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NIAAA's 2022 definition of recovery from alcohol use disorder (AUD) includes two core components, remission of DSM-5 AUD criteria and cessation of heavy drinking. This study's purpose was to assess patterns of AUD symptoms and heavy drinking in a heterogeneous national sample, in order to clarify the utility of the definition. Participants who self-reported having resolved an alcohol problem for at least 6 months were recruited through Amazon Mechanical Turk (N = 386) and surveyed about their problem severity, current drinking, and AUD symptomology. We used latent class analysis to discern meaningful clusters of AUD symptoms and heavy drinking, as well as factors associated with class membership. A two-class model was the best fit for the data. The first class, which we termed Less Symptomatic, included 83.4% of the sample. Individuals in this class were unlikely to endorse any of the 10 AUD criteria (<2.5% of the time) and 24.3% reported heavy drinking. In the second class (16.6% of the sample), termed Symptomatic, 45% of respondents endorsed at least one AUD criterion and 88.2% reported heavy drinking. These findings suggest that some individuals in recovery may continue to drink heavily with minimal problems, while others continue to experience AUD symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Most patients with pancreatic cancer who have undergone surgical resection eventually develop disease recurrence. ‍This study aimed to investigate whether there is evidence to support routine surveillance after pancreatic cancer surgery, with a secondary aim of analyzing the implementation of surveillance strategies in the Nordic countries. Materials and Methods: A scoping review was conducted to identify clinical practice guidelines globally and research studies relating to surveillance after pancreatic cancer resection. This was followed by a survey among 20 pancreatic units from four Nordic countries to assess their current practice of follow-up for operated patients. Results: Altogether 16 clinical practice guidelines and 17 research studies were included. The guidelines provided inconsistent recommendations regarding postoperative surveillance of pancreatic cancer. The clinical research data were mainly based on retrospective cohort studies with low level of evidence and lead-time bias was not addressed. Active surveillance was recommended in Sweden and Denmark, but not in Norway beyond the post-operative/adjuvant period. Finland had no national recommendations for surveillance. The Nordic survey revealed a wide variation in reported practice among the different units. About 75% (15 of 20 units) performed routine postoperative surveillance. Routine CA 19-9 testing was used by 80% and routine CT by 67% as part of surveillance. About 73% of centers continued follow-up until 5 years postoperatively. Conclusion: Evidence for routine long-term (i.e. 5 years) surveillance after pancreatic cancer surgery remains limited. Most pancreatic units in the Nordic countries conduct regular follow-up, but protocols vary. [ABSTRACT FROM AUTHOR]

There is an increasing demand for community-based palliative care services in regional Australia, but feasibility and economic benefits are unclear. This study describes the financial components of service delivery, economic viability from a provider perspective, and potential cost-savings from a health service perspective. We used case study methodology and obtained data from the service provider performance measurement data, annual reports, and internal records. Economic viability included an appraisal of all financial activity, cash on hand, total assets, and liabilities from July 2019 to June 2022. Direct service provision data determined the value for money given total costs and outcomes. Annual cost savings due to decreased utilisation of other healthcare services were estimated using case study data and cost estimates from the literature. The service is largely funded by the government (61%) and community donations & fundraising (34%). Applying a conservative cost estimate based on a reduction of healthcare use (hospitalisations and emergency admissions), cost savings are estimated to range from AU$730 000 to AU$980 000 per year for the cohort of n = 160 clients in the last year of life alone. Average costs per person per year of providing palliative care services were much lower for these clients (AU$6194) compared to the national average for in-home (AU$8000) or hospital-based palliative care services (AU$15 373). The case study site is a viable community-based service but is highly dependent on government funding. It provides excellent value for money from a health service perspective and provides cost saving. Future studies should investigate the generalizability of results. [ABSTRACT FROM AUTHOR]

The democratic potential of literature education has often been accentuated. In this article, we draw on Gert Biesta’s subjectification conception of democratic education, and view democracy as a concept open for (re)negotiation in the classroom. We are informed by Chantal Mouffe’s agonistic democratic theory, and its view of dissent as a foundational aspect of democracy, in that the struggle itself constitutes the identities of the opponents. Agonistic proposals for democratic education also pay attention to political emotions in the classroom. We pair agonism with Sara Ahmed’s view of emotion as performative to explore how power, identity and emotions are entangled in a student group and how this entanglement is integrated in the students’ conceptions of democracy. The students were in their last year of upper secondary school in Sweden. We analysed audio recordings from three group interviews with a total of eleven students. The interviews followed a literary discussion about the short story ‘Farangs’ by Rattawut Lapcharoensap, which was video recorded. The analysis shows that students referred to emotion when constructing the collective identities of themselves and their opponents, and that the power relations between these collective identities influenced what literary interpretations were centred in the discussion. [ABSTRACT FROM AUTHOR]

Vulvodynia, a long-term genital pain disorder with a high lifetime prevalence, profoundly impacts both the affected women and their partners. However, the experiences of these partners have been under-researched. Using Braun and Clarke’s thematic analysis, this qualitative study explored the experiences of male partners of women with vulvodynia. In individual interviews with seven men (20–32 years), four themes were identified: “Trying to be a good and caring partner,” “Fear of sexual and emotional rejection,” “Feelings of insecurity and being misled,” and “Keeping up the façade.” Despite efforts to support their partners, the men often faced rejection, leading to insecurities about their attractiveness, the relationship’s future, and their ability to conform to social expectations. They coped by concealing insecurities from their partners and overemphasizing traditional masculinity among peers. We discuss these results using sexual script theory, suggesting that gendered sexual scripts play a significant role in relationships with vulvodynia, with prevailing cultural assumptions regarding masculinity challenging men’s ability to be simultaneously caring and sexual. As a result, the men found themselves negotiating two contrasting ideals associated with masculine behavior: those of good caregiver and assertive, virile sexual partner. Our research suggests that male partners of women with vulvodynia tend to be left alone to deal with the resulting ambivalence and distress. Supporting these men could benefit both parties in managing vulvodynia. [ABSTRACT FROM AUTHOR]

Refugee young people in countries of first asylum navigate daily life through a set of deeply challenging, and often traumatic, structures, circumstances, and expectations. Attending to the complex interaction and relationship between identities, structures of legality, space and place facilitates an important critical lens to examine and understand refugee young people’s experiences, including their sense of belonging, hopes for the future and their conceptualisation of life stages of murahik (adolescence) and shabaab (youth) in shifting transnational spaces.Based upon participatory and exploratory research conducted in 2022 with Syrian & Iraqi refugee shabaab, this paper uses a socio-spatial justice framework which centres young people’s voices and explores the everyday places and spaces that these young people access, inhabit, frequent and avoid within the cities of Amman and Zarqa, the urban and economic heartland of Jordan.Using an approach which is sensitive to the role of identity, policy and structural constraint ensures plural insights into the spatial and mobile lives of young people and illustrates the diversity of their experiences, particularly highlighting the role of gendered identities and diverging refugee policies in impacting these diverse experiences, contributing to the growing research field on refugee youth and spatiality. [ABSTRACT FROM AUTHOR]

AbstractBackground: Cognitive impairment is observed in up to 50% of patients with amyotrophic lateral sclerosis (ALS). The Edinburgh Cognitive and Behavioral ALS Screen (ECAS) is an ALS-specific multi-domain screening tool. Few studies have examined the relationship between ECAS scores and [18F]fluorodeoxyglucose positron emission tomography ([18F]FDG-PET) findings. Objective: To assess the relationship between ECAS scores and glucose metabolism patterns on [18F]FDG -PET images in ALS. Methods: We collected [18F]FDG-PET images from 65 patients with ALS and 39 healthy controls. ECAS scores were collected on all patients and we calculated the correlation to [18F]FDG-PET in order to investigate the potential links between cognition and glucose metabolism. Results: We observed hypometabolism in the frontal cortex, insula, and limbic system, together with hypermetabolism in the cerebellum in patients with ALS compared to controls. A lower ECAS total score was associated with lower glucose metabolism in the right orbitofrontal gyrus and higher glucose metabolism in lateral occipital, medial occipital, and cerebellar regions, among patients with ALS. Similar results, although less widespread, were observed in the analyses of ECAS ALS-specific scores. Conclusions: The metabolic patterns in [18F]FDG -PET show that changes in the glucose metabolism of corresponding areas are related to cognitive dysfunction in ALS, and can be detected using the ECAS. [ABSTRACT FROM AUTHOR]

Antibiotic resistance is an increasing global threat, accelerated by both misuse and overuse of antibiotics. Most antibiotics to humans are prescribed in primary care, commonly for respiratory symptoms, and there is a need for research on the usage of and outcomes after antibiotic treatment to counteract antibiotic resistance. To evaluate symptom duration, treatment length, and adverse events of antibiotic treatment in children. Observational study at four out-of-hours services and one paediatric emergency clinic in Norwegian emergency primary care. 266 children aged 0 to 6 years with fever or respiratory symptoms. Duration of symptoms and absenteeism from kindergarten/school, treatment length, and reported adverse events. There were no differences in duration of symptoms, fever or absenteeism when comparing the groups prescribed (30.8%) and not prescribed (69.2%) antibiotics. This lack of difference remained when analysing the subgroup with otitis media. In the group prescribed antibiotics, 84.5% of parents reported giving antibiotics for 5-7 days, and 50.7% reported no difficulties. Adverse events of antibiotics were reported in 42.3% of the cases, the vast majority being gastrointestinal disturbances. Children with fever or respiratory symptoms experience similar duration of symptoms and absenteeism regardless of antibiotic treatment. A substantial number of parents reported adverse events when the child received antibiotics. Several parents experienced additional difficulties with the treatment, some ending treatment within day 4. NCT02496559; Results. Children with fever or respiratory symptoms treated at OOH services experience similar duration of symptoms or absenteeism, regardless of antibiotic treatment. Parents often choose to end antibiotic treatment prematurely due to adverse events, bad taste, or that they find treatment unnecessary. Children often experience adverse events when prescribed antibiotics, mainly gastrointestinal symptoms. [ABSTRACT FROM AUTHOR]

This paper makes three important contributions: to research on media and gender equality, specifically through the lens of gender equal sports coverage; to understanding the lived experiences of women in public service sports broadcasting, and to gender-sensitive public discourse and policy debates concerning the relationship between media and sport. In it, we examine industry attempts to achieve gender equal coverage in public service broadcasting (PSB) in Ireland and Sweden. The paper draws on a three-way dialogic exchange between the authors who, together, have sizeable professional and personal experiences of public service sports broadcasting, sports participation (from amateur to elite levels), and of voluntary sports coaching and administration. This novel exchange also responds to calls for greater insights into women's engagements with media. The paper concludes by considering current issues for PSBs in relation to gender equal coverage and suggesting potential future lines of enquiry. [ABSTRACT FROM AUTHOR]

Digital technology offers an opportunity for increased productivity in public organizations, but organizations struggle to gain revenue from their investments, known as the productivity paradox. This study examines the role and relations of digital adoption (DA), deliberate learning (DL), and managerial dynamic capability (MDC) on improving productivity in a digital transformation (DT) process in the Norwegian courts. The results show that DL had a strong impact on productivity and that MDC plays an important role in enabling DL processes. [ABSTRACT FROM AUTHOR]

Increased levels of digitalisation present major opportunities for efficiency in the oil and gas industry but can also contribute to new risks and vulnerabilities. Based on developments in the industry, the Norwegian Ocean Industry Authority (HAVTIL) has in recent years pursued targeted knowledge development and follow-up of company's digitalisation initiatives. This paper explores data collected through HAVTIL's audits of the development and use of automated systems within well operations. The analysis of the data resulted in the identification of five main topics related to the implementation of digital technologies. The five main topics were organisational complexity, follow-up and implementation of technology, analysis and documentation, user-interface and alarms and competence and training. Overall, the results support research findings within human factors and technology development, pointing out that there is a lack of focus on human factors in both development projects and in operations. In addition, this paper provides insight into how digitalisation initiatives are followed-up and explores the results from the analysis in light of the current developments in the industry. To investigate automated operations and human performance, three audits were performed by the Norwegian Ocean Industry Authority (HAVTIL). These audits have been used as case studies and the basis for this paper. Results from the analysis support research findings within the field of human factors and technology development, pointing out that there is a lack of focus on human factors in both development projects and in operations. [ABSTRACT FROM AUTHOR]

BackgroundObjectiveMethodsResultsConclusionPhysical therapists play a vital role in the Norwegian health care system, and their work environment may be a significant determinant for their wellbeing and job performance.1) Assess differences in work environment, mental health problems, and work engagement between physical therapists working in specialist versus municipal health care services. 2) Assess the relationships between work environment factors and work engagement and mental health problems.In this cross-sectional study, 273 physical therapists responded to the Survey for Workplace Health Promotion (response rate = 35%). Independent-sample t-tests, Pearson correlations, and multiple regression analyses were performed.This study did not find any significant differences between physical therapists working in Norwegian hospitals and therapists working in the municipal health care services. Analyses showed that general demands (β = 0.21), fragmented work tasks (0.18), predictability (−0.17) and social support (−0.34) were associated with mental health problems, while meaningful work (0.41), the opportunity to use one’s strengths and potential (0.14), and social support (0.25) were associated with higher work engagement.This study highlights the role of poor job design and professional isolation as hindrances to work engagement among physical therapists, whereas work related meaningfulness and peer support promote their health and wellbeing. [ABSTRACT FROM AUTHOR]

A minority of the patients who search for online health information report discussing or having an intention to discuss this information with their healthcare provider. Not discussing online health information inhibits the provision of patient-centered care and limits the healthcare provider's possibility to tackle misinformation. Within the confines of the linguistic model of patient participation, we first provide an overview of barriers to discussing online health information during consultations. Second, we pinpoint which of these barriers indicate a need for improvement. Participants from the Netherlands (N = 300) completed a survey that measured the communication barriers (N = 15) as identified based on previous literature and interviews. Using the QUality Of Care Through the patient's Eyes (QUOTE) approach, we measured the extent to which a specific factor was a barrier ("importance") and assessed whether the barrier would withhold patients from discussing online health information ("performance"). Scores on importance and performance were multiplied to identify which barriers show the most significant room for improvement. Especially "preferring to discuss other matters" often occurred. Nine barriers showed a moderate need for improvement. We discuss the implications of these findings for healthcare providers in consultations. Future research should include observational data to analyze communication barriers to discussing online health information in consultations. [ABSTRACT FROM AUTHOR]

The older adult population in the United States is projected to grow significantly due to improvements in healthcare and sustained population growth. Adults aged 65 and older experience unique risks for, and consequences of, substance misuse. This End Page applies recovery capital theory to outline the distinctive physical, social, human, and community and cultural forms of recovery capital for older adults. Based on this conceptualization, we provide directions for examining recovery from substance use disorders among older adults. [ABSTRACT FROM AUTHOR]

Using the Risk and Vulnerability Assessment (RVA) as a lens, this study examines the making of risk communication in Swedish municipalities by comparing two central professions in this work, safety and communication. Sweden's decentralised responsibility for risk preparedness means that municipalities are given a central role in promoting increased preparedness among residents and local actors. However, there is little guidance on how to organise the work and how to coordinate between the different professions involved. Municipal officials are tasked with developing strategies to implement national policies, including conducting and communicating RVA. The study is comparing two central professions in Swedish municipalities' risk communication, safety, and communication, to analyse their views on central tasks and perceptions of their practice. The theoretical approach is based on risk communication and institutional theory, and the empirical material consists of an interview study with both safety and communication officers (N = 36). The findings reveal that while both professional logics are active in municipal risk communication, interactions, and negotiations between them are somewhat limited. The organisational structure of the RVA favours the logic of safety officers, which has implications for how risk communication is made in practice. The article concludes by discussing what effect this may have on preparedness. [ABSTRACT FROM AUTHOR]

ObjectiveWhile college can be a period of exploration, it is also marked by risky alcohol use. Brief alcohol screening and intervention for college students (BASICS) has yet to be used in the telehealth platform among minority students. This study assesses the short-term outcomes of a pilot telehealth brief alcohol abuse intervention for students attending a Hispanic Serving Institution (HSI). Participants: One hundred and fifty-two students attending a large public university participated. MethodsStudents participated in a BASICS-adapted telehealth brief intervention with a certified alcohol counselor. Baseline and 30-day follow-up surveys were completed electronically. ResultsThere were significant changes in drinking behaviors at 30-day follow-up after participating in the telehealth pilot among high-risk drinkers. ConclusionTelehealth interventions are accessible and convenient for students at a HSI, and brief alcohol interventions adapted from BASICS utilizing telehealth can significantly impact alcohol use behaviors. [ABSTRACT FROM AUTHOR]

Legumain is known to be regulated in atherosclerotic disease and may have both pro- and anti-atherogenic properties. The study aimed to explore legumain in individuals with familial hypercholesterolemia (FH), a population with increased cardiovascular risk. Plasma legumain was measured in 251 subjects with mostly genetically verified FH, of which 166 were adults (≥18 years) and 85 were children and young adults (<18 years) and compared to 96 normolipidemic healthy controls. Plasma legumain was significantly increased in the total FH population compared to controls (median 4.9 versus 3.3 pg/mL, respectively, p < 0.001), whereof adult subjects with FH using statins had higher levels compared to non-statin users (5.7 versus 3.9 pg/mL, respectively, p < 0.001). Children and young adults with FH (p = 0.67) did not have plasma legumain different from controls at the same age. Further, in FH subjects, legumain showed a positive association with apoB, and markers of inflammation and platelet activation (i.e. fibrinogen, NAP2 and RANTES). In the current study, we show that legumain is increased in adult subjects with FH using statins, whereas there was no difference in legumain among children and young adults with FH compared to controls. Legumain was further associated with cardiovascular risk markers in the FH population. However the role of legumain in regulation of cardiovascular risk in these individuals is still to be determined. [ABSTRACT FROM AUTHOR]

The One, by theoretical physicist Heinrich Pas, reviews the history of monism from the Greeks to the modern period. Pas proposes a monism he calls "the One." His One follows from quantum mechanics. It is a universal wave function. He is then faced with how our everyday world arises. To answer he relies on a version of Evert's many-worlds interpretation of quantum mechanics and a process of decoherence that results in a dualism of consciousness and the quasi-classical world of space, time, and matter. C. G. Jung proposed a dual-aspect monism influenced by synchronicity. A comparison between Pas's monism and dualism and Jung's finds some apparent differences, but in the end they are found to be remarkably similar. [ABSTRACT FROM AUTHOR]

Understanding why patients seek informational and/or emotional support online is fundamental to providing patients with accurate and reliable support that is tailored to their needs, preferences, and personal situation. Based on the stress and coping theory and uses and gratifications theory (UGT), this study aimed to identify theoretically-founded profiles of cancer patients differing in their motives for seeking informational and/or emotional support online, and to compare the profiles in terms of patients' psychological and background characteristics, and perception of health care services. Hierarchical cluster analysis was conducted, using questionnaire data from patients visiting a large Dutch health website (N = 181). This revealed three distinctive profiles, i.e., overall seekers (n = 83, 46.0%), occasional information seekers (n = 83, 46.0%), and contact exchangers (n = 15, 8.0%). Patients across these profiles differed in their eHealth literacy, with the contact exchangers being more eHealth literate than the overall seekers and occasional information seekers. The results can be used to create awareness among health care providers, web designers, and patient organizations on different types of cancer patients with different motives for seeking informational and/or emotional support online, and help them to tailor recommendations to and development of (online) sources that fit patients' needs. Future research could further investigate the integration of stress and coping theory with UGT by acknowledging the interplay of different coping strategies and different gratifications. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to identify final-year medical students' experiences with thought-provoking and challenging situations in general practice. Design setting and subjects: We conducted a qualitative analysis of 90 reflective essays written by one cohort of Norwegian final-year medical students during their internship in general practice in 2017. The students were asked to reflect upon a clinical encounter in general practice that had made a strong impression on them. A primary thematic content analysis was performed, followed by a secondary analysis of encounters that stood out as particularly challenging. Main outcome measures: Clinical scenarios in general practice that make students feel professionally 'caught off guard'. Results: The analysis identified several themes of challenging student experiences. One of these was 'disorienting encounters' for which the students felt totally unprepared in the sense that they did not know how to think and act. Five different scenarios were identified: (1) patients with highly distracting appearances, (2) 'ordinary consultations' that suddenly took a dramatic turn, (3) patients who appeared unexpectedly confrontational or devaluating, (4) scornful rejection of the young doctor's advice, and finally, (5) confusion related to massive contextual complexity. Conclusions: Disorienting encounters stood out as particularly challenging clinical experiences for medical students in general practice. These scenarios evoked an acute feeling of incapacitation: not knowing what to think and do. Further curriculum development will focus on preparing the students to 'know what to do when they don't know what to do'. [ABSTRACT FROM AUTHOR]

Using a large data set of online media content in eight European countries, this paper broadens the empirical investigation of the online hostility hypothesis, which posits that interactions on social sites such as blogs and forums contain more hostile expressions toward minority groups than social interactions offline or in editorial news media. Overall, our results are consistent with the online hostility hypothesis when comparing news media content with social sites, but we find that negatively charged representations are common in both media types. It is instead the amount of attention to Muslims and Islam on social sites that most clearly differs and is the main driver of online hostility in the online media environment more broadly conceived. [ABSTRACT FROM AUTHOR]

Basella alba (B. alba) is known for health benefits owing to its beneficial phytochemicals. This study aimed to process B. alba leaves into candies which has prolonged shelf life. B. alba candy was analyzed for the physicochemical characteristics like color, pH, titratable acidity, total soluble solid, moisture content, water activity, texture profile analysis. During storage, significant increase in TSS and TA, while a nonsignificant increase in water activity was observed. pH and moisture contents were found to decrease significantly during storage at both ambient and accelerated temperature. Hardness and adhesion of candy showed significant decrease upon storage at both ambient and accelerated temperature. Yeast and mold count of 100 cfu/g suggests that the candies were safe for human consumption during storage at both ambient and accelerated temperature and the desired sensory characteristic of the candy was retained for 28 days at ambient temperature and less than 14 days at accelerated temperature. [ABSTRACT FROM AUTHOR]

The demand for mineral resources is increasing mining activities worldwide. In Norway, marine tailing disposal (MTD) is practiced, introducing mineral particles into fjord ecosystems. We investigated the effects of two concentrations (high and low) of fine tailings from a CaCO3 processing plant on early life stages of the marine copepod Calanus finmarchicus. Results show that the exposure did not significantly impact hatching success or development in non- and early feeding life stages. However, feeding stage nauplii ingested tailings, which caused a significantly slower development in later nauplii stages in high exposure groups, with most individuals being two stages behind the control group. Further, high mortality occurred in late nauplii and early copepodite stages in low exposure groups, which could be caused by insufficient energy accumulation and depleted energy reserves during development. Individuals exposed to high exposure concentrations seemed to survive by arresting development and potentially by reduced activity, thereby conserving energy reserves. In nature, slower development could affect lipid storage buildup and reproduction. [ABSTRACT FROM AUTHOR]

Responsibility frames on social media could shape recipients' responses toward people with depression, which is crucial for the public (de)stigmatization of the mental disorder. Thus, the present study examines the effects of different responsibility frames (individual, social, combination) in Instagram-posts about depression on respondents' related attributions as well as their emotional and behavioral reactions toward people suffering from the illness. Our online-experiment (N = 1,015) revealed that frames emphasizing the responsibility of one's social network (e.g. family, friends and professionals) for depression, i.e. social frames, strengthened participants' attributions to the social network, i.e. social attributions, most effectively. Individual frames, however, primarily intensified individual attributions to those affected by depression. Contrary to previous findings, a combination frame did not prove to increase recipients' social attributions more than a one-sided social frame. For emotional and behavioral responses, we did not find any effects of responsibility frames compared to the control group–possibly due to buffering effects of the narrative structure of the Instagram posts. [ABSTRACT FROM AUTHOR]

This article explores imaginings of transgender ageing, and more specifically visions of transfeminine ageing futures, through an analysis of the auto-fictional novel Q by Swedish author Fredrik Ekelund. The novel tells the story of Fredrik, who comes out as transvestite at the age of 60, and subsequently struggles to come to terms with and explore their transfeminine identity as Marisol. Overall, cultural representations of lesbian, gay, bisexual, transgender and queer ageing are rare, and often tell tales of misery. As such, Q is a unique example of a complex and relatively positive narrative of transgender ageing. On the one hand, transgender ageing is portrayed as a potential escape from both time and growing old, a form of "rebirth". On the other hand, failure emerges as a constant threat, including both the failure to perform age-appropriate femininity and failure in the sense of becoming stuck with self-loathing and shame. The protagonist's struggles to age successfully become intimately connected with pride and standing up for oneself, struggles that are in turn bound to homonationalist discourses of Scandinavian progressiveness and LGBT exceptionalism. [ABSTRACT FROM AUTHOR]

When news stories cover health and illness, they often address issues of responsibility. These responsibility frames can affect recipients' responsibility beliefs (i.e. attributions) and thereby indirectly affect emotions and motivation to support people affected by health problems. To date, it is not fully understood how responsibility frames affect social support intentions, and if attributions and emotions mediate this effect. In an online experiment with N = 1,088 German participants, we tested the effects of responsibility frames (individually controllable vs. non-controllable) for type 2 diabetes and depression on social support intentions through responsibility attributions and emotional reactions. Mediation analyses show that responsibility frames indirectly affect social support intentions through social-societal attributions and sympathy. This mediation effect was observed in both depression and type 2 diabetes, despite issue-specific differences in attributions, emotions, and social support intentions. We discuss these findings considering framing effects research and health reporting. [ABSTRACT FROM AUTHOR]

A growing strand of studies either analyzes the effects of age or gender diversity on team performance. We contribute to this literature by analyzing whether there is a gender-specific impact of age diversity on team performance. Based on the categorization-elaboration model, we first predict that age diversity in teams leads to better team performance. Second, we hypothesize that gender-mixed teams with age diversity perform significantly worse than single-sex teams with age diversity. Our research question is analyzed for biathlon relays of the seasons 2009/10–2016/17. We apply pooled OLS, Tobit and random effects regressions to explain the relay's shooting precision by the relay's age diversity and the gender composition including several controls. The empirical analysis for male, female and gender-mixed professional biathlon relays supports our first hypothesis. Moreover, gender-mixed teams significantly outperform all-female teams. Implications of this finding are that sport officials and coaches of professional athletes, should be aware of the positive effect of age diversity on team performance but consider that this link might depend on the gender composition of the respective team. [ABSTRACT FROM AUTHOR]

As in several other European countries, the end of the last century in the Netherlands saw the emergence of a multicultural literature written by second-generation immigrants. Unlike writers of Moroccan origin, however, Turkish-Dutch authors are barely visible in the literary field, with two notable exceptions: Özcan Akyol and Murat Isik. How and why did these writers achieve a breakthrough in the past decade with their respective novels Eus (2012) and Wees onzichtbaar ['Be invisible'] (2017)? My analysis covers not only textual aspects such as theme and style, but also literary sociological factors, in particular, the awarding of prizes, authors' self-fashioning and media exposure, and reader appreciation. To this end, I use both professional criticism and amateur reviews posted on Bol.com, the Dutch market leader in online book sales, and Hebban.nl, the largest online reader community in the Netherlands. The bestselling status of the two novels appears to be due to different factors: while the success of Wees onzichtbaar is entirely the result of high praise from both literary critics and consumer reviewers, in the case of Eus, Akyol's strong television and social media presence clearly contributed to the book's success. [ABSTRACT FROM AUTHOR]

This scoping review addresses peer-reviewed research on musical interaction with children and young people with severe/profound intellectual and multiple disabilities (S/PIMD). Twenty-five articles published between the years 2000 and 2020 met the inclusion criteria. A narrative synthesis was used to summarise and evaluate different features, including participant characteristics, study design and methods, type of musical interaction, the abilities and behaviours in focus, reported benefits, promising components of musical interaction, and quality appraisal of the studies. The results revealed a variation in participant characteristics and study designs, where small-sample descriptive case studies were most common. In terms of the type of musical interaction, active music therapy was the most commonly used approach, followed by technology-mediated and multisensory musical activities. In terms of abilities and behaviours, a large majority of the studies focused on social interaction and communication, followed by engagement, attention and affect. Six categories were identified as promising components of musical interaction: the responsivity of the interaction partner, singing songs, structure and predictability in the activities, long-term interventions, technology-mediated and multisensory musical activities, and a therapeutic alliance between interaction partners. Based on this review, we discuss future research and practical implications for musical interaction and music therapy for children and young people with S/PIMD. [ABSTRACT FROM AUTHOR]

Background: Pharmacist's involvement in optimizing medication adherence among diabetic patients has been implemented for over a decade. Diabetes Medication Therapy Adherence Clinic (DMTAC) was set up to educate diabetic patients, monitor treatment outcomes, and manage drug-related problems. While evidence shows that pharmacist-led DMTAC was effective in reducing HbA1c, there was limited data regarding the impact of different intervention types and default to follow-up on glycemic control. Aim: To assess the impact DMTAC on glycemic control and the difference in glycemic control between hospital and health clinic settings as well as defaulter and non-defaulter. In addition, the impact of pharmacist's interventions, DMTAC follow-up frequencies, and duration of diabetes on glycemic control were also determined. Methods: A retrospective study was conducted among diabetes patients under DMTAC care between January 2019 and June 2020 in five hospitals and 23 primary health clinics. Patients' demographics data, treatment regimens, frequencies of DMTAC visits, defaulter (absent from DMTAC visits) and types of pharmacists' intervention were retrieved from patients' medical records and electronic database. HbA1c was collected at baseline, 4–6 months (post-1), and 8–12 months (post-2). Results: We included 956 patients, of which 60% were females with a median age of 58.0 (IQR: 5.0) years. Overall, the HbA1c reduced significantly from baseline (median: 10.2, IQR: 3.0) to post-1 (median: 8.8, IQR: 2.7) and post-2 (median: 8.3, IQR: 2.6%) (p < 0.001). There were 4317 pharmacists' interventions performed, with the majority being dosage adjustment (n = 2407, 55.8%), followed by lab investigations (849, 19.7%), drugs addition (653, 15.1%), drugs discontinuation (408, 9.5%). Patients treated in hospitals received significantly more interventions than those treated in primary health clinics (p < 0.001). We observed significantly less reduction in HbA1c in DMTAC follow-up defaulters than non-defaulters after 1 year (− 1.02% vs. − 2.14%, p = 0.001). Frequencies of DMTAC visits (b: 0.19, CI: 0.079–0.302, p = 0.001), number of dosage adjustments (b: 0.83, CI: 0.015–0.151, p = 0.018) and number of additional drugs recommended (b: 0.37, CI: 0.049–0.691, p = 0.024) had positive impact on glycemic control whereas duration of diabetes (b: − 0.0302, CI: − 0.0507, − 0.007, p = 0.011) had negative impact. Conclusion : Glycemic control improved significantly and sustained up to one year among patients in pharmacists-led DMTAC. However, DMTAC defaulters experienced poorer glycemic control. Considering more frequent visits and targeted interventions by pharmacists at DMTAC resulted in improved HbA1c control, these strategies should be taken into account for future program planning. [ABSTRACT FROM AUTHOR]

Interprofessional collaboration among welfare services is a policy objective promoted to ensure successful service provision to people with complex needs. In the Nordic region, people who are not in education, employment, or training often have challenging life situations requiring help from a multitude of services. In Norway, significant political and institutional efforts focus on implementing policies that support collaboration. However, we know little about how service workers formalize joint efforts. In this study, I used institutional ethnography to explore how interprofessional collaboration was constructed through negotiations of collaborative agreements among leaders of welfare services and how such negotiations are consequential for collaborative practices. I explored two cases of negotiations initiated by the leader of the Norwegian Labor and Welfare Administration. The negotiations were with the local child welfare and protection services and Refugee services, focusing on the transition of care regarding youth and refugees. The data includes two collaborative agreements between the services, an observation of the negotiation of one agreement, and 10 interviews with leaders and staff. Results show that collaboration is constructed based on holistic service provision. The negotiations, however, do not result in such collaborative practices, but are characterized by the demarcation of responsibilities and work. [ABSTRACT FROM AUTHOR]

Working environment, work engagement and health among occupational and physical therapists in Norway have rarely been investigated. (1) To compare the psychosocial working environment, work engagement and mental health problems of occupational therapists with those of physical therapists; (2) to compare the same measures among occupational therapists working in the specialist and municipal healthcare services, respectively; and (3) to identify job demands and resources that influence the work engagement and mental health problems of occupational therapists. The Survey for Health Promoting Workplaces was used to collect data from 170 occupational therapists and 273 physical therapists (response rate =35%) working in specialist and municipal health care in Norway. Student's t-test, Pearson correlations and multiple regression analysis were used. Occupational therapists experienced higher job demands and poorer health than physical therapists. Occupational therapists in the municipal healthcare services were slightly more satisfied with their job resources than colleagues in specialist healthcare services. Meaningful work and the opportunity to use one's strengths and potential contributed the most to high work engagement. Low work engagement was the most important contributor to poor mental health. The mental health of occupational therapists seems to be closely related to the opportunity to perform high-quality therapy. It is important that work is organised so that occupational therapists have meaningful work tasks and opportunity to use their strengths and potential. [ABSTRACT FROM AUTHOR]

Ancient and traditional cultures have claimed another realm exists beyond everyday experience that can be accessed by shamanic and divination methods. Modern science views such claims with suspicion. Evidence is presented that this may be changing. Carl Jung proposed a conscious realm and an unconscious realm—the unconscious realm included the personal unconscious and the collective unconscious. Later, with his theory of synchronicity, he proposed a material realm and a psychic realm arising from a unitary realm. This essay follows Jung's colleague, Marie-Louise von Franz, and her efforts to identify ideas in science similar to Jung's. Von Franz found two French scientists with two realms similar to what Jung proposed: Olivier Costa de Beauregard and Albert Lautman. At the time von Franz published Divination and Synchronicity, quantum physicist David Bohm likewise proposed two realms: an implicit order and an explicit order. Recently, English physicist and Anglican priest Sir John Polkinghorne published his version of two realms. Contemporary physics claims there is an everyday world modeled by causal mechanistic science and a different quantum realm. This leads a contemporary physicist to sound like a shaman or diviner. The examples just considered are theoretical. In contrast, two examples from experimental physics—the hydrogen spectrum and Shaw's dripping faucet—embody a realm of time and a timeless pattern. The evidence considered supports Polkinghorne's suggestion that changes are underway, transforming science in ways similar to Jung's and von Franz's dual realms. [ABSTRACT FROM AUTHOR]

This paper is based on a questionnaire of all Danish Orientation & Mobility instructors, assessing the importance of 34 physical elements as clues in the pedestrian environment to support blind and visually impaired people (BVIP)'s orientation. The aim is to contribute to a body of knowledge about why the design of physical elements is so crucial for (BVIP)'s orientation, accounting for the perceptual sight function and using other senses to compensate for the impaired vision. The study shows that all elements were generally assessed as being very important. Furthermore, the paper discusses how to plan urban space in the future. [ABSTRACT FROM AUTHOR]

Policy-makers need to know whether they can afford those effects, whether they could have achieved them more cheaply through other interventions, and what the opportunity costs are across other outcomes, sectors, and interventions. The arguments for including cost-analysis when assessing the effectiveness and benefits of policies and interventions are compelling: in a world of limited resources, it is not enough to know whether an intervention has an effect on the desired outcomes, such as improved early-grade reading, nor even the size of the effect. [Extracted from the article]

To evaluate the long-term effects of a multilevel community intervention to improve the quality of prescription practice of potentially addictive medications (PAMs). We conducted a retrospective study, using anonymized data from the Norwegian prescription registry. Based on an initiative from the GPs in Molde Municipality in Norway, a multilevel community intervention was initiated by the municipal chief physician in 2018. The intervention targeted GPs, patients, and the public. We retrieved prescription data from 26 of 36 GPs. By using the standardized defined daily dose (DDD), we compared prescription of three groups of PAMs from before the intervention (2017) throughout the intervention in 2018, and through 2020 to determine long-term effects. Three years after the intervention, the GPs in our study sample prescribed 26% less opioids, 38% less benzodiazepines, and 16% less z-hypnotics. Overall prescription of PAMs decreased by 27%. The number of individuals receiving at least 90 DDD of benzodiazepines and z-hypnotics were reduced from 9 to 7 and 34 to 24 per 1000, respectively. Also, the number of individuals receiving two and three PAMs concomitantly were reduced. Addressing prescription practice among GPs in a community as a joint intervention, combined with addressing patients and the public may be a feasible method to obtain long-term reduction of PAM prescriptions. Non-therapeutic prescriptions of potentially addictive medications (PAMs) are both a public health concern and a frequent challenge in general practice. A multilevel community intervention, targeting general practitioners, patients, and the public, led to 27% reduction in prescription of PAMs. Both the number of daily users and concomitant use of several PAMs were reduced. The reduction in prescription persisted for three years. [ABSTRACT FROM AUTHOR]

New sexual scripts on later life are emerging, discourses on "sexy oldies" challenge pervasive discourses on asexual old age. Still, sexuality among people with dementia, who are generally older, is rarely affirmed. Research on sexuality and dementia is, moreover, dominated by biomedical accounts that regard sexual and intimate behaviours as expressions of pathology. However, sexuality and intimacy could be significant aspects of later life, also when living with dementia. This qualitative study explores experiences of sexuality and intimacy among heterosexual couples where one partner was diagnosed with Alzheimer's disease. Interviews were conducted with seven couples, aged 55–87, and both the person with the dementia diagnosis and their partner participated. The findings point to a diversity of experiences, with differences between the older and younger couples. The older couples experienced changes more as a result of embodied ageing, and sexuality and intimacy were experienced as sources of pleasure, comfort and recognition. The younger couples understood changes more as caused by Alzheimer's disease and experienced a greater loss of intimacy and desire. The study shows how experiences of sexuality and intimacy when living with dementia are shaped by varying sexual scripts and expectations of health in different parts of the life course. [ABSTRACT FROM AUTHOR]

Eminent historians reflect on the creation, evolution, and in some cases the destruction of the field of military history's 'grand narratives,' 'master narratives', or 'metanarratives' over the past forty years in the following areas: race and the history of the modern US military; Asian military history; US military history; African military history: Europe 1789 to 1900; European history since 1914; wars of decolonisation; explanations of Confederate defeat; gender and war; and early modern European warfare. [ABSTRACT FROM AUTHOR]

Background: Opioid-related overdose deaths recently accelerated. In response, overdose education and naloxone distribution (OEND) has been implemented widely, though access remains sparse in rural Appalachia. Despite increasing OEND, risk factors for non-evidence-based overdose responses among the training-naïve remain unknown. Methods: We enrolled 169 adults who use prescription opioids non-medically and reside in rural West Virginia (August 2014-March 2015). Participants were interviewed about witnessing overdose (lifetime and prior-year), characteristics of the most recent overdose, responses to the overdose, and OEND acceptability. Logistic regression was used to assess factors associated with non-evidence-based responses to overdose. Results: Among the 73 participants who witnessed an opioid-related overdose, the majority (n = 53, 73%) reported any non-evidence-based responses. Participants were significantly more likely to report a non-evidence-based response when victims were unresponsive (OR = 3.36; 95% CI = 1.07, 10.58). Common evidence-based responses included staying with the victim until help arrived (n = 66, 90%) and calling 911 (n = 63, 86%), while the most common non-evidence-based responses were hitting or slapping the victim (n = 37, 51%) and rubbing the victim with ice or placing them in a cold shower or bath (n = 14, 19%). While most (n = 60, 82%) had never heard of OEND, the majority (n = 69, 95%) were willing to train, particularly those reporting non-evidence-based responses (n = 52, 98%). Conclusions: These findings underscore the need to expand access to OEND in rural communities and indicate OEND is acceptable to training-naïve individuals who use opioids in rural Appalachia. Given the "harm reduction deserts" in the region, approaches to expand OEND should be pursued. [ABSTRACT FROM AUTHOR]

Temporary protection is increasingly presented as a 'novel approach' to displaced people that have crossed an international border as it can provide a level of protection and access to basic social services for a defined time period. This paper calls into question the objectives of such measures by highlighting the geopolitical context in which they operate. We argue that while temporary arrangements, particularly in so-called 'transit' countries, may address humanitarian needs of displaced people, they also embed precarity and temporality into protection norms. Combined with polices that externalise migration management, they risk normalising the exclusion of individuals from avenues to permanent protection in a country that they feel safe. By analysing the potential implications of holding temporary status, with recipients' well-being and permanent status application in mind, an alternative lens is provided. Using examples of temporary protection mechanisms in Turkey and Mexico, we argue that a deeper critical assessment is needed to understand their impact for people. [ABSTRACT FROM AUTHOR]

Immediate breast reconstruction (IBR) is an integral part of modern breast cancer treatment. Our aim was to investigate patient experience with implant loss after IBR by using interpretative phenomenological analysis (IPA). We conducted semi-structured interviews with eight informants. We analyzed data according to the IPA flexible seven-stage process and four main themes were developed: immediate breast reconstruction as the indisputable choice, a difficult experience, an altered body: redefining normality, and trying to cope. The experience of implant loss appears to affect women for many years and might overshadow some of the benefits of IBR. [ABSTRACT FROM AUTHOR]

The demand for the Dongfeng Highway connecting Dongshi and Fengyuan, Taiwan, originates from a 7.3 ML earthquake disaster affecting residents' medical treatment and material transportation. The Dongfeng Highway route selection was identified as the socioscientific issues (SSI) and the Decision Factors Table and SageModeler (two representational modelling tools) were used to design a teaching module with two Generation-Evaluation-Modification modelling cycles. This study aims to explore the impacts of the Modelling-based SSI (M-SSI) teaching module on 23 preservice teachers' (PSTs) plans, factor dimensions, and quality of decision making. The results indicated that the PSTs focused on the original purpose of constructing the Dongfeng Highway; therefore, the Fengshi plan, which has advantages in safety, economy, and ecology, was chosen by most participants. Initially, PSTs focused only on 'relevance to the topic' factor and few relationships among other factors. However, they improved their decision quality by focusing on 'comparability and measurement' and 'sufficient evidence or justification' factors and more vertical relationships among factors after completing the module. Although the PSTs' horizontal relationships among factors still need to be strengthened, they demonstrated significant increases in factor, relationship, and overall scores with large effect sizes, indicating that the M-SSI teaching module can improve decision quality. [ABSTRACT FROM AUTHOR]

In Denmark there is an ongoing trend towards a more ambitious literacy instruction in the first school year (Kindergarten). This calls for a clarification of present-day reading levels, and for a profile of the students who become readers while attending the semi-formal literacy program. The present study examined the extent to which a group of 209 Danish students had acquired word reading skills after 7 months of schooling, and whether reading levels in this group could be predicted from new measures of extended letter-sound knowledge and measures of memory skills. Results showed that 28% had acquired basic word reading skills. Further, measures of extended letter-sound knowledge explained significant variance above the measure of the fluency with which letters were named. Moreover, short term memory capacity was a stronger predictor of word reading compared to working memory and explained modest variance in reading after controlling for letter knowledge. [ABSTRACT FROM AUTHOR]

Adverse life experiences increase the risk of health problems. Little is known about General Practitioners' (GPs') thoughts, clinical concepts, and work patterns related to eliciting, including, or excluding their patients' stories of painful and adverse life experiences. We wanted to explore GPs' perceptions of the medical relevance of stories of painful and adverse life experiences, and to focus on what hinders or facilitates working with such stories. Eighteen Norwegian GPs participated in three focus group interviews. The interviews were analysed using reflexive thematic analysis. The participating GPs' views on the clinical relevance of patients' painful and adverse experiences varied considerably. Our analysis revealed two distinct stances: a confident-accepting stance, and an ambivalent-conditional stance. GPs encountered barriers to exploring such stories: scepticism on behalf of the medical discipline; scepticism on behalf of the patients; and, uncertainty regarding how to address stories of painful and adverse experiences in consultations. Work with painful stories was best facilitated when GPs manifested personal openness and prepared availability, within the context of a doctor-patient relationship based on trust. Clearer processes for handling biographical information and life experiences that affect patients' health are needed to facilitate the work of primary care physicians. [ABSTRACT FROM AUTHOR]

Injecting drug use is one of the leading risk factors for infections and drug-related deaths. Despite these risks, many people who inject drugs (PWID) continue to inject despite access to alternative intake methods. In this study, we explore this seemingly paradoxical attraction. We conducted 80 qualitative interviews with PWID, recruited from low threshold settings in five Norwegian cities, where we focus on the process of injection initiation and why PWID maintain such behaviour over time, despite associated negative consequences. The analysis shows how participants' experiences evolved from a fear of the needle, to embracing it as a meaningful practice. First, this involved social interaction and learning from other PWID, second, appreciating the intensity and speed of the intoxication, third, the positive ritual aspect of injecting, and finally, a devaluation of other modes of use. The study thereby helps expand upon and provide new understandings of the interactional process and cultural context of drug use, in which the interplay of social factors influences individual actions and promotes injecting over other modes of use. Future interventions for reducing the number of PWID thus need to consider how various social contexts impinge on, or even encourage, injecting drug use. [ABSTRACT FROM AUTHOR]

Objectives: Human nutrition plays an important role in prevention or at least slowing down the progression of age- and diet-related diseases. Thereby, mitochondrial dysfunction represents one common underlying mechanism, which is being investigated in mouse models. However, the influence of the selected diets in preclinical studies on cognition and mitochondrial function has not yet been reported cohesively. Methods: Therefore, we present the results of three different studies that addressed this question. First, we investigated the influence of two standard control chow diets and a special diet low in antioxidants over 6 months in aged NMRI mice. Additionally, a 70% high-fat (HF) chow diet as well as a western-style diet (WSD) rich in lard and fructose were examined in C57/BL6 mice. Cognitive performance, mitochondrial function and bioenergetics in the brain were investigated. Moreover, cerebral expression of genes involved in biogenesis and antioxidant defence (citrate synthase, complex I, complex IV, SOD2, Cat1, GPx-1) were quantified. Results: The results show that a modified, low antioxidant diet increased ATP levels in the brain of aged mice, while cognitive functions remained largely unaffected. A HF diet also showed significant effects on ATP levels and gene expression levels of relevant antioxidant markers, while the WSD had marginal effects on mitochondrial function and bioenergetics in the brain. Discussion: Our results indicate that standard- and special diets have an impact on cognition and mitochondrial function in the brain. Thus, appropriate caution is warranted when selecting a suitable diet for preclinical studies in mice. [ABSTRACT FROM AUTHOR]

Low self-esteem is a common problem among adolescents and is related to psychiatric problems such as depression and anxiety. However, effective and available interventions primarily targeting low self-esteem are scarce, in particular for youths. To address this gap, the aim of this pilot study was to evaluate a novel internet-based Cognitive Behavioral Therapy (ICBT) program for low self-esteem in adolescents using a randomized controlled design. Fifty-two participants (15-19 years) were recruited and randomly allocated to seven weeks of therapist-supported ICBT (n=26) or to a waitlist control condition (n=26). The primary outcome was the Rosenberg Self-Esteem Scale (RSES). Secondary outcomes measured domain-specific aspects of self-esteem, self-compassion, quality of life, depression and anxiety. The treatment group showed significantly higher levels of self-rated self-esteem compared to the control group at post-treatment, with a large between-group effect-size (RSES, d = 1.18). Further, the treatment had significant positive impact on secondary measures of self-esteem, self-compassion, quality of life, depression and anxiety. The results of this pilot-RCT suggest that ICBT can be effective for treating low self-esteem in adolescents, decrease depression and anxiety levels, and increasing quality of life. Replication of the results in larger samples is needed. [ABSTRACT FROM AUTHOR]

Objective: The prognosis for ovarian cancer patients remains poor. A key to maximizing survival rates is early detection and treatment. This requires an accurate prediction of malignancy. Our study seeks to improve the accuracy of prediction by focusing on early subjective assessment of malignancy. We therefore investigated the assessment of patients themselves in comparison to the assessment of physicians.Methods: One thousand three hundred and thirty patients participated in a prospective and multicenter study in six hospitals in Berlin. Using univariate analysis and multivariate logistic regression models, we measured the accuracy of the early subjective assessment in comparison to the final histological outcome. Moreover, we investigated factors related to the assessment of patients and physicians.Results: The patients' assessment of malignancy is remarkably accurate. With a positive predictive value of 58%, the majority of patients correctly assessed a pelvic mass as malignant. With more information available, physicians achieved only a slightly more accurate prediction of 63%.Conclusions: For the first time, our study considered subjective factors in the diagnostic process of pelvic masses. This paper demonstrates that the patients' personal assessment should be taken seriously as it can provide a significant contribution to earlier diagnosis and thus improved therapy and overall prognosis. [ABSTRACT FROM AUTHOR]