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Introduction: The implementation and evaluation of patient participation to obtain high‐quality transitional care for older people is an international priority. Intermediate care (IC) services are regarded as an important part of the patient's pathway from the specialist to the primary care levels, bridging the gap between the hospital and the home. Patients may experience varying capacities and conditions for patient participation. Yet, few tools for evaluating patients' preferences for patient participation within IC services are at hand. Accordingly, further knowledge is needed to understand and scaffold processes for patient participation in IC. Therefore, the aim of this project was to translate, validate and pilot test the Patient Preferences for Patient Participation (the 4Ps) with patients in IC services in Norway. Methods: This project comprised two phases: (1) a careful translation and cultural adaptation process, followed by a content validity trial among 15 patients and staff in Norwegian IC and (2) a cross‐sectional survey of the instrument with 60 patients admitted to IC. Results: The translation between Swedish and Norwegian required no conceptual or contextual adaptations. The subsequent cross‐sectional study, designed as a dialogue between the patients and staff, revealed that only 50% of the participants received a sufficient level of patient participation based on their preferences, mostly indicating that patients were receiving less‐than‐preferred conditions for engaging in their health and healthcare issues. Conclusion: The 4Ps instrument was deemed suitable for measuring patient participation based on patient preferences in the IC context and was feasible for both healthcare professionals and patients to complete in an interview when arriving at and leaving services. This may support person‐centred communication and collaboration, calling for further research on what facilitates patient participation and the implementation of person‐centred services for patients in IC. Patient or Public Contribution: First, the current paper is part of the IPIC study (i.e., the implementation of patient participation in IC). Influenced by a James Lind Alliance process, the study addresses research uncertainties identified by patients, next of kin, staff and researchers in the cocreation process. Second, cognitive interviewing was conducted with 15 representatives of the target population: seven patients receiving IC services, one home‐dwelling previous IC patient (altogether four women and four men, most of them 80 years or older) and seven healthcare staff working in IC services. The interviews determined the relevance, comprehensiveness and clarity of the 4Ps. Finally, 60 patients admitted to IC took part in the cross‐sectional study. [ABSTRACT FROM AUTHOR]

The present study aims to explore the forms paternalistic communication can take in doctor–patient interactions and how they should be considered from a normative perspective. In contemporary philosophical debate, the problem with paternalism is often perceived as either undermining autonomy (the autonomy problem) or the paternalist viewing their judgment as superior (the superiority problem). In either case, paternalism is problematized mainly in a general, theoretical sense. In contrast, this paper investigates specific doctor–patient encounters, revealing distinct types of paternalistic communication. For this study, I reviewed videorecorded encounters from a Norwegian hospital to detect paternalism—specifically, doctors overriding patients' expressed preferences, presumably to benefit or protect the patients. I identified variations in paternalistic communication styles—termed paternalist modes—which I categorized into four types: the fighter, the advocate, the sympathizer, and the fisher. Drawing on these findings, I aim to nuance the debate on paternalism. Specifically, I argue that each paternalist mode carries its own normative implications and that the autonomy and the superiority problems manifest differently across the modes. Furthermore, by illustrating paternalism in communication through real‐life cases, I aim to reach a more comprehensive understanding of what we mean by paternalistic doctors. [ABSTRACT FROM AUTHOR]

This paper focuses on how immigrant women experience and negotiate their everyday life with children prior to and after leaving a violent partner. Twenty‐three women staying at domestic violence and abuse shelters with their children were interviewed about their experiences with assistance services and their everyday life with their children. At the time of the interviews, most of the women were legally separated or divorced and were either living in or in touch daily with shelters. In this paper, we look at some of the challenges that women face when exposed to violence in a relationship that involves children. Being exposed to violence from a partner raises a number of economic, practical, and emotional concerns, both prior to and after leaving. For the mothers in our study, maintaining a regular routine is key to making the children feel safe in an unpredictable setting. For many, economic dependence on the partner is replaced with economic dependence on assistance services after leaving the partner. Services must recognize that providing help to mothers who have left a violent partner constitutes more than just practical support but is crucial for mothers' ability to re‐establish a predictable everyday life with their children. [ABSTRACT FROM AUTHOR]

Background: The surge of online platforms has generated interest in how specialized platforms support formal and informal learning in various disciplinary domains. Knowledge is still limited regarding how undergraduate students navigate and use platforms to learn. Objectives: This study explores computer and software engineering students' learning practices, wherein online platforms are used as resources for both curricular learning activities and students' interest‐driven learning. Methods: The learning practices of 73 students were examined using a mixed‐methods design and a conceptualization of practices accounting for the context and purpose of their enactment. The dataset includes students' self‐reports on domain‐specific learning activities, three‐month‐long web‐browsing history of multiple platforms and stimulated‐recall interviews. The data were analysed through latent class and thematic analyses. Results and Conclusion: Five distinct patterns were found in the use of online platforms. These patterns show that different types of platforms were used purposely and in combination during curricular and interest‐driven activities aimed at learning software development. Moreover, students' purposes were driven by both the need to progress in their learning activities and the development of their interest in software development. The findings highlight the complexity of students' learning with online platforms, which develop quite extensively beyond curricular boundaries. Implications: The findings stress the need to recognize that undergraduate students' learning practices involve multiple online platforms and activities beyond the formal curriculum and that these play a key role in developing students' interests in learning software development. Moreover, our findings indicate the importance of taking into account the way students' learning practices unfold within platforms and how these relate to domain‐specific practices. Lay Description: What is already known about this topic?: Online platforms are mostly used by teaching staff in undergraduate education to support student learning during formal curricular tasks.Research knowledge is limited mostly to specific features of social networking platforms, such as Facebook Groups or instant messaging technologies.Students informally use interest‐driven activities and both social and domain‐specific platforms to support their learning.Research on students' interest in using massive open online courses suggested that students' learning is motivated by academic success, prospective economic opportunities, and personal interests. What this paper adds?: Students combine various types of online platforms purposely (e.g., search engines or Q&A sites), many of which are domain‐specific (e.g., Stack Overflow).Students use online platforms informally during work on curricular tasks to, for example, collaborate, solve problems, and understand concepts or methods.Domain‐specific (e.g., software engineering) platforms are used during other study‐related leisure and entrepreneurial activities.Online platforms play a key role in how students develop their interests in learning. Through them, students connect not only with other students but also with professionals, companies, and information about them. Implications of study findings for practitioners: Curriculum developers and faculty should consider preparing students to use disparate types of online platforms beyond what is included in the curriculum.Curriculum developers should also consider other activities beyond the classroom that are study‐related and meaningful for students and their learning. [ABSTRACT FROM AUTHOR]

Background: Globally, digital skills are a crucial aspect of education that schools should develop systematically. Research on digital skills tends to be measured using self‐reports, performance tests or interventions. There is less knowledge about student and teacher uptake of technology in school, making it important to investigate the actual use of technology and digital skills in authentic classroom settings. Objectives: This study contributes unique baseline data concerning students' use of technology and digital skills across mandatory English courses in real classroom settings in secondary schools in Norway over time. Methods: The study adapted a national framework for digital skills into an observation protocol. With it, this study analysed videos from 60 naturally occurring English lessons in 13 English classes at seven lower secondary schools over two school years (grades 9 and 10), following 186 students (aged 13–15) and 10 teachers. Results and Conclusions: Students used digital skills critical for education in half of the video‐recorded English lessons, with more digital skill use at some schools over time. The main finding across classrooms and school years regards students' use of basic, not advanced, digital skills. Takeaways: Although teachers provide opportunities for students to use digital skills in school, more advanced skills are needed. This work calls for continued use of video recordings to provide systematic comparisons of potential shifts in students' digital skills in real English secondary classroom settings over time. Lay Description: What is currently known: Digital skills is a crucial aspect of education globallyStudent and teacher uptake of technology varies extensivelyMost studies on the use of digital technology concern self‐reports and interventionsFew studies exist concerning the actual use of digital skills in the classroom What this paper adds: Video recordings from seven English classrooms across two school years are analysed.A framework for digital skills is adopted and used as observation protocolAttention is given to the difference between basic and advanced digital skillsHow technology is actually used matters more than how much technology is available Implications of study findings for practitioners: Teachers should offer opportunities for students' use of digital skills in the classroomSubject‐specific use of digital skills should be prioritizedThere is a need for more emphasis on reflection and digital judgementWe need to encourage the use of advanced digital skills and not only basic skills [ABSTRACT FROM AUTHOR]

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

This paper investigates different uses of the Journal Impact Factor (JIF) in national journal rankings and discusses the merits of supplementing metrics with expert assessment. Our focus is national journal rankings used as evidence to support decisions about the distribution of institutional funding or career advancement. The seven countries under comparison are China, Denmark, Finland, Italy, Norway, Poland, and Turkey—and the region of Flanders in Belgium. With the exception of Italy, top‐tier journals used in national rankings include those classified at the highest level, or according to tier, or points implemented. A total of 3,565 (75.8%) out of 4,701 unique top‐tier journals were identified as having a JIF, with 55.7% belonging to the first Journal Impact Factor quartile. Journal rankings in China, Flanders, Poland, and Turkey classify journals with a JIF as being top‐tier, but only when they are in the first quartile of the Average Journal Impact Factor Percentile. Journal rankings that result from expert assessment in Denmark, Finland, and Norway regularly classify journals as top‐tier outside the first quartile, particularly in the social sciences and humanities. We conclude that experts, when tasked with metric‐informed journal rankings, take into account quality dimensions that are not covered by JIFs. [ABSTRACT FROM AUTHOR]

Background: Problem‐solving is a multidimensional and dynamic process that requires and interlinks cognitive, metacognitive, and affective dimensions of learning. However, current approaches practiced in computing education research (CER) are not sufficient to capture information beyond the basic programming process data (i.e., IDE‐log data). Therefore, how cognition and affect intertwine and unfold over time in programming problem‐solving activities are rarely investigated. Objectives: In this study, we examined how the theory‐informed measures from multimodal data that we have selected as proxies for cognitive and affective dimensions of learning, are associated with student performance, and in comparison, to prior‐knowledge. Methods: A high‐frequency temporal data was collected with a camera, an electroencephalogram, and an eye‐tracker from 40 computer science students (bachelor and master studies) in the context of a code‐debugging activity. To study the cognitive processes associated with learning we focused on cognitive load theory (CLT) and the human information processing model. In addition, we complemented CLT with the model of affective dynamics in learning to avoid the machine reductionism perspective. Results: Our findings demonstrated that attention, convergent thinking, and frustration were positively correlated with students' successful code‐debugging (i.e., performance), and frequently manifested by high performing participants. Cognitive load, memory load, and boredom were negatively correlated with students' performance, and typically manifested by low performing participants. Implications: Extending the context of analysis in reference to student cognitive processes and affective states, affords educators not just to identify lower performers, but also to understand the potential reasons behind their performance, making our method an important contribution in the confluence of CER and the learning technology communities. In addition, the insights extracted from our analyses allow us to discuss potential avenues for improving learning design and the design of interactive learning systems to support the development of students' problem‐solving skills. Lay Description: What is currently known about the subject matter: ● Problem‐solving interlinks cognitive, affective and metacognitive dimensions of learning. ● In digital settings instructors struggle to distinguish cognitive‐affective states of students. ● Learning technologies require interventions based on cognitive‐affective states of students. What the paper adds: ● When and what cognitive‐affective states are triggered during solving a programming problem. ● What and how measures as proxies for cognitive‐affective states are associated with performance. ● Emphasizes the benefits of augmenting IDE‐log data with sensor data in the context of learning design. Implications of study findings for practitioners: ● Methodology guidelines to identify and model variability in humans' natural behaviours. ● Importance of content and instructions personalization for student engagement and learning. ● Identification of multimodal data proxies for flexible and adaptive multimodal interfaces. [ABSTRACT FROM AUTHOR]

This paper examines the discretionary reasoning of the judiciary in three jurisdictions, England, Germany and Norway, in cases deciding whether a newborn child is safe with her parents or intervention is necessary. Our analysis focuses on one specific dimension of decision makers' exercise of discretion, namely, if and how the strengths and weaknesses of the mother are considered. The data material consists of all decisions concerning care orders of newborns from one large city in Germany from 2015 to 2017 (n = 27) and 2016 in Norway (n = 76) and all publicly available newborn removal decisions in England for 2015–2017 (n = 14). The findings reveal a high number of risk factors in the cases and less focus on risk‐reducing factors. The situation of the newborn is considered to be harmful, as most cases result in a care order. Judicial discretion differs by how much information, and what types of factors, are included in the justification for the decision. A learning point for decision makers and policymakers would be to actively undertake a balancing act between risk‐increasing and risk‐reducing factors. [ABSTRACT FROM AUTHOR]

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

Across stages of acquisition, second language (L2) competencies are contingent on the variation among individuals learning the language, in both informal and formal learning contexts. This study investigates a group of outliers whose extreme test scores serve as a foundation to examine them as individuals. The study addresses the outliers' characteristics as good L2 readers but poor first language (L1) readers. Combining quantitative (test results, survey, and language logs) and qualitative (focus groups and interviews) data among 21 adolescents in Norway (aged 16–17 years), the study identifies dimensions of individual language use in L1 Norwegian and L2 English. Findings revealed that they explained their English proficiency by the role of interest and their extensive use of English technology and tools outside school. In‐depth analysis identified three profiles: the Gamer, who spends up to 8 hr daily playing online games while using English mainly; the Surfer, who spends hours on the Internet, searching for authentic language situations, commonly involving English; and the Social Media User, who produces and consumes information in English through social media. Additionally, the Gamers read printed novels voluntarily outside the classroom. This study offers unique perspectives and new directions for future L2 research. Lay Description: What is currently known: Most young people read better in their first language (L1) than in a second language (L2).Young people with an outlier profile read significantly better in L2 English than L1 Norwegian.Internet access facilitates opportunities to improve English skills outside formal schooling. What this paper adds: Outliers develop L2 English reading proficiency due to informal digital technology use.Three different outlier profiles are identified: Gamers, Surfers, and Social Media Users.Most online Gamers also read printed novels voluntarily outside the classroom. Implications of study findings for practitioners: Teachers should bridge English use in the classroom with young people's voluntary use of digital technology.Young people might profit from experiencing a bridging of virtual and physical realities.Their use of digital texts might extend to texts in school, which could help develop L2 reading proficiency. [ABSTRACT FROM AUTHOR]

Child welfare removals of children are among the most invasive decisions a state can make toward its citizens, and typically it is the courts that make these decisions. These interventions are regularly exposed to criticism. In this paper, we examine if and how care order proceedings could be improved in England, Finland, Norway, and California, USA. We have asked the judiciary decision‐makers about their view on what should be improved. Our findings show that the organization of the proceedings, including time and staff, are identified as issues in all four systems. Furthermore, the preparations by the child welfare agency are also mentioned as an issue, for English, Finnish, and Californian decision‐makers. Very few decision‐makers indicate features related to the individual, situational, and contextual dimensions, which is interesting since this would be expected from organization theory. The strong call for change in the way proceedings are organized indicates a need for modernization as well as better use of available competency from child development experts. The respondents focus on the elements that a decision‐maker has direct experience with and knowledge about, and this is indeed worth noting for policymakers in the four systems. [ABSTRACT FROM AUTHOR]

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

Scand J Caring Sci; 2012; 26; 553-560 Variations in older persons' descriptions of the burden of loneliness Research indicates that approximately one-third of older people over the age of 65 years report loneliness, with even higher rates among those aged over 85. Loneliness is associated with a variety of health issues, such as depression, anxiety, physical impairment and social isolation. The purpose of this paper is to describe the characteristics of the burden of loneliness, and investigate the variability in how it is described by older. In-depth interviews were conducted with 12 older people in autumn 2006 and spring 2007 in Norway. Participants aged from 70 to 97 years were recruited from a variety of backgrounds, and varied in health status and social status. The findings reported in this paper are based on hermeneutic analyses of the interviews. Our findings indicate that some of the participants experienced loneliness that they felt able to manage. They experienced a fluctuating loneliness that was linked to feeling valuable and having power and energy. However, another group described experiences of agonising loneliness. They felt a present and extensive loneliness, together with feeling less valuable and lacking in power and initiative. They seemed trapped in their loneliness, and unable to overcome their situation themselves. Our findings indicate that the burden of loneliness is experienced differently. For some older persons, the experience of loneliness is so severe that they urgently need help to manage their situation. [ABSTRACT FROM AUTHOR]

ABSTRACT Using aggregated national data, this paper compares outcomes of Australian 'child protection' (CP) and Norwegian 'child welfare services' (CWS). We highlight each nation's context and key elements of their CP/CWS organizations, with emphasis on policy and programme orientation. System outcomes are examined along with the implications of their different approaches. The main policy focus in Australia is protection and risk, while Norway's systemic approach stresses prevention, early intervention and support. These differences influence practitioner's intervention strategies and how the needs of children and parents are met. In Norway, approximately 80% of the children in the CWS receive some sort of supportive services. In contrast, Australian services for supporting families are narrowly targeted. Both countries share the 'best interest of the child' principle and an increased focus on children's rights, and have experienced increased service demands and rates of children in out-of-home care. The paper explores the relative merits of these systems. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper presents the findings of an exploratory study on parenting in the midst of suspicion of child sexual abuse (CSA). Data were drawn from in-depth interviews with 19 parents. Five of these had been accused of CSA. Study methods followed guidelines of grounded theory approaches. Specific parenting conditions during CSA suspicion were identified. Six analytic categories were developed: uncertainty concerning abuse, dilemmas on protection, changes in parent-child relationships, changes in the natural support network, dependency upon professional competence and severe emotional strain. The results are suggested as a tool for identifying themes in order to support and strengthen parenting in ensuring the safety and well-being of children in these kinds of situations. The current paper contributes to the field by exploring the perspectives of both suspected and non-suspected parents. [ABSTRACT FROM AUTHOR]

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

This paper investigates how enhanced support for foster parents, such as covering fees and providing consultants and relief, may reduce the number of replacements experienced by children in foster care. It also investigates the extent to which replacements are associated with family (kin) vs. non‐family foster parents, or with legal characteristics of the placement (i.e. forced administrative decisions vs. relief measures agreed upon by the parents). Statistical analyses of administrative data from Norway investigated the longitudinal relationships between these characteristics and the number of replacements at two levels – children (N = 16 109) and municipalities (N = 418) – over 5 years (2007–2011). The results reveal modest associations between enhanced support and fewer replacements; for example, replacement rates are lower for children placed in homes of kin than in non‐family homes. Replacements also tend to be fewer when the placement is forced rather than consensual. [ABSTRACT FROM AUTHOR]

Background Studies on Norwegian nursing homes have shown that the general care is at a relatively high level, while the level of physical and social activities is relatively low. As a response to these findings, the Norwegian government has stressed the importance of activities in various white papers and circulars and, in recent years, has launched several campaigns specifically aimed at increasing the level of activities. Aim The aim of the study was to examine the following: (i) how the government has succeeded in increasing the level of physical and social activities in Norwegian nursing homes; (ii) how the level of activities compares to the general care; and (iii) how the level of activities and the general care are influenced by the following facility characteristics: residents' mobility level, total staffing levels, ratio of RNs, ratio of unlicensed staff and ward size. Method A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Results On a scale ranging from 1 to 7, the staff members assess the activity dimension to be 4.31 and the general care dimension to be 5.66. The activity dimension was significantly negatively correlated with the ratio of unlicensed staff, the ratio of Registered Nurses and the residents' mobility level, while the general care dimension was significantly negatively correlated with the ratio of unlicensed staff. Conclusion The study shows that the level of physical and social activities offered to the residents is relatively low, while the general care level is significantly higher, in line with earlier studies. Consequently, the government has not succeeded with its current policy to increase the level of activities in nursing homes. The relationship between the two quality dimensions and the explanatory variables shows that nursing home quality is a complicated phenomenon. [ABSTRACT FROM AUTHOR]

Using data from a national survey (n = 6979) of young people in their last year in Norwegian secondary schools in 2007 (aged 18–19), this paper explores the relationship between sexual abuse and experiences of violence among young people in Norway and their reporting of suicidal ideation and self‐harm. This investigation includes three types of abuse experienced by young people: non‐physical, physical and sexual. We investigate suicidal ideation and two types of self‐harming behaviour: non‐suicidal self‐injury and suicidal self‐injury. The analyses that are reported involve descriptive analysis, chi‐square and t‐tests, and logistic regression. The hypothesis that was confirmed by the analysis was that being subject to sexual abuse or other violence was associated with increased risk of self‐harm. The hypothesis that was partially supported by the analysis was that violence experienced during childhood would have more effect on suicidal ideation and self‐harm than violence experienced at a later age. Contrary to our expectations, it was found that peer bullying has a stronger effect on young people's suicidal ideation and self‐harming behaviours than sexual abuse or physical violence. The implications of these findings for practitioners working with children and youth involve raising awareness about the long‐term effects of verbal, physical, sexual and witnessed abuse. [ABSTRACT FROM AUTHOR]

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

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

ABSTRACT Objective The aim of this paper was to internally validate previously reported relations (Knoph Berg et al., Aust N Z J Psychiatry, 42, 396-404, 2008) between psychosocial factors and bulimia nervosa (BN) outcomes during pregnancy. Method This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Participants were women enrolled during pregnancy ( N = 69,030). Internal validity was evaluated by way of bootstrapped parameter estimates using the overall sample and a split sample calibration approach. Results Bootstrap bias estimates were below the problematic threshold, and extend earlier findings (Knoph Berg et al., Aust N Z J Psychiatry, 42, 396-404, 2008) by providing support for the validity of the models at the population level of all pregnant women in Norway. Bootstrap risk ratios indicated that prevalence, incidence, and remission of BN during pregnancy were significantly associated with psychosocial factors. The split sample procedure showed that the models developed on the training sample did not predict risks in the validation sample. Discussion This study characterizes associations between psychosocial exposures and BN outcomes among pregnant women in Norway. Women with lifetime and current self-reported psychosocial adversities were at a much higher risk for BN during pregnancy. Psychosocial factors were associated with BN remission during pregnancy, inviting the prospect of enhancing therapeutic interventions. We consider the findings in the context of reproducibility in science. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2015; 48:654-662) [ABSTRACT FROM AUTHOR]

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

Aim: To explore midwives' experiences with providing home‐based postpartum care during the COVID‐19 pandemic in Norway. Design: A descriptive and explorative qualitative study. Methods: The study is based on semi‐structured individual interviews with 11 midwives experienced in offering home‐based postpartum care. We explored their experiences of such care during the first wave of the COVID‐19 pandemic. Data collection occurred from October through November 2020. An inductive thematic analysis was performed using Systematic Text Condensation (STC) by Malterud (2012). Results: The following two main results emerged from the analyses: (1) the midwives adapted quickly to changes in postpartum care during the pandemic and (2) midwives saw the experience as an opportunity to re‐evaluate their practices. Conclusion: This study highlights midwives' resilience and adaptability during the first wave of COVID‐19 pandemic. It emphasises the crucial role of face‐to‐face interactions in postpartum care, while recognising the value of technology when direct access is limited. By shedding light on midwives' experiences, this research contributes to improving postpartum care in unforeseen circumstances. It underscores the significance of interdisciplinary integration in planning postpartum care services and the lasting influence of lessons learned on addressing future challenges. Implications for Practice: The valuable insights gained from lessons learned during the COVID‐19 pandemic may have a lasting influence on the postpartum care system, empowering it to tackle unforeseen challenges both today and in the future. Impact: The current study addressed midwives' experience with providing home‐based postpartum care during the COVID‐19 pandemic in Norway. Midwives received an opportunity to re‐evaluate their own practices and valued being included when changes were implemented. The current findings should alert policy makers, leaders and clinicians in postpartum care services when planning future practice. [ABSTRACT FROM AUTHOR]

Background: During the COVID‐19 pandemic, nursing home leaders implemented infection control to protect residents and staff. Aim: To understand the barriers and facilitators for leading nursing homes through the COVID‐19 pandemic. Methods: We invited 34 nursing homes to participate, and 20 leaders (59%) attended focus group interviews. The COM‐B model and the theoretical domains framework were used in design and analysis of the study. Results: The barriers for infection control were organisational unpreparedness, high volumes of information, lack of clinical skills, protective equipment, and testing capacity, the nursing home's architectural design, health authorities' low priority of nursing homes, staff's fear, and mental pressure on the leaders over time. The facilitators were having a customised corona plan, change of routines, certification of new skills, access to the municipal quality system, the ability for crisis leadership, loyalty to the nursing home, and support from the environment. The number of part‐time positions and the opportunity to outsource parts of the services were also important determinants for infection control. Conclusions: The results identify several barriers and facilitators for nursing home leaders' behaviour for infection control. The results confirm the importance of supporting the leaders' resilience and crisis leadership while working in the pressurised environment of a pandemic. Relevance to Clinical Practice: The study provides important insights into barriers and facilitators for leading nursing homes through the COVID‐19 pandemic, which could help to inform future strategies for infection control. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

In three experimental studies, with managers and students as participants, we explore in this paper the relation between two kinds of responsibility judgments, called Responsibility 1 (R1) and Responsibility 2 (R2). Decision makers can be viewed as being more or less responsible for their choice and its consequences (R1). Their actions can also be evaluated, from a normative point of view, as instances of more or less responsible behavior (R2). Experiment 1 showed that managers who depart from the default or 'normal' course of action, by choosing a new (versus familiar) alternative, changing (versus sticking to) an initial decision, or going against (versus following) the advice of a management team, are rated as more responsible (R1) for the outcomes of their decision. At the same time, they are perceived to act in a less responsible way (R2). Experiment 2 compared decision makers choosing between more or less risky options. High risk takers were held more responsible (R1) for their choice and for its consequences, but were again viewed as behaving in a less responsible way (R2) than low risk takers. In Experiment 3, participants judged decision makers who followed or opposed others' advice by choosing either a high or a low risk option. Opposing others' advice led to higher R1 and lower R2 scores, especially when choosing the high risk option, moderated by outcome (successful decisions appearing more responsible than those that went wrong). Thus R1 and R2 judgments should be distinguished as having different and sometimes even opposite determinants. [ABSTRACT FROM AUTHOR]

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

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

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

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

The Positive and Negative Syndrome Scale (PANSS) is the most widely used scale to assess a variety of symptoms in patients with schizophrenia and other psychoses. The factor structure of the PANSS has been examined with confirmatory factor analyses in several studies, but not in a well-defined first-episode psychosis sample. The aim of this paper is to examine the statistical fit of five different PANSS models in a first-episode, non-affective psychosis sample. Confirmatory factor analyses were performed on PANSS data (n = 588). A main criterion for best fit was defined as the Expected Cross Validation Index (ECVI). No tested model revealed an optimally satisfactory model fit index. The Wallwork/Fortgang five-factor model demonstrated the most optimal psychometric properties. The corresponding subscales of all evaluated five-factor models were strongly intercorrelated. The Wallwork/Fortgang five-factor model was found to be statistically and clinically ideal among patients with first-episode psychosis. Therefore, we recommend this model in forthcoming studies among patients with first-episode psychosis. However, to prevent the loss of clinically valuable information on an item level, we do not recommend removing any items from the original form. Our study also implies that the specific choice of model will not have a substantial effect on outcome results in studies on the course and outcome in first-episode psychosis. [ABSTRACT FROM AUTHOR]

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

Objective This paper aims to study long-term bone mineral development in former patients with an onset of anorexia nervosa during childhood and adolescence. Methods Bone mineral density (BMD) in lumbar spine and total hip was measured in 39 female participants (mean age = 23.1 years, SD 3.5) an average of 8.1 (±3.3) years after treatment start. Results At follow-up, seven participants (17.9%) still suffered from an eating disorder. Mean BMD in the former patients was within the normal range in the hip but significantly reduced in the spine. Fourteen (36%) of the participants had osteopenia, and three (8%) had osteoporosis in the spine and/or hip. Amenorrhea for more than two years was associated with reduced BMD in the spine, whereas low weight at follow-up was associated with low BMD in both the spine and the hip. Conclusion A large minority of these former patients had low bone mass in young adulthood. In accordance with other studies, our findings support the importance of weight restoration for future bone health in young patients with anorexia nervosa. Copyright © 2012 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

ABSTRACT Group boundaries between immigrant minority and majority members are currently undergoing considerable and complex changes in European multicultural societies due to migration. In this paper, we present a descriptive, longitudinal investigation of the usage of linguistic expressions in Norwegian media discourse that describe symbolic boundary developments between immigrant minority and majority members, and their multicultural context. Seventy-two expressions are analyzed, and three temporal usage patterns are described (increasing, decreasing, and 'mountain') as central to understanding current symbolic boundaries and how they may both frame and be shaped by ideologies. Expressions describing immigrant minorities have increasingly focused on their establishment in the Norwegian multicultural society and have also shifted from general boundaries of outsiderness to increasingly specified boundaries of origins, visibility, and immigrant otherness. Norwegian majority expressions have mostly shifted toward a focus on origins. Our analysis suggests that symbolic boundaries in the Norwegian multicultural society have been changing rapidly. They seem to be shaped by complex ideological patterns constructing both similarities and differences, and which simultaneously seem to promote both inclusion and exclusion for certain immigrant minorities. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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

Depression is a major problem for mental health. Empirical studies and clinical observations have shown that the symptoms of depression occur across four main domains-emotional, cognitive, somatic and interpersonal. However, commonly used depression assessment scales fail to address the evaluation of interpersonal symptoms, as summarized in this paper. Therefore, a new depression assessment scale, which aimed to evaluate all four domains of depressive symptomatology, was developed. In an initial analysis, a pilot 85-item questionnaire containing possible depressive symptoms was distributed for evaluation to experts from different mental health professions, from which 52 items were subsequently selected for the new multidimensional depression assessment scale. One hundred community participants completed the questionnaire along with the Beck Depression Inventory-II. The results indicated that the new depression scale had good psychometric properties. It was found to be reliable and valid for the assessment of depression severity and symptomatology, though it is emphasized that these data are only preliminary and based on a relatively healthy sample. Copyright © 2012 John Wiley & Sons, Ltd. Key Practitioner Message [ABSTRACT FROM AUTHOR]

This longitudinal study examined the dynamic relationship between work engagement (vigour and dedication) and symptoms of anxiety and depression. A sample of 3475 respondents from eight different occupational groups (lawyers, physicians, nurses, teachers, church ministers, bus drivers, people working in advertising and people working in information technology) in Norway supplied data at two points in time with a 2-year time interval. The advantages of longitudinal design were utilized, including testing of reversed causation and controlling for unmeasured third variables. In general, the results showed that the hypothesized normal causal relationship was superior to a reversed causation model. In other words, this study supported the assumption that work engagement is more likely to be the antecedent for symptoms of depression and anxiety than the outcome. In particular, the vigour facet of work engagement provides lower levels of depression and anxiety 2 years later. However, additional analyses modelling unmeasured third variables indicate that unknown third variables may have created some spurious effects on the pattern of the observed relationship. Implications of the findings are discussed in the paper. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

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

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

Aims: The aim of this study was to assess the paediatric and adult diabetes care provided to adolescents and young adults with childhood‐onset type 1 diabetes during the transition. Methods: This nationwide population‐based cohort study included 776 individuals with type 1 diabetes who were last registered in the Norwegian Childhood Diabetes Registry (NCDR) between 2009 and 2012 and had received adult health care for at least 2 years. The patients' experiences were reported in a validated questionnaire. Clinical data from the annual registrations in the NCDR were coupled with data from the medical records in adult diabetes care. The longitudinal measures of glycaemic control were analysed using a growth mixture model. Results: A total of 321 young people answered the questionnaire and provided written informed consent for the collection of their data from their medical records. The mean age at transfer was 18.0 years (range = 15.0–23.5 years), and the mean age at participation was 22.7 years (range = 20.9–26.7 years). Significant differences (p < 0.001) in patient experiences were found between paediatric and adult diabetes care in several areas: contact with health‐care personnel, continuity of care, interval between consultations and overall satisfaction. Registry and medical records data confirmed the patient‐reported experiences. The longitudinal analyses identified two groups with distinctly different trajectories of glycaemic outcome over time. Patient–provider continuity and perceived preparedness for transfer were the most influential predictors. Conclusions: This study highlights several areas to be addressed for improving health care and the transition to adult diabetes care in adolescents and young adults with type 1 diabetes, including provider continuity, individualised care and involvement of multidisciplinary teams. [ABSTRACT FROM AUTHOR]

Adolescents with a visible difference to the face or body (e.g., due to a congenital condition, illness, or injury), may be at risk of elevated psychological distress. Young Person's Face IT (YPF), a web‐based psychosocial intervention, has displayed effectiveness, but no previous study has specifically evaluated its cost‐effectiveness. The aim of our study was to investigate whether YPF could be a cost‐effective alternative for psychosocial support to adolescents distressed by a visible difference, relative to care‐as‐usual (CAU). Within the context of a randomized controlled trial in Norway, 102 participants (43% boys) were allocated to intervention (n = 55) or waiting list control group (n = 47). Mean age was 13.9 years (SD = 1.71; range 11–18), and all self‐identified as experiencing distress related to a visible difference. Participants answered questionnaires including measures of health‐related quality of life and social anxiety at baseline and 3‐month follow‐up. A health economic evaluation using the method of cost‐utility analysis was performed, including quality‐adjusted life‐years (QALYs). Results indicated that the incremental cost‐effectiveness of YPF was 63,641 Norwegian kroner per QALYs gained, which is well within the acceptability threshold in the Norwegian healthcare sector. Hence, YPF could potentially be considered a cost‐effective intervention for adolescents experiencing distress related to a visible difference, but more research is needed that includes comparisons of YPF to other health‐ and societal resources and long‐term follow‐ups. Our study also constitutes an addition to research as, compared to interventions for somatic diseases, there is a lack of studies exploring the cost‐effectiveness of psychological interventions. [ABSTRACT FROM AUTHOR]

Introduction: Scarce health resources and differing views between persons with hand osteoarthritis (OA) and health professionals concerning care preferences contribute to sustaining a gap between actual needs and existing clinical guidelines for hand OA. The aim of this study is to explore the experiences of persons diagnosed with hand OA in their encounters with health services and how those experiences influence negotiations and decision‐making in hand OA care. Methods: Data from 21 qualitative interviews with persons diagnosed with hand OA were collected, transcribed verbatim and analysed using reflexive thematic analysis. Results: Three main themes were developed: symptoms are perceived as ordinary ageing in everyday life, consultations are shaped by trust in healthcare and the responsibilities of prioritisation and self‐care govern interactions. Conclusion: Ideas of ageing, professional knowledge and self‐management dominate hand OA health encounters and contribute to shaping illness perceptions, preferences and opportunities to negotiate decisions in consultations. Patient or Public Contribution: Two patient research partners with hand OA are members of the study project group. One of them is also a co‐author of this manuscript. [ABSTRACT FROM AUTHOR]

If children in child protection cannot be cared for by their natural parents, should they be adopted or live in foster home? Results from a study of representative samples of populations (n = 12 330), in eight European countries—Austria, England, Estonia, Finland, Germany, Ireland, Norway and Spain—and California, USA, reveal that people would recommend adoption over foster care, if a child in public care cannot grow up with their natural parent(s). There are cross‐country differences between populations, and examining if institutional context such as type of child protection system explains differences, we find that child maltreatment‐oriented systems are more supportive of adoption than other types of systems. Citizens having little confidence in the child protection system were only weakly correlated with preference for adoption. In conclusion, people prefer adoption as placement options for children in care are more than foster homes, and possible this finding reflects a sort of refamalialization of children into the private sphere. [ABSTRACT FROM AUTHOR]

In child welfare policies, as in contemporary society in general, great attention has been given to parenting roles and investing in 'positive' parenting practices. Several studies have suggested that socio‐economic factors frame parenting practices. There is broad evidence of a significant correlation between socio‐economic inequalities and child welfare intervention rates. Nevertheless, few studies have investigated parenting practices in a child welfare population. The aim of the present study was to investigate the association between socio‐economic status (SES) and parenting practices in a Norwegian child welfare population. The study was based on a cross‐sectional survey conducted in 2018–2019. The sample consisted of 256 parents (71.5% females). Linear regression analysis, adjusting for potential confounding and intermediate factors, was conducted. Lower SES was associated with higher levels of positive parenting/involvement practices (b = 0.146, CI: 0.026–0.266, P = 0.018), indicating an inverse pattern compared with the general population. When adjusting for symptoms of anxiety and depression, the association was slightly attenuated but remained statistically significant. No significant association was found between SES and inconsistent discipline/other disciplinary practices. The present study offers insights that should be useful in practice and further large‐scale studies. [ABSTRACT FROM AUTHOR]

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

Background: Fetal alcohol spectrum disorder (FASD) describes a combination of developmental, cognitive, and behavioral disabilities in children with prenatal exposure to alcohol. The literature suggests that there are higher rates of sleep disturbances in these children. Few studies have investigated sleep disturbances in relation to common comorbidities of FASD. We examined the prevalence of disturbed sleep and the relationship between parent‐reported sleep problems in different FASD subgroups and comorbidities like epilepsy or attention‐deficit hyperactivity disorder (ADHD) and impact on clinical functioning. Methods: In this prospective cross‐sectional survey, caregivers of 53 children with FASD completed the Sleep Disturbance Scale for Children (SDSC). Information about comorbidities was collected, and EEG and assessment of IQ, daily‐life executive and adaptive functioning were performed. Group comparisons and ANCOVA interaction models were used to test the associations between different sleep disturbances and clinical factors that could interfere with sleep. Results: An abnormal sleep score on the SDSC was very common, affecting 79% of children (n = 42) with equal prevalence in all FASD subgroups. Difficulty falling asleep was the most common sleep problem, followed by difficulty staying asleep and waking early. The incidence of epilepsy was 9.4%, with an abnormal EEG seen in 24.5%, and a diagnosis of ADHD in 47.2% of children. The distribution of these conditions was equal in all FASD subgroups. Children with signs of sleep disturbance had poorer working memory, executive function, and adaptive functioning. Children with ADHD had a greater prevalence of sleep disturbance than those without ADHD (OR 1.36; 95% CI 1.03 to 1.79). Conclusion: Problems with sleep are very common in FASD children and seem independent of FASD subgroup and the presence of epilepsy or a pathological EEG finding, while those with ADHD had more sleep problems. The study underscores the importance of screening for sleep disturbances in all children with FASD as these problems may be treatable. [ABSTRACT FROM AUTHOR]

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

This qualitative case study aimed to explore environmental circumstances and interactional processes that appeared to be relevant for the dynamics of resilience in adolescents exposed to child abuse. Fieldwork at a learning and coping centre for children and their families was combined with semi‐structured interviews with adolescent participants aged 12 to 18 years. A critical realist approach was used to unpack what has been called the 'ordinary magic' of resilience. We found that intensively validating qualities of both the environment and relationships seemed to be driving components for resilience. Borrowing ideas from the sociometer theory, we propose that particularly the consistent intensiveness may offer a recalibration of the adolescents' immediate life‐worlds, in terms of how they perceive the people they meet and the environments they step into. In keeping with the transactional‐ecological model of resilience, we suggest that such a recalibration leads to altered social agency that becomes visible through their immediate social participation. [ABSTRACT FROM AUTHOR]

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