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Background: Quality improvement work is an essential feature of healthcare services, including general practice. In this study, we aimed to gain more knowledge regarding general practitioners' (GPs) motivation for such work in their practices, as well as what kind of measures were considered motivating and feasible. Materials and methods: We conducted five focus group interviews among Norwegian GPs between November 2021 and November 2022. We included 21 GPs of varying age, gender, experience, and geographic situation. The data were transcribed verbatim and analysed by Systematic Text Condensation, a thematic cross-case analysis. Results: Many GPs had a diverse and imprecise understanding of the term quality improvement, and sound routines in everyday practice were often given as examples of quality improvement measures. There was a universal attitude that quality improvement initiatives should be close to practice, professionally relevant, and sufficiently small to be manageable. The availability of professional communities, either in the GP practices or in continuous medical education groups, was important for motivation. The role of nurses and health secretaries was highlighted as essential to achieve change. Participants commonly described negative reactions to programs that were imposed by external actors without regard for the GPs' perceived needs. Conclusion: GPs were motivated for quality improvement measures provided feasibility within the framework of general practice. Well-functioning professional communities, including involvement of nurses and health-secretaries, were emphasised as requisite for quality improvement. Small scale quality improvement programs suited for the needs of general practice were well received and should be further developed. [ABSTRACT FROM AUTHOR]

Background: Involvement in research and shared priorities among occupational therapists (OTs) can enhance the quality of occupational therapy practice. Aims: To explore the research involvement and research priorities of OTs in Norway. Materials and methods: An online survey comprising 14 open-ended and closed questions was made available to participants at the Seventh Norwegian Congress in Occupational Therapy to fill out. Results: Out of 633 congress participants, 307 (49%) OTs completed the survey. Among the respondents, ∼40% were involved in research. The most commonly reported area of research was rehabilitation. Research involvement was associated with employment in education or specialist healthcare services and with greater work experience and post-bachelor's degree education. The most frequently prioritized research question addressed the effect of occupational therapy. Unmet needs and factors conducive to increasing OT's involvement in research were identified. Conclusions and significance: The survey revealed that a considerable, but uneven, distribution of OTs were involved in research. To encourage greater participation in research, researchers, decision-makers, and employee associations should take steps to make research more appealing to OTs. The research priorities highlighted by Norwegian OTs align with those stated by OTs in other countries. [ABSTRACT FROM AUTHOR]

High frequency words, commonly referred to as sight words, are often a focus of emergent reading instruction. Instructional practices abound that require emergent readers to memorize the spelling and pronunciation of the words without drawing attention to grapheme-phoneme correspondences (GPCs) in the words. These approaches ignore a critical aspect of Ehri's theory of orthographic mapping. This article reviews the literature on storing words in memory, in general, and the research on learning high frequency words, more specifically. Analyses of high frequency words on the widely used, Dolch list, are included that show the overwhelming regularity of the GPCs in these words. The analyses provide insight into the most common GPCs in these high frequency words, and they provide examples of GPCs that if taught, unlock the regularity of several other high frequency words. Discussion focuses practitioners gaining more advanced phonetic knowledge in order to better understand the orthographic regularity of high frequency words. Recommendations include supplementing traditional phonics programs for students with at least some advanced phonetic knowledge, ensuring practitioners have this level of knowledge in order to capitalize on teachable moments with high frequency words, and/or organizing classroom lists of high frequency more strategically. [ABSTRACT FROM AUTHOR]

Organisations of Persons with Disabilities (OPDs) are critical to promoting and protecting the rights of people with disabilities. However, little is known about the extent to which people with disabilities are aware and members of OPDs. This study uses data from nine population-based surveys in low- and middle-income countries to explore OPD awareness and membership. Across settings, about a third of people with disabilities were aware of OPDs and fewer than 15% were members. Awareness and membership were lower amongst older adults, women, people with difficulties communicating, remembering and with self-care, people with less education, in poverty and in rural areas. Underrepresentation of certain groups may indicate a need to seek out the voices of people less likely to be associated with OPDs. Further, low total membership may be a cause for concern in settings where OPDs are relied upon to deliver essential services in the absence of state structures. Points of interest: Organisations of Persons with Disabilities can serve many roles, including advocacy, policymaking and service provision. The increasing involvement of Organisations of Persons with Disabilities in direct provision of essential services, particularly in low- and middle-income countries, is often a result of poor availability and quality of inclusive public services. This study explores awareness and membership of people with disabilities across nine low- and middle-income countries using population-based surveys. About a third of people with disabilities were aware of Organisations of Persons with Disabilities across settings, ranging from 12% in Lesotho to 73% in the Maldives. Fewer than 15% of people with disabilities were members across settings, ranging from 3.5% in Zambia to 14% in Vietnam (Cam Le district). Awareness and membership were generally lower amongst older adults, women, people with difficulties communicating, remembering and with self-care, people with less education, in poverty and in rural areas. Given the increased role of Organisations of Persons with Disabilities in direct service delivery, low total membership may indicate that many people with disabilities – particularly the most marginalised or experiencing the greatest need – are not being reached. Additional efforts may also be needed to seek out the voices of groups underrepresented in Organisations of Persons with Disabilities, particularly for advocacy and policymaking. [ABSTRACT FROM AUTHOR]

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The induction period is a frequently discussed element in a teacher's career. While there is a recognised need for support during induction, the access to support is not available to all newly qualified teachers (NQTs). However, little is known about the micro-political processes of NQTs' access to support in the workplace. The purpose of this study is to investigate experiences of support during NQTs' first year in teaching, using concepts from micro-political theory. The findings show that NQTs experience reactive support, a lack of formal support, and self-initiated informal peer support. The findings are based on a thematic analysis of written accounts collected from 15 NQTs in Norwegian secondary schools every month during their first year, as well as individual interviews at the end of the year. The study concludes that the use of power in interactions among members of the school organisation impact NQTs' access to induction-support. [ABSTRACT FROM AUTHOR]

Policy tools have become widespread in education, which indicates efforts to standardise content and professional practices. However, such standardisation might be in contrast to Nordic early childhood education and care (ECEC) traditions of diversity and local variation. We therefore study the distributors and enactment of policy tools in ECEC in light of content regulations and calls for evidence-based practices in ECEC through comparative case studies of 14 Norwegian centres. We identify the tools that are used in ECEC centres and analyse how they are enacted by staff. The material consists of documents from ECEC centres and semi-structured interviews with heads and staff. By employing a theoretical framework based on discursive institutionalism, we find that efforts are being made to standardise didactical practices. The tools are distributed by a range of actors, but our analysis reveals that staff shape and develop tools through coordinative discourses. [ABSTRACT FROM AUTHOR]

Succeeding at university can be a complex matter, and the barriers are manifold for students with disabilities (SwDs). Accommodations are available for those with needs, but these alone do not meet the political goals of inclusive educations. Student ambassadors act as experienced representatives on campuses, supporting others and gaining individual benefits themselves. Approaches building on SwDs' experiences and capacities can be a means to overcome the complex barriers often faced throughout education. This scoping review aimed to map research on student ambassador interventions for SwDs in higher education and identify the interventions' key concepts. The result will inform an ambassador intervention in higher education. Six electronic databases were searched for peer-reviewed articles of any design published between 2010 and December 2020. Six studies met the inclusion criteria. A thematic synthesis resulted in three key concepts: peer guidance and supportive relationships; building strategies and transferable skills; and advocating for change. However, no program utilises exclusively students with disabilities in ambassador roles. The results indicate a lack of research as well as awareness on the unexplored potential of actively involving SwDs in ambassador roles. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has necessitated essential modifications to the administration of psychotherapy for patients with panic disorder (PD) through the increased use of videoconferencing. However, the effect of this change on treatment efficacy remains unclear. The current study is a long-term (1.5 years) investigation of the Bergen 4-day treatment (B4DT) for PD delivered as a combination of videoconferencing and face-to-face therapy. This study reported the long-term outcomes of B4DT for PD when delivered in a hybrid format. The B4DT includes multiple components delivered over four consecutive days. As the pandemic unfolded, B4DT was adapted to include different levels of in-person versus videoconference delivery, depending on COVID-19 infection rates and public health recommendations. Outcome measures included clinician-rated illness severity on the Panic Disorder Severity Scale (PDSS) and patient-rated symptoms of PD, agoraphobia, generalized anxiety, and depression. Follow-up treatment, work status, and current medications were assessed. We used multilevel models to estimate whether clinical improvement was maintained over time. Treatment effects achieved at three months were maintained at the 1.5-year follow-up. Patients who completed the PDSS scored M = 14.78 (SD = 3.37) before treatment, M = 5.88 (5.28) at the three-month follow-up (d = 2.01), and M = 5.44 (SD = 5.12) at the long-term follow-up (d = 2.15). The reduction in generalized anxiety and depression symptoms was maintained over time. The current study suggests that B4DT can be delivered successfully in a combination of face-to-face and videoconference therapy sessions. Moreover, long-term effects are maintained, even during the challenging circumstances of the pandemic. [ABSTRACT FROM AUTHOR]

Many recent higher education reforms worldwide have been legitimated by their potential impact on the performance of universities and colleges. However, we know less about the actual impact of the changes implemented. This article examines the extent to which research performance can be associated with specific organizational characteristics at the department level. The analysis is based on Norwegian university departments, where high- and low-performing departments have been selected as cases for further investigations. The policy context is the organizational reform in Norway from 2016 onwards aiming at reorganizing the higher education landscape through institutional mergers. The key findings indicate that there are few distinct departmental characteristics associated with research performance, such as elected or appointed leadership, single or multi-campus organization, or departmental size. However, the study reveals that highly productive individuals do matter and suggests that cultural dimensions and working conditions may be interesting factors to pursue in further research. [ABSTRACT FROM AUTHOR]

To identify modifiable risk factors in early midlife associated with incident hypertension 26 years later in women and men. We used data from 1025 women and 703 men in the community-based Hordaland Health Study examined at the mean age of 42 years (baseline) and after a 26-year follow-up. Patients with hypertension at baseline were excluded. Blood pressure (BP) was classified according to European guidelines. Factors associated with incident hypertension were identified in logistic regression analyses. At baseline, women had a lower average BP and a lower prevalence of high-normal BP (19% vs 37%, p <.05). Overall, 39% of women and 45% of men developed hypertension during follow-up (p <.05). Among those with high-normal BP at baseline, 72% of women and 58% of men developed hypertension (p <.01). In multivariable logistic regression analyses, high-normal BP at baseline was a stronger predictor of incident hypertension in women (odds ratio, OR 4.8, [95% confidence interval, CI 3.4–6.9]) than in men (OR 2.1, [95% CI 1.5–2.8]), p <.01 for sex interaction. A higher baseline body mass index (BMI) was associated with incident hypertension in both sexes. High-normal BP in midlife is a stronger risk factor for developing hypertension 26 years later in women than in men, independent of BMI. There is a knowledge gap regarding the understanding of sex differences in hypertension and cardiovascular disease. The World Health Organisation has identified hypertension as the leading cause of morbidity and mortality in women. This manuscript focuses on sex differences in risk factors in early midlife associated with the development of hypertension 26 years later. We studied 1025 women and 703 men who participated in the community-based Hordaland Health Study at the age of 42 years, and after 26 years. Factors associated with hypertension were identified in statistical analyses. Our main findings were that having a high-normal blood pressure (systolic blood pressure 130–139 mmHg or a diastolic blood pressure 85–89 mmHg) in midlife was a significantly stronger risk factor for the development of hypertension in women than in men during follow-up. Having a higher body mass index in midlife was associated with the development of hypertension in both sexes. This study contributes to the understanding of sex differences in hypertension development and adds further knowledge regarding high-normal blood pressure as a particularly important risk factor for hypertension and cardiovascular disease in women. [ABSTRACT FROM AUTHOR]

Background: Acute sinusitis is a frequent reason for primary care visits. Most patients recover within two weeks without antibiotic treatment. Despite this, about 50% of patients with acute sinusitis in Norwegian general practice are still prescribed antibiotics. We do not know the reason behind this discrepancy. Aim: To explore the clinical decision-making process and reasons for treatment with antibiotics for acute sinusitis among Norwegian general practitioners (GPs). Methods: Five focus group interviews were conducted (N=25) in different parts of Norway, including GPs of various age, gender, and experience. The interviews were analysed using Systematic Text Condensation. Results: The results showed a very diverse management of acute sinusitis among GPs, with decisions regarding antibiotics not always aligning with guideline recommendations. Many of the GPs did not agree with the Norwegian guidelines for antibiotics and chose something other than phenoxymethylpenicillin as their first choice. Clinical predictors emphasized in decision-making were pain complaints and patient exhaustion. Pragmatic factors such as weekday, travel plans, or a full waiting room could also influence the decision. Conclusion: GPs found it difficult to identify when patients would benefit from antibiotic treatment for acute sinusitis, and different strategies were used to make prescribing decisions. For several GPs the degree of pain was one of the decisive reasons for antibiotic prescribing, however the guidelines for antibiotics do not give sufficient advice regarding pain treatment. These results suggest a need for revaluation of guideline contents and the way they are communicated to GPs. [ABSTRACT FROM AUTHOR]

Research on academic staff experiences with mergers in higher education points out that they often struggle with the change process. Reform appears to go hand in hand with uneasiness and even anxiety, but studies also report mixed results: part of those involved share concerns, others report positive experiences. This study on mergers in Norwegian higher education uses a survey among academic staff, enabling us to compare the experiences of academic staff at merged institutions with staff at institutions that did not merge. We find that academic staff at merged institutions are less positive about developments within their study programmes and research units compared to those not having been part of a merger process. Further fine-grained analyzes show that both background characteristics of respondents and discipline play a role as well. Our contribution to the literature on mergers is that attention should be paid to the background characteristics of academic staff, for these factors are important to understand impact. [ABSTRACT FROM AUTHOR]

Having a somatically ill parent can influence adolescents' daily lives and mental health. This study aimed to explore the lived experiences of mental health promotion among adolescents with a somatically ill parent, based on a salutogenic orientation. Individual interviews with 11 adolescents (13–18 years of age) with a somatically ill parent were conducted. The data were analysed according to interpretative phenomenological analysis. A superordinate theme, feeling at home in a house of mental health–promoting conversations, frames the participants' perceptions of a prominent mental health promotion experience, including decisive characteristics of the significant conversation partners and different important conversation contexts. The metaphor of feeling at home expresses that the participants ascribe the conversations taking place there as promoting mental health. The themes elucidate the superordinate theme: (a) significant conversation partners characterised by the three subthemes: (i) being available, (ii) being competent and (iii) being caring and (b) rooms reflecting conversation contexts containing four subthemes: (i) room of increased knowledge, (ii) room of disclosure, (iii) room for meeting points and (iv) room for breaks. Adolescents with a somatically ill parent perceived that conversations about important topics with significant others with special characteristics in distinct contexts promoted mental health. [ABSTRACT FROM AUTHOR]

The present study asks what challenges student teachers meet in today's school and how they present, respond to, and reflect on these challenges in an online discussion forum. The study explores these questions by analysing cases written by student teachers in their last practice placement in a one-year post-graduate teacher education programme for secondary school in Norway. The findings show that the cases centre around students and classroom management, and that student teachers take on a role as either participant or observer. The responses are a mix of advice, descriptions of similar experiences, and support. They tend to normalise the situations rather than explore them. Learning from challenging incidents does not happen by itself. Timing is crucial, and so is space for reframing, reflection, and for considering alternative perspectives. This means that there is a need for distance to the situation and a process of interaction with various perspectives. [ABSTRACT FROM AUTHOR]

Fatigue is a common symptom of inflammatory rheumatic disease and has a great impact on everyday life. Activity-pacing is proposed as an intervention to increase participation in meaningful activities. To explore participants' experiences with an activity-pacing group, how participants perceived self-managing everyday life after group attendance, and their reflections on unmet needs that could enhance self-management of everyday life with fatigue. Semi-structured interviews were conducted with 10 participants who had attended an activity-pacing group. Thematic analyses were conducted. Prior to group attendance, the participants expressed an awareness of their lack of knowledge of fatigue. Through group attendance, they increased their understanding of fatigue and their ability to apply strategies to better manage everyday life. Participants found it difficult to balance their energy use and realised that implementing activity-pacing strategies takes time. Therefore, they requested follow-up sessions with the activity-pacing group. They also desire that rheumatologists pay more attention to and acknowledge fatigue. Enhancing the understanding of fatigue and how to manage everyday life with fatigue, appears to be important. Group interventions led by occupational therapists and with a focus on activity-pacing may be a suitable approach. Follow-up sessions are recommended. [ABSTRACT FROM AUTHOR]

The development of intercultural competence is a crucial part of foreign language (FL) education, yet it remains under-explored in teaching materials and teacher education. Transnational perspectives on FL teaching, and specifically literary texts on migration and exile, may help expand teaching beyond the traditional monocultural focus and stimulate the development of intercultural competence. The article presents case studies of three literary texts that can be used for this purpose. The texts may contribute to the development of the students' intercultural competence as they give access to other perspectives, while simultaneously encouraging students to reflect on their own life-world. However, the texts are highly dependent on contextualization and adaptation of classroom activities, thus underlining the crucial role of the teacher in the development of students' intercultural awareness. [ABSTRACT FROM AUTHOR]

Cervical arterial dissection (CeAD) is a serious condition that can mimic a musculoskeletal condition. A diagnostic tool using five key criteria could help prompt early medical referral, but these criteria may occur in healthy people or benign neck pain/headache. To determine the frequency of CeAD criteria in healthy individuals and those with neck pain/headache, and identify refinements needed to improve specificity. An interview and neurological screen to identify the presence of the five criteria was conducted. Definitions were refined and the frequency of the modified criteria in each individual was determined. The criteria were re-administered using data from 37 CeAD cases of the derivation cohort, to examine how the modifications impact sensitivity of the tool. One hundred healthy and 20 participants with neck pain/headache were interviewed. Most participants had ≤ 2 criteria, mainly age or trauma, 3% had 3 criteria, but had migraine or resolving symptoms. None had >3. Modifications to definitions were needed to improve potential specificity of the tool (96.7%). Changes did not impact sensitivity of the tool (81%). Further refinements may be required. Strictly defined CeAD criteria may assist in identifying when to refer, when to wait and monitor, or when management can proceed. Trialing the tool in those with migraine and in emergency departments to calculate risk scores is recommended. [ABSTRACT FROM AUTHOR]

The aim of this study is to explore how Norwegian female employees experience work-related alcohol use in British working life using cultural analysis. Explorative design with strategic population; in-depth interviews with eight female Norwegian employees working in London, in addition to field observation in two typical 'after-work' pubs in London. The data was analysed through bricolage: themes and subthemes were identified and Hall's theory of high- and low-context cultures and Bourdieu's concepts of capital and field were applied. The pub appeared to be a significant arena for Norwegian female employees in London to adapt to British working culture and work-related drinking. Four main themes emerged: (1) Breaking the code in communication at work, (2) Adjusting to English office 'etiquette' through pub visits, (3) Adhering to pub rules and developing strategies, and (4) Balancing after-work pub culture and family obligations. Navigating British pub culture demands cultural awareness to maintain one's work-related position and career progress, including balancing gender-specific expectations and contextual drinking culture. [ABSTRACT FROM AUTHOR]

The current study is a collective self-study on how we as 15 teacher educators at a university in Norway tried to improve our teaching through working with cases with the aim of better supporting student teachers in making links between theory and practice. We wanted to address the common criticism in teacher education concerning a perceived gap between practice and theory. Our presupposition was that one way to prepare student teachers for work and bring together theoretical and practical knowledge would be through case-based teaching. We agreed that we wanted to try different ways of working with cases and to follow our own actions with research and conduct a self-study. Throughout the project, each teacher educator experienced to learn about case-based teaching, but our joint learning was limited due to practical issues and lack of time. With teacher education as a shared responsibility, our conclusion is that teacher educators need time to develop as a team, not only as individual teachers. [ABSTRACT FROM AUTHOR]

To address the data gap on efforts to assess use of assistive technology among children with disability in sub-Saharan Africa. Contribute towards efforts examining access to assistive technologies in sub-Saharan Africa. The paper uses data from the 2017 survey on Living conditions among persons with disabilities in Malawi and the 2015-16 Malawi Demographic and Health survey to address the objective of the study. The two datasets were statistically matched through random hot deck technique, by integrating the two datasets using randomly selected units from a subset of all available data donors. Results indicate that statistical matching technique produces a composite dataset with an uncertainty value of 2.2%. An accuracy assessment test of the technique also indicates that the marginal distribution of use of assistive technology in the composite dataset is similar to that of the donor dataset with an Overlap index value of close to 1 (Overlap = 0.997). The statistical matching procedure does enable generation of good data in data constrained contexts. In the current study, this approach enabled measurement of access to assistive products among children with disabilities, in situations where the variables of interest have not been jointly observed. Such a technique can be valuable in mining secondary data, the collection of which may have been funded from different sources and for different purposes. This is of significance for the efficient use of current and future data sets, allowing new questions to be asked and addressed by locally based researchers in poor settings. In resource-poor settings, the technique of statistical matching can be used to examine factors that predict the use of assistive technology among persons with disabilities. The statistical matching technique is of significance for the efficient use of current and future datasets, allowing new questions to be asked and addressed by locally based researchers. [ABSTRACT FROM AUTHOR]

This study aimed to explore associations at the group level between patient characteristics at baseline and the outcomes of physical functioning and fatigue in patients with chronic fatigue syndrome (CFS) participating in a randomized controlled trial on cognitive behavioural therapy (CBT). Consecutively, 236 adult participants fulfilling the Centres for Disease Control and Prevention (CDC) 1994 criteria for CFS were randomly allocated to either 16 weeks of standard CBT, 8 weeks of Interpersonal CBT or a treatment as usual control group. In secondary analyses we investigated how gender, age, pain, anxiety, depression, memory and VO2max at baseline were associated with physical function and fatigue before and after treatment, controlling for the CBT-interventions and the baseline levels of the outcome measures. For the two groups receiving CBT, a 1-year follow-up analysis was also done. Bivariate and multivariable linear regression was used to explore the targeted associations. At baseline, less pain (p <.001) and higher VO2max (p = 0.014) were associated with better physical function, while better memory (p = 0.001) and fewer depressive symptoms (p = 0.017) were associated with less fatigue. Better memory and physical function at baseline (p = 0.015 and p <.001, respectively) and male gender (p = 0.003) were associated with higher physical function post-intervention. Male gender (p = 0.010) was associated with higher physical function at 1-year follow-up. Fatigue severity at baseline was the only variable associated with follow up scores for fatigue (p <.001). Our findings show that fatigue and physical function were associated with different types of characteristics at baseline, indicating a heterogeneity among CFS patients. Trial registration: ClinicalTrials.gov identifier: NCT00920777 , registered June 15, 2009. REK-project number: 4.2008.2586, registered April 2, 2008. [ABSTRACT FROM AUTHOR]

An integrated part of teaching is to face unexpected situations. Teachers have to make immediate decisions, and these decisions may have a great impact on many people. An important question is how teacher education can prepare students for unexpected situations. The aim of this practitioner research study is to investigate if case-based teaching can contribute to reducing the perceived gap in teacher education. A step-wise model was introduced for the students and data based on the student teachers' experiences was collected through questionnaire and focus-group conversations. The findings show three main arguments for why teacher education should be case-based. First, analysing cases helps students to understand that every situation in practice is unique. Second, cases link to practice and theory, and finally, a case opens for different perspectives depending on how the diagnosis is made. [ABSTRACT FROM AUTHOR]

Ionizing radiation (IR) impact cellular and molecular processes that require chromatin remodelling relevant for cellular integrity. However, the cellular implications of ionizing radiation (IR) delivered per time unit (dose rate) are still debated. This study investigates whether the dose rate is relevant for inflicting changes to the epigenome, represented by chromatin accessibility, or whether it is the total dose that is decisive. CBA/CaOlaHsd mice were whole-body exposed to either chronic low dose rate (2.5 mGy/h for 54 d) or the higher dose rates (10 mGy/h for 14 d and 100 mGy/h for 30 h) of gamma radiation (60Co, total dose: 3 Gy). Chromatin accessibility was analysed in liver tissue samples using Assay for Transposase-Accessible Chromatin with high-throughput sequencing (ATAC-Seq), both one day after and over three months post-radiation (>100 d). The results show that the dose rate contributes to radiation-induced epigenomic changes in the liver at both sampling timepoints. Interestingly, chronic low dose rate exposure to a high total dose (3 Gy) did not inflict long-term changes to the epigenome. In contrast to the acute high dose rate given to the same total dose, reduced accessibility at transcriptional start sites (TSS) was identified in genes relevant for the DNA damage response and transcriptional activity. Our findings link dose rate to essential biological mechanisms that could be relevant for understanding long-term changes after ionizing radiation exposure. However, future studies are needed to comprehend the biological consequence of these findings. [ABSTRACT FROM AUTHOR]

Histologic chorioamnionitis (HCA) is most often caused by ascending bacterial infection originating from the cervicovaginal tract. To investigate whether HCA with a fetal inflammatory response (FIR) has a worse clinical outcome than HCA alone. Further, if FIR or a positive maternal microbiologic culture obtained prior to birth were related to adverse neonatal outcomes in a cohort of extremely preterm (EP) neonates. Prospective observational cohort study recruiting EP singleton pregnancies (gestational age at birth ≤28 weeks) with confirmed HCA. FIR was defined by fetal neutrophils in the chorionic vessels and/or umbilical vessels. Positive culture was defined as growth of potentially pathogenic bacteria in a sample from the cervicovaginal tract prior to birth, or if a cervicovaginal culture was lacking, a culture result from the placenta was used. Logistic regression was used to estimate odds ratios and 95% confidence intervals for the associations between FIR, a positive culture result and adverse outcomes, defined as bronchopulmonary dysplasia (BPD), brain pathology assessed by magnetic resonance imaging, retinopathy of prematurity, necrotizing enterocolitis, early-onset neonatal sepsis, and perinatal death. A composite outcome variable included one or more adverse outcomes. We included 71 cases with HCA, of which 51 (72%) had FIR. Maternal age, rate of clinical chorioamnionitis (CCA), preterm pre-labor rupture of membranes (PPROM), the number of women receiving antenatal steroids and antibiotics, and the rate of positive maternal cultures of potentially pathogenic bacteria were all significantly higher in the HCA with FIR. Neonates in the FIR group had significantly higher levels of blood leukocytes compared to those without. FIR was associated with a longer interval from PPROM to delivery (log-rank test: p =.022). Microbiological sampling had been performed in 63 (89%) cases, of which 60 (95%) were cervicovaginal samples. No associations were found between a positive culture and adverse neonatal outcomes, in contrast to FIR, that was significantly associated to BPD and brain pathology. In a cohort of EP pregnancies with confirmed HCA, the presence of FIR was associated with advanced maternal age, CCA, PPROM, antenatal steroids and antibiotics, and a positive maternal culture of potentially pathogenic bacteria. However, the presence of FIR, and not a positive culture, was associated with adverse neonatal outcomes. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the prevalence of daytime contacts and consultations, and pain as a reason for encounter (RFE) with a general practitioner (GP), in children with cerebral palsy (CP) (cases) to that of the general paediatric population (controls). The study linked the Norwegian Directorate of Health's database for the control and reimbursement of health expenses, and the Norwegian Quality and Surveillance Registry for Cerebral Palsy, including children born from 1996 to 2012 in the period 2006 to 2018. All daytime contacts were included. International Classification for Primary Care was applied for RFE. Cases accounted for 0.46% of all daytime contacts and 0.27% of all daytime consultations, the latter corresponding with the estimated national prevalence of CP. GPs registered more administrative contact and coded pain as an RFE less frequently in consultations with cases (6%) than with controls (12%). Children with CP did not consult GPs more than the general paediatric population did. In consultations, GPs should ask for pain even if the child with CP or parent does not address pain. The local multidisciplinary team should encourage the family to consider consulting a GP if the child is in pain. Prevalence of GP consultations in children with CP is similar to that of children in the general population. GPs perform more administrative work for children with CP than for their other paediatric patients. GPs code pain as an RFE less frequently in consultations with children with CP than in consultations with children in the general population. [ABSTRACT FROM AUTHOR]

Employment is (1) an important predictor of sustainable recovery for people with drug-use problems, (2) a high priority among those in recovery, and (3) an important goal for welfare policies. However, previous explorations of the process of gaining employment have been inadequate. The purpose of this study was to explore how people in recovery from lives dominated by drug use engage in securing paid employment, and how they make sense of this process. In-depth interviews were performed on three different occasions over 2.5 years with people experiencing the demanding process of gaining employment. We analyzed their stories employing a narrative approach, and located them in a social structural context drawing on human-capital framework. Our findings show how our participants drew on socially circulating stories of the 'useless addict', 'normality', and the 'employable citizen', which intersect with human-capital logic embedded in public activation programs. The knowledge obtained from this study demonstrates how socially circulating stories and human-capital logic contribute to the perception that people have about their readiness for work and how they can become employable. Further, it illuminates how recovery discourses mirror neoliberal values constituting the contextual setting in which the job hunt takes place. [ABSTRACT FROM AUTHOR]

The aim was to examine how humanoid robots have been used in the care of older persons and identify possible benefits and challenges associated with such use from older persons' points of view. The study was a scoping review based on Arksey and O'Malley's methodological framework. To identify peer-reviewed and non-peer-reviewed literature, a systematic search of the PubMed, Cinahl and Google Scholar electronic databases was conducted for studies published between 2013 and 2019. The PRISMA-ScR guidelines have served as a guideline. A total of 12 studies were included and resulted in four main categories related to how humanoid robots have been used in care of older persons (domain of use): Supports everyday life, Provides interaction, Facilitates cognitive training and Facilitates physical training. Potential for humanoid robots to be accepted as companions for older persons was seen, but technical issues, such as humanoid robots' slow response time or errors, emerged as key challenges. Older persons' perceived enjoyment of using a humanoid robot might also decrease over time. Validated measurements to estimate the effectiveness of using humanoid robots in the care of older persons are needed. [ABSTRACT FROM AUTHOR]

The aim of this prospective study was to investigate the potential influence of the fat mass and obesity-associated gene (FTO), SNP rs9939609, on body mass index (BMI) and body composition in women with anorexia nervosa (AN) undergoing intensive nutrition therapy. Twenty-five female patients with AN (20.1 ± 2.3 years; BMI, 15.5 ± 0.9 kg/m2) were included for 12 weeks of treatment with a high-energy diet. FTO was genotyped and body composition parameters were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography at baseline and after 12 weeks. The distribution of the different FTO genotypes were as follows: AA, 24%; TA, 48%; and TT, 28%. Patients gained a median of 9.8 kg (range, 5.5–17.0 kg) and BMI increased to 19.0 ± 0.9 kg/m2. The increase in BMI, fat mass, and the quotient fat/muscle area was significant for the TT and TA genotype groups. Total lean mass was stable in all genotype groups. We could not demonstrate any difference among the 3 FTO genotypes related to the increases in BMI during nutrition therapy when the additive, dominant, and recessive models of inheritance were applied. Irrespective of the FTO genotype, there was no difference in weight response during nutrition therapy. Hence, in this small study there was limited support for individualized nutrition therapy for AN based on FTO genotype. [ABSTRACT FROM AUTHOR]

Peptic ulcers and erosions are the most common causes of upper gastrointestinal bleeding. The aim of this study was to investigate the management and outcomes of these patients. A total of 543 patients with endoscopically confirmed bleeding from peptic ulcers and erosions were included from March 2015 to December 2017. The patient characteristics, endoscopic findings, Forrest classification and endoscopic treatment were recorded. Moreover, the rebleeding rates, repeated endoscopies and transcatheter angiographic embolization and surgery incidences were registered. A follow-up endoscopy after discharge from the hospital was scheduled. Among the patients, high-risk stigmata ulcers were present in 36% (198/543) and low-risk stigmata ulcers and erosions in 60% (327/543) at first endoscopy. Endoscopic therapy was performed in 30% (165/543) of the patients, and hemostasis was achieved in 94% (155/165). The incidence of rebleeding was 9% (49/543) for the whole cohort and 14.8% (23/155) for those patients who had received successful endoscopic treatment. Moreover, rebleeding was significantly more frequent in duodenal ulcers than in gastric ulcers (11.9% vs 4.0%, p =.004). In a multivariable analysis, rebleeding was significantly related to comorbidity and Forrest classification. Transcatheter angiographic embolization and surgery were required in 6% (34/543) and 0.07% (4/543) of patients, respectively. Complete peptic ulcer healing was found at follow-up in 73.3% (270/368) of patients. Endoscopic hemostasis was achieved in the majority of patients with high-risk ulceration, although the occurrence of rebleeding is a significant challenge, especially in patients with duodenal ulcers. Clinical trial registration: Bleeding Ulcer and Erosions Study (BLUE Study), ClinicalTrials.gov identifier: NCT03367897. [ABSTRACT FROM AUTHOR]

Purpose: Due to environmental concerns, there is a demand to reduce the use of peat as a growing medium for horticultural crops. Simultaneously, there is an interest to recycle organic waste materials in the form of compost. This study aimed to document effects on growth, yield, and fruit quality of tomato plants when cultivated in a sewage digestate-based compost in a subirrigation container system. Materials and methods: The compost used in this experiment consisted of 30% hygienised sewage digestate from biogas extraction and 70% garden waste. The treatments were 100% compost, a peat mix and mixtures of the two in 25/75, 50/50 and 75/25 ratios. Results and conclusion: Considering the contrast in chemical and physical properties of the treatments, variations in growth, yield and quality were expected. The plants differed in leaf area and number of leaves, but there were no differences in yield or quality of the tomato fruits. It is assumed that this is in great part due to the remediating effects of subirrigation with an ideal nutrient solution, and the use of pre-established plants. Further research should focus on benefits of this cultivation system for use in sustainable horticulture in combination with recycled organic waste. [ABSTRACT FROM AUTHOR]

This qualitative study investigates, through focus groups, how students in upper secondary school in Norway experience schooling. The background for the study is a tension between measurable outcomes and the educational aim of supporting students' human growth, their Bildung. As teacher educators, we wanted to learn about situations that made an impression on students and thereby might promote Bildung and the desire to learn. Findings show that what made an impression was primarily related to teachers, fellow students, school atmosphere, and to aesthetic experiences and variations. Students emphasise teachers' attitudes, interpersonal skills and ability to vary their teaching. Teachers content knowledge was taken for granted. Based on the findings, we suggest implications for how to educate teachers, for teachers working conditions and for cooperation in schools. In order to promote students' Bildung, also teachers' human development needs to be put on the agenda. [ABSTRACT FROM AUTHOR]

The paper presents a scoping review of existing economic evaluations of assistive technology (AT). The study methodology utilized a PRISMA flow approach with final included studies that met an adapted PICOS framework. Types of economic evaluations employed, study type and rigor and domains of AT impact were considered and analyzed. The economic evaluations in this study included 13 CBA, 9 CMA, 18 CEAs and 10 CUA. The majority of studies (32 studies in total) mentioned or recorded that AT investment, access and/or usage had impacts on the domain of both informal and formal health care. Specifically, care costs, time, and resources were affected. Our study has found that current AT economic evaluations are limited. This study advocates for a wider use of robust alternative evaluation and appraisal methodologies that can highlight AT value and which would subsequently provide further evidence that may make governments more willing to invest in and shape AT markets. [ABSTRACT FROM AUTHOR]

This article discusses experiences harvested when communicating migration research from an academic position as media researcher, partly influenced by other positions. It discusses transnational literacy illustrated by the case of Afghanistan and Afghan refugee experiences, arguing for a more holistic contextual approach to the phenomenon of flight and all its processes. A critical human rights perspective in media research proves useful guidance to approaching marginalisation and the 'silenced other'. This also entails a critical approach to methodological nationalism and media domestication, and 'unlearning privilege as loss'. Furthermore, it discusses how researchers within certain fields (such as migration) may be associated with (or accused of) political correctness. [ABSTRACT FROM AUTHOR]

To explore Nordic patients' ranking of the importance of different aspects of general practice. Patients ranked the importance of 47 statements reflecting five quality domains: communication, involvement, accessibility, continuity, and comprehensiveness. Nordic general practice. Patients ≥18 years in general practitioners waiting rooms. Items rated as important or very important by ≥ 90% in all countries were identified. Associations with patient characteristics were analysed by logistic regression. 209 Danish, 175 Norwegian, 129 Finnish, 112 Swedish and 82 Icelandic patients responded. Ten statements were ranked as important or very important by ≥90% in each country. Six pertained to communication, three to patient involvement and one to the comprehensiveness of care. No items regarding accessibility or continuity exceeded the 90% limit. The item most frequently rated as very important was 'I understand what the GP explains". Female patients were more likely to value personal treatment (OR = 2.9; 95%CI 1.5–5.5) and receiving instructions if things went wrong (1.7; 1.2–2.2). Older patients >65 years put less emphasis than those <35 on whether the GP takes them seriously (0.4; 0.3–0.5) and on the importance of instructions (0.5; 0.4–0.7). Patients with chronic diseases were less concerned (0.6; 0.4–0.8) with receiving instructions, but valued strongly that a GP knows when to refer (2.2; 1.5–3.3). Patients in all countries assigned high value to good communication. Availability was deemed important but came secondary to good communication. Organisational framework for general practice must allow for acceptable communication quality as well as availability. In order to identify relevant service areas for quality improvement in primary care, we aimed to increase knowledge of patient ranked importance of different dimensions of care. Nordic primary care patients valued good communication and involvement in decisions higher than accessibility to care. A singular focus on the access of care when developing services may not be in accordance with patient preferences. [ABSTRACT FROM AUTHOR]

Many children with disabilities in low- and middle-income countries do not attend school and one-third are out of school. In order to ensure that education is for all including children with disabilities, research is needed on barriers to schooling to identify targets for intervention. The study will examine the determinants of school achievement among persons with and without disabilities as well as among each type of impairment. The study will utilize data from a recent national, representative household survey on living conditions among persons with and without disabilities. The individual level data used in this article comprise 2123 persons with and 2000 persons without disabilities. The results show that an alarmingly high proportion of persons in Nepal have not accessed formal education, with access being significantly lower among persons with disabilities. While the results may be influenced by the assumed relationship between disability and poverty, results from analyzing the cross-sectional data cannot be conclusive on the influence of disability vs. poverty in determining differences in access and school attainments. Increased environmental barriers, higher age, rural location, and increased levels of disability were found to be associated with lower educational achievement. Pronounced differences in access to education were found between impairment types, with individuals with physical impairments achieving the highest level and individuals with multiple impairments, hearing and mental impairments achieving lowest. It is necessary both to strengthen the entire educational sector and at the same time allocate resources that will ensure that all children are on board and that particular efforts are implemented to cater for those who are easily side-lined. An alarmingly high proportion of persons in Nepal have not attended school. Substantially more individuals with than without disabilities have never attended school. Increased environmental barriers, higher age, rural location, and increased levels of disability were found to be associated with lower educational achievement. Pronounced differences in access to education were found between impairment types, with individuals with physical impairments achieving the highest level and individuals with multiple impairments, hearing and mental impairments achieving lowest. It is necessary both to strengthen the entire educational sector in Nepal and at the same time ensure that particular efforts are implemented to cater for those who are easily sidelined. [ABSTRACT FROM AUTHOR]

Severe parental somatic illnesses can influence the entire family, including adolescents' everyday life, psychosocial functioning and health. Within salutogenesis, it is highlighted that stressor life events, such as parental somatic illness, might lead to a chain of events that can produce tension. There is a lack of in-depth understanding regarding how adolescents living in a situation with a severely somatically ill parent (SIP) perceive their own mental health. The aim of this study was therefore to explore the lived experience of Norwegian adolescents living with an SIP, and their perception of the parental illness' influence on their mental health. Interpretative phenomenological analysis was used. In-depth interviews were conducted with 11 adolescents (aged 13–18 years) who had an SIP. Two adolescents with an SIP participated in study preparation and data analysis. Adolescents perceived parental somatic illness as a multifaceted influence on their mental health as it represented both personal and relational strain and growth. Their perceptions can be conceptualized by the super-ordinate theme "living in an earthquake zone", and by two themes, "inner shakes—but not falling apart" and "relational aftershocks—gains and losses". For adolescents, parental somatic illness means personal and relational strain and growth. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this theoretical article is to broaden our conception of the organization as context for music therapy. The theoretical concepts presented can be of interest to music therapy practitioners, researchers, and communities that work with implementing music therapy. Method: Based on a review of the music therapy literature, the author explores how organization theory is currently used to understand the organizational context of music therapy. The author uses an abductive approach in the analysis of the adapted organization theories in the literature, and the implications of the prevailing view of the organization as context for music therapy. Results: The adapted organizational perspectives which are identified in the music therapy literature, leave a theoretical gap between theory and practice. The implication of this gap is that music therapists' experiences with the organization and other workers' values, norms, practice, identity, and culture are not sufficiently theoretically captured. In response to these implications, the Institutional Logics Perspective (ILP) is introduced to broaden our understanding of the organizational context for music therapy. Discussion: ILP provides a framework that enables music therapists to assess their organizational context in a way that captures values, norms and established practices. This enabling can potentially lead music therapists to both adopt and change existing values, norms and practices in the organizational context. This reciprocal process can lead to increased understanding of music therapy as mind-set and practice in the organization, which, in turn can contribute to strengthening music therapy as a profession and an institutional field. [ABSTRACT FROM AUTHOR]

Acute upper gastrointestinal bleeding is a well-recognized complication of peptic ulcers and erosions. The aim of this study was to assess the incidence rate and identify risk factors for this complication in southeastern Norway. Between March 2015 and December 2017, a prospective observational study was conducted at two Norwegian hospitals with a total catchment area of approximately 800,000 inhabitants. Information regarding patient characteristics, comorbidities, drug use, H. pylori status and 30-day mortality was recorded. A total of 543 adult patients were included. The incidence was 30/100,000 inhabitants per year. Altogether, 434 (80%) of the study patients used risk medication. Only 46 patients (8.5%) used proton pump inhibitors (PPIs) for more than 2 weeks before the bleeding episode. H. pylori testing was performed in 527 (97%) patients, of whom 195 (37%) were H. pylori-positive. The main comorbidity was cardiovascular disease. Gastric and duodenal ulcers were found in 183 (34%) and 275 (51%) patients, respectively. Simultaneous ulcerations at both locations were present in 58 (10%) patients, and 27 (5%) had only erosions. Overall, the 30-day mortality rate was 7.6%. The incidence of upper gastrointestinal bleeding due to peptic ulcers and erosions was found to be lower than previously demonstrated in comparable studies, but the overall mortality rate was unchanged. The consumption of risk medication was high, and only a few patients had used prophylactic PPIs. Concurrent H. pylori infection was present in only one-third of the patients. Bleeding Ulcer and Erosions Study 'BLUE Study', ClinicalTrials.gov Identifier. NCT03367897. [ABSTRACT FROM AUTHOR]

Children adopt lifelong attitudes, behaviors, and beliefs from media messages, yet little is known about what messages visual media send to children on religion. This study addresses this literature gap by analyzing depictions of religion in holiday specials aired in 2018 from three top preschool networks: Disney Junior, Nick Jr., and PBS Kids. Using qualitative content analysis, this study reveals that preschool holiday specials are shifting away from more in-depth portrayals of diverse religions toward commercialized, generalized, and secularized portrayals of Christmas. Although Chanukah and other non-Christmas religious holiday specials are, on average, older and less common than Christmas specials, they portray non-Christmas traditions in greater religious depth than the more recent and numerous Christmas specials portray Christmas. These findings illumine American religious holiday practices and attitudes and provide insights for enhancing media literacy on religion in children's media and for understanding television's potential influence on children's perceptions of religion. [ABSTRACT FROM AUTHOR]

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This study analyzes fresh and brackish water aquacultures—especially carp, tilapia, and shrimp production—in major Asian aquaculture-producing countries. Different indicators have been used, involving dimensions that may be affected by climate change. High diversity is believed to indicate high adaption capacity, while resilience is estimated by known biological properties of each species. The results confirm that China, by far, has the largest diversity of species and values, followed by Bangladesh, Indonesia and Vietnam. Evaluation of the resilience of major species in light of the impacts climate change may have on warming, seawater intrusion and reduced fish meal supply, indicates that shrimp species are more resilient than tilapia, carp and catfish. In general, resilience of aquaculture products in Asia seems to be high, and the aquaculture production could adapt to climate change impacts by proper modifications in farming systems and infrastructure facilities in the future. [ABSTRACT FROM AUTHOR]

At present, the planet faces a change in the composition and bioavailability of nutrients. Zinc deficiency is a widespread problem throughout the world. It is imperative to understand the mechanisms that organisms use to adapt to the deficiency of this micronutrient. In the Ascomycetes fungi, the ZIP family of proteins is one of the most important for zinc transport and includes high affinity Zrt1p and low zinc affinity Zrt2p transporters. After identification and characterization of ZRT1/ZRT2-like genes in Ustilago maydis we conclude that they encode for high and low zinc affinity transporters, with no apparent iron transport activity. These conclusions were supported by the gene deletion in Ustilago and the functional characterization of ZRT1/ZRT2-like genes by measuring the intracellular zinc content over a range of zinc availability. The functional complementation of the S. cerevisiae ZRT1Δ ZRT2Δ mutant with U. maydis genes supports this as well. U. maydis ZRT2 gene, was found to be regulated by pH through Rim101 pathway, thus providing novel insights into how this Basidiomycota fungus can adapt to different levels of Zn availability. [ABSTRACT FROM AUTHOR]

This article examines the sociocultural shaping of teacher agency by focusing on how various conditions mediate teachers' perceived professional space. Agency is understood from a sociocultural perspective as the mediated capacity to act, which is achieved and exercised in a professional space, and, consequently, shaped by the perceptions of this space. Based on thematic and interpretative analysis of interviews with Norwegian L1 upper secondary teachers, the article identifies several conditions that mediate the teachers' perceived professional space: the exam, the curriculum, accountability demands, school leadership, colleagues, students, learning materials, and subject traditions and purposes. Two aspects of mediation are identified, what we respectively term extension and remodelling. Extension conveys how mediating conditions provide resources or constraints that contribute to expanding or narrowing the teachers' perceived professional space. Remodelling, however, conveys how mediating conditions qualitatively transform the perceived professional space. Findings highlight the subject as a resource for teachers, and teacher agency as socioculturally shaped by the perceived size and character of professional space. [ABSTRACT FROM AUTHOR]

Purpose: Health should be a universal phenomenon. However, little is known about the relationship between disability status and health issues – particularly in rural areas. This study looks at health issues of persons with disabilities in Madwaleni, a rural impoverished area in South Africa in 2011, and compares them to persons with no disabilities. Materials and Methods: Standardized questionnaires were used in the survey to assess disability and health status. The sample comprised of 773 individuals – 322 persons with disability and 451 comparisons (without disability) – covering 527 households. Children under the age of five were excluded from the sample. We used purposive sampling. Results and Conclusion: This study found that persons with disabilities have poorer reported health outcomes than persons with no disabilities. There is also an association between disability severity and mental health issues as assessed by the GHQ-12. A significantly higher percentage of persons with disability did not get health care when needed. Persons with disabilities also have less favorable attitudes toward competence of health care workers. This study has shown greater health needs and less satisfaction with services, which strongly indicates insufficient access for persons with disabilities in a rural impoverished are within South Africa. Persons with disabilities in rural South Africa have poorer reported health outcomes. Persons with disabilities have less favorable attitudes towards competence of health care workers in rural South Africa. Better access to health care for persons with disabilities is needed in rural South Africa. [ABSTRACT FROM AUTHOR]

Toxic effects of silver nanoparticles (Ag NPs) are, in most cases, measured within a single generation, while information regarding multigenerational exposure remains scarce. The current study assessed changes in toxic response (reproduction, fertility, and development) towards Ag NPs (NM300K; uncoated, 16.7 ± 6.5 nm) compared to AgNO3 over six generations, following chronic exposure of the model organism Caenorhabditis elegans. This revealed that AgNO3 exposure was associated with no changes in susceptibility to Ag. In contrast, multigenerational exposure to sub-lethal concentrations of Ag NPs resulted in persistent delayed development, but rendered increased tolerance to Ag NP with respect to fertility and fecundity. The results thus permit inference of a difference in toxic mode of action of the two forms of Ag, which instigate different response patterns. Results reveal a novel mechanism for the adaptation toward Ag NPs, where increased reproductive fitness occurs at the expense of somatic growth. This adaptive mechanism was, however associated with increased susceptibility to AgNO3 with respect to growth, fertility and reproduction. The current study thus demonstrates that a nano-specific resistance can be developed by C. elegans. Importantly, this adaptation renders increased vulnerability to another environmental stressor, and thus exposure to a second contaminant could be detrimental to such populations. [ABSTRACT FROM AUTHOR]

Objectives: Chest pain is one of the most frequent chief complaints in patients admitted to the emergency department (ED). No study has evaluated this patient population in Norway. The aim of the present study was to describe the diagnoses and logistics of chest pain patients admitted to the ED at a Norwegian university hospital.Design: Data were collected from all patients referred to the ED at St. Olav's Hospital-Trondheim University Hospital in 2015. Patients presenting at the ED with a chief complaint of chest pain based on the Rapid Emergency Triage and Treatment System were included in this study.Results: In the study period, 22,403 patients were admitted to the ED. Chest pain was the second most common chief complaint (11%), only exceeded by acute abdominal pain (18%). Among the chest pain patients, 12% had acute coronary syndrome (ACS) and 37% were diagnosed with non-specific chest pain. Gastrointestinal, musculoskeletal, and pulmonary conditions were less common, affecting 6%, 4%, and 4% of the patients, respectively. In total, 90% of the ED chest pain patients were handled by the Clinic of Cardiology.Conclusions: Chest pain was the second most common chief complaint among patients admitted to the ED, and most patients were handled by the Clinic of Cardiology. More than one-third of the patients received a cardiac diagnosis, but the largest group of patients was discharged with a diagnosis of non-specific chest pain. Other conditions managed by non-cardiac medical specialties were less common. [ABSTRACT FROM AUTHOR]