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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.

The revised two-factor study process questionnaire (R-SPQ-2F) has widely been considered valid and reliable in many contexts for measuring students' learning approaches. However, its cultural specificity has generated considerable discussion, with inconclusive results when translated to different languages. This paper provides more insights into the construct validity of a Norwegian version of this instrument. The R-SPQ-2F is composed of ten items designed to expose deep learning approaches and 10 items designed to expose surface learning approaches. A survey research design involving a sample of 253 first year university students in a mathematics course was adopted. Ten hypothesized models were compared using a series of confirmatory factor analyses following the model proposals reported in the literature. A weighted least square mean and variance adjusted (WLSMV) estimator was used to enhance model parameter estimations under multiple violations of assumptions inherent in ordinal data. The results favored a two first-order factor model with ten items measuring the deep approach and nine items measuring the surface approach including a deletion of one item from this instrument. The findings of this study provide empirical evidence for the cultural specificity of the instrument that is consistent with the literature. The R-SPQ-2F is therefore recommended to assess students' approaches to learning, and further studies into its cultural specificity are recommended.

In recent decades, Norwegian schools have experienced increased cultural diversification among students. Growing heterogeneity in origin and culture may enhance the risk of student marginalisation, segregation and exclusion. In response to these challenges, this paper examines students' intercultural empathy and, particularly, how schools can develop their intergroup empathy to support social inclusion. Theoretically, we applied an inclusive citizenship perspective. The study draws primarily on quantitative data gathered from paper questionnaires collected from 1006 students in two upper secondary schools and three lower secondary schools. We explored the antecedents of intercultural empathy among the students using regression analyses. First, we found that there are substantial differences between the scores of boys and girls on intercultural empathy. Second, we found that information on culture and diversity was a predictor of certain aspects of intercultural empathy. Third, a variety of school variables were applied to explore possible ways to support student intercultural empathy, which showed moderate associations with intercultural empathy. Fourth, variables measuring students' perceptions of human rights implementation in school were also moderately associated with aspects of intercultural empathy. The results and their implications for teaching are discussed.

Although well researched in educational studies, inquiry-based learning, a student-centred way of teaching, is far away from being implemented in day-to-day science and mathematics teaching on a large scale. It is a challenge for teachers to adopt this new way of teaching in an often not supportive school context. Therefore it is important to provide high-quality professional development (PD) at a large scale. However, there is little empirical evidence about the effects of scaled-up professional development initiatives. Therefore, this paper presents an international research study for which long-term PD courses have been designed. These courses have been implemented across Europe in twelve different countries at scale by using the so-called "Cascade Model." Here, course leaders are educated, who in turn educate other teachers. The research study aimed at evaluating the overall impact the scaled-up PD had on teachers and at also identifying variables influencing this impact.

A collective Competence Improvement Project (CIP) was conducted for educational psychological counselors (n = 5) along with teachers (n = 11), special education teachers (n = 7), and child and youth workers (n = 11). All of the participants were involved in the training and teaching of children with autism/ASD in a small municipality in Norway. The CIP focused primarily on competence improvement in the participants' overall knowledge and theoretical conceptions about autism/ASD. Additionally, other goals included competence improvement in Discrete Trial Teaching (DTT), Pivotal Response Training (PRT), and Social Stories™ (SS). The results demonstrate that the CIP contributed to improvements in some of these targeted areas but not in all. Educational psychological counsellors and special education teachers benefited more and satisfactorily from the CIP than teachers and child and youth workers (CYWs). It is now clear that achieving significant improvement in competency does not necessarily equate to satisfactory improvement. Additionally, improving the professionals' theoretical knowledge is important, but it does not necessary lead to improving their operational knowledge--their capacity for implementing their knowledge in practice. This paper presents the background, implementation, and results of the CIP, and it closes with a discussion of the findings and conclusions about their implications for future CIPs and research.

The increasing relevance of information and communication technologies (ICT) and society's transition towards an information or knowledge society have led to the emergence of new challenges for schools and school systems. Thus, the need for students to develop new forms of skills like "digital literacy" or "computer and information literacy" (CIL) is constantly gaining in importance. In the IEA's ("International Association for the Evaluation of Educational Achievement") ICILS 2013 ("International Computer and Information Literacy Study"), the aforementioned competencies were investigated--along with CIL learning contexts and outcomes (such as school-level factors in different education systems)--for the first time for secondary schools by applying computer-based student tests. The research presented in this paper focuses on the school-level factors that support or hinder the use of ICT by teaching staff and students' CIL, drawing in the process on information obtained through school and teacher questionnaires. A multilevel approach was chosen for this research, drawing on representative data from four of the countries which participated in ICILS 2013, namely Australia, Germany, Norway and the Czech Republic. The results show that the relevance of school-level determinants for the use of ICT by teaching staff in schools differs between education systems. Only in Germany, for example, does pedagogical IT support seem to be crucial for the use of ICT in teaching. In the Czech Republic, the self-efficacy of teaching staff plays a key role, whereas in Australia, the participation of teaching staff in professional development activities can be identified as relevant for students' acquisition of CIL. The results also show a statistically significant correlation between the teachers' use of ICT in schools and students' CIL for Germany, yet indicate no significant effects for Australia, Norway and the Czech Republic. In addition to these and the more specific findings for the considered countries, the international comparison presented in this paper reveals both strengths and developmental potential for the selected education systems.

Teaching online requires different skills, roles and competencies for online instructors compared to teaching in traditional learning environments. Universities should offer ongoing support in various forms to help academic staff through their online journey. This paper provides insights into a multinational faculty development program for teaching online, elaborating on results of expectancy and satisfaction surveys. From a local program to a subproject within the Swiss National Science Foundation Project Scopes, e-Tutor aimed at expanding competencies in online lecturing and providing OER material for training colleagues. Designed in the form of a descriptive case study, this research was conducted with 34 attendees of e-Tutor. Data was collected using an e-learning readiness and expectancy questionnaire, and open-ended questions after the program to measure satisfaction. Descriptive statistics were used to analyze the survey data and content analysis for open-ended data. Participants considered e-Tutor a well-planned and targeted program with good theoretical and practical balance. Duration of such courses, opportunities for adaptation to real-life situations, and localization of the content are areas to be explored further. For future studies, it would also be interesting to see whether participants can apply their newly acquired knowledge and skills to create efficient online learning environments.

Validation of data collection instruments is a necessary step in all research and should be regarded as an integral component in every stage of the research process; however, the validation process is often not accounted for in detail in published studies. The purpose of this paper is to describe the development and validation of the Ungspråk electronic questionnaire, which was designed to explore teenagers' multilingualism and multilingual identity in the Norwegian school context. It aims to examine whether having a multilingual identity correlates with several variables such as language practices, languages studied in school, open-mindedness, and beliefs about multilingualism. To our knowledge, the Ungspråk questionnaire is one of the first validated tools for quantitatively investigating learners' multilingual identity in school settings. Different qualitative and quantitative procedures were adopted for validating Ungspråk, including piloting sessions with students from two lower secondary schools. The results of the validation processes suggest that the Ungspråk questionnaire is a robust instrument for investigating young learners' multilingual identity. It is easy to use, acceptable to learners, and fulfils stringent criteria of reliability and validity.

Purpose:The aim of the present paper was to study preferences for web based self-administered questionnaires (web SAQs) vs. paper-based self-administered questionnaires (paper SAQs) and to evaluate the feasibility of using web SAQs in patients referred to cardiac, lung, occupational and cancer rehabilitation programs. Methods:The patients were approached by mail and given the choice to answer the compulsory SAQs either on paper or on a web-based platform. Results:Hundred and twenty seven out of 183 eligible patients (69.3%) were willing to participate and 126 completed the study. Web SAQs were preferred by 77.7%, and these patients were significantly younger, more often cohabiting and tended to have higher level of education than paper SAQ users. Mean number of data missing per patient was less among the web SAQ users than the paper SAQ users (0.55 vs. 2.15,p < 0.001). Costs related to human resources were estimated to be 60% lower with web SAQs compared to paper SAQs. Conclusions:Web SAQs were well accepted among the patients scheduled for rehabilitation, led to less missing data and considerable cost savings related to human resources. Patients referred to rehabilitation should be offered the choice to complete self-administered questionnaires on internet platforms when internet access is common and available.Implications for RehabilitationThe high acceptability of web-based self-administered questionnaires among rehabilitation patients suggests that internet platforms are suitable tools to collect patient information for rehabilitation units.Web-based modes of patient data collection demonstrate low number of missing data and can therefore improve the quality of data collection from rehabilitation patients.Use of web-based questionnaires considerably reduces administrative costs of data collection in rehabilitation settings compared to traditional pen and paper methods. [ABSTRACT FROM PUBLISHER]

Background: The latest curriculum reform in Norway is one example of an education reform with a highly emphasised assessment for learning (AfL) agenda. Acknowledging that there is a lack of empirical research on AfL in physical education (PE), and that AfL potentially can have an important role to play in development of PE pedagogy, this paper set out to examine the extent to which the emphasis on AfL from educational authorities has led to change in assessment practice in PE. Purpose and research question: The purpose of this paper is to examine the implementation of AfL in PE at upper secondary level in Norway, and discuss possible implications. More specifically we ask "How do students' and teachers' perspectives of assessment practices in PE reflect AfL key principles?" Methods: A mixed-method design has been applied in this study. Quantitative data, collected through a questionnaire answered by 1486 students from six upper secondary schools (15-19 years), were combined and compared with qualitative data from focus groups of a total of 23 PE teachers at the same schools. Data were analysed in relation to four key principles of AfL. Findings: For the majority of the students in the study, their reports of assessment practice in PE did not reflect the four key principles of AfL. This result was supported by the fact that their PE teachers conveyed very varied understandings and enactments of AfL. The study revealed some difference between teacher and student perspectives regarding AfL key principles, in particular regarding feedback that moves learners forward. Conclusions: The study demonstrates limited implementation of AfL principles in PE and we conclude that the educational authorities' emphasis of AfL has not proven productive in PE. However, most of the teachers acknowledged the need to change teaching and assessment practices in PE, and all schools in the study are observed to be in an area of changing assessment. Considering the findings on different AfL key principles, this study highlights engaging student more directly in assessment processes as an important development area.

There is a need for a more sustainable diet in many countries. Using Mediterranean principles could provide a possible answer. The principles of the Mediterranean diet and suitability to the Nordic diet have been discussed in courses mainly for Norwegian food and health teachers and students visiting Greece. What benefits do the participants experience after returning home and how do they apply their new knowledge in Norwegian conditions? We studied the themes from the exam papers to find out which knowledge the participants acquired from the course, and how they transferred their knowledge about the Mediterranean diet to Norwegian conditions. We also conducted a survey among the participants; they reported that they felt they benefited from the course. It seems the students are able to translate their knowledge about Mediterranean diet to Norwegian conditions, and the teachers who participated in the course used their knowledge in teaching. Most of the participants use this knowledge in their daily lives.

This paper focuses on a generational change taking place in the Polish academic profession: a change in behaviors and attitudes between two groups of academics. One was socialized to academia under the communist regime (1945-1989) and the other entered the profession in the post-1989 transition period. Academics of all age groups are beginning to learn how tough the competition for research funding is, but young academics ("academics under 40"), being the target of recent policy initiatives, need to learn faster. Current reforms present a clear preferred image for a new generation of Polish academics: highly motivated, embedded in international research networks, publishing mostly internationally, and heavily involved in the competition for academic recognition and research funding. In the long run, without such a radical approach, any international competition between young Polish academics (with a low research orientation and high teaching hours) and their young Western European colleagues (with a high research orientation and low teaching hours) seems inconceivable, as our data on the average academic productivity clearly demonstrate. The quantitative background of this paper comes from 3704 returned questionnaires and the qualitative background from 60 semi-structured in-depth interviews. The paper takes a European comparative approach and contrasts Poland with 10 Western European countries (using 17,211 returned questionnaires).

Over time international large-scale assessments have grown in terms of number of studies, cycles, and participating countries, many of which are a heterogeneous mix of economies, languages, cultures, and geography. This heterogeneity has meaningful consequences for comparably measuring both achievement and non-achievement constructs, such as social and emotional skills. In this paper we propose one way to directly incorporate country-specific differences into the methods used to construct background scales. We use research that demonstrates data quality issues in international assessment and the degree to which these issues can impact inferences. Our proposed solution incorporates innovations that have been developed for achievement measures but have not been applied to background scales. We demonstrate this possible solution with PISA 2012 data.

This paper reports on the results from administering a modified version of the Introductory Astronomy Questionnaire (IAQ) to middle school students and preservice science teachers in Norway. Ranking tasks formed a key part of the instrument, and we detail a new method for analyzing ranking task data. One of our main findings was that even after instruction, a significant proportion of students held erroneous views and conceptions regarding sizes, distances, and the nature of basic astronomical entities, such as stars and planets. We argue that the commonalities between some of the issues we identified and those presented in extant studies--from a variety of countries, with samples ranging from junior high school students and undergraduates to primary school teachers--may point to deeper cognitive issues inherent in, and possibly unique to, engaging with astronomy.

This paper presents the experienced difficulties of students participating in the multidisciplinary, remote collaborating engineering design course challenge-based innovation at CERN. This is with the aim to identify learning barriers and improve future learning experiences. We statistically analyse the rated differences between distinct design activities, educational background and remote vs. co-located collaboration. The analysis is based on a quantitative and qualitative questionnaire (N = 37). Our analysis found significant ranking differences between remote and co-located activities. This questions whether the remote factor might be a barrier for the originally intended learning goals. Further a correlation between analytical and converging design phases was identified. Hence, future facilitators are suggested to help students in the transition from one design phase to the next rather than only teaching methods in the individual design phases. Finally, we discuss how educators address the identified learning barriers when designing future courses including multidisciplinary or remote collaboration.

Extensive research emphasises the importance of parental involvement for children's learning and academic achievement. This paper reports from a Norwegian study researching parents' experiences on follow-up after their child's cochlear implantation. Within this context, parental involvement is suggested to be of major importance for the child's language learning. The study explores the parents' talk on their involvement in the child's language after implantation. Data consist of 27 written parental accounts and interviews with 14 of these parents. The analysis shows the parents' extensive involvement in the child's language learning. The study brings into conversation how understandings of learning influence parental involvement, leading to implications for the parents and children involved. It addresses a need for debate on how parents can support children's learning, whilst avoiding parenthood becoming a series of educational tasks.

A crucial skill for researchers in inter- and transdisciplinary environmental projects is the ability to be reflexive about knowledge and knowledge production. Few studies exist on the operationalization of reflexive skills and teaching and learning strategies that help students master these skills. This research aims to contribute in this direction. We distinguished two components of reflexive skills: (i) assessing the relative contributions of scientific disciplines and non-academic knowledge in addressing environmental issues; (ii) assessing the role of norms and values in research. We developed a framework for teaching and learning reflexive skills and evaluated this framework within a quasi-experimental educational setting involving 3 groups of 30 students. Students' reflexive skills were assessed quantitatively using a pre- and post-test questionnaire. Moreover, students' reflection papers were analysed to get a better understanding of their perspectives on the teaching and learning framework. We show that it is possible to train students in reflexive skills, but it requires a well-designed learning setting.

Introduction: In this paper, Spanish future primary teachers' pedagogical knowledge of numbers and operation, as revealed through their results in the TEDS-M ("Teacher Education and Development Study in Mathematics"), is compared with that of two other groups. The first group are the future primary teachers of other OECD countries that also participated in the study: Norway, Germany, Chile and Poland. The second group are the future primary teachers of participating countries where preservice teachers receive training similar to Spain's teacher training, namely, China-Taipei, Singapore, United States, Philippines and Switzerland. Method: To meet this objective, data was analyzed and parameters were calculated based on categories that characterize the pedagogical knowledge required to correctly answer the questions in this conceptual domain, using response assessment criteria. Results: We found that Spanish prospective teachers have lower results, in general, than those of the other OECD countries and of countries in the group with similar training programs. The Spanish scores are lower than Norwegian, Swiss and Singaporean scores in all aspects considered. For most categories, Spain obtained higher scores than Philippines and Chile, and similar scores to the U.S.A. Discussion: When comparing the results from the OECD countries that participated in the two international studies, TEDS-M and TIMSS 2011 (Spain, Poland, USA, Norway, Germany and Chile), we find that their relative positions are maintained in the ranking of assessed mathematical knowledge of numbers and operations, whether in preservice teachers or in primary students. Spanish results in the TIMSS are just above Poland and Chile and below the rest. The results obtained in this study may be useful in the current syllabus design process for subjects in the Elementary Teacher Education degree.

In this paper an analysis is carried out whether objective tests and subjective self-assessments in international large-scale studies yield similar results when looking at cross-national differences in the effects of skills on earnings, and skills patterns across countries, fields of study and gender. The findings indicate that subjective skills measures do not correlate well with objective measures of similar constructs when looking at cross-national differences. Countrywise associations between subjective skills measures and earnings do not correlate well with those found using objective skills measures. Moreover, cross-national differences in the level of subjective skills measures do not correlate well with cross-national differences in skill levels based on objective tests. Nor do gender differences found using subjective skills measures correlate with those found using objective skills measures. This does not mean that self-assessments cannot be used, but they need to be restricted to analysing within-country differences. Within countries, self-assessments do a good job in predicting skills differences across fields of study and also in predicting the effect of skills on earnings. When comparing gender differences in skills levels within countries, however, one needs to be aware that females tend to overestimate their skills levels in typical "female" domains like literacy.

Purpose: This paper aims to research about the effect of mind-body training on the development of emotional competencies of managers. Design/methodology/approach: Quasi-experimental design, i.e. before and after (test-retest). Findings: Results showed that the experimental group, after training, achieved around 15 per cent higher scores compared to results before training on all three subscales of an emotional skills and competence questionnaire (ESCQ-45), a statistically significant improvement in scores. The control group (no training) scores showed no significant difference. This result indicates support for the view that emotional intelligence may be treated as a competency and is responsive to training programmes. Research limitations/implications: Emotional competencies are still a contested concept. The participants may provide socially desirable responses because of the self-assessment questionnaires. The sample is not a representative sample of European managers; hence, there is a limited generalisability of the results. Practical implications: These research findings indicate Mind-body training is a practical method for people to improve the management of their emotions, and hence impact positively on core organisational activities. Originality/value: This is the first research on this mind-body training (emotional relief technique) in an eight-week programme in a management context. The findings indicate the positive impact that can be achieved on emotional competencies scores from this method of self-development.

This paper explores teacher-reported prevalence of rough-and-tumble play (R&T) in preschool and investigates how their restriction to such play varies in different play environments (indoor and outdoor). An electronic questionnaire exploring preschool teachers' beliefs and practices regarding children's dramatic play themes was conducted by 138 female Norwegian preschool teachers. The results show that the teacher-reported prevalence of nurture/care and house/family types of dramatic play is higher among girls than among boys, while superhero play, pretend fighting, chase games and protect/rescue play is more prevalent among boys than girls. The results also show that play-fighting and chase games are the dramatic play types most restricted by the preschool teachers, and that R&T play is significantly less restricted in outdoor environments compared to indoors. The results are discussed within a Norwegian early childhood education and care (ECEC) context and implications for ECEC practice are suggested.

Introduction: Radiotherapy is the main treatment modality in cancer. There is sparse knowledge on how patients with cancer experience their radiotherapy trajectory, and which factors might be associated with patients' experiences. Objectives: The aim of the present study was to explore how adults with cancer receiving radiotherapy evaluate the quality of their care, utilizing a patient-reported experience measure, and how patient- and service-related characteristics are associated with their evaluation. Methods: An explorative cross-sectional study using a self-completed questionnaire to assess patients' radiotherapy experiences was performed. Participants were recruited consecutively, within their last week of treatment, from two different hospitals in Norway from January 2021 to January 2022. Four hundred and eighty paper questionnaires were distributed to recruited patients, 240 at each hospital. Questionnaires were self-completed at home and returned by mail. The instrument person-centered coordinated care experience questionnaire (P3CEQ) was used. In addition to this, participants completed the European Organization of Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30) and The Sense of Coherence 13 scale (SOC-13). Data were analyzed using descriptive statistics, parametric tests, and unadjusted/adjusted linear regression models were estimated. Results: The study included 373 patients. Patients evaluated quality of care in terms of P3CEQ scores, with a mean score of 19.5 (standard deviation = 5.4). Lowest scores were identified in areas concerning person-centeredness and service coordination. There were no significant differences in P3CEQ scores between the younger and older groups. Having a partner and better SOC-13 scores were independently associated with the overall patient-reported experience score, whereas age was not. Conclusion: Patient-reported experience scores indicate that improvements are needed in some areas, such as informing and involving patients in the planning and coordination of their care. Findings suggest paying special attention to patients without a partner to offer patients the best possible care. [ABSTRACT FROM AUTHOR]

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Making sure that health surveillance data are integrated into public health planning and decision-making is demanding. Politicians and their administration may lack knowledge, interest, or will to take it into account. Politics is at its core solution-driven, and this need for imminent action may outweigh the importance of solid knowledge. This paper focuses on Norwegian municipalities and fleshes out two factors that may provide an enabling environment for educating relevant personnel in health surveillance data; i) the existence of a public health coordinator and ii) the set-up of inter-sectoral working groups. We have anticipated that those organisational resources play an important role in linking the bodies of information provided in the municipalities' health surveillance document ; the municipal health profile ; and the health promotion priorities. The findings confirm the anticipated centrality of organisational resources. Having dedicated and inter-sectoral organizational resources working as boundary spanners – such as public health coordinators – is decisive to meeting the demands of current public health challenges. Moreover, dedication is useless unless there is a critical volume of the coordinator's work. It is only when she/he is in a full position that the profile is fully integrated. The study further identifies other conducive conditions for integration. For example, does knowledge on health determinants resides not only in statistical data, but also in qualitative experiences of people and professional practitioners. Of interest for further research is to explore how to educate such organisations to integrate such experiences into health promotion action. [ABSTRACT FROM AUTHOR]

Background: Cancer survivors are a diverse group with varying needs that are patient-, disease-, and/or treatment-specific. Cancer survivors have reported supplementing conventional anti-cancer treatment with Traditional and Complementary Medicine (T&CM). Although female cancer survivors are reported to have more severe anticancer adverse effects, little is known about the association between anticancer treatment and T&CM use among Norwegian cancer survivors. The aims of this study are therefore to investigate (1) associations between cancer diagnosis characteristics and T&CM utilization and (2) associations between anticancer treatment and T&CM utilization among cancer survivors in the seventh survey of the Tromsø study. Methods: Data was collected from the seventh survey of the Tromsø Study conducted in 2015-16 among all inhabitants of Tromsø municipality aged 40 and above (response rate 65%), where inhabitants received online and paper form questionnaires. Data from the data linkage to the Cancer Registry of Norway for cancer diagnosis characteristics was also used. The final study sample was made up of 1307 participants with a cancer diagnosis. Categorical variables were compared using Pearson's Chi-square test or Fisher's exact test while independent sample t-test was used to compare continuous variables. Results: The use of T&CM the preceding 12 months was reported by 31.2% of the participants with natural remedies as the most reported modality of T&CM (18.2%, n = 238), followed by self-help practices of meditation, yoga, qigong, or tai chi, which was reported by 8.7% (n = 114). Users of T&CM were significantly younger (p =.001) and more likely to be female (p <.001) than the non-users, with higher use of T&CM among female survivors with poor self-reported health and being 1–5 years post-diagnosis. Lower use of T&CM was found among female survivors who received a combination of surgery with hormone therapy and those who received a combination of surgery with hormone therapy and radiotherapy. Similar usage was seen in male survivors, but not at a significant level. For both male and female survivors, T&CM was most frequently used by those with only one cancer diagnosis (p =.046). Conclusion: Our results indicate that the profile of the Norwegian cancer survivor who uses T&M is slightly changing compared to previous findings. Additionally, compared to male survivors, more clinical factors are associated with use of T&CM among female cancer survivors. These results should serve as a reminder to conventional health care providers to discuss the use of T&CM with patients across the entire cancer survivorship continuum to promote safe use, especially among female survivors. [ABSTRACT FROM AUTHOR]

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]

Accessible summary: What is known on the subject: Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors.Mental health nurses often describe role confusion in relation to other health professionals.Opportunities for interdisciplinary communication with other professionals may benefit health care. What the paper adds to existing knowledge: The current large‐scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities.Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so. What are the implications of practice: The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needsInterdisciplinary teamwork could strengthen nurses' ability to address patient needsFinding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met. Introduction: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors. Aim/Question: The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs. Method: A cross‐sectional web‐based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded. Results: The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs. Discussion/Implication for practice: Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services. [ABSTRACT FROM AUTHOR]

The paper sets out to study Norwegians' experiences of non-monogamy. Data were collected by questionnaires in a web sample of 4160 Norwegians (18–89 years). 26.3% of men and 17.8% of women reported that they ever had non-consensual non-monogamy. Consensual non-monogamy was reported by 3%. Compared to participants with no or non-consensual experience, consensual non-monogamy was highly related to relationship intimacy and positive sexual attitudes toward sex and sexuality. At the most recent extradyadic event, 21.5% of heterosexual men and 47.1% of gay/bisexual men reported condom use, which implies a risk for sexually transmitted diseases. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present and discuss mental health services for people with intellectual disability (ID) in Norway.Design/methodology/approach A literature review and a survey were conducted to map services for people with ID and mental health problems in Norway.Findings The results were sparse and confirmed what is already known among clinicians working with these patients. The Norwegian services are fragmented and there are geographical differences.Research limitations/implications There are no special services for children with ID developing mental illness. For offenders with ID, a national unit assesses and follows up, also when the person is sentenced to compulsory care and services are provided in their home municipality.Practical implications More data about both the patients and the services are needed in order to improve mental health services for people with ID in Norway.Originality/value This paper describes mental health services for people with ID in Norway. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Many carers report feeling unrecognized by professional healthcare teams.Carers often report difficulty accessing mental health services for relatives.Carers who are also mental health professionals may experience role conflict as found for General Practitioners. What this paper adds to existing knowledge?: Carers who are mental health professionals are often not recognized for their professional knowledge and face similar communication barriers as other carers.Difficulties for carers who are mental health professionals are concerned with information sharing, decision‐making and continuity of care. What are the implications for practice?: Opportunity for services to learn from the experiences of mental health professional and carers to develop better communication and shared decision‐making methods for carersCarers who are mental health professionals should be recognized by services for their dual role (and skills).Service development opportunity for training in supporting and engaging carers who are mental health professionals Introduction: Around 60% of carers of relatives with mental health problems report feeling unrecognized by professional health care, and many report a lack of engagement, shared decision‐making and information sharing. There is a paucity of research examining these issues for carers who are also mental health professionals. Aims: This was an exploratory study to (a) explore the extent of this role among health service staff, (b) gather an indication of the issues faced by carers when interacting with the health system and (c) test the feasibility of conducting research. Methods: Mental health professionals in mental health services completed an online survey that assessed the frequency, content and satisfaction of the experiences of carers. Results: The sample comprised 453 mental health professionals (74% female), 52% being carers. Half of carers reported having therapist contact, and 25% were satisfied with the contact. Negative experiences were related to Information, Decision‐making and Continuity of care. Discussion: There was a high frequency of mental health professionals who were carers. The majority were dissatisfied, and this was primarily in relation to communication with services. Implications for practice: Improving information sharing through training of staff and identification of the system barriers is likely to enhance experiences for service users and families. [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]

Purpose: Access to adaptive equipment is a crucial factor that can determine if a child or youth with disabilities is going to participate in physical activities, sports and play in different local settings. A prerequisite for success is awareness of and specific knowledge concerning the equipment and its use among relevant actors. The aim of this paper is to explore how important groups of actors working with young people with disabilities perceive their level of knowledge concerning adaptive equipment and discuss these actors' role in children and youths' opportunities to obtain relevant equipment to participate in activities. Methods: An online, population-based national survey was distributed to: (1) occupational therapists and physiotherapists, (2) teachers, and (3) leaders and coaches in sports clubs in Norway. Results: The findings generally indicate that overall knowledge concerning adaptive equipment among the three groups is limited. However, significant statistical difference is found, indicating that occupational therapists and physiotherapists have higher levels of general knowledge, about the accessibility of equipment, regulations and legislation and that they are more familiar with adaptive equipment than teachers, leaders and coaches. Conclusions: A practical implication of the results is that the actors' varying knowledge and experiences need to be brought together to form a coherent picture of how the equipment will be used and by whom. This can contribute to an increased understanding concerning adaptive equipment and its importance among different actors, which could help more young people with disabilities to participate. Important actors must utilize the knowledge and experience possessed by young people with disabilities concerning adaptive equipment. Improved access to knowledge concerning adaptive equipment among important actors is required. Increased collaboration between different actors relating to adaptive equipment and participation is needed. [ABSTRACT FROM AUTHOR]

Objectives: In Norwegian aquaculture, safer technology and better safety management systems have been developed during the last decade. Safety commitment and safe behavior are still vital to ensure a safe working environment. The objective of this paper is to explore what factors might influence the reporting of hazardous situations in aquaculture. The significance of factors on both the individual (work experience, position) and company/organizational level (company size, safety climate) was studied. It was hypothesized that reporting of hazardous situations was positively predicted by work experience, having the position as operational manager, company size, and safety climate. Methods: The study is based on a quantitative questionnaire study involving 428 fish farmers, operational managers, and service vessel employees in the Norwegian aquaculture industry, interviewed by telephone. A purposive sampling procedure was employed. Correlation and hierarchical regression analyses were applied. The data quality was considered satisfactory. Results: Individual factors had no significant relationship with the reporting of hazardous situations. Company size and safety climate factors had positive associations with reporting. Larger companies might have more resources for safety management and the development of practical reporting solutions. A positive safety climate might increase the motivation for reporting. Conclusion: Efforts by management to improve the safety climate can contribute to the reporting of hazardous events, continuous improvement of safety management and improvement of the safety level. [ABSTRACT FROM AUTHOR]

Mixing languages within a sentence or a conversation is a common practice among many speakers of multiple languages. Language mixing found in multilingual speakers with aphasia has been suggested to reflect deficits associated with the brain lesion. In this paper, we examine language mixing behaviour in multilingual people with aphasia to test the hypothesis that the use of language mixing reflects a communicative strategy. We analysed connected language production elicited from 11 individuals with aphasia. Words produced were coded as mixed or not. Frequencies of mixing were tabulated for each individual in each of her or his languages in each of two elicitation tasks (Picture sequence description, Narrative production). We tested the predictions that there would be more word mixing: for participants with greater aphasia severity; while speaking in a language of lower post-stroke proficiency; during a task that requires more restricted word retrieval; for people with non-fluent aphasia, while attempting to produce function words (compared to content words); and that there would be little use of a language not known to the interlocutors. The results supported three of the five predictions. We interpret our data to suggest that multilingual speakers with aphasia mix words in connected language production primarily to bypass instances of word-retrieval difficulties, and typically avoid pragmatically inappropriate language mixing. [ABSTRACT FROM AUTHOR]

Background: The idea of chiropractors treating children is controversial, yet many parents seek chiropractic care for their children. The reasons for this are not well documented. Part one of this study aimed to document the profile of all paediatric patients consulting Norwegian chiropractors in 2013 using National Health Insurance data (NHI) with regards to age, gender and primary complaints. Part two aimed to provide a more detailed description of these patients in the form of a descriptive, paper-based survey. Methods: Part one involved Norwegian NHI data from 2013. Part two consisted of a year-long, paper-based survey. Chiropractors registered with the Norwegian chiropractic association (NKF) were invited to participate via email. Participating chiropractors were assigned one random month to collect data. All paediatric patients (or their parents) during that were asked to complete questionnaires containing information on presenting complaint, consequences of this complaint, age, and mode of referral. Results: In general, there was good concordance between part one and two of the study in terms of age, gender and presenting complaint. The youngest children constituted the largest paediatric group in Norwegian chiropractic practice. Musculoskeletal problems were the most common reason for children visiting a chiropractor in all of the age categories, according to NHI data. Part two of the study found that one-third of young school children and adolescents reported pain lasting longer than 1-year. Eleven percent of children found that their complaint had severely affected their mood and 22 % felt their activities were very limited by their condition. Referrals from healthcare professionals were uncommon. The survey's results were based on 161 completed questionnaires, received from 15 % of the Norwegian chiropractors. Conclusions: Musculoskeletal problems constituted the most common presenting complaint for children and adolescents presenting to Norwegian chiropractors. A sizable proportion of children seemed to be adversely affected by their complaints in terms of low mood and limitations of daily activities. Chronic presentations were not uncommon. The small sample size of the survey demands that the results be interpreted with caution. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life is included in the economic evaluation of health services by measuring the preference for health states, i.e. health state utilities. However, most intervention studies include a disease-specific, not a utility, instrument. Consequently, there has been increasing use of statistical mapping algorithms which permit utilities to be estimated from a disease-specific instrument. The present paper provides such algorithms between the MacNew Heart Disease Quality of Life Questionnaire (MacNew) instrument and six multi-attribute utility (MAU) instruments, the Euroqol (EQ-5D), the Short Form 6D (SF-6D), the Health Utilities Index (HUI) 3, the Quality of Wellbeing (QWB), the 15D (15 Dimension) and the Assessment of Quality of Life (AQoL-8D). Methods: Heart disease patients and members of the healthy public were recruited from six countries. Non-parametric rank tests were used to compare subgroup utilities and MacNew scores. Mapping algorithms were estimated using three separate statistical techniques. Results: Mapping algorithms achieved a high degree of precision. Based on the mean absolute error and the intra class correlation the preferred mapping is MacNew into SF-6D or 15D. Using the R squared statistic the preferred mapping is MacNew into AQoL-8D. Implications for research: The algorithms reported in this paper enable MacNew data to be mapped into utilities predicted from any of six instruments. This permits studies which have included the MacNew to be used in cost utility analyses which, in turn, allows the comparison of services with interventions across the health system. [ABSTRACT FROM AUTHOR]

Background: Patient experience is an important indicator of the quality of healthcare. Patients with multimorbidity often face adverse health outcomes and increased healthcare utilisation. General practitioners play a crucial role in managing these patients. The main aim of our study was to perform an in-depth assessment of differences in patient-reported experience with general practice between patients living with chronic conditions and multimorbidity, and those with no chronic conditions. Methods: We performed secondary analyses of a national survey of patient experience with general practice in 2021 (response rate 41.9%, n = 7,912). We described the characteristics of all survey respondents with no, one, two, and three or more self-reported chronic conditions. We assessed patient experience using four scales from the Norwegian patient experience with GP questionnaire (PEQ-GP). These scales were used as dependent variables in bivariate and multivariate analyses and for testing the measurement model, including confirmatory factor analysis and a multigroup CFA to assess measurement invariance. Sentiment and content analysis of free-text comments was also performed. Results: Patients with chronic conditions consistently reported lower scores on the GP and GP practice experience scales, compared to those without chronic conditions. This pattern persisted even after adjustment for patient background variables. The strongest associations were found for the scale of "Enablement", followed by the scales of "GP" and "Practice". The subscale "Accessibility" did not correlate statistically significantly with any number of chronic conditions. The analysis of free-text comments echoed the quantitative results. Patients with multimorbidity stressed the importance of time spent on consultations, meeting the same GP, follow-up and relationship more often than patients with no chronic conditions. Our study also confirmed measurement invariance across patients with no chronic conditions and patients with multimorbidity, indicating that the observed differences in patient experience were a result of true differences, rather than artifacts of measurement bias. Conclusions: The findings highlight the need for the healthcare system to provide customised support for patients with chronic conditions and multimorbidity. Addressing the specific needs of patients with multimorbidity is a critical step towards enhancing patient experience and the quality of care in general practice. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important in preventing and detecting child maltreatment. In Norway, children undergo universal preventive health assessments and receive complimentary follow-up care from specialized public health nurses in child and family health clinics. These nurses conduct regular check-ups and home visits to monitor children for signs of maltreatment. Objective: The objective of this study is to describe how public health nurses at child and family health clinics follow the National Clinical Guidelines to prevent and detect child maltreatment, with a particular focus on clinical procedures and interdisciplinary collaboration. Furthermore, we aim to determine factors that are associated with identification of child maltreatment. Design: A cross-sectional online survey was conducted among public health nurses working in primary care between October 24th and December 31st, 2022. Public health nurses who worked with children aged 0–5 years and had consultations with families were eligible to participate, resulting in 554 responses. The study employed descriptive analysis, including frequency, percentage and mean, as well as a two-step logistic regression analysis. The study was approved by the relevant authority, and informed consent was obtained through questionnaire completion. Results: The public health nurses in this study displayed strong adherence to the guidelines and utilized various comprehensive assessment procedures to monitor child well-being, growth, and development. However, there was limited and infrequent collaboration with other professionals, such as child protection services, general practitioners, and hospitals. Most public health nurses reported occasional suspicion of child maltreatment, with age and years of experience in child and family clinics influencing these suspicions. Older public health nurses were more likely to suspect physical violence, while those with less than two years of experience reported less experience in suspecting maltreatment. Additional education increased the probability of suspecting sexual violence. Conclusions: This study provides insights into the practices of public health nurses in Norway regarding the detection and prevention of child maltreatment in child and family clinics. While adherence to guidelines is strong, suspicion of maltreatment is relatively rare. Collaboration across agencies is crucial in addressing child maltreatment. Age and experience may influence the detection of maltreatment. Improved collaboration, targeted guidelines, and ongoing professional development are needed to enhance child protection. [ABSTRACT FROM AUTHOR]

Introduction: Patients with cancer often want to spend their final days at home. In Norway, most patients with cancer die in institutions. We hypothesized that full integration of oncology and palliative care services would result in more time spent at home during end-of-life. Methods: A prospective non-randomized intervention trial was conducted in two rural regions of Mid-Norway. The hospitals' oncology and palliative care outpatient clinics and surrounding communities participated. An intervention including information, education, and a standardized care pathway was developed and implemented. Adult non-curative patients with cancer were eligible. Proportion of last 90 days of life spent at home was the primary outcome. Results: We included 129 patients in the intervention group (I) and 76 patients in the comparison group (C), of whom 82% of patients in I and 78% of patients in C died during follow-up. The mean proportion of last 90 days of life spent at home was 0.62 in I and 0.72 in C (p = 0.044), with 23% and 36% (p = 0.073), respectively, dying at home. A higher proportion died at home in both groups compared to pre-study level (12%). During the observation period the comparison region developed and implemented an alternative intervention to the study intervention, with the former more focused on end-of-life care. Conclusion: A higher proportion of patients with cancer died at home in both groups compared to pre-study level. Patients with cancer in I did not spend more time at home during end-of-life compared to those in C. The study intervention focused on the whole disease trajectory, while the alternative intervention was more directed towards end-of-life care. "Simpler" and more focused interventions on end-of-life care may be relevant for future studies on integration of palliative care into oncology. Trial Registration: ClinicalTrials.gov Identifier: NCT02170168. Plain Language Summary: Palliative care is an important part of cancer care to improve patients' quality of life. To be cared for and die in the preferred place are quality markers in palliative care. Patients with cancer often want to spend their final days at home. In Norway, most patients with cancer die in institutions. We hypothesized that full integration of cancer and palliative care would result in more time spent at home during end-of-life. An intervention that included information, education, and a standardized care pathway was developed and implemented in a region of Mid-Norway (the intervention region, I). A similar region served as comparison region (C). Adult patients with cancer treated with non-curative intent were eligible. Altogether, 129 patients in I and 76 patients in C were included in the study, of whom 82% in I and 78% in C died during follow-up. The mean proportion of time spent at home last 90 days of life was 0.62 in I and 0.72 in C (p = 0.044), and 22.6% and 35.6% (p = 0.073) died at home, respectively. A higher proportion died at home in both groups compared to pre-study national levels (12%). During the study period, C developed and implemented an alternative intervention to the study intervention, with the former placing more focus on end-of-life care compared to the she study intervention that focused on the whole disease trajectory. This may explain why the intervention did not result in more time spent at home during end-of-life as compared to C. "Simpler" interventions directed towards the study's primary outcome may be relevant for future studies on integration of palliative care into oncology. [ABSTRACT FROM AUTHOR]

Background: Too often, the background activities of social science studies remain opaque; however, by describing the Ungdata Junior survey from its initiation to the present day, we illuminate the need to include children in quantitative survey research so that their opinions may be factored into the policymaking calculus. Aim: This article aims to describe the motivation, development and application of the annual large-scale Ungdata Junior survey constructed for children in Norway. Method: Ungdata Junior is an age-adjusted survey that monitors the life activities, experiences and emotions of children in grades 5 to 7. This survey is annual and has been completed thus far by more than 57,000 children between 2017 and 2021. Conclusions: We demonstrate that large-scale child-focused surveys are feasible and reasonable. [ABSTRACT FROM AUTHOR]

Objective: As prospective outcomes of septoplasty with or without turbinoplasty beyond the first year are few and have diverging results, this study evaluated later septoplasty results three to four years post-operatively. Methods: Patients undergoing septoplasty completed the Nasal Surgical Questionnaire pre-operatively, and at 6–12 months (early post-operative assessment) and 36–48 months (late post-operative assessment) after surgery. Primary outcome was visual analogue scale ratings for nasal obstruction (with a scale ranging from 0 to 100). Results: In 604 patients with high response rates, the largest improvements in nasal obstruction were from pre-operative to early post-operative assessments (daytime score reduction = 33.9, night-time reduction 40.5). Nasal obstruction ratings worsened slightly between early and late post-operative assessments (daytime score increase = 5.3, night-time score increase = 9.7). Improvements were better in patients aged over 35 years and in those with pre-operative nasal obstruction scores of more than 62. There were no differences based on surgery type, septal deviation, allergy or smoking. Conclusion: Septoplasty improves nasal obstruction in both the first and the fourth year after surgery. Post-operative improvements decline slightly over time but remain significant. [ABSTRACT FROM AUTHOR]

Aim: The aim of the present study was to explore the associations between the economic, political, sociocultural and physical environments in kindergartens, along with the frequency and variety of vegetables served, and the amount of vegetables eaten. Method: The BRA Study collected data through two paper-based questionnaires answered by the kindergarten leader and pedagogical leader of each selected kindergarten, and a five-day vegetable diary from kindergartens (n = 73) in Vestfold and Buskerud Counties, Norway. The questionnaires assessed environmental factors, and the frequency and variety of vegetables served. The non-parametric Mann–Whitney U and Kruskal–Wallis tests were used to explore the associations between factors in the kindergarten environments and vegetables served and eaten. Results: Kindergartens that included expenditures for food and beverages in the parental fees served a larger variety of vegetables (p = 0.046). A higher frequency of served vegetables (p = 0.014) and a larger amount (p = 0.027) of vegetables eaten were found in kindergartens where parents paid a monthly fee of 251 NOK or more. Similarly, the amount of vegetables eaten was higher (p = 0.017) in kindergartens where the employees paid a monthly fee to eat at work. Furthermore, a larger amount (p = 0.046) of vegetables was eaten in kindergartens that had written guidelines for food and beverages that were offered. Conclusions: This study indicates that the economic environment in a kindergarten seems to be positively associated with the vegetables served and eaten there. This is of high relevance for public health policy as vegetable consumption is an important factor in reducing the risk of non-communicable diseases. [ABSTRACT FROM AUTHOR]

This study is a national cross‐sectional survey, conducted in November 2014, of 366 dental hygienists and dentists who had suspected maltreatment but did not report it to Norwegian Child Welfare Services (CWS). The aims of the present paper are to identify the reasons why public dental healthcare professionals are reluctant to report suspected child maltreatment to CWS and to determine whether there are differences in the identified barriers according to socio‐demographic variables. The questionnaire was based on earlier studies and was adapted to fit the Norwegian context. The most frequently chosen reason for not reporting was "unsure of own assessment" (90.4%). Thirteen items pertaining to not reporting were factorised into three factors of barriers. These factors were "insufficient knowledge of child maltreatment and reporting", "fear of the consequences for oneself and the dental clinic", and "fear of the consequences for the patient and their family". A t test revealed that public dental healthcare personnel who had not received training on maltreatment and reporting to CWS during their professional education scored significantly higher on the barrier "insufficient knowledge of child maltreatment and reporting" than did dental personnel who had received such training. Furthermore, dental personnel with more years of experience (11+) scored higher on this barrier than did dental personnel with less experience. No other significant differences in barriers were observed. Public dental healthcare personnel have a mandatory obligation to report to CWS if they suspect child maltreatment. Despite this obligation, the present study reveals that several barriers to reporting exist. This study underscores the importance of strengthening knowledge among dental hygienists and dentists about when and how to report, both during education and in clinical practice. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to improve understanding of how different kinds of power influence trust and motivation in hospitals.Design/methodology/approach To analyze the links between power, trust and motivation, a framework of social power is tested on measures of trust in managers and motivation. Quantitative data from 137 respondents were collected. Partial least square is used to evaluate the theoretical model.Findings Legitimate, referent and reward power has a positive influence on trust, while coercive power has a negative influence on trust. In total, 41.8 per cent of the variation in trust in managers was explained by power. Trust, reward power and expert power explained 30.9 per cent of the variation in motivation.Practical implications The research indicates that in knowledge organizations such as hospitals, leaders should be careful in using coercive power. Expert power seems to influence motivation but not trust, while legitimate power seems to influence trust directly and motivation only through trust. Referent power seems to have a weak influence on trust and no direct influence on motivation. Reward power has a very strong influence both on trust and motivation.Originality/value It is important for leaders to consider how power can influence trust, motivation and the performance of a health organization. Although this study was conducted in Norway and Finland, the findings may have relevance on a broader scale. [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]

Purpose The purpose of this paper is to examine the mechanisms through which change-oriented leadership in hospitals influences job performance and employee job satisfaction. The authors examine the direct and the mediating effects of perceived learning demands and job involvement.Design/methodology/approach This cross-sectional study is based on a survey of four public hospitals in a regional health authority in Norway.Findings The findings illustrate how change-oriented leadership directly and indirectly influences work performance and job satisfaction. Learning demands and job involvement play mediating roles. Higher levels of change-oriented leadership decrease learning demands and increase job involvement, work performance and job satisfaction. Learning demands have a negative influence on work performance and job satisfaction. Job involvement has a positive influence on work performance and job satisfaction. The strongest relationship in the structural modelling is between change-oriented leadership and job involvement.Research limitations/implications This study is based on cross-sectional data. Future studies should therefore explore this further using a longitudinal design.Practical implications The practical implication of the study is to show how leaders by change-oriented behaviour can influence work performance and job satisfaction by reducing learning demands and increasing job involvement.Social implications This study illustrates different paths towards influencing job performance and job satisfaction from change-oriented leadership. It is important to use the potential of reducing learning demands and increasing job involvement, to improve job performance and job satisfaction.Originality/value The authors have developed and validated a new theoretical mediational model explaining variance in job performance and job satisfaction, and how this is related to change-oriented leadership, job involvement and learning demands. This knowledge can be used to increase the probability of successful change initiatives. [ABSTRACT FROM AUTHOR]