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Background: The development and promotion of educational games are still outpacing knowledge of these games' effects, raising calls for evidence of benefits and challenges. Studies suggest that students and teachers like games, but the payoff of the investment in terms of increased motivation and achievement remains unclear. Objectives: This study investigates the pure effect of a marketing simulation game on motivation, perceived learning and achievement, above and beyond regular student‐active instruction. Methods: We applied a randomized, controlled experiment in a marketing course in upper‐secondary schools (Nclasses = 22; Nstudents = 433) comparing a collaborative–competitive marketing simulation game with regular, case‐based, student‐active instruction on three groups of outcome measures: motivation, perceived ability, and achievement. Additionally, students and teachers provided quantitative and qualitative feedback on game experiences. Results and Conclusions: We showcase the importance of a robust study design with valid compound instruments. Moreover, investigations of the game implementation and experiences reveal insights about intervention timing, differential negative consequences by gender and need for reflection opportunities. We find no clear evidence of positive or negative effects of the game, despite students' and teachers' satisfaction. Implications: Beyond the effect evaluation, we offer recommendations to researchers and developers of educational games about scaffolding, timing and teacher competence building. Lay Description: What is already known about this topic: Some curricula contains many terms and complex knowledge links.Simulation games are a popular remedy for these challenges.Prior studies have relied on users' satisfaction with the game and unrealistic comparisons. What this paper adds: This experiment compares game usage and regular student‐active instruction.They use various measures of satisfaction, motivation, perceived learning and achievement.The game has no effect on main outcomes. Implications for practice and/or policy: Game implementation requires digitally acquainted and trained teachers.Uncritical game design and use may motivate competitive boys over collaborative girls. [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]

This paper examines the relationship between professional work and standardization. There has been an increase in the use of standardized programmes in child welfare services (CWS) in Western society. Some researchers have criticized standardized programmes suggesting that they undermine professionals expertise and threaten their position, whereas others argue that such programmes strengthen professional practice. In this paper, we examine how standardized tools, in this case, a standardized parenting programme and a standardized Norwegian assessment tool, influence professional roles as experienced by child welfare workers (CWS professionals) in Norway. Semistructured individual and group interviews were conducted with 31 frontline workers in two CWS agencies. Our findings suggest that standardized tools increase the social workers experienced professional competence but challenge their professional knowledge base, reflective practice, and professional accountability. Professional and practical implications for CWS work are discussed in the light of these findings. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore the reasons for unintended placement disruptions in foster care. Based on a semistructured survey, the paper presents the views of 132 Norwegian foster parents who have experienced placement disruption between 2013 and 2015. Foster parents rated several relevant causes of placement disruption: the child's behaviour, the need for care, concern for the well‐being of their biological children, and lack of support from the Child Welfare Service (CWS). Although the child's behaviour was the cause most frequently reported in the quantitative data, CWS‐related factors such as poor collaboration, not being valued and listened to, insufficient support and follow‐up, and a mismatch between the child's needs and the foster carers' capacity were reported most frequently in the qualitative data. Placement disruption appears to be caused by the sum and interaction of several coexisting causes. It may not be the child's behaviour per se but rather the combination of challenging behaviour, concern for one's biological children, and insufficient support from CWS that lead to disruption. Good collaboration with the CWS in the form of respect, recognition, support, and follow‐up appears to be of the utmost importance in reducing the risk of placement disruption. [ABSTRACT FROM AUTHOR]

Siblings are key actors in the social network of young people in care. This paper explores young people's perceptions of changes in the quality of sibling relationships and the pathways relationships follow during the transition from the biological family into care. A thematic analysis of interviews with young Norwegian people (n = 25) in care showed that, in the biological family, sibling relationships are characterized by alliances, parentification, conflicts or nonexistence. After admission to child welfare services care, sibling relationships developed along multiple pathways. Their sibling relationships reshaped into either close and supportive, conflictual or completely broken relationships. Sibling relationships were dynamic, complex, with the pathway, and its impact on well‐being, being unique to each young person. Sibling relationship quality in the biological home did not predict relationship quality after admission to child welfare services. The implications for social worker practice are discussed. [ABSTRACT FROM AUTHOR]

This paper explores a change process in the Central Norway Regional Health Authority that was brought about by the implementation of a new economics and logistics system. The purpose of this paper is to contribute to understanding of how employees' attitudes towards change develop over time and how attitudes differ between the five health trusts under this authority. In this paper, we argue that a process‐oriented focus through a longitudinal diary method, in addition to action research and feedback loops, will provide greater understanding of the evaluation of organizational change and interventions. This is explored through the assumption that different units will have different perspectives and attitudes towards the same intervention over time because of different contextual and time‐related factors. The diary method aims to capture the context, events, reflections and interactions when they occur and allows for a nuanced frame of reference for the different phases of the implementation process and how these phases are perceived by employees. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Aim: This paper reports associations among socio‐demographic variables, stressor experience, self‐efficacy and life satisfaction among Norwegian adolescents aged 15–21 years and the potential moderating role of self‐efficacy on the association between stressor experience and life satisfaction. Methods: The cross‐sectional school‐based survey study involved 1816 upper‐secondary school students from Mid‐Norway. Data were analysed with independent samples t test, Pearson's product moment correlation and multiple linear regression analysis. Results: Bivariate results showed that boys scored higher than girls on life satisfaction and self‐efficacy, whereas girls scored higher than boys on all stressor domains. Multiple linear regression analysis showed that life satisfaction declined weakly with age, whereas stronger family economy and having parents who work full‐time associated with higher life satisfaction. Stress with teacher interaction, peer pressure, home life, school attendance, school–leisure conflict and school performance were all negatively associated with life satisfaction, whereas self‐efficacy associated positively and strongly with life satisfaction. Self‐efficacy moderated the association between both interpersonal and school‐related stressors and life satisfaction. Conclusion: The results provide support for the unique role of stressor experience and self‐efficacy in association with adolescents' life satisfaction as well as self‐efficacy as a stress moderator in relation to life satisfaction. [ABSTRACT FROM AUTHOR]

This paper compares how frontline staff in four national child welfare systems and policy contexts - Finland, Norway, England and the USA (specifically, California) - respond to questions about a scenario of possible harm to children. The countries have different child welfare systems that we anticipated would be reflected in the workers' responses ( n = 1027). The analysis shows differences and similarities between the systems, although often not in line with system expectations. There is also variation within the country samples. The study shows the complex interactions of individual and agency characteristics in addition to the role of proceduralised decision-making systems and professional discretion. Key Practitioner Messages Professional discretion differs., Proceduralised and high threshold systems result in less variation between workers' responses., System categories do not seem to capture the nuances of frontline decision-making. [ABSTRACT FROM AUTHOR]

Studies show that client confidentiality can inhibit proper adaptation to emotional work stress, which can affect health and well-being among help service professionals. There is a lack of knowledge on the link between confidentiality and symptoms of ill health. It is likely that confidentiality can be a hidden stressor that modifies coping strategies necessary for healthy adaptation to emotional work demands. The aim of the current paper was to investigate the influence of client confidentiality on different modes of coping among child welfare workers and possible variation according to proximity to clients and years of experience. The study included survey data among all child welfare workers ( n = 142) situated at six office locations in a Norwegian city with a population of >150 000. The analyses included descriptive statistics, t-test, analysis of variance and multiple linear regressions. The results showed that client confidentiality can interfere with a range of coping strategies which are important to reduce stress from emotionally demanding work experiences among child welfare workers. This was prominent among workers with less experience or high proximity to clients. The results imply that confidentiality can interfere with adaptation to work stress, which can affect the health and well-being of child welfare workers. [ABSTRACT FROM AUTHOR]

This paper examines how child welfare workers in England, Norway and the USA (California) perceive children's participation building on 91 qualitative interviews. First, analysing the data using Hart's ladder of children's participation, we found that all Norwegian workers perceived children's participation as some form of decision‐making, whereas 40% of English and 35% of US workers embraced views of children's participation that can be considered token or non‐participation. Second, we coded the data for main themes and found that child welfare workers in all three countries perceived children's participation as hearing the child's opinion and information gathering. The themes of age, maturity and ability to form an opinion also emerged from the data. English workers' reflections about children's participation were more nuanced than their Norwegian and US counterparts; and US workers understood children's participation as children providing valuable information during the investigation of a case more frequently than workers in England and Norway. We discuss the implications of these findings on future research. [ABSTRACT FROM AUTHOR]

This paper examine how a sample of 301 child welfare workers in Norway, England and California, USA assess risk in cases of domestic violence. Decisions in child welfare cases are made under a high degree of uncertainty, and by using the vignette method, we explore whether child welfare systems and risk assessment approaches result in different assessment of risk level and substantiations. We find both cross‐country differences and similarities: Norwegian workers consider the risk level to be significantly higher than their peers in England and USA. However, workers' justifications for and identification of decisive factors in the case are strikingly similar across countries. These similarities are observed for both high‐risk and low‐risk assessors, and they may exist due to widespread knowledge about domestic violence and its negative consequences. We argue that the international differences in risk level assessments are due to system differences in the countries studied. [ABSTRACT FROM AUTHOR]

The aim of this paper is to address facilitators for successful interprofessional collaboration (IPC) between social workers (SWs) and teachers. Individual interviews were carried out with seven SWs employed in municipal child welfare services and six teachers from primary and secondary schools. The informants had at least two years' experience within multidisciplinary teams. The transcripts were analysed using an inductive thematic approach and the NVIVO9 computer software package for qualitative data analysis. Thematic analysis revealed three themes: ‘personal commitments’, ‘creating a positive atmosphere for IPC’ and ‘pulling together towards future goals’. Results are discussed in relation to the Norwegian context concerning IPC in multidisciplinary teams for children at risk. [ABSTRACT FROM AUTHOR]

Aiming at preventing excessive weight gain during pregnancy, 10 specific dietary recommendations are given to pregnant women in the intervention arm of the Norwegian Fit for Delivery (FFD) study. This paper presents the rationale and test-retest reliability of the food frequency questionnaire (FFQ) and a dietary score measuring adherence to the recommendations. The study is part of the ongoing FFD study, a randomised, controlled, intervention study in nulliparous pregnant women.A 43-item FFQ was developed for the FFD study.A dietary score was constructed from 10 subscales corresponding to the 10 dietary recommendations.Adding the subscales yielded a score from 0 to 10 with increasing score indicating healthier dietary behaviour.The score was divided into tertiles, grouping participants into low, medium and high adherence to the dietary recommendations. Pregnant women attending ultrasound screening at about week 19 of pregnancy were asked to complete the FFQ twice, 2 weeks apart. Of 154 pregnant women completing the first questionnaire, 106 (69%) completed the form on both occasions and was included in the study.The test-retest correlations of the score and subscales were r = 0.68 and r = 0.56-0.84, respectively (both P ⩽ 0.001). There was 68% test-retest correct classification of the score and 70-87% of the subscales. In conclusion, acceptable test-retest reliability of the FFQ and the dietary score was found. The score will be used in the FFD study to measure adherence to the dietary recommendations throughout pregnancy and in the following year post-partum. [ABSTRACT FROM AUTHOR]

The aim of this paper is to study: (1) the prevalence of flight anxiety among Norwegian airline passengers; (2) situations that may be of concern during flights and situations not related to flying; (3) whether passengers feel more afraid after the terror act of September 11, 2001; and (4) whether passengers were more afraid in 2002 than in 1986.A questionnaire was distributed during domestic flights in Norway in 1986 and 2002. To asses flight anxiety, a six point scale was used, from 0 = not afraid at all, to 5 = always very afraid, and sometimes avoid flying because of that. A 10-cm visual analogue scale ( VAS) was used to measure the degree of anxiety. There were 50.8% who were not afraid at all. There were 12 women (5.2%) and one man (0.4%) with flight phobia. However, 22 (4.5%) had cancelled flights because of anxiety during the last two years. Situations that caused most concern during flights were turbulence and fear of terrorism and highjacking. After September 11, 48% were not more afraid, 38% a little more, 10% moderately, 3% rather much and 2% very much. The passengers, however, were not more afraid of flying in 2002 than in 1986. About 3% of Norwegian airline passengers have a flight phobia. Women are significantly more concerned than men. The impact of the terror act September 11, 2001 was rather moderate. The level of flight anxiety among Norwegian airline passengers was not significantly different in 2002 and 1986. [ABSTRACT FROM AUTHOR]

This paper examines the prevalence of multiple symptoms and the relationships between future expectations and multiple symptoms in a cross-sectional study of 100 patients with chronic obstructive pulmonary disease. A questionnaire was used to examine the patients' symptoms of breathlessness, anxiety, depression, sleeplessness, fatigue, and pain, and their outlook for the future. All patients reported breathlessness, 64% anxiety, 69% depression, 28% sleeplessness, 72% fatigue, and 45% pain. Those with anxiety reported significant depression ( P < 0.001), and those with fatigue reported significant depression ( P = 0.004). Patients who reported pain also reported significant sleeplessness ( P = 0.022). A negative outlook for the future was reported by 42% of patients who also reported significantly more anxiety, depression, sleeplessness, fatigue, and pain ( P ≤ 0.049). Multiple symptoms are common in chronic obstructive pulmonary disease, and patients with a pessimistic view of the future reported more symptoms. Those with multiple symptoms and a negative outlook toward the future may benefit from interventions to help them achieve a more positive outlook for the future, which may relieve symptom burden. [ABSTRACT FROM AUTHOR]

The objective of the paper is to explore bottom-up auditory and top-down cognitive processing abilities as part of long-term outcome assessment of preterm birth. Fifty-five adolescents (age 13-15) born with very low birth weight ( VLBW) were compared to 80 matched controls born to term, using three consonant-vowel dichotic listening ( DL) instruction conditions (non-forced, forced-right and forced-left). DL scores were correlated with cortical gray matter thickness derived from T1-weighted structural MRI volumes using FreeSurfer to examine group differences also in the neural correlates of higher cognitive processes. While showing normal bottom-up processing, VLBW adolescents displayed impaired top-down controlled conflict processing related to significant cortical thickness differences in left superior temporal gryus and anterior cingulate cortex. Preterm birth with VLBW induces fundamental changes in brain function and structure posing a risk for long-term neurocognitive impairments. Deficits emerge in situations of increasing cognitive conflict and can be related to measures of executive functions as well as morphology. [ABSTRACT FROM AUTHOR]

The aim of this paper was to investigate whether psychosocial functioning in adulthood (e.g., friends support, cohabitation, community connectedness and work satisfaction) could be predicted by mental health, subjective well-being, social relations and behavior problems in adolescence, and whether gender was a moderator in these associations. Data were obtained from a major population-based Norwegian study, the Nord-Trøndelag Health Study ( HUNT), in which 517 men and 819 women completed an extensive self-report questionnaires at baseline (mean age 14.4 years) and at follow-up (mean age 26.9 years). Community connectedness as well as work satisfaction were predicted by subjective well-being. Cohabitation was predicted by male gender and frequency of meeting friends in adolescence, and friends support was predicted by frequency of meeting friends. Gender had a minor effect as a moderator. Frequency of meeting friends and subjective well-being seemed to be the strongest adolescent predictors of psychosocial functioning in young adulthood. These findings may have implications both for prevention and intervention in adolescence, as well as for future research. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to describe the prevalence of self-reported types of extradyadic romantic and sexual activity among adult Norwegians and to explore the role of infidelity in breaking up a permanent relationship. The results are based on 1,001 web interviews with persons ranging in age from 18 to 67 years. The majority of respondents reported having engaged in some kind of extradyadic romantic and/or sexual activity. Forty-five percent of the women and 39% of the men claimed they had experienced a previous breakup from a marriage or cohabiting relationship. Among those aged 50 years or older, the most important reasons for breaking up a previous relationship were infidelity (38%) and lost love (38%). More men (44%) than women (33%) reported infidelity. Respondents younger than 50 years were more motivated by boredom. Among respondents below the age of 50 years, the most frequently reported reasons for considering termination of a present relationship were quarreling (37%), poor sex life (29%), and 'other' reasons (25%). Accordingly, infidelity was not identified as an essential factor for considering a breakup from the present relationship. [ABSTRACT FROM AUTHOR]

Moksnes, U. K. & Espnes, G. A. (2012). Self-esteem and emotional health in adolescents - gender and age as a potential moderators. Scandinavian Journal of Psychology 53, 483-489. The present paper investigates possible gender and age differences on emotional states (depression and anxiety) and self-esteem as well as the association between self-esteem and emotional states. The cross-sectional sectional sample consists of 1,209 adolescents 13-18 years from public elementary and secondary schools in mid-Norway. The results showed that girls reported higher scores on state anxiety and state depression, whereas boys consistently scored higher on self-esteem in all age groups. Self-esteem was strongly and inversely associated with both state depression and state anxiety. An interaction effect of gender by self-esteem was found on state depression, where the association was stronger for girls than for boys. The associations found give support for the positive role of self-esteem in relation to adolescents' emotional health and well-being. [ABSTRACT FROM AUTHOR]

Jøsendal, O. & Aarø, L. E. (2012). Adolescent smoking behavior and outcome expectancies. Scandinavian Journal of Psychology 53, 129-135. Adolescent smoking behavior is assumed to be associated with smoking outcome expectancies. Results in this paper are based on data from the control group of two data collections among Norwegian secondary school students taken approximately 30 months apart (T1 and T2). The dimensionality of smoking outcome expectancies was the same at both time points, revealing three components ('Addicted', 'Not harmful' and 'Social'). After correction for attenuation, the Pearson's correlation between T1 and T2 was 0.41 for the total sumscore, indicating low to moderate relative stability. When examining smoking expectancy sumscore means by smoking habits at T1 and T2, never smokers were different from smokers on both occasions. Never smokers scored low on 'Social' and 'Not harmful', and high on 'Addictive'. All associations were statistically significant ( p < 0.001). The 'Social' dimension was the strongest predictor of smoking behavior at T1 and T2. One of the outcome expectancy sumscores ('Addictive') at T1 predicted smoking habits at T2 after controlling for smoking habits at T1 ( p < 0.01). This predictor was significant also after entering outcome expectancy sumscores at T2 into the model ( p < 0.05). These results indicate that outcome expectations other than the health-related ones should be paid attention to when planning new prevention programs. [ABSTRACT FROM AUTHOR]

Introduction: Regular exercise is associated with reduced risk of cardiovascular disease. Paradoxically, an increased risk of sudden cardiac arrest (SCA) is documented during or immediately after exercise and in athletes compared to the nonathletic population. Our objective was to identify, through multiple sources, the total number of exercise‐related versus non‐exercise‐related SCA in the young population in Norway. Methods: We collected primary data from the prospective Norwegian Cardiac Arrest Registry (NorCAR) for all patients aged 12–50 suffering SCA of presumed cardiac cause from 2015 to 2017. We collected secondary data about prior physical activity and the SCA, through questionnaires. We searched media reports for SCA incidents in sports. Exercise‐related SCA is defined as SCA during or <1 h after exercise. Results: Overall, 624 patients, median age 43 years, were included from NorCAR. Two thirds (393) replied to the study invitation, of whom 236 answered the questionnaires: 95 survivors and 141 next of kin. The media search resulted in 18 relevant hits. With a multiple source approach, we identified 63 cases of exercise‐related SCA, equivalent to an incidence of 0.8/100 000 person‐years, versus 7.8/100 000 person‐years of non‐exercise‐related SCA. Among those who answered (n = 236), almost two thirds (59%) exercised regularly, most commonly (45%) 1–4 h/week. Endurance exercise (38%) was the most prevalent type of regular exercise and the most common activity during exercise‐related SCA (53%). Conclusion: The burden of exercise‐related SCA was low (0.8 per 100 000 person‐years) and ten times lower than non‐exercise‐related SCA in the young population in Norway. [ABSTRACT FROM AUTHOR]

Aim: The aim of this retrospective observational study was to describe the scope of physiotherapy, the population and the physiotherapy management of Covid‐19 patients referred to physiotherapy at a university hospital in the period from March 2020 to July 2021. Method: A descriptive observational study with access to data from a quality register, which contains clinical data of all patients admitted with Covid‐19 to a university hospital in Norway. Data was obtained from electronic data sheets, where daily parameters for physiotherapy treatment were registered. Results: In total, 729 Covid‐19 patients were admitted during this period. Of these, 507 (69.6%) received treatment by a physiotherapist (3510 sessions). The physiotherapy treatments were performed on intensive care units (ICU) (50%), intermediate care units (11%) and general medical units (39%), respectively. Patients were mainly treated during the day (98.5%) and 21% of the sessions were given on weekends or holidays. Within the 3510 sessions, 9459 interventions were performed in total (one to seven interventions per session). The most common intervention provided was positioning (35.4%). The most common interventions in medical units and intermediate care units were training with a positive expiratory pressure device (17.3% and 15.9% respectively), and techniques for reducing work of breathing (13% and 15% respectively). The most common intervention in the ICUs was passive mobilization (21.3%), mostly in combination with positioning, manual techniques and/or airway clearance. Conclusion: This study provides characteristics of, and experiences with early physiotherapy, in sequentially hospitalized patients at a university hospital in Norway. [ABSTRACT FROM AUTHOR]

Abstract: Within the context of Norwegian Child Welfare Services, children's best interests are often promoted through inter‐professional collaboration. Although children have the right and desire to participate, research reveals that professionals do not listen to them. On the basis of qualitative interviews with 10 children about their experiences collaborating with professionals, we have identified ways in which professionals can facilitate children's participation. The findings show that trusting relationships, emotional support, and pedagogical approaches increase children's participation in their interactions with professionals. The results show the importance of including a relational understanding of participation as a theoretical concept in child welfare and an awareness that power and dominance are in play. [ABSTRACT FROM AUTHOR]

Background: Women who experience physical or sexual violence report poor self‐perceived health. Knowledge of daily hassles, daily uplifts and coping styles, as well as how these factors can affect health and well‐being among survivors of sexual abuse, is important for healthcare professionals to understand and target their needs. Aim: The aim of the current study was to explore the association of daily hassles, daily uplifts, coping strategies and stress‐related symptoms among female survivors of sexual abuse. Methods: A group of women (n = 57), exposed to sexual abuse, were recruited from nine support centres in Norway. Participants completed a questionnaire that addressed demographics, socioeconomic conditions, trauma history, daily hassles, daily uplifts, coping styles and stress‐related symptoms. Two groups of participants were compared: one group that had above‐median scores on uplifts and adaptive coping styles and one group that had above‐median scores on daily hassles and maladaptive coping styles. Results: Results indicate that women who experienced more daily hassles and used maladaptive coping styles reported significantly more stress‐related symptoms, and particularly emotional symptoms, than women who experienced more daily uplifts and used adaptive coping styles. There were few differences between the two groups related to socioeconomic conditions and trauma history. Conclusion: The results indicate that women in both groups struggle with stress‐related physical, emotional, cognitive and target group‐specific symptoms. However, high incidence of daily hassles and the use of maladaptive coping styles were associated with an increase in stress‐related symptoms. Novell's findings indicate that despite severe traumatic experiences, adaptive coping styles and favourable perceptions of stress in everyday life were associated with a lower frequency of stress‐related symptoms. It may therefore be helpful to focus on altering maladaptive coping styles to reduce stress‐related symptoms among sexual abuse survivors. [ABSTRACT FROM AUTHOR]

How is expert evidence used in care order proceedings when children are considered for foster care placement because of familial violence? What are important factors and how do the decision‐makers use and evaluate evidence from specialists and experts? In this in‐depth analysis of 104 published care order decisions from the Norwegian County Boards, I investigate how decision‐makers use and evaluate evidence from expert witnesses to determine whether a care order may be granted. The analysis shows that the evidence largely revolves around social functioning, care context and topics about how parents and children relate to each other. Led by the law, the decision‐makers use this evidence to determine whether the child's situation is harmful, whether support services are viable and whether a care order is in the child's best interests. I find that decision‐makers draw unevenly on evidence with regards to these legal requirements, and that the use predominantly defers to expert authority. However, there is also evidence of independent reasoning, where deferral to the epistemic authority of the experts is weakened. This is shown through evaluative and critical assessments and scrutiny of the disciplinary evidence. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to report the presence of categorical and dimensional personality disorders (PD) in adults with longstanding eating disorders (ED) over a period of 17 years and to investigate whether changes in PD predict changes in ED symptoms or vice versa. Methods: In total, 62 of the 80 living patients (78% response rate) with anorexia nervosa (n = 23), bulimia nervosa (n = 25), or other specified feeding or ED (n = 14) at baseline were evaluated during hospital treatment and at 1‐year, 2‐year, 5‐year, and 17‐year follow‐up. PD were assessed using the Structured Clinical Interview for DSM‐IV Axis II disorders, and the eating disorder examination (EDE) interview was used to assess ED. Data were analyzed using multilevel modeling. Results: From baseline to the 17‐year follow‐up, the number of patients with any PD decreased significantly from 74.2% to 24.2%, and the total number of PD diagnoses declined from 80 to 22. Mean EDE score was significantly reduced from 4.2 (SD: 1.1) to 2.0 (SD: 1.6). There was a positive association between ED and PD where the initial level of either disorder was followed by similar levels of the other disorder throughout the entire follow‐up period. High baseline levels of borderline PD predicted less decrease in ED symptoms. No significant within‐person effects were found. Conclusions: Both ED and PD significantly declined over time. As the severity of either disorder seems to be associated with the other, thorough assessment and treatment that incorporates both the ED psychopathology and the personality disturbances are advisable. Public Significance Statement: While personality disorders were highly prevalent in the sample of patients with longstanding eating disorders, both disorders were significantly reduced at the 17‐year follow‐up. The disorders are related in the sense that an initial high level of either disorder is associated with a high level of the other over time. A thorough assessment and attention to both illnesses are advisable in therapy. Clinical Trial Identifier: NCT03968705. [ABSTRACT FROM AUTHOR]

Aim: Given the apparent link between gender and ethnicity, and the diversity and career opportunities in nursing, this study examined gender and ethnicity's influence on first‐year nursing students' educational motivation and career expectations. Design: Cross‐sectional. Methods: Through bootstrapped linear regressions, we analysed data on 504 Norwegian first‐year nursing students' self‐reported educational motivation and career expectations, from the StudData survey at the Centre for the Study of Professions (SPS) at Oslo Metropolitan University (OsloMet). Results: The sample consisted of 67 (13%) male and 437 (87%) female nursing students. Female students were more motivated compared to male students by professional interest and to pursue a specialization, less likely to assume leadership positions in the future, and more likely to prioritize family and pursue positions in the traditional nursing field. In total, 425 (84%) respondents stated a Norwegian background. Respondents who stated that both of their parents were born in a country other than Norway made up the 79 (16%) students of immigrant background. Those with immigrant backgrounds were more motivated than other students by income, status and flexible working hours and less likely to pursue a specialization or future employment in the nursing field. [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]

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]

Background: The Recovery Knowledge Inventory (RKI) was developed to operationalise the recovery construct and in turn contribute to moving mental health services towards recovery‐oriented practice. This study validated the RKI in a sample of Norwegian mental health care practitioners and examined mental health workers' knowledge of and attitudes towards patient recovery. Methods: The RKI was translated into Norwegian and tested on 317 mental health workers from 7 primary and 22 specialised mental health care units within a defined geographical area of Norway. Results: Psychometric challenges to the RKI were observed and called into question the previously proposed four‐factor structure. The findings of the scale revealed that the study sample scored significantly lower than a comparable sample in a previous study, suggesting that the Norwegian mental health workers have relatively low orientation towards recovery. This finding was especially applicable to the reduction of symptoms and treatment, which the respondents perceived as essential for recovering from mental illnesses and substance abuse disorders. Conclusions: To operationalise the recovery construct, the development of a measure such as the RKI needs further attention. For psychiatric practice to be moved in a more recovery‐oriented direction, consensus on what constitutes well‐functioning recovery must be reached by patients, practitioners and researchers alike. [ABSTRACT FROM AUTHOR]

In this study, we investigated whether perceiving goals as invariable is negatively related to work performance and whether this relationship is mediated by perceived job autonomy. Perceiving goals as invariable refers to the extent to which employees believe that the goals in a performance management system represent absolute standards that they must meet without exception, even if they think other factors are more important (e.g., situational factors or factors that are not associated with goals). In support of our hypotheses, we found a negative relationship between perceiving goals as invariable and work performance and that perceived job autonomy mediated this relationship. Theoretical and practical implications and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Background and purpose: Reduced balance and musculoskeletal pain are frequently reported among patients with long‐lasting dizziness. However, the association between musculoskeletal function and postural sway among these patients has not been examined. The objective of this study was to examine if there is an association between aspects of musculoskeletal function and postural balance in patients with long‐lasting dizziness. Methods: This was a cross‐sectional study, using data of 105 outpatients with long‐lasting dizziness. Aspects of musculoskeletal function was assessed by examining body flexibility, grip strength, preferred and fast walking speed, in addition to musculoskeletal pain. Musculoskeletal pain was evaluated using the Subjective Health Complaints questionnaire. Postural balance was assessed by path length of postural sway by using a balance platform on both firm and soft surfaces, with eyes open and closed. The association between musculoskeletal function and postural sway was assessed using linear regression analyses. Results: When adjusting for age and gender we found that on a firm surface, there was an association between increased musculoskeletal pain and increased postural sway measured with eyes open (p = 0.038). In addition, there was an association between decreased body flexibility and decreased postural sway with eyes open (p = 0.025). On a soft surface, decreased fast walking speed was associated with increased postural sway with eyes open (p = 0.027). In addition, decreased grip strength was associated with increased postural sway on a soft surface with eyes closed (p = 0.015). Discussion: The findings from this study imply that musculoskeletal function may associate with postural sway in patients with long‐lasting dizziness, although the associations were weak. [ABSTRACT FROM AUTHOR]

Background: There have been inconsistent findings from studies examining factors associated with quality of life (QoL) for children affected by parental illness. Aim: The aim of this study was to explore factors associated with self‐reported QoL in children affected by parental illness or parental substance abuse. Design: A cross‐sectional multicentre study. Methods: The sample included 246 families with children 8–18 years recruited via ill parents who received treatment for severe physical illness, mental illness or substance abuse in specialised health services. We performed multiple linear regression analyses to examine factors associated with the children's self‐reported QoL. Main outcome measure: KIDSCREEN‐27. Results: The children's self‐reported QoL was positively associated with the ill parent's self‐reported physical health, the children's self‐reported social skills, the degree to which other adults took over the ill parent's responsibilities, provision of sibling care, provision of health care for the ill parent and positive outcome of caregiving. The children's QoL was negatively associated with the children's self‐reported responsibilities due to parental illness, provision of emotional care for the ill parent, negative outcomes of caregiving and external locus of control. The model explained 63% of the variance (adjusted R2) in children's total QoL. Study limitations: Sampling bias may have occurred during recruitment. Conclusions: The findings suggest factors of importance for the children's QoL. Clinicians should assess whether an ill parent's physical health may influence negatively on their ability to perform daily responsibilities at home and care for their children, and clinicians can use children's self‐reported QoL to identify children who are most negatively affected. [ABSTRACT FROM AUTHOR]

Background: Patients are expected to participate in the hospital discharge process, assume self‐management after discharge and communicate relevant information to their general practitioner; however, patients report that they are not being sufficiently empowered to take on these responsibilities. The aim of this study was to explore and understand the discharge process with a focus on medicines communication, from the patient perspective. Methods: Patients were included at a hospital ward, observed during health‐care personnel encounters on the day of discharge and interviewed 1‐2 weeks after discharge. A process analysis was performed, and a content analysis combined data from observations and data from patient interviews focusing on medicines communication in the discharge process. Results: A total of 9 patients were observed on the day of discharge, equalling 67.5 hours of observations. The analysis resulted in the following themes: (a) the observed discharge process; (b) patient initiatives; and (c) the patient role. The medicines communication in the discharge process appeared unstructured. Various patient preferences and needs were revealed. The elements of the best practice structured discharge conversation were observed; however, some patients did not have a discharge conversation at all. Conclusions: The study contributes to a broader understanding of the discharge process, how patients experience it, including their role. It is evident that the discharge process is not always tailored to meet the patients' needs. More focus on early patient involvement and communication, in order to better prepare patients for self‐management of their medications, is important for their health outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to describe the prevalence and associated factors for xerostomia and hyposalivation in a young‐elderly population. A random sample of 460 65‐yr‐old people living in Oslo, Norway, answered a questionnaire and underwent a clinical examination (237 men and 223 women; response rate 58%). Ten percent of respondents reported xerostomia. The median Summated Xerostomia Index was 6 (interquartile range [IQR]: 5–7) and the median Clinical Oral Dryness Score was 2 (IQR: 1–3). The median unstimulated whole saliva (UWS) secretion rate was 0.34 (IQR: 0.20–0.53) mL min–1 and the median stimulated whole saliva (SWS) secretion rate was 1.74 (IQR: 1.24–2.38) mL min–1. In 8% of the study participants the UWS secretion rate was ≤0.1 mL min–1 and in 4% the SWS secretion rate was ≤0.7 mL min–1. Three percent of the study participants had both xerostomia and hyposalivation with respect to UWS. Xerostomia was significantly associated with medication use, having rheumatic disease, and having received radiation therapy to the head/neck region. Hyposalivation with respect to UWS and SWS was significantly associated with medication use and type II diabetes. Even though xerostomia and hyposalivation were not prevalent conditions in this population, clinicians should be especially aware of the salivary conditions in patients taking four or more medications, patients diagnosed with type II diabetes, and those who have undergone radiation therapy to the head/neck region. [ABSTRACT FROM AUTHOR]

Iodine deficiency during pregnancy and in the post‐partum period may lead to impaired child development. Our aim is to describe iodine status longitudinally in women from pregnancy until 18 months post‐partum. Furthermore, we explore whether iodine status is associated with dietary intake, iodine‐containing supplement use and breastfeeding status from pregnancy until 18 months post‐partum. We also assess the correlation between maternal iodine status 18 months post‐partum and child iodine status at 18 months of age. Iodine status was measured by urinary iodine concentration (UIC) during pregnancy (n = 1,004), 6 weeks post‐partum (n = 915), 6 months post‐partum (n = 849), 12 months post‐partum (n = 733) and 18 months post‐partum (n = 714). The toddlers' UIC was assessed at 18 months of age (n = 416). Demographic variables and dietary data (food frequency questionnaire) were collected during pregnancy, and dietary data and breastfeeding practices were collected at all time points post‐partum. We found that iodine status was insufficient in both pregnant and post‐partum women. The UIC was at its lowermost 6 weeks post‐partum and gradually improved with increasing time post‐partum. Intake of milk and use of iodine‐containing supplements significantly increased the odds of having a UIC above 100 μg/L. Neither the mothers' UIC, vegetarian practice, nor exclusion of milk and dairy products were associated with the toddlers UIC 18 months post‐partum. Women who exclude milk and dairy products from their diets and/or do not use iodine‐containing supplements may be at risk of iodine deficiency. The women possibly also have an increased risk of thyroid dysfunction and for conceiving children with nonoptimal developmental status. [ABSTRACT FROM AUTHOR]

The measurement of user experience has gained international attention as a tool for improving quality of care. Because foster families have a high need for service support, we examined quality of care from the foster parent's perspective and associated characteristics. We collected information about type and frequency of service use in the last 2 years and standardized measures of user‐reported experiences and outcomes from foster parents of youths aged 11–18 years in Norway (N = 290). We analysed the data using descriptive statistics, independent samples t‐tests and multiple regressions. Overall, foster parents had positive service experiences, and around half reported improvement in youth condition and function compared with before the service contact. The foster parents gave similar evaluations of child welfare services and specialized mental health services but indicated different strengths and weaknesses of the providers. Younger age, more frequent service contact and less waiting time were associated with positive service experiences, while less mental health problems and fewer years in current foster home were related to positive perceptions of outcomes. Our results indicate focus areas for increasing quality of care from the user perspective, for example, sharing information, cooperation between services, having frequent enough service contact and reducing waiting time. [ABSTRACT FROM AUTHOR]

Key Practitioner Messages: The COVID‐19 pandemic has resulted in negative consequences for children exposed to violence and abuse.Domestic violence refuge staff were greatly concerned about children both living outside and inside refuges.Domestic violence refuges have played a pivotal role during the COVID‐19 pandemic and should receive wider acknowledgement and greater support for their work. [ABSTRACT FROM AUTHOR]

The purpose of the study was to understand if and how 2 proposed facets of self‐identity (work‐self and career‐self) and journals' perceived quality (impact, visibility, and content quality) influence and explain the intention to publish in open access (OA) or nonopen access (non‐OA) journals. This study integrates attitude and identity theory within a cross‐sectional survey design. The sample consists of about 1,600 researchers in Norway, and the data were collected via e‐mail invitation using a digital surveying tool and analyzed using structural equation modeling techniques. We determined that perceived impact‐quality increases the intention to publish non‐OA, while decreasing the intention to publish OA. Content quality is only associated with non‐OA journals. Perceived visibility increases the intention to publish OA, while the opposite effect is found for non‐OA. Career‐self salience has the strongest effect on impact‐quality, while content quality is most important when work‐self is salient. This research contributes to a deeper understanding about how perceived quality influences intention to publish in OA and non‐OA journals, and how self‐identity salience affects different facets of perceived quality in valence and strength. Findings have implications for policy development, implementation, and assessment and may contribute to improving OA adoption. [ABSTRACT FROM AUTHOR]

Background: Post‐traumatic stress (PTS) symptoms following intensive care unit (ICU) treatment can lead to post‐traumatic stress disorder and represent a severe health burden. In trauma patients, a strong sense of coherence (SOC) is associated with fewer PTS symptoms. However, this association has not been investigated in a general ICU sample. Aims and objectives: To examine the occurrence of PTS symptoms in general ICU patients early after ICU discharge and to assess possible associations between PTS symptoms and SOC, ICU memory, pain, and demographic and clinical characteristics. Design: This was a cross‐sectional study. Methods: Adult patients aged ≥18 years admitted for ≥24 hours to five ICUs between 2014 and 2016 were recruited. PTS symptoms and SOC were measured at the ward within the first week after discharge from the ICU using the Posttraumatic Stress Scale‐10 and Sense of Coherence Scale‐13. Multiple linear regression analysis was used to identify associations between PTS symptoms and SOC and the selected independent variables. Results: A total of 523 patients were included (17.8% trauma patients; median age 57 years [range 18‐94]; 53.3% male). The prevalence of clinically significant PTS symptoms was 32%. After adjustments for gender and age, lower SOC (P < 0.001), more ICU delusional memories (P < 0.001), greater pain interference (P < 0.001), not being a trauma patient (P = 0.02), and younger age (P = 0.03) were significantly associated with more PTS symptoms. Conclusions: One third of patients experienced clinically relevant PTS symptoms early after discharge from the ICU. In the present study, SOC, delusional memory, pain interference, younger age, and not being a trauma patient were factors associated with more PTS symptoms. Relevance to clinical practice: Early individual follow up after ICU discharge focusing on pain relief and delusional memory may reduce PTS symptoms, with a potential of improving rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Workforce inclusion is an important political goal in many countries. However, nearly 70% of Norwegians registered with mild intellectual disabilities (IDs) are not registered employed or attending in day care centres. This study investigates the association between age, gender, functional level and hospital admissions with employment or attendance in public financed, community‐based day care centres for adults with mild IDs in Norway. Method: This study is based on data from a linkage of the national population‐based registries from 2013 to 2015: Statistics Norway (SSB), the Norwegian Information System for the Nursing and Care Sector (IPLOS) and the Norwegian Patient Registry (NPR). The sample consisted of 2370 adults registered with a mild ID, receiving disability pension in Norway, aged 18–67 years. Binary and multinomial logistic analyses, adjusted for age, gender, functional level and hospital admissions, were performed. Results: In 2015, 45.7% and 19.6% of the samples aged 20–31 and 52–63 years, respectively, were registered as employed or in day care centres. Participation in day care is a public service registered in IPLOS, which requires registration of functional level, while attendance in employment support is registered in SSB, where functional level is not registered. Compared with people registered with a high functional level, the probability of being employed or in day care centres was lower for people without registration of functional level. People with hospital admissions were less likely to be employed, especially if they had both psychiatric and somatic hospital admissions. People were less likely to attend day care and open employment only if they had a combination of both types of hospital admissions. Attendance in day care centres was less likely for men than women. Conclusions: Older people with mild ID, without registered functional level (meaning not receiving public community‐based services) and with a history of hospital admissions were significantly less likely to be employed or participate in day care centres. The clear association between not being employed or attending day care centres and not having one's functional level registered implies there is a need for increased focus on how to enhance work participation among people with mild IDs who are not within the system of receiving public services. [ABSTRACT FROM AUTHOR]

This article elucidates the challenges parents face when they lose the care of their children and their experiences of family counselling as a support service in Norway. A qualitative study following five mothers and one father whose children were in care was conducted through two focus groups and six individual interviews. The study found that the parents struggled to understand why their children had been placed in care and felt disempowered by the Child Protection Services (CPS). This situation led to complicated relationships with the CPS. We drew upon positioning theory and Goffman's theories about stigma and identity in this study, and these theories are explicitly used in discussing our analytic results. The study reveals the challenges encountered by CPS due to their dual role: On the one hand, they remove the children, and on the other, they offer support. The parents in this study also received assistance from the Family Counselling Services. Important results of this study are the parents' experiences of the two systems and, in particular, the different positions the systems seemed to place them in. [ABSTRACT FROM AUTHOR]

Background: Correct electrode placement and proper skin preparation for cardiac telemetry monitoring of patients at risk for arrhythmias increase the quality of the arrhythmic surveillance. Inconsistent arrhythmia surveillance can compromise patient safety and care outcomes. An inspection of international literature demonstrates that nurses generally do not adhere to cardiac monitoring standards. Aim: The aims of this study were to determine cardiovascular nurses' knowledge of and adherence to practice standards for cardiac surveillance and whether their knowledge and practice improves over time. Study design: A comparative study design was applied, and data were obtained by survey methodology. Methods: Nurse delegates at the Annual National Congress on Cardiovascular Nursing in Norway completed surveys in 2011 and 2017 (delegates from 44 and 38 hospitals, respectively). Results: In total, 363 cardiac nurses (70%) responded to the questionnaires. Of these, 95% were female, with a mean age of 41 years. In 2011, 97% of participants were unaware of international practice standards. However, by 2017 unawareness decreased to 78% (P <.001). Despite their lack of knowledge of practice standards, 94% of participants often or always prepared patients' skin for telemetry; this improved from 2011 to 2017 (P =.001). Overall, 73% of nurses never or seldom scrubbed or washed the patients' skin before electrode placement, and 38% of the electrodes were misplaced. In 2011, 49% of nurses used protective telemetry covers; this increased to 80% in 2017 (P <.001). Overall, 64% always informed patients of the purpose of cardiac monitoring. Conclusion: A significant percentage of nurses fail to adhere to recommendations for electrode placement, skin preparation and providing patients with telemetry information. In order to raise the quality of arrhythmic surveillance, investment in educational programmes in cardiac telemetry monitoring is required. Relevance to Clinical Practice: Improved in‐hospital telemetry practice is required to ensure patient safety and better care outcomes. [ABSTRACT FROM AUTHOR]

Purpose: This study illustrates the huge untapped potential of quantifying the impact of culture in making meaningful comparisons across groups. Our focus is on cross‐national differences in nurses' reports of their relations with physicians, and how the measurement of this complex construct and the evaluation of true differences are related to dimensions of national culture. Design: We examine across 14 European countries the association between indices of national culture from the seminal work of Hofstede and 39,435 nurses' ratings of their relations with physicians. Multilevel confirmatory factor analysis was used to evaluate strong factorial invariance across countries and to examine the influence of power distance and masculinity. Findings: There was wide variation across countries in nurses' reports of their relations with physicians. Strong factorial invariance was shown for a one‐factor model, which confirmed that across countries the seven survey items measure a common factor of physician‐nurse relations. This model showed no country bias for any of the seven survey items, which suggests that differences across countries reflect true differences. These true differences were significantly associated with variation in country values of power distance, which showed a significant negative correlation with physician–nurse relations. Conclusions: Continuously pursuing a better understanding of characteristics that impact the studied indicators, such as national culture, is elementary to better understand the construct under study. In this application, country values of power distance negatively impacted nurse‐reported relations with physicians, which strongly varied across countries. Clinical Relevance: Better nurse‐reported relations between nurses and physicians link to higher nurse job satisfaction, lower emotional exhaustion, better nurse‐perceived quality of care, and lower patient mortality. The Practice Environment Scale of the Nursing Work Index is an excellent instrument to characterize variation in working relations between nurses and physicians as well as physicians' professional posture towards nurses. [ABSTRACT FROM AUTHOR]

Background: Patient participation is a key concern in health care. Nevertheless, older patients often do not feel involved in their rehabilitation process. Research states that when organizational conditions exert pressure on the work situation, care as a mere technical activity seems to be prioritized by the health‐care staff, at the expense of patient involvement. Objective: The aim of this article is to explore how health‐care professionals experience patient participation in IC services, and explain how they perform their clinical work balancing between the patient's needs, available resources and regulatory constraints. Design: Using a framework of professional work and institutional logics, underpinned by critical realism, we conducted semi‐structured interviews with 18 health‐care professionals from three IC institutions. Results: IC appears as an important service in the patient pathway for older people with a great potential for patient participation. However, health care staff may experience constraints that prohibit them from using professional discretion, which is perceived as a threat to patient participation. Further, they may adopt routines that simplify their interactions with patients. Our results call for more emphasis on an individualized rehabilitation process and a recognition that psychological and social aspects are critical for patient participation in IC. Conclusion: Patients interact in the face of conflicting institutional priorities or protocols. The study adds important knowledge about the practice of patient participation in IC from a front‐line provider perspective. Underlying mechanisms are identified to understand and recommend how to facilitate patient participation at different levels in narrowing the gap between policy and clinical work in IC. [ABSTRACT FROM AUTHOR]

Participation in organized sports is a popular and important part of the lives of children and adolescents and is associated with improved psychological and social health, as well as an increased likelihood of meeting physical activity (PA) recommendations. Changes in modern society, including increased car ownership and use of technology and electronic media, have led to an additional focus on the importance of health‐enhancing PA among children and adolescents. The aim of this article was to study the secular changes in self‐reports of participation in organized sports clubs and leisure‐time vigorous physical activity (LVPA), and whether the relationship between participation in organized sports clubs and LVPA has changed from 1985 to 2014. Questionnaire data were collected in two cross‐sectional samples of Finnish and Norwegian 11‐, 13‐ and 15‐year‐olds in 1985/1986 (n = 7137) and 2014 (n = 9218). Overall, participation in organized sports clubs and level of LVPA appears to have changed in the same direction in the two Nordic countries. The proportion of 11‐year‐olds reporting to be participants in organized sports clubs increased from 1985/1986 to 2014. There was an overall increase in self‐reported LVPA. The association between participation in sports clubs and LVPA was stronger in 2014 than in 1985/1986. The findings indicated subgroup differences, in particular with regard to a steeper increase in LVPA and participation in sports clubs among Finnish girls. We suggest that attention should be given to the role of organized sports to better understand secular changes in PA. [ABSTRACT FROM AUTHOR]

Background: Multiple factors can influence the working alliance and treatment outcome in speech and language therapy. The 'working alliance' is an important concept in treatment and can be described as the degree to which a treatment dyad is engaged in collaborative, purposive work. To date, relatively little attention has been paid to this concept within speech and language treatment in general, and within stuttering treatment research in particular. Aims: To investigate the role of the working alliance within stuttering treatment, and to evaluate whether the quality of the working alliance correlated with clients' concept of motivation and treatment outcomes 6 months post‐therapy. Methods & Procedures: Eighteen adults (21‐61 years) participated in this multiple single‐case treatment study, with treatment facilitated by an experienced speech and language therapist. The working alliance was investigated using the Working Alliance Inventory—Short Version Revised (WAI‐SR), an Extended version of the Client Preferences for Stuttering Treatment (CPST‐E), the Overall Assessment of Speakers' Experience of Stuttering—Adult version (OASES‐A), the Wright & Ayre Stuttering Self‐Rating Profile (WASSP) and the Hospital Anxiety and Depression Scale (HADS). Outcomes & Results: Analyses demonstrated significant associations between the working alliance and client motivation (r = 0.781) and treatment outcomes (r = 0.644) 6 months post‐treatment. The association between client‐led goals and therapy tasks appeared particularly important. Conclusions & Implications: : The working alliance between speech and language therapists and persons who stutter matters. Within the alliance, the level of client–clinician agreement on treatment goals and therapy tasks may be of greater importance than the bond between client and clinician. Further research with greater numbers of participants is warranted. [ABSTRACT FROM AUTHOR]

Background: In most maternity wards in Norway, early discharge (<48 hour) is the norm. To monitor newborns' and women's health during the first week after delivery, most maternity wards offer early check‐ups, where families return to the hospital (standard care). However, a few municipalities offer home visits by midwives (domiciliary care) to ensure seamless services for the family. Aim: The primary aim of this study was to explore whether different follow‐up strategies were differently associated with maternal depression and breastfeeding habits, 6 weeks and 6 months postpartum. The secondary aim was to investigate whether families at risk of postpartum depression were included in the home visiting programme in the municipality that offered both follow‐up strategies. Method: This study draws on data from the 'Little in Norway' (LIN) study, which followed families from pregnancy until the child was 18 months. This study used data from two different well‐baby clinics in two municipalities, where one offered standard care (n = 95) and the other domiciliary (n = 64) and standard care (n = 17). The Edinburg Postnatal Depression Scale (EPDS) was used to measure maternal depression. Breastfeeding habits were measured using a self‐report questionnaire. The Life Stress subscale of the Parenting Stress Index (PSI) was used to identify women at risk of postpartum depression. Results: There were no differences in maternal depressive symptoms or breastfeeding habits at neither 6 weeks nor 6 months postpartum between women who received standard or domiciliary care in the two municipalities. Within the municipality that offered both follow‐up strategies, a higher number of women scoring high on prenatal life stress were included in domiciliary – compared to standard care. Conclusion: Differential follow‐up strategies in the first week after birth did not impact on maternal depression or breastfeeding habits. However, domiciliary care seems to be regarded as supportive and nonstigmatising for women at risk of postpartum depression. [ABSTRACT FROM AUTHOR]

The purpose of this pilot study was to design and test research instruments to measure qualified intensive care nurses' implicit and explicit attitudes and behavioral intentions toward obese intensive care patients. In previous studies researchers have demonstrated that some health professionals hold negative attitudes toward obese patients; however, little is known about qualified intensive care nurses' attitudes toward these patients. Our cross‐sectional pilot study involved Implicit Association Tests, the Anti‐fat Attitude questionnaire, an explicit bias scale comprising ratings of explicit beliefs and feelings, assessment of behavioral intentions based on vignettes, and demographic questions. Thirty qualified intensive care nurses from a general intensive care unit in Norway (80% female; age range 31–62 years) completed the study. Nurses reported implicit and explicit preferences for thin over thick patients and found obese patients lazier than normal‐weight patients. Measures of behavioral intentions and anti‐fat attitudes were reliable. Generally, the nurses intended to help obese patients immediately. Nevertheless, explicit anti‐fat attitudes (rho = −0.49) as well as implicit anti‐obese stereotypes (rho = −0.40) were negatively correlated with such intentions. Data supported satisfactory face validity, and convergent and discriminant validity within and between implicit and explicit attitudes and stereotypes. The set of research instruments were reliable, valid, and suitable tools to measure qualified intensive care nurses' implicit and explicit attitudes; however, the present findings need to be replicated in a larger‐scale study. [ABSTRACT FROM AUTHOR]