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Background: Fecal Microbiota Transplant (FMT) is an effective treatment for recurring Clostridioides Difficile Infections (rCDI). FMT administered via oral capsules (caFMT) offers several practical advantages to conventional liquid FMT. We began using caFMT in 2021 imported from an external institution. Based on similar production methods, we began our own caFMT production in 2022. We aimed to evaluate the quality of our caFMT. Study Design and Methods: We created a database of all FMT treatments (n = 180) provided by our institution. Quality of all FMT was evaluated by treatment success rates. We compared our caFMT to the imported caFMT. Results: Our caFMT yielded similar success rates compared to that of the imported caFMT, 65% (CI 95% 58–72%) and 72% (CI 95% 66–79%) respectively. FMT administered via colonoscopy had a significantly higher success rate, 79% (CI 95% 73–85%) than own our caFMT and other routes of administration. The combined success rate of treatments increased notably for all routes of administration when repeating FMT after prior failure. Discussion: The fact that our caFMT compared similarly to the imported caFMT was viewed as a success in terms of quality assurance. Our caFMT had a slightly lower success rates compared to data from other studies, but could be affected by several other factors than our FMT-production methods. A lower success rate of caFMT compared to FMT via colonoscopy is acceptable due to the practical advantages offed by caFMT. Our study serves as a practical example, proving that of the standardization of caFMT production is indeed viable. [ABSTRACT FROM AUTHOR]

This field study set out to test whether consumers' history of making decisions in a particular choice context moderated the effectiveness of a nudge intervention to reduce meat consumption. In a Danish hospital canteen that served both staff members and visitors, a combination of nudges (Chef's recommendation sticker + prominent positioning) was implemented to promote vegetarian sandwiches. The sales of these sandwiches increased from 16.45% during the baseline period to 25.16% during the nudge intervention period. Most notably, this increase was caused by the visitors, who had weak location-bound preferences. Hospital staff members (who had strong location-bound preferences) were unaffected by the nudge in their choice. This is an important finding because the two consumer groups did not differ on their person-bound preferences for meat. It seems that behaviour change is best predicted by location-bound preferences, whereas the behaviour itself is best predicted by person-bound preferences. These findings can help organizations in estimating whether a nudge intervention has enough potential for behaviour change, or whether more directive policies are required. [ABSTRACT FROM AUTHOR]

Objective: To explore how clients in psychodynamic or psychoanalytic psychotherapy, conducted in the traditional in-person setting, experience the transitions in time and space between psychotherapy sessions and everyday life. Method: Twelve semi-structured interviews were analyzed with inductive experiential thematic analysis, focusing on how the participants experience and make sense of the phenomenon in focus. Results: The participants described therapy as a sheltered space where they could be open, vulnerable, receptive, and present. Approaching and leaving psychotherapy sessions, the participants established different behavioral patterns and routines dealing with their anxieties and resistances. In this in-between area, the participants could handle interconnections and differences between therapy and everyday life. Participants stressed the clinical impact of transitions: transitions affect both therapy and everyday life; disturbed transitions have an adverse impact; transitions are insufficiently addressed in therapy. Conclusion: Transitions between therapy and life appear to be an essential but seldom recognized part of the therapy process beyond the borders of therapy sessions. Implications of these findings for psychotherapy training and practice are discussed, and a tentative transtheoretical framework for further research is proposed. [ABSTRACT FROM AUTHOR]

Attempts in the UK to regulate the sharing and use of health data for secondary purposes such as research have been dogged by controversy and failure. This article considers health data stewardship as a response to these challenges. It develops a normative understanding of the concept through an examination of stewardship in a variety of contexts. This leads to a definition of health data stewardship which encapsulates the necessary constituent elements that focus group participants viewed as crucial to an accountable health data sharing scheme in which they could place their trust. It examines two potential mechanisms for facilitating health data stewardship, the data trust and the data cooperative, arguing that whichever regulatory mechanism is adopted must incorporate mechanisms responsive to citizens' requirements for accountable stewardship of their data. Without this, their wishes, and societal aims of improving health through research using comprehensive data sets may be unachievable. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionTo report a case of tuberculosis-related serpiginous-like choroiditis (TB-SLC) in Denmark in a patient with few risk factors.Single case report.A 54-year-old Caucasian male with no relevant travel history presented with unilateral light placoid confluent elements in the macula of the right eye with a best-corrected visual acuity of 0.2 Snellen. The left eye was normal. Wide-field Fluorescein and Indocyanine green-angiography were performed, and findings were consistent with acute posterior multifocal placoid pigment epitheliopathy. Since the condition was considered sight-threatening, and the patient had no recognizable risk factors for tuberculosis (TB), he was prescribed 50 mg of oral prednisolone. Blood tests and an X-ray were ordered to exclude infectious causes. The first interferon-ỿ release assay (IGRA) test was inconclusive and a new test was ordered. Over the following weeks new white dots appeared in the retina. After the patient had been treated for seven weeks with prednisolone, the second IGRA came back positive, and he was diagnosed with TB-SLC. Upon repeated questioning two months after baseline, the patient remembered that ten years ago he had been in a workplace with 50 different nationalities, and seven years ago he had been in contact with a friend who was treated for latent TB, thus supporting relevant exposure.TB-SLC may occur even in a patient with few recognizable risk factors and in a setting that is not TB endemic. It is imperative to continuously reassess differential diagnoses and initiate or repeat paraclinical testing in cases with atypical features. [ABSTRACT FROM AUTHOR]

It is generally accepted that we need more research into concussions and other injuries with potential long-term effects in sport because such research underpins effective, evidence-based prevention, management, support, and treatment. This paper provides an analysis of the obligations of sports federations to support and facilitate such research, as well as an analysis of the role active participants in the sport should have in the research process. The paper focuses on concussion and concussion research, though very similar arguments apply to other common sports injuries with potential long-term effects. The paper argues that sports federations have a moral obligation and a prudential interest in initiating, facilitating, and funding concussion research. This follows from their duty of care towards active participants and from considerations of reciprocity. The ability to discharge these research obligations depends on the resources available to a particular federation, but those who can discharge them should do so. The paper further argues that athletes and other active participants in sport should be involved in all aspects of the concussion research process from conception to design, i.e. that Active Participant Involvement and Engagement (APIE) should be a non-negotiable element of concussion research projects. This is supported by instrumental reasons, but also by philosophical argument based on standpoint epistemology and on ethical arguments related to the interests of active participants. Standpoint epistemology is the epistemological position that the knowledge a person has and can have depends on that person's standpoint in the world. Keywords: Concussion, funding, participant involvement, sport, sport association, sport federation [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate whether narrative identity challenges are specific to Bipolar Disorder (BD) as a mental illness or a reflection of living with chronic illness. Nineteen individuals diagnosed with BD, 29 individuals diagnosed with Type 1 Diabetes Mellitus (T1DM) and 25 controls without chronic mental or somatic illness identified past and future life story chapters which were self-rated on emotional tone and self-event connections and content-coded for agency and communion themes. Individuals with BD self-rated their past chapters as more negative and less positive, and their chapters were lower on content-coded agency and communion themes compared to T1DM and controls. There were fewer group differences for future chapters, but BD was associated with lower self-rated positive emotional tone and self-stability connections as well as lower content-coded agency and communion themes. The results indicate that narrative identity is affected in individuals with BD above and beyond the consequences of living with chronic illness. This may reflect distinct effects of mental versus somatic illness on narrative identity. [ABSTRACT FROM AUTHOR]

Recent decades have seen a significant rise in interest in spirituality in different mental health contexts. A comprehensive systematic review by Milner, Crawford, Edgley, Hare-Duke, and Slade (2019) shows that a gap exists between professionals and service users in the value they place on spirituality. The aim of this article is to synthesize existing literature on how people with mental health issues experience spirituality as a resource. A systematic literature search was performed in four international databases between January 2019 and October 2022. Nine studies were selected. This synthesis resulted in three themes, longing for connection, the need for vital relationships, and searching for a new meaning. [ABSTRACT FROM AUTHOR]

Hospital social workers (HSW) play an important role in health care, providing psychosocial support to families affected by severe illness, and having palliative care needs involving dependent children. However, there are few evidence-based family interventions for HSWs to apply when supporting these families. The Family Talk intervention (FTI), a psychosocial family-based intervention, was therefore evaluated in an effectiveness-implementation study. Within the study, HSWs were educated and trained in the use of FTI in clinical practice. This study examined HSWs' experiences of barriers and facilitating factors during their initial use of FTI in clinical practice. Altogether, 10 semi-structured focus groups were held with HSWs (n = 38) employed in cancer care and specialized palliative home care for adults, pediatric hospital care, and a children's hospice. Data were analyzed using content analysis. HSWs considered FTI to be a suitable psychosocial intervention for families affected by severe illness with dependent children. However, the way in which the care was organized acted either as a barrier or facilitator to the use of FTI, such as the HSWs' integration in the team and their possibility to organize their own work. The HSWs' work environment also impacted the use of FTI, where time and support from managers was seen as a significant facilitating factor, but which varied between the healthcare contexts. In conclusion, HSWs believed that FTI was a suitable family intervention for families involving dependent children where one family member had a severe illness. For successful initial implementation, strategies should be multi-functional, targeting the care organization and the work environment. [ABSTRACT FROM AUTHOR]

To investigate satisfaction with and perceived benefits of a model of needs-assessment related to rehabilitation (NARR) in women with early breast cancer after (neo)adjuvant chemotherapy. Mixed methods were applied using survey (N = 200) along with interviews (N = 20). The survey included measurement of distress and self-assessed need of and satisfaction with the NARR. Type of experienced side/late effects were registered along with numbers of and reasons for referrals to rehabilitation. Individual semi-structured interviews were conducted. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed with thematic analysis. Overall, 217 patients participated in a NARR and 200 (92%) accepted participation in the survey. Furthermore, 20/37 (54%) invited patients were interviewed. After the NARR, 39 patients (20%) were referred to rehabilitation. While satisfaction was high, findings regarding distress and need of the NARR were equivocal and indicated a need for talking about experiences throughout the cancer trajectory. While only 20% had rehabilitation needs, satisfaction with the NARR was high and patients benefitted from being confirmed in normality of their experiences. It is recommended to address patients' side/late effects after chemotherapy for early breast cancer to identify rehabilitation needs, reduce distress, and improve quality of life. One fifth of patients with early breast cancer were referred to rehabilitation after needs-assessments conducted 2 months after chemotherapy termination. Higher distress and higher self-reported need were significantly associated with not working and experiencing a higher number of side effects/late effects. It is recommended to address patients' side effects/late effects, including psychological distress, after termination of chemotherapy for early breast cancer to identify rehabilitation needs, reduce distress, and ultimately improve quality of life. [ABSTRACT FROM AUTHOR]

Stickler syndrome (STL) is a collagenopathy caused by pathogenic variants in collagen-coding genes, mainly COL2A1 or COL11A1 associated with Stickler syndrome type 1 (STL1) or type 2 (STL2), respectively. Affected individuals manifest ocular, auditory, articular, and craniofacial findings in varying degrees. Previous literature and case reports describe high variability in clinical findings for patients with STL. With this case report, we broaden the clinical spectrum of the phenotype. Case report on two members of a family (mother and son) including clinical examination and genetic testing using targeted trio whole exome sequencing (trio-WES). A boy and his mother presented with microphthalmia, congenital cataract, ptosis, and moderate-to-severe sensorineural hearing loss. Trio-WES found a novel heterozygote missense variant, c.4526A>G; p(Gln1509Arg) in COL11A1 in both affected individuals. We report a previously undescribed phenotype associated with a COL11A1-variant in a mother and son, expanding the spectrum for phenotype-genotype correlation in STL2, presenting with microphthalmia, congenital cataract, and ptosis not normally associated with Stickler syndrome. [ABSTRACT FROM AUTHOR]

Next-generation sequencing (NGS) affords comprehensive insights into the genomic landscape of lymphomas. We examined the mutational pattern in patients with Waldenström macroglobulinemia (WM) or lymphoplasmacytic lymphoma (LPL) as well as the diagnostic and clinical utility of a tailored NGS lymphoma panel. A consecutive series of 45 patients was reviewed and NGS analysis was performed as part of a routine diagnostic setup. The custom designed NGS panel assayed all coding sequences of 59 genes of known clinical significance in lymphoid neoplasms. The most frequently mutated genes were MYD88, CXCR4, BIRC3, CD79B, and ARID1A. Additional somatic mutations were detected in 17 genes with four mutations categorized as pathogenic or likely pathogenic. BIRC3 and TP53 mutations were associated with adverse clinical phenotypes. NGS performance for the MYD88L265P variant was 96% when compared to qPCR. In conclusion, targeted NGS provided important diagnostic and prognostic information in a routine clinical setting. [ABSTRACT FROM AUTHOR]

A case report published in the Scandinavian Journal of Clinical & Laboratory Investigation discusses a 25-year-old woman who developed thrombocytopenia and other inflammatory responses after receiving the Gardasil 9 vaccine for human papillomavirus (HPV). The patient's inflammatory markers were compared to those of patients with vaccine-induced immune thrombotic thrombocytopenia (VITT) after adenoviral vector vaccination for COVID-19. The study found a transient increase in inflammatory markers following the HPV vaccination, suggesting immune activation and inflammation as potential features of vaccine-induced complications. The authors emphasize the need for caution in interpreting data from a single patient and suggest that immune reactions to vaccination may play a causal role in these responses. [Extracted from the article]

AbstractThe Dual Process Model of Coping with Bereavement (DPM) proposes that there is an adaptive oscillation between loss-oriented (LO) and restorative-oriented (RO) coping processes. Empirical data supports these processes, but the oscillation process is not well-understood. This study explored the correspondence between the DPM and lived experience of bereaved people, with an additional investigation of perceived changes in grief over time. Using a cooperative inquiry inspired participatory research design, nine bereaved adults and three researchers met nine times to discuss experiences of grief. Knowledge production took place through ongoing sharing, exploration, and reflection upon personal experiences and grief theory. Support was found for the LO and RO processes, but they were perceived to overlap. Support was also found for the oscillation process, which was found to hold learning properties. Time off from grief was not supported. Perspectives on how and why grief experiences change over time emerged, emphasizing the importance of acceptance, learning, time, and contextual factors. [ABSTRACT FROM AUTHOR]

Alcohol use disorders (AUD) among people living with HIV (PLHIV) are associated with poor health outcomes. This cross-sectional study examined current alcohol use and AUD among 300 PLHIV on ART at four HIV care centres in Northwest Tanzania. Participants' data were collected using questionnaires. Alcohol use was assessed using Alcohol Use Disorders Identification Test (AUDIT). Logistic regression was used to examine associations between each outcome (current drinking and AUD) and sociodemographic and clinical factors. Association between alcohol use and ART adherence was also studied. The median age of participants was 43 years (IQR 19-71) and 41.3% were male. Twenty-two (7.3%) participants failed to take ART at least once in the last seven days. The prevalence of current drinking was 29.3% (95% CI 24.2-34.8%) and that of AUD was 11.3% (8.2%−15.5%). Males had higher odds of alcohol use (OR 3.03, 95% CI 1.79-5.14) and AUD (3.89, 1.76-8.60). Alcohol use was associated with ART non-adherence (OR = 2.78, 1.10–7.04). There was a trend towards an association between AUD and non-adherence (OR = 2.91, 0.92–9.21). Alcohol use and AUD were common among PLHIV and showed evidence of associations with ART non-adherence. Screening patients for alcohol use and AUD in HIV clinics may increase ART adherence. [ABSTRACT FROM AUTHOR]

Studies of children's consistency of word production allow identification of speech sound disorder. Inconsistent errors are reported for two groups of children: childhood apraxia of speech (CAS) due to difficulty with the motoric precision and consistency of speech movements; and inconsistent phonological disorder (IPD) attributed to impaired phonological planning. This paper describes the inconsistent productions of children with IPD in comparison to typically developing children. In two studies of suspected SSD (N = 135), 22 children pronounced ≥40% of 25 words inconsistently on three repeated trials. No participant had symptoms of CAS. They were monolingual and spoke Australian- or Irish-English. Assessment determined the proportions of words said consistently (i.e. the same across productions: all correct or with the same error) or inconsistently (i.e. differently across productions: at least one correct and one error or different errors in productions). Qualitative analyses examined error types and explored the effect of target words' characteristics on inconsistency. Children with IPD produced 52% of words with different errors. While 56% of all phoneme errors were developmental (age appropriate or delayed), atypical errors typified inconsistency: default sounds and word structure errors. Words with more phonemes, syllables and consonant clusters were vulnerable to inconsistency, but their frequency of occurrence had no effect. TD children and those with IPD had different quantitative and qualitative error profiles, confirming IPD as a diagnostic category of SSD. Qualitative analyses supported the hypothesised deficit in phonological planning of words' production for children with IPD. [ABSTRACT FROM AUTHOR]

Despite a recent boom in information and communication technologies (ICTs) in many developing countries, there is limited research on how social media is being used in political campaigns in emerging democracies. In these contexts, the introduction of electoral gender quotas often forms part of the constitutional reform. This paper investigates the gendered use of social media among political candidates during the 2019 parliamentary election campaign in Tunisia, which recently adopted an ambitious gender quota system. We have mapped the use of Facebook among a random sample of 400 men and women candidates and carried out interviews with 19 men and women candidates who ran in these elections. The results demonstrate how patriarchal structures interact with political-institutional features – the electoral gender quota system, the electoral system (a closed-list proportional-representation system), and the fragmented party system – in shaping the gendered use of social media among political candidates in Tunisia. We show that men are more likely to use Facebook for campaign purposes since they are more often placed at the top of the candidate lists. Hence, rather than having an equalizing effect, the study suggests that social media become a new tool for already privileged candidates in Tunisia. [ABSTRACT FROM AUTHOR]

A common problem with ranking lists (e.g., regarding success/failure proportions of treatments at hospitals) is that smaller units tend to end up either in the top or in the bottom just by pure chance. To alleviate this problem, we propose a method that, for a given unit, gives a confidence interval for the position of this unit within the distribution of the other units. The confidence interval is based on asymptotic normality. The method is illustrated by an empirical example. The small sample confidence level is investigated in a simulation study. [ABSTRACT FROM AUTHOR]

Online self-harming and suicidal behavior is a novel and rapidly increasing phenomenon warranting comprehensive mapping of used research methods. To identify and map how knowledge on online self-harming and suicidal behavior is gathered, including how data are collected e.g. questionnaires and interviews. The review follows the Joanna Briggs Institute Manual for Scoping Reviews in tandem with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A keyword search of three electronic databases was conducted on two occasions, yielding 5422 records. Following duplicate removal, the records were screened based on the following inclusion criterions; (1) in English or Nordic language and published between 2011–2022, (2) presenting results for self-harming and/or suicidal behavior on social media and (3) using tools for either interview or questionnaire aiming at assessment of the experience of online self-harming and suicidal behavior from the perspective of the person who engages in the behavior. A total of 64 articles were included. 45 used questionnaires, 17 used interviews, and two studies mixed the two approaches. 17% of the studies had made some effort to ensure validity within the questionnaires and 15.8% gave full access to the interview guide. Research into online self-harming and suicidal behavior is characterized by a lack of validated measurements and methodological transparency. The results emphasize a need for further development, testing, and validation of questionnaires and greater openness and reflexivity in qualitative methodology to enable cross-study comparison and advance knowledge of this complex phenomenon. [ABSTRACT FROM AUTHOR]

This article focuses on a Swedish school company and its operations in India, examining how setting up and operating schools in another national place forge particular spatial imaginaries. It contributes to literature on the Global Education Industry by focusing on international moves of commercial non-Anglo-Saxon actors. Drawing on interviews and extensive fieldwork in India, we show how the 'marriage' between the global (represented by the Swedish company) and local (the 'Indian') are manifested in the spatial imaginary of the 'glocal school', encompassing hierarchical otherings rooted in discourses of both globalisation and colonialism. [ABSTRACT FROM AUTHOR]

The purpose of this study was to (1) explore associations between preparedness for caregiving and preparedness for death among family caregivers of patients with advanced cancer and (2) explore modifiable preparedness factors, such as communication and support. Data was derived from a baseline questionnaire collected in specialized home care. The questionnaire included socio-demographics, the Preparedness for Caregiving Scale, and single items addressing preparedness for death, received support and communication about incurable illness. Data was analyzed using descriptive statistics and Spearman correlations. Altogether 39 family caregivers participated. A significant association was found between preparedness for caregiving and preparedness for death. Received support and communication about the illness was associated with higher levels of preparedness for caregiving and death. This study contributes to evidence on the association between preparedness for caregiving and death, but also that communication and support employed by healthcare professionals could improve family caregiver preparedness and wellbeing. [ABSTRACT FROM AUTHOR]

The prevalence of hepatitis C (HCV) among psychiatric patients is elevated compared to the background population in many studies, but the prevalence among Danish psychiatric patients is unknown. The aim of the study was to determine the HCV prevalence and the proportion of the psychiatric patient population that remains to be diagnosed and treated in a Danish setting. During a 5-month period, patients attending the psychiatric emergency room in Vejle, Denmark, were offered point-of-care anti-HCV testing. Previous hepatitis C tests for all patients attending the Psychiatric Department in the study period were extracted from the national laboratory database (DANVIR). We combined the survey and register data in a capture–recapture estimate of undiagnosed patients with HCV. During the study 24.9% (589 of 2364) patients seen at the psychiatric department attended the emergency room. The prevalence of anti-HCV among those tested in the emergency room was 1.6%. The laboratory register identified 595/2364 patients previously tested for anti-HCV with a positive prevalence of 6.1%. The undiagnosed anti-HCV positives among the 1483 never tested was estimated to 1.1%. Thus the total estimated prevalence of anti-HCV was 2.3% (54/2364, 95% CI 1.7%–3.0%) in the population, of whom 70.4% had been diagnosed, and 72.2% of diagnosed patients had received treatment or cleared HCV. Combining survey and register data showed that the WHO target of 90% diagnosed and 80% treated was not met. To eliminate HCV in the psychiatric population, both undiagnosed and untreated patients must be targeted. [ABSTRACT FROM AUTHOR]

Over half of the world’s mortality is associated with chronic diseases. Living with chronic diseases can significantly affect patients’ quality of life. The daily management of these diseases falls mostly on patients themselves. Self-management interventions have become increasingly used as a complementary intervention to treatment and care. The Chronic Disease Self-Management Programme (CDSMP) is the most widespread self-management intervention. It aims to empower patients and provide them with the skills to manage their disease and prevent complications. A locally adapted CDSMP was piloted in the Republic of Moldova in 2018/2019 in five villages across three rural districts. In five groups led by peer facilitators, 63 participants were enrolled in the programme. Four participants were lost to follow-up. To evaluate the intervention, we used the Self-Efficacy for Managing Chronic Diseases six-item scale questionnaire with participants before and after the programme, along with a questionnaire to assess satisfaction with the programme. Additionally, we conducted a focus group discussion (FGD) with the 10 programme facilitators. We found that, not only did participants’ self-efficacy significantly increase between baseline and follow-up (from mean score of 5.3 to 8.3; t(58) = -12.2, p < 0.001), they also improved their knowledge on every individual item on how to manage a chronic disease (p < 0.001). Participants’ satisfaction was high, with 96% of respondents satisfied with content, format and delivery elements of the intervention. Hence, we believe the CDSMP is locally acceptable and effective at least in the short-term, and offers promises for scale-up in the Republic of Moldova. [ABSTRACT FROM AUTHOR]

Mentorship may be conceptualised in terms of the form it takes, function it serves or it's learning centred nature which makes research in mentoring to receive attention within different disciplines. This article attempts to understand how a mentoring programme can contribute to enhanced research capacity building in the field of Innovation and Development (I&D) studies in Africa. It does this through a qualitative study of an African-oriented research capacity building network (AfricaLics) that aims at building a critical mass of scholars in I&D studies in the continent of Africa. Drawing on theoretical approaches in higher education that support systems of interaction thinking, the paper finds that more systematic and extensive mentorship, and awareness about different types of mentorship can enhance capacity building in the field of I&D studies. The paper recommends that development of an I&D mentorship programme must consider a mix of both structured and unstructured elements that are aligned to the local context. These context-specific elements are critical to building sustainable research capacity building programmes in academic disciplines that are transdisciplinary in nature such as I&D studies. [ABSTRACT FROM AUTHOR]

Postirradiation examination of nuclear fuel is routinely performed to characterize the important properties of current and future fuel. Gamma emission tomography is a proven noninvasive technique for this purpose. Among various measurement elements of the technique, a gamma-ray detector is an important element whose spectroscopic abilities and detection efficiency affect the overall results. Finding a combination of high detection efficiency and excellent energy resolution in a single detector is often a challenge. We have designed a novel planar segmented high-purity germanium detector that offers simultaneous measurement in six lines of sight with excellent energy resolution. The simultaneous detection ability enables faster data acquisition in a tomographic measurement, which may facilitate achieving higher spatial resolution. In this work, we have demonstrated the first use of the detector by performing a full tomographic measurement of mockup fuel rods. Two methods of detector data analysis were used to make spectra, and the images (tomograms) were reconstructed using the filtered back projection algorithm. The reconstructed images validate the successful use of the detector for tomographic measurement. The use of the detector for real fuel measurement is being planned and will be performed in the near future. [ABSTRACT FROM AUTHOR]

This study evaluated counseling services provided by counselor trainees to individuals on probation within a partnership between a counselor training program and a community supervision department. Eighty-one participants were included in the program evaluation, with 65 reporting demographics. Participants ranged in age from 18 to 74 and included 35 men and 30 women. Of those 65, 67.7% identified as White, 24.6% as African American, 6.2% as another race not specified, and 1.5% Native American or Alaskan Native. Additionally, 83.1% identified as non-Hispanic and 16.9% as Hispanic. Pre–post assessments were completed and Wilcoxon signed-rank tests revealed statistically significant reduction of anxiety, depression, posttraumatic stress symptoms, anger reactions, and relapse symptoms, and a statistically significant increase in presence of meaning in life, self-efficacy, and life satisfaction. Percentage improvement revealed more than half of the participants had clinically significant improvement in depression, anxiety, and posttraumatic stress disorder symptoms. Results indicate promise for community-engaged partnerships to provide no-cost responsive counseling services to individuals on probation. [ABSTRACT FROM AUTHOR]

The scholarly literature on Russia's influence in Europe has so far mainly focused on Russia's influence activities, discussed either as 'disinformation' or 'soft power'. Less attention has been paid to understanding the agency of European audiences receptive to Russian narratives. Through discourse analysis of Norwegian media texts (February 2014 – December 2020) where authors or interviewees accepted or were prone to accept Crimea as part of Russia, this paper investigates into the arguments put forward by these constituencies. Why were commentators, representing various political affiliations, willing to accept Crimea as part of Russia, contrary to Norway's official position? The paper shows that the Norwegian commentators used many arguments coinciding with the official Russian ones put forward to legitimize the annexation, arguments informed by political realism, pragmatism, sovereignism and in some cases anti-Americanism. However, they also used arguments structured by the socio-political and historical Norwegian context. Constituencies abroad sharing opinions with official Russia may provide Russia with a certain soft power. In this case, the fact that these dissenting discourses in Norway represent fringes of the debate on the annexation rather than a strong united opposition to Norway's official stand, speaks quite clearly of the limited scope of this soft power. [ABSTRACT FROM AUTHOR]

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants' locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frameworks for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant's real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in participant-centered research, we present a novel framework specific to the ethical, legal, and social implications of returning IRRs in digital phenotyping research. Our framework offers researchers, clinicians, and Institutional Review Boards (IRBs) urgently needed guidance, and the principles developed here in the context of psychiatry will be readily adaptable to other therapeutic areas. [ABSTRACT FROM AUTHOR]

Duplicate measure of hemoglobin mass by carbon monoxide (CO)-rebreathing is a logistical challenge as recommendations prompt several hours between measures to minimize CO-accumulation. This study investigated the feasibility and reliability of performing duplicate CO-rebreathing procedures immediately following one another. Additionally, it was evaluated whether the obtained hemoglobin mass from three different CO-rebreathing devices is comparable. Fifty-five healthy participants (22 males, 23 females) performed 222 duplicate CO-rebreathing procedures in total. Additionally, in a randomized cross-over design 10 participants completed three experimental trials, each including three CO-rebreathing procedures, with the first and second separated by 24 h and the second and third separated by 5–10 min. Each trial was separated by >48 h and conducted using either a glass-spirometer, a semi-automated electromechanical device, or a standard three-way plastic valve designed for pulmonary measurements. Hemoglobin mass was 3 ± 22 g lower (p < 0.05) at the second measure when performed immediately after the first with a typical error of 1.1%. Carboxyhemoglobin levels reached 10.9 ± 1.3%. In the randomized trial, hemoglobin mass was similar between the glass-spirometer and three-way valve, but ∼6% (∼50 g) higher for the semi-automated device. Notably, differences in hemoglobin mass were up to ∼13% (∼100 g) when device-specific recommendations for correction of CO loss to myoglobin and exhalation was followed. In conclusion, it is feasible and reliable to perform two immediate CO-rebreathing procedures. Hemoglobin mass is comparable between the glass-spirometer and the three-way plastic valve, but higher for the semi-automated device. The differences are amplified if the device-specific recommendations of CO-loss corrections are followed. [ABSTRACT FROM AUTHOR]

Research during COVID-19 has shown that rapid transition to distance learning environment has influenced student's emotions. Yet, there is a lack of studies about how this transition might have changed achievement emotions in mathematics. We investigated six mathematics-related achievement emotions (enjoyment, pride, anger, anxiety, shame, and boredom) among Finnish high school students (N = 1348) in contact learning and distance learning. We analysed the relationship between gender, achievement emotions, and the learning environment using latent growth curve structural models. Our results revealed that students reported higher levels of boredom and lower levels of pride, enjoyment, shame, and anxiety in distance learning than in contact learning. The distance learning effect was stronger for females than for males, particularly for students following the advanced syllabus. Female students reported a larger decrease in pride and enjoyment and a larger increase in boredom than male students when moving from contact learning to distance learning. The theoretical and practical implications of the results are discussed. [ABSTRACT FROM AUTHOR]

Digital 3D technologies are emerging methods for recording and visualizing forests. Therefore, it is not surprising that these technologies have seen many applications and developments in recent years. In this study, we conducted a comprehensive review of existing 3D technologies within the context of forestry and how they interact with users and stakeholders. We present a summary of the requirements, visualization, and application of virtual forests. This includes an overview of state-of-the-art 3D reconstruction and visualization tools, which have seen a major increase in interest in the past few years, as evidenced by a preliminary analysis on research keywords. Based on the reviewed studies, we present the current trend and emerging questions, as well as challenges in the field of virtual forests. Further, we discuss the identified trends and challenges related to data acquisition, along with existing and potential future interactions between the 3D data and more specific demands from the forestry sector. We conclude that the use of digital 3D data in forestry is on the rise and that such novel methods show great potential and merit further attention. [ABSTRACT FROM AUTHOR]

Exercise is an effective component in rehabilitation of a range of chronic conditions. There is a growing interest in the use of exercise-based nature interacted rehabilitation (EBNIR), but an overview of current evidence is missing. The objective of this scoping review was to map existing exercise-based rehabilitation interventions conducted with incidental or intentional nature interaction focusing on its populations, types of outcomes, and theoretical rationale for people with physical and mental disabilities. This scoping review identified peer-reviewed publications, registered upcoming trials and grey literature. To map all available knowledge, a comprehensive search of selected databases (MEDLINE; EMBASE; CINAHL; Cochrane; Web of Science; Pedro) from inception to October 2022. Data were synthesized in a thematic presentation guided by TIDieR, supplemented by a checklist developed for this study accounting nature incidental or intentional interaction. Twelve studies including 856 participants met the inclusion criteria. Eleven were completed trials and one was registered in clinicaltrials.gov to be run in 2023. A total of 856 patients were enrolled in the 12 studies (range 18–262, median 50). The included studies had great variation. The incidental or intentional interacted exercise-based interventions consisted of outdoor walks, neck exercises and surfing interventions in patients with physical or mental health conditions. This scoping review presents an overview of limited and diverse evidence within the field of EBNIR, in patients with physical or mental health conditions. Our review provides an overview that will be helpful in the design of future EBNIR trials. [ABSTRACT FROM AUTHOR]

Reablement aims to enable older persons with functional decline to re-engage in meaningful activities. The benefits of engagement in outdoor activities are significant; however, reablement services primarily target function in indoor environments whereas descriptions of outdoor activities are sparse. The aim of this study was to create a model that integrates outdoor recreation into reablement. We therefore elaborated on an experienced based co-design methodology to create a model that integrates outdoor recreation for older persons in reablement in an Arctic, rural context in northern Norway. Stakeholders (N = 35), including reablement participants, participated in workshops, focus groups, and individual interviews. Based on the results, we co-created a person-centred model for outdoor recreation in reablement, including an assessment tool that can guide reablement staff in goal-setting practices. Accordingly, we argue that cherished locations holds significant meaning in the lives of older people and warrant recognition in reablement programmes. There is a need to evaluate the effects and feasibility of the model and the possibility for its implementation in other health care settings. [ABSTRACT FROM AUTHOR]

The reactive hyperaemia index (RHI) assesses endothelial function, with a proposed cut-off of <1.67 for prevalent endothelial dysfunction (ED). However, uncertainties remain about whether this cut-off is age-dependent and applicable in healthy individuals. We aimed to explore ED in relation to age within a large population-based cohort of young to middle-aged, healthy individuals. Within the Malmö Offspring Study, a total of 1812 subjects (50.9% women, mean age 48 ± 11 years) were included. Post-occlusion/pre-occlusion ratio of the pulsatile signal amplitudes in the non-dominant upper arm was used to calculate RHI by EndoPat®. ED was defined as RHI < 1.67. Multivariable regression models were used to explore associations between ED and age. Prevalent ED was found in 534 (29.5%) participants. In subjects aged ≤30 years, ED was present in 47.4% compared to 27.6% in subjects ≥30 years (p < 0.001). In multivariable logistic regression analyses, ED was associated with younger age (p < 0.001), higher BMI (p < 0.001) and current smoking (p < 0.001). No sex differences were observed. In a large healthy population, RHI < 1.67, an early marker of endothelial dysfunction, was more prevalent in younger individuals, implying that RHI might not be a suitable measure of endothelial function in individuals under 30 years of age. Our findings suggest that low RHI in young, healthy individuals may not necessarily indicate true ED but rather an artefact of the limited ability of young and healthy arteries to dilate post-occlusion. Therefore, the term "pseudo-ED" may be applicable to young individuals with low RHI values. What is the context? The endothelium is a thin layer of cells that lines the inside of blood vessels, and its proper function is crucial for the maintenance of vascular health. Endothelial dysfunction (ED) is an early marker of cardiovascular disease and is characterised by impaired dilation of blood vessels, which can lead to reduced blood flow and increased risk of heart attacks and strokes. The reactive hyperaemia index (RHI) is a widely used non-invasive test that measures endothelial function by evaluating the dilation of blood vessels in response to temporary occlusion. What is new? This study aimed to investigate the relationship between age and ED in a large population-based cohort of young to middle-aged healthy individuals. The results showed that prevalent ED was more common in younger individuals, with 47.4% of participants aged ≤30 years having ED, compared to 27.6% in those ≥30 years. The study also found that ED was associated with higher BMI and current smoking, but no sex differences were observed. What is the impact? The findings suggest that the proposed RHI cut-off of <1.67 for prevalent ED may not be applicable to individuals under the age of 30, as young and healthy arteries may have limited ability to dilate post-occlusion, resulting in low RHI values that do not necessarily indicate true ED. Therefore, the term "pseudo-ED" may be more appropriate for young individuals with low RHI values. [ABSTRACT FROM AUTHOR]

Objective: Paternal participation and experiences in childhood weight management is an understudied studied area. Given the important role fathers play in childhood obesity prevention and treatment, the aim of this study was to explore Norwegian fathers' experiences of helping to prevent further weight gain in their children with overweight or obesity. Methods: Data were collected through semi-structured interviews with eight fathers of ten children with overweight or obesity and analysed by qualitative content analysis. Results: The analysis resulted in one overall theme: Balancing between assuming and avoiding responsibility for weight management with a desire to preserve the child's dignity, comprising two themes: 1) Alternating between concern, helplessness and responsibility, 2) Needing acknowledgement, and flexible and tailored professional support, both of which have several sub-themes. Conclusion: Fathers need guidance on how to talk to their children to prevent further weight gain, while at the same time emphasizing safeguarding the child's dignity. Healthcare professionals should address parents' own emotional barriers and include fathers to a greater extent as a resource in family-centred counselling and tailor guidance and support to help with childhood weight management. [ABSTRACT FROM AUTHOR]

During the so-called refugee crisis in 2015, movements to welcome refugees became widespread in Northern Europe. While numerous studies have documented the activities and motivations of these civic initiatives, few have investigated what became of them once the immediate situation was over. Based on fieldwork conducted between 2017 and 2020, this article explores the process of institutionalisation within Venligboerne (Friendly Neighbours) in Denmark. It focuses on debates about organisation and the challenges of maintaining a non-formalised structure in a society strongly marked by associational culture and close ties between the state and civil society. While responding to a transnational movement of people, Venligboerne represents a form of vernacular humanitarianism that is also deeply shaped by the social-cultural context in which it takes place. An ethnographic approach situating refugee relief initiatives within the local context is able to shed light on their political dimensions and potential for social change beyond the refugee context. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyse conflicting landscape associations linked to nature parks. Drawing from an R&D project in one of the largest former wetlands in Denmark, we examine how diversified landscape perceptions and conflicting landscape preferences result from and condition the re-enchantment of nature parks for tourism development. The case study relies on various procedures. First, a combination of local accounts and fieldwork observations of tourism and landscapes. Second, interviews with tourists and local stakeholders on processes of engagement and disengagement with conservation, restoration, and re-wilding processes. Third, collaborative mapping with local stakeholders and citizens and their imaginaries of local nature. By combining literature reviews with findings from the case study, we derive different social imaginaries among tourism entrepreneurs, property owners, farmers, industrial actors, local citizens, and NGOs. Six conflicting landscape imaginaries are identified that, to varying degrees, may apply to other nature parks. Each approach holds different human-nature relations and views on what needs to be sustained locally, and what landscapes need to be developed. We conclude that conflicting positions and preferences over landscapes (geo-positionalities) may hinder interventions for sustainable transition, and that mapping these landscape positionalities may be useful for deliberation in tourism development initiatives. [ABSTRACT FROM AUTHOR]

In this paper, we discuss the impact of artificial intelligence (AI) on innovation dynamics and argue that AI has affected innovation dynamics in at least two distinct ways. First, innovation using AI has unique dynamics that are characterised by data playing a central role and the increasing importance of external collaboration; however, data security and privacy issues also present new risks to external collaboration. When innovating in AI, collaboration with customers and competitors is critical, yet there are considerable risks associated with data sharing. Second, unique organisational challenges emerge during the diffusion of AI innovations, because adopting AI in an organisation not only results in the need for additional employee competencies but also challenges organisational power structures. We also discuss the merits of AI as a general purpose technology and argue that conclusions about AI in relation to innovation dynamics are likely to change when generative AI is widely adopted. [ABSTRACT FROM AUTHOR]

This study focuses on students' orientations towards multilingualism in a Swedish-speaking educational degree program in Finland. Swedish is one of the two national languages in Finland and basic education is provided separately in Finnish and Swedish, even if the current national policies strongly support multilingualism in education. We analyzed the language orientations in the students' coursework (N = 52) in an educational sciences degree program that has an emphasis on multilingualism and social justice. The results showed that multilingual identities and linguistic repertoires were presented as valuable, but the students rarely identified themselves as multilingual. They perceived multilingualism as a resource and a means for inclusion, but concurrently also saw challenges in balancing between protecting the minority language and multilingual practices. The connection between multilingualism and social justice was visible in the students' multiple and sometimes contradicting views, but the texts hardly raised questions of broader language-related societal inequality or discrimination. [ABSTRACT FROM AUTHOR]

Interprofessional collaboration between general practitioners (GPs) and community pharmacists (CPs) is important for ensuring antibiotics are used correctly and combating antibiotic resistance. The study's main objective was to investigate how CPs, GPs and patients, respectively, position CPs in their interactions with patients on antibiotic-related matters in Norwegian pharmacies. Seven focus-group interviews were performed. Data were analyzed using systematic text condensation. Positioning theory was used to identify positions assigned to CPs by themselves, by GPs and by patients. CPs position themselves as helpful, accessible drug specialists responsible for advising on antibiotic use, but also consider themselves dependent on GP-supplied information to do so. GPs position CPs as helpful, responsible businesspeople who, however, lack clinical experience and are overzealous gatekeepers. Patients position CPs as helpful people who supply information in "everyday language" and as the GP's extended arm. Patients utter they are best served when GPs and CPs collaborate. This discrepancy is a barrier to optimal service to patients in general, and to proper antibiotic use in particular. [ABSTRACT FROM AUTHOR]

In Head and Neck surgery Transoral Robotic Surgery (TORS) is evolving as a key treatment option for benign and malignant lesions in the oropharynx. Even so, postoperative pain is one of the primary early complaints following TORS. Well established evidence-based procedure specific pain treatment guidelines are available for a variety of other surgical specialties. However, there are no guidelines for TORS This review describes the available data of early pain intensity following TORS during rest and procedure related activity. Literature concerning pain in the immediate postoperative phase following TORS were obtained from two literature databases Most data on pain intensity following TORS are based upon a numeric rating scale, e.g. the Visual Analogue Scale and/or analgesic demands. Only one randomized clinical trial is available reflecting that the literature is mainly based on retrospective and a few prospective studies. Only one study analyzed pain during relevant functionality, i.e. swallowing. Overall, the studies suffer from a non-standardized approach and there is a need for transparent information concerning the timing of pain ratings and methodology The evidence for optimal pain control is limited, particularly during surgical relevant activity. Postoperative pain rating during activity is a fundamental element in pain trials in order to enhance recovery thereby calling for future consensus on assessment methodology [ABSTRACT FROM AUTHOR]

Pain is prevalent after most TransOral Robotic Surgery (TORS) procedures and may limit function i.e. swallowing. Currently, there is limited knowledge regarding optimal pain treatment in TORS. This clinical trial randomized patients to either a high-dose dexamethasone or low-dose dexamethasone treatment in addition to a multimodal basic analgesic protocol. The aim of the trial was to investigate the pain intensity during rest and swallowing using the Visual Analogue Scale (VAS) after TORS lingual tonsillectomy. Secondary outcomes were acceptable food consistency, nausea, vomiting, opioid rescue usage, length of hospitalization, feeding tube placements, readmissions, blood glucose levels and postoperative complications. The trial was conducted between August 2020 and October 2022. Eligible patients were patients scheduled for TORS-L treatment of obstructive sleep apnea syndrome or as part of the diagnostic work-up of head and neck carcinoma of unknown primary. Eighteen patients were and randomized 1:1. There were overall no significant differences between groups in the reported VAS scores during rest or swallowing (p ≥.05). Overall, there were no differences in the secondary outcomes. There were no differences in the pain intensity in the two treatment groups allocated to a basic multimodal analgesic package and either high-dose dexamethasone or low-dose dexamethasone treatment. The trial is the first RCT to include pain measurement during a procedure-relevant activity, thus creating a platform for future recovery studies. [ABSTRACT FROM AUTHOR]

The reported hospital length of stay (LOS) following transoral robotic surgery lingual tonsillectomy (TORS-L) is variable, with limited understanding of the factors requiring hospitalization and no evidence-based criteria for discharge. This observational cohort study investigated factors hindering discharge following TORS-L in a well-defined postoperative care program. Patients were included between August 2020 and October 2022. A discharge scheme was filled out twice daily, specifying the factor(s) for hospitalization among patients undergoing TORS-L. This trial was a sub-investigation of a national multicentre randomized clinical trial (RCT) testing the efficiency of high-dose dexamethasone on postoperative pain control. Participation in the RCT demanded admission to the fourth postoperative day as dexamethasone/placebo was given intravenously in repeated dosages till day 4 postoperatively. Eighteen patients were included in the analysis. The main factor for hospitalization was nutritional difficulties, while pain was a limiting factor for discharge only on the first postoperative 1-3 days. More than half of the patients could have potentially been discharged on postoperative day 2 when omitting the RCT treatment plan in the analysis. The study estimates that the majority of patients may be discharged on postoperative day 2 following TORS-L. [ABSTRACT FROM AUTHOR]

Being a subject matter expert does not make someone a good ins-tru-ctor. Most institutions do little to prepare first-time instructors. The Marine Corps puts new instructors of graduate-level programs through a rigorous 4-week program to prepare them as first-time instructors. They are exposed to adult learning theory, assessment processes, and classroom management and are given the opportunity to teach for the first time in front of peers who serve as the types of students who often -present problems for the first-time teacher. Following a similar approach, traditional institutions could ensure a more positive experience for first-time faculty and their students. [ABSTRACT FROM AUTHOR]

Discussions of site orientation in public art have often been framed by contrasting the temporal notions of permanence and temporariness. This article leans on cross-disciplinary theorization of infrastructure—and its attention to climate change—to suggest that we see a new type of artistic interest in reengaging with permanence in the form of infrastructure development and maintenance. Specifically, the article analyzes the case of Super Reef, an artistic project that aspires to construct at least fifty-five km2 of reef along the coastline of Denmark. The article unpacks the material, social, political, and aesthetic dimensions of Super Reef as performing a dynamic durationality of interspecies infrastructure. This dynamic durationality implies a recognition of the always-already-provisional and precarious quality of any infrastructure project, while still invoking aspirations for long-term commitment to reconcile, repair, and maintain multispecies environments. If site orientations in the 1990s and early 2000s favored temporary, mobile, and social forms of artistic interventions, contemporary site orientations are suggestively more concerned with reimagining new forms of durationality. [ABSTRACT FROM AUTHOR]

Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease, both regarding clinical presentation, response to treatment and outcome. Recently, subclassification of DLBCL based on mutational profile has been suggested, and next generation sequencing (NGS) analysis may be relevant as part of the diagnostic workflow. This will, however, often be based on analysis of one tumor biopsy. Here, we present a prospective study where multi-site sampling was performed prior to treatment in patients with newly diagnosed DLBCL. Two spatially different biopsies from 16 patients were analyzed using NGS with an in-house 59-gene lymphoma panel. In 8/16 (50%) patients, mutational differences were found between the two biopsy sites, including differences in TP53 mutational status. Our data indicate that a biopsy from the extra-nodal site may represent the most advanced clone, and an extra-nodal biopsy should be preferred for analysis, if safely accessible. This will help ensure a standardized stratification and treatment decision. [ABSTRACT FROM AUTHOR]

Atlantic salmon and rainbow trout with initial weights of 460–468 g were fed two diets either high in fish oil (FO) or rapeseed oil (RO) content. The abilities of the fish to metabolize and deposit lipid and n-3 fatty acids were compared. Growth rates, FCR, and fat digestibility were similar in both species. Rainbow trout showed higher condition factors and lower dress-out percentage and hepatosomatic index than salmon. Whole-body content of EPA and DHA were higher in both species fed the FO diet than in the RO diet, but indicated higher capacities to produce DHA in rainbow trout than in salmon. The total fat content in the RO group was lower and DHA higher in rainbow trout liver than in salmon, indicating a greater ability of rainbow trout to increase metabolism to DHA. [ABSTRACT FROM AUTHOR]

The article explores how epistemic inequality, similar to the trust we place in car mechanics, affects AI-supported medical decision-making and the ethical implications of co-reasoning. Topics discussed include the nature of epistemic superiority in professional interactions, the role of explainability and contestability in AI systems, and the balance between professional expertise and patient involvement.