with women without diabetes. The study findings emphasize the importance of including sexual health in relation to diabetes distress and psychological aspects in diabetes care and future research. [ABSTRACT FROM AUTHOR]

Youth within the child welfare system (CWS) have often experienced adverse life events, and many need support from health services. This study aimed to compare mental health problems and health service use among adolescents receiving in‐home services (IHS), living in foster care (FC) and general population youth (GP). Data stem from the youth@hordaland survey, a population‐based study of adolescents (N = 10,257, age 16–19) conducted in 2012 in Hordaland County, Norway. The adolescents provided self‐reported data on CWS contact, health service use, adverse life events and multiple instruments assessing mental health problems. The IHS and FC groups had significantly higher symptom scores across most mental health measures than peers from the GP. Youth receiving IHS had significantly higher scores on measures of general internalizing and externalizing problems, attention deficit hyperactivity disorder (ADHD) and depression compared with peers in FC. Those receiving IHS reported the highest health service use. Adverse life events accounted for a substantial part of the differences between the groups. Mental health problems are frequent among older adolescents within the CWS, especially among youth receiving IHS. Service providers and policymakers should be aware of the present and likely continued challenges faced by many of these youth. [ABSTRACT FROM AUTHOR]