Search

Pervasive gaming is a new and emerging gaming genre where the physical and social aspects of the real world are integrated into the game and blends into the player's everyday life. Given the nature of pervasive games, it may be possible to use that type of game as a tool to support learning in a university course by providing a gameplay where the students, by playing the game, expands the area of learning beyond the lecture hall and lectures and into the students everyday life. If this is possible, the area for learning will also become pervasive and be everywhere and anywhere at any time. To address this research area, a prototype of a playable pervasive game to support learning in university studies has been designed. This paper presents the experimental pervasive game "Nuclear Mayhem" and how the game was designed to be pervasive and support the curriculum of the course. Analysis of log files showed that 87% of the logins in the game client was done outside of the time period that was allocated to lectures and lab exercises and that logins where registered in all the 24 hours of a day. These numbers indicate that the game became pervasive and a part of the students/players everyday life. Interviews with the players indicate that they found the game exciting and fun to play, but that the academic tasks and riddles that they had to solve during the game were too easy to solve. The paper concludes that games such as "Nuclear Mayhem" are promising tools to support learning and transform the area for learning to become pervasive relative to the players everyday life and suggest improvements in the game for the next versions.

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

This paper presents a conceptual model of information behaviour. The model is part of the Search Situation Transition method schema. The method schema is developed to discover and analyse interplay between phenomena traditionally analysed as factors influencing either information retrieval or information seeking. In this paper the focus is on the model's five main categories: the work task, the searcher, the social/organisational environment, the search task, and the search process. In particular, the search process and its sub-categories search situation and transition and the relationship between these are discussed. To justify the method schema an empirical study was designed according to the schema's specifications. In the paper a subset of the study is presented analysing the effects of work tasks on Web information searching. Findings from this small-scale study indicate a strong relationship between the work task goal and the level of relevance used for judging resources during search processes.

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

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

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

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

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

This paper describes three case studies, where language learners were invited to use "LingoBee" as a means of supporting their language learning. LingoBee is a mobile app that provides user-generated language content in a cloud-based shared repository. Assuming that today's students are mobile savvy and "Digital Natives" able to engage in language learning autonomously using technology, initial studies were conducted with little or no intervention by the language teachers. However, the support and guidance provided within a teacher-led context can impact positively on learner engagement and use of LingoBee. The authors discuss this hypothesis using three case studies conducted in three European countries, within the EU LLP project SIMOLA, Situated Mobile Language Learning. This paper answers the research question: Does the level of the support and guidance, pedagogical approach and prior learning impact on learners' engagement and use of LingoBee? An earlier version of this paper was presented at the IADIS Mobile Learning 2013 conference.

The present paper investigates the relationship between the revised Adult Dyslexia Check List (ADCL), and the performance on a standardized battery of reading and spelling tests in adults, when used in an incarcerated population in Norway. The paper reports two sub studies. Study 1 examined the psychometric attributes of the ADCL by analysing the internal consistency and factor structure of the questionnaire. Six hundred subjects responded to the ADCL and also rated their self-perceived reading and writing difficulties on two simple graded scales. The ADCL yielded acceptable internal consistency and a three factor solution was identified in the Norwegian version of the ADCL. In study 2 the ADCL was analysed for its ability to predict objectively measured reading and spelling skills. Ninety-two incarcerated adults completed the test. Their ADCL scores, their response on the self-perception questions and the three factors were correlated with the subjects' achieved scores on the standardized reading and spelling test. The analyses revealed that participants' ADCL scores and their standardized test scores did not share much variance. However, self-perceived reading and writing difficulties correlated moderately with the standardized test. (Contains 8 tables.)

This paper is focused on virtual campuses, i.e. virtual worlds representing real educational institutions that are based on the metaphor of a university and provide users with different learning tools. More specifically, the idea of integrating a virtual campus into the context of a virtual city is suggested. Such a virtual city, where students live and work, can extend the possibilities of a virtual campus in supporting learning and socializing. This paper provides a description and analysis of an empirical case study that was performed to test and develop these ideas. Based on the results of the study, a set of guidelines for designing a virtual campus in a city context is presented. (Contains 15 figures.)

Web 2.0 technologies are becoming popular in teaching and learning environments. Among them several online collaborative writing tools, like wikis and blogs, have been integrated into educational settings. Research has been carried out on a wide range of subjects related to wikis, while other, comparable tools like Google Docs and EtherPad remain largely unexplored in the literature. This work presents a case study investigating education students' perceptions of collaborative writing using Google Docs and EtherPad. Both tools provide opportunity for multiple users to work on the same document simultaneously, have a separate space for written metacommunication, and are promoted by software designers to be fairly intuitive to adopt without prior training. The work investigates if perceptions depend on factors such as gender, age, digital competence, interest in digital tools, educational settings, and choice of writing tool, and examines if the tools are easy to use and effective in group work. This paper focuses on quantitative results of survey questionnaires. Further qualitative analysis will be presented in a later paper. The theoretical framework is drawn from two learning theories, the social-constructivist learning theory and the community of practice, and their relationships to collaborative tools. Related research literature is characterized by a number of issues: positive elements of use, advantages of using Web 2.0 technologies, critical issues regarding the pedagogical value of Web 2.0, and the role of the teacher in using these technologies. The case study participants were 201 education students who just began their four-year initial teacher education at two study programs with a total of six classes at the university Teacher Education Unit. They were assigned a collaborative writing task and asked to take an on-line survey on completion. When the survey closed, a total of 166 students (83.6%) had participated. The results were analyzed based on frequency distributions. The hypothesis that students with high digital competence and a positive attitude towards digital tools are more positive than average seems to be confirmed. Also gender does not play any particular role. As for younger students being more positive than older, the population of older students was so low that no conclusion can be drawn. The work does not validate that EtherPad users are more positive than Google Docs users, but this may be explained by EtherPad being unavailable for some time during the students' collaborative writing period. Furthermore only 13.9% of the students were motivated to use the tools for collaboration, and only a minority of the students (15.7%) reported that the quality of collaboration in the group increased with use of the tools. Likewise, the tools did not work as expected for a majority of the students (70.5%). Forty-seven percent of the students liked to comment and edit others contributions to group work. Although the results cannot be generalized to a larger group of students, and no definite conclusions can be drawn from the questionnaires about the usefulness and effectiveness of Google Docs and EtherPad for collaborative writing, the results cannot be underestimated since some results are consistent with the research literature. Future research consists of the qualitative evaluation of the students' comments to open ended-questions in the questionnaire, the students' collaborative essay papers, and their contributions to group work. It may also be important to examine the extent and quality of utilization of the tools for collaborative writing. Triangulation of the data collected may shed light on how they really perceived the effectiveness of Google Docs and EtherPad to support collaborative writing among students. (Contains 3 tables and 2 figures.)

In this paper the academic English reading proficiency of 578 Norwegian university students was quantitatively examined. Self-assessment items were used to measure reading proficiency in Norwegian and English and validated using an International English Language Testing System Academic Reading Module. The study found that about 30% of the respondents had serious difficulties reading English, while an additional 44% found it more difficult than reading in their first language. The main problems encountered were unfamiliar vocabulary and slow reading, while extracurricular readers and respondents who were able to guess word meanings from context had higher reading scores. Poor language proficiency was a problem for many, to the extent that they fell below the linguistic threshold level. The study showed that, contrary to expectations, Norwegian EFL instruction at upper-secondary schools fails to develop the academic English reading proficiency needed for higher education. (Contains 4 tables.)

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

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

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

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

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

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

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

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

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

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

There is increasing attention toward students' satisfaction and how they perceive the quality of the program they attend. This study examined stability and change across time with regard to the relationships between learning environment factors and occupational therapy students' satisfaction with the program. In the two consecutive cross-sectional analyses performed in this study, 163 second-year students and 193 third-year students from all six occupational therapy education programs in Norway participated. The Course Experience Questionnaire was used to assess learning environment factors and study satisfaction. The data were analyzed with Pearson's correlation coefficient r and with hierarchical linear regression. Bivariate associations between the learning environment scales were positive and most associations were statistically significant in both study years. Relatively stable associations between the learning environment variable "good teaching" and higher study satisfaction were detected, while other associations differed between years of study. Embedding quality into the learning process, in particular by emphasizing good teaching and the clear dissemination of goals and standards, is important for student satisfaction throughout years of study. [ABSTRACT FROM AUTHOR]

Background: Stress and burnout are widespread problems among radiological personnel Individual and organizational resilience and mindfulness offer protection against burnout. Aim: To investigate the level of resilience and mindfulness among radiological personnel, the associations between organizational resilience, individual resilience, and mindfulness, and how these factors impact the quality of care provided in radiological departments. Methods: An online questionnaire consisting of the Connor-Davidson Resilience Scale, the Mindful Attention Awareness Scale, the Benchmark Resilience Tool, and questions regarding burnout, and quality and safety was used. Data analysis consisted of descriptive statistics, bivariate correlation and standard multiple regression. Results and Conclusion: Few participants considered burnout a significant challenge. Individual and organizational resilience were low (30.40 ± 4.92 and 63.21 ± 13.63 respectively), and mindfulness was high (4.29 ± 0.88). There was a significant correlation between individual and organizational resilience (p = 0.004), between individual resilience and mindfulness (p = 0.03), and between organizational resilience and mindfulness (p = 0.02). Individual and organizational resilience affect each other. However; neither significantly affect quality and safety, nor mindfulness [ABSTRACT FROM AUTHOR]

Background: Research has indicated that providing women with information about menopause can improve their attitudes towards it and symptom experience. Nevertheless, information shared on the menopause is often arbitrary. Aim: To examine women's information needs about menopause, and understand if, when, and from whom they want information. Design & setting: A cross-sectional study was undertaken. A questionnaire survey was distributed to women in the waiting room of 54 general practice clinics in South-Eastern Norway in autumn 2022. Method: Medical students recruited women in the clinic waiting rooms. A 1-page study-specific questionnaire was used, focusing on need for information about menopause. A multinominal logistic regression model was used to analyse the association between the desire for information and education level, country of birth, and menopausal status. Results: A total of 625 women were included, with a mean age of 44.4 years (standard deviation [SD] 8.7). In all, 59% answered that they wanted information about menopause, and 81% of these wanted their GP to inform them, from a median age of 45 years. According to the women, only 10% of GPs had initiated a discussion on the menopause. Higher education was a predictor for wanting information. A main driver of information needs was to help oneself in the present and in the future. In all, 33% did not want information. The main reasons were that they already possessed sufficient information, would take menopause as it comes, were too young, or were already postmenopausal. The sex of the GP did not influence the results. Conclusion: Most women wanted information about menopause from their GP. The study emphasises the need for GPs to consider prioritising this discussion, and to keep up to date on recommendations and treatment options. [ABSTRACT FROM AUTHOR]

Presented paper aims to compare internationalization of Lithuanian and Norwegian SMEs by exploring the main motives and barriers restricting internationalization process. The authors strive to reveal the patterns of internationalization taking into account the aspects of main theoretical models. The research is based on the main ideas of stage, network and international entrepreneurship approaches. The main motives and barriers restricting internationalization process are based on the previous studies. In order to compare internationalization patterns of Lithuanian and Norwegian SMEs, quantitative research has been performed. The quantitative research is based on responses to a questionnaire embracing various aspects of internationalization. The sample of 300 SMEs was selected taking into consideration previous research. The survey allows concluding that Lithuanian SMEs emphasise geographic proximity as the most important criteria for international market selection. On the other hand, Norwegian SMEs perceive variables of international entrepreneurship theory as the important contributory factors in internationalization process. The authors conclude that Lithuanian SMEs rely on exporting; meanwhile Norwegian SMEs choose subcontracting/licensing or own representative abroad. Hence, Norwegian SMEs are seen at the more advanced stage of internationalization. Authors of the research have elaborated proposals, which are useful for further development of Lithuanian SMEs and take into consideration experience of Norwegian SMEs. The presented paper will contribute to the International Entrepreneurship Forum by providing new insights into further development of SMEs of Lithuania and Norway taking into consideration opportunities and threats. [ABSTRACT FROM PUBLISHER]

Background. According to the World Health Organization, depression ranks as a major contributor to the global burden of disease. A large proportion of adult depressions had their first appearance in adolescence.Aim. Because primary health care professionals lack valid instruments for early identification of depression, we sought to validate HSCL-10. The design of study is a GP multicentre study conducted in Norway and Denmark. The setting of the study is adolescents (14–16 years) responded by answering a questionnaire and later completed a Composite International Diagnostic Interview, which was used as the gold standard. Depression was defined by International Classification of Diseases-10 (ICD-10). Both internal and external validity were examined, the likelihood between pretest and posttest measured and a cut-off point for depression calculated by using the Youden index.Results. The Hopkins Symptom Checklist-10 test (HSCL-10) met the criteria for external and internal validity. When analysed separately, the criteria were met both in Denmark and in Norway and both for paper and web. The optimal cut-off point for the HSCL-10 test was 16 (HSCL-10 = 16/10 items = 1.6), with no gender differences. For girls and boys, respectively, it yielded a sensitivity of 87.5% and 87.5%, specificity of 72.4% and 87.9% and likelihood of 3.2 and 7.2.Conclusion. HSCL-10 is a suitable and valid instrument for detecting depression in young people in primary care. [ABSTRACT FROM PUBLISHER]

Background: Improved discharge arrangements and targeted post-discharge follow-up can reduce the risk of adverse events after hospital discharge for elderly patients. Although more care is to shift from specialist to primary care, there are few studies on post-discharge interventions run by primary care. A generic care pathway, Patient Trajectory for Home-dwelling elders (PaTH) including discharge arrangements and follow-up by primary care, was developed and introduced in Central Norway Region in 2009, applying checklists at defined stages in the patient trajectory. In a previous paper, we found that PaTH had potential of improving follow-up in primary care. The aim of this study was to establish the effect of PaTH-compared to usual care-for elderly in need of home care services after discharge from hospital.Methods: We did an unblinded, cluster randomised controlled trial with 12 home care clusters. Outcomes were measured at the patient level during a 12-month follow-up period for the individual patient and analysed applying linear and logistic mixed models. Primary outcomes were readmissions within 30 days and functional level assessed by Nottingham extended ADL scale. Secondary outcomes were number and length of inpatient hospital care and nursing home care, days at home, consultations with the general practitioners (GPs), mortality and health related quality of life (SF-36).Results: One-hundred and sixty-three patients were included in the PaTH group (six clusters), and 141 patients received care as usual (six clusters). We found no statistically significant differences between the groups for primary and secondary outcomes except for more consultations with the GPs in PaTH group (p = 0.04). Adherence to the intervention was insufficient as only 36% of the patients in the intervention group were assessed by at least three of the four main checklists in PaTH, but this improved over time.Conclusions: Lack of adherence to PaTH rendered the study inconclusive regarding the elderly's functional level, number of readmissions after hospital discharge, and health care utilisation except for more consultations with the GPs. A targeted exploration of prerequisites for implementation is recommended in the pre-trial phase of complex intervention studies.Trial Registration: Clinical Trials.gov NCT01107119 , retrospectively registered 2010.04.18. [ABSTRACT FROM AUTHOR]

INTRODUCTION Increasing numbers of maternity units are implementing routine and standardized monitoring of all women using a form of Early Warning Score System with the aim to early detect women at risk of developing critical illness or a deterioration of their condition. The implementation in Norway is relatively new. This study aimed to describe Norwegian midwives' experiences with the Obstetric Norwegian Early Warning System (ONEWS). METHODS We performed a cross-sectional study based on an electronic questionnaire, sent to heads of midwifery at all maternity units in Norway for distribution to their clinically active midwives. Thirty-one of 48 units had implemented ONEWS for over a month. About 1020 midwives received the questionnaire, 232 (23%) responded. RESULTS Of the participants, 217 (93.5%) reported receiving sufficient training and 230 (99.1%) reported using the same scoring system, including the same vital parameters measured. The criteria for use of ONEWS varied between units regarding inclusion criteria and frequency of scoring. A total of 214 (92.2%) midwives agreed that ONEWS has value in the surveillance of high-risk women, while 152 (65.5%) agreed that ONEWS contributes to medicalization of the care of low-risk women. Some 166 (71.6%) midwives reported that ONEWS was time consuming and 159 (68.5%) that the measures need to be better adapted to childbearing women. CONCLUSIONS Maternity units in Norway implementing ONEWS use an almost identical scoring system but varying criteria for whom to score and how often. Midwives considered ONEWS particularly suited for high-risk women and not for low-risk childbearing women. [ABSTRACT FROM AUTHOR]

Background: Symptom assessment is key to effective symptom management and palliative care for patients with advanced cancer. Symptom prevalence and severity estimates vary widely, possibly dependent on the assessment tool used. Are symptoms specifically asked about or must the patients add them as additional symptoms? This study compared the prevalence and severity of patient-reported symptoms in two different versions of a multi-symptom assessment tool. In one version, three symptoms dry mouth, constipation, sleep problems were among those systematically assessed, while in the other, these symptoms had to be added as an "Other problem". Methods: This retrospective cross-sectional study included adult patients with advanced cancer at an inpatient palliative care unit. Data were collected from two versions of the Edmonton Symptom Assessment System (ESAS): modified (ESAS-m) listed 11 symptoms and revised (ESAS-r) listed 9 and allowed patients to add one "Other problem". Seven similar symptoms were listed in both versions. Results: In 2013, 184 patients completed ESAS-m, and in 2017, 156 completed ESAS-r. Prevalence and severity of symptoms listed in both versions did not differ. In ESAS-m, 83% reported dry mouth, 73% constipation, and 71% sleep problems, but on ESAS-r, these symptoms were reported by only 3%, 15% and < 1%, respectively. Although ESAS-r severity scores for these three symptoms were higher than on ESAS-m, differences did not reach statistical significance. Conclusion: We identified significant differences in patient symptom reporting based on whether symptoms like dry mouth, obstipation and sleep problems were specifically assessed or had to be added by patients as an "Other problem". [ABSTRACT FROM AUTHOR]

Background: The objective was to investigate self-reported hand eczema, and skin complaints at other skin locations among workers exposed to particulate matter, especially ultrafine particles. Method: We conducted a cross-sectional study on workers from one ferro-silicon smelter plant, eight chimney sweeper stations and one firefighter station across Norway. Participants answered an extended version of the Nordic Occupational Skin Questionnaire (NOSQ-2022), with additional questions about whole-body skin complaints and visible dust deposition. Results are presented as descriptive data using firefighters as reference group. Odds ratio (OR) was calculated using logistic regression on lifetime prevalence of hand eczema adjusted for potential confounders and mediators. P-values were calculated using likelihood ratio test against the crude OR. Results: A total of 186 participants answered the questionnaire: 74 chimney sweepers, 52 firefighters and 60 smelter workers. Participation rate was 95.0, 94.5 and 63.6%, respectively. Lifetime prevalence of hand eczema was 9.5, 9.6, and 28.3%, respectively. The point prevalence of hand eczema was 1.4, 1.9 and 10.0%, respectively. We estimated OR for lifetime hand eczema in smelter workers to 4.36 [95% CI: 1.31–14.43, p = 0.016] and for lifetime skin complaints in other locations to 2.25 [95% CI: 0.98–5.18, p = 0.058]. The lifetime prevalence of skin complaints at other locations was 18.9, 23.1 and 40.0%, respectively. The point prevalence was 14.9, 9.6 and 16.7%, respectively. These estimates were not statistically significant but indicates that smelter workers have more skin complaints also at other locations. Conclusion: This study reports a more than four-fold increased risk of hand eczema in smelter workers, and possibly a higher risk of skin complaints in other body locations, compared to the other occupations. Longitudinal studies with larger population are needed to verify the marked increased risk of eczema among smelters and establish causation. [ABSTRACT FROM AUTHOR]

Background: The understanding and conceptualizing of gender and sexuality are continuously negotiated between individuals and cultures. Recently, new gender identity orientations have emerged, fighting pathologization and establishing new spaces and options for being sexually active gendered beings. Objective: To investigate variations in sexual activities across different gender identity orientations. Method: A questionnaire used in France was adapted to the Norwegian context and implemented in this study. The participants were recruited through therapists, TGD organizations, and social media. Results: A total of 538 individuals responded to the questionnaire, of which 336 provided a written description of their gender identity. Based on an analysis of the degree of male gender identity orientation, the degree of female gender identity orientation, and the degree of nonbinary gender identity orientation, three clusters appeared and were used in the analyses of sexual activities and preferences. Conclusions: Some findings could be attributed to lingering aspects of traditional gender roles, while others may be indicative of sexual expression stemming from societal acceptance of gender diversity and new identity orientations. [ABSTRACT FROM AUTHOR]

Introduction: People should have access to healthcare services that are effective, safe and secure, patient‐centred, and coordinated and continuous. One group that has consistently reported negative experiences and feels dissatisfied with services are patients with Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS). The objective of this study was to develop a deeper understanding of the experiences of dissatisfaction among ME/CFS patients and explore the reasons for such dissatisfaction. Methods: We conducted in‐depth interviews with 48 people from 24 households (comprising patients and family members), providing insight into the experiences of 37 ME/CFS sufferers in Norway. The participants were purposively sampled and included persons of different ages, genders, time since having the condition (3–30 years), and severity. Results: Four main themes were developed: (1) 'Nonexistent services' cover patients' experience that healthcare services had nothing to offer them after receiving their ME/CFS‐diagnosis. (2) 'Nonpersonalised services' documents experiences where patients did receive services, which in theory was appropriate for relieving a specific health problem, but in practice were experienced as inappropriate because they were not adapted to the patient's need. (3) 'Slow services' address patients' experience of getting services too late (or too little) to be useful. (4) 'Wrong services' comprise patients' experiences of being offered and/or 'forced' to accept services that they felt were inappropriate for their health problems. Conclusions: Providers' lacking knowledge of the condition and lack of precise recommendations for follow up may partly explain unsatisfactory experiences. Providers' belief (or disbelief) in the condition could furthermore influence caregiving. Also, systemic issues in the healthcare sector, like high workloads and bureaucracy, can negatively affect care provision. Finally, users' unsatisfactory experiences may also be due to a lack of patient involvement in the design of such services. Further research should investigate how patients can be involved in service design, and also providers' perspectives on caregiving and the barriers they experience for providing high‐quality care. Patient or Public Contribution: The ME‐patient organisation suggested research topics to the call from which this study got funding. Patients and caregivers provided feedback during analysis and interpretation of data. [ABSTRACT FROM AUTHOR]

Background: The mouth is a central organ for communication and fluid intake, also for dying nursing home patients. This study describes the prevalence and severity of oral symptoms from nursing home admission until the day of perceived dying and the day of death. Methods: A prospective, longitudinal cohort study including 696 patients who were admitted to 47 Norwegian nursing homes in 35 municipalities. During the first year of their stay, 189 died (27%), of whom 82 participants were assessed on the day they were perceived as dying and 134 on the day of death. Mouth care, nutrition, and bedsores were assessed with the Residents' Assessment Instrument for nursing homes (RAI-NH) and palliative care (RAI-PC). Pain intensity was assessed with the Mobilization-Observation-Behaviour-Intensity-Dementia-2 Pain Scale (MOBID-2). Results: The proportion of patients with ≥ 6 oral symptoms increased from 16% when perceived as dying to 20% on the day of death (P = 0.001). On the day of death, xerostomia (66%), dysphagia (59%), and mastication problems (50%) were the most frequently observed oral symptoms. Only 16% received mouth care every hour and 12% were in pain during this procedure. Compared to people without dementia, those with a diagnosis of dementia at admission (N = 112, 86%) had xerostomia and mastication problems more frequently (50% vs. 73%; 32% vs. 56% (P = 0.038), respectively) on the day of death. Conclusions: The high extent of oral symptoms such as xerostomia, dysphagia, and mastication problems underline the need for systematic assessment and improved oral palliative care for dying nursing home patients with dementia. Trial registration: Clinicaltrials.gov NCT01920100 08/08/2013. First submission to BMC oral 15/03/2023. [ABSTRACT FROM AUTHOR]

Background: The present study protocol describes the evaluation of a comprehensive integrated care model implemented at two hospital sites at the University Hospital of North Norway (UNN). The PAtient Centred Team (PACT) model includes proactive, patient-centred interdisciplinary teams that aim to improve the continuum and quality of care of frail elderly patients and reduce health care costs. The main objectives of the evaluation are to analyse the effectiveness and cost effectiveness of using patient-centred teams as part of routine service provision for this patient group. The evaluation will analyse the effect on patient health and functional status, patient experiences and hospital utilisation, and it will conduct an economic evaluation. This paper describes the PACT model and the rationale for and design of the planned effectiveness and cost-effectiveness study.Methods/design: This is a prospective, non-randomised matched control before-and-after intervention study. Patients in the intervention group will be recruited from the hospital sites that have implemented the PACT model. The controls will be recruited from two hospitals without the model. The control patients and the index patients will be matched according to sex, age and number of long-term conditions. The study aims to include 600 patients in each group, which will provide sufficient power to detect a clinical change in the primary outcome. The primary outcome is the physical dimension of the Short Form Health Survey (SF-36). Secondary outcomes are the Patient Generated Index (PGI), the Patient Activation Measure (PAM), the Patient Assessment of Chronic Illness Care (PACIC), hospitalisation and length of stay. The cost-effectiveness study takes a health provider perspective and calculates the cost per quality-adjusted life-years (QALYs) gained. The data will be collected at baseline, 6 and 12 months. The data will be analysed using techniques and models that recognise the lack of randomisation and the correlation of cost and effect data.Discussion: The study results will provide knowledge about whether the integrated care model implemented at UNN improves the quality of care for the frail elderly with multiple conditions. The study will establish whether the PAC. T model improves health and functional status and is cost effective compared to the usual care for this patient group.Trial Registration: ClinicalTrials.gov: NCT02541474. [ABSTRACT FROM AUTHOR]

The article reports on studies concerning sacroiliac joint movements and pelvic joint fusion outcomes. Topics discussed include the accuracy of radiostereometrics in analyzing sacroiliac joint movement, the outcomes for patients with severe pelvic girdle pain (PGP) who underwent pelvic joint fusion and the possible causes of PGP. Also discussed are the tests to diagnose PGP and the biomechanical considerations for sacroiliac joint movement.

Sudden and unexpected death represents a severe life event incorporating multiple stressors and is potentially more traumatizing than natural deaths. Religiosity is an important resource in everyday life and may be especially important during times of loss. The aim of this paper is to explore the significance of religiosity in the coping process after sudden death, using a qualitative semi-structural in-depth interview guide to investigate the experiences of 30 bereaved people from different Sámi areas in Northern Norway. The findings showed that religiosity might be a great source of help in the grieving and coping process. [ABSTRACT FROM AUTHOR]

Aiming at preventing excessive weight gain during pregnancy, 10 specific dietary recommendations are given to pregnant women in the intervention arm of the Norwegian Fit for Delivery (FFD) study. This paper presents the rationale and test-retest reliability of the food frequency questionnaire (FFQ) and a dietary score measuring adherence to the recommendations. The study is part of the ongoing FFD study, a randomised, controlled, intervention study in nulliparous pregnant women.A 43-item FFQ was developed for the FFD study.A dietary score was constructed from 10 subscales corresponding to the 10 dietary recommendations.Adding the subscales yielded a score from 0 to 10 with increasing score indicating healthier dietary behaviour.The score was divided into tertiles, grouping participants into low, medium and high adherence to the dietary recommendations. Pregnant women attending ultrasound screening at about week 19 of pregnancy were asked to complete the FFQ twice, 2 weeks apart. Of 154 pregnant women completing the first questionnaire, 106 (69%) completed the form on both occasions and was included in the study.The test-retest correlations of the score and subscales were r = 0.68 and r = 0.56-0.84, respectively (both P ⩽ 0.001). There was 68% test-retest correct classification of the score and 70-87% of the subscales. In conclusion, acceptable test-retest reliability of the FFQ and the dietary score was found. The score will be used in the FFD study to measure adherence to the dietary recommendations throughout pregnancy and in the following year post-partum. [ABSTRACT FROM AUTHOR]

Background: The relationships between periodontitis and non-communicable diseases (NCDs) have been investigated through several different case-definitions. The differences in methodology may have hindered the basis of comparison between these studies. The classification from the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions offers a unison platform that may facilitate future comparison of such research. The present study aimed to reproduce associations between periodontitis and other NCDs using the 2017 Classification, in the Trøndelag Health Study (HUNT). Material and methods: The fourth HUNT-survey was carried out between 2017 and 2019. Clinical variables, blood samples and answers to questionnaires were collected from 4933 participants. Periodontal status was assessed based on the latest staging system, and its associations with NCDs were estimated by logistic regression models adjusted for potential confounders. Results: Compared to no or Stage I periodontitis, participants with Stage III/IV periodontitis (radiographic bone loss exceeding 33%) were associated with cardiovascular disease, hyperglycemia in participants with diabetes and chronic obstructive pulmonary disease (COPD)/emphysema. Associations with hyperglycemia in participants with diabetes and COPD/emphysema were also observed in participants with Stage II periodontitis. The only observed association when considering never-smokers alone, was with COPD/emphysema. Conclusion: Periodontitis Stage II and III/IV were associated with major NCDs. Effect sizes increased with increasing periodontitis stages, which implies greater occurrence of coincident comorbidities in patients with severe periodontitis. [ABSTRACT FROM AUTHOR]

Background: Pregnancy-related lumbopelvic pain is a frequently reported musculoskeletal disorder, but few studies have compared data between countries. Objectives: Examine prevalence, severity, and sick leave and explore potential risk factors associated with pregnancy-related lumbopelvic pain in Italian women and compare the results to a similar study in Norway, utilizing the same questionnaire. Design: Cross-sectional Methods: Italian (n = 481) and Norwegian women (n = 435) were allocated from two public hospitals in Rome (Fatebenefratelli San Giovanni Calibita-Isola Tiberina) and Oslo (Oslo University Hospital), as well as four antenatal clinics in Modena (Italy). The questionnaire was completed between gestation weeks 32 and 36, addressing women's experiences of pregnancy-related lumbopelvic pain and sick leave in current week, and retrospectively for prepregnancy, first and second trimesters. Results: In Italy and Norway, 39% and 57% of pregnant women reported pregnancy-related lumbopelvic pain, respectively, with 11% and 25% experiencing severe pregnancy-related lumbopelvic pain. Pregnancy-related lumbopelvic pain was associated with sick leave in Norway (p < 0.01), but not in Italy (p = 0.66) at late gestation. In both countries, women with pregnancy-related lumbopelvic pain versus those with no pregnancy-related lumbopelvic pain were more likely to be multiparous (Italy: 40% versus 31%, p = 0.06 and Norway: 53% versus 38%, p < 0.01), and have gestational weight gain above guidelines (Italy: 21% versus 13%, p = 0.02% and Norway: 27% versus 14%, p < 0.01) and previous experience of pregnancy-related lumbopelvic pain (Italy: 15% versus 2%, p < 0.01 and Norway: 31% versus 4%, p < 0.01). Maternal exercise (⩾2 times weekly) was associated with less pregnancy-related lumbopelvic pain (Italy: odds ratio = 0.33, 95% confidence interval = 0.11–1.0, p = 0.05 and Norway: odds ratio = 0.55, 95% confidence interval = 0.29–1.0, p = 0.06). Conclusion: We observed high rates of pregnancy-related lumbopelvic pain in Italy and Norway, with Norwegian women reporting the highest prevalence and severity level. While both countries had similar rates of sick leave in late gestation, an association between pregnancy-related lumbopelvic pain and sick leave was observed among Norwegian women only. Health care providers should be proactive in addressing pregnancy-related lumbopelvic pain through open communication and seeking input from pregnant individuals. However, it is essential to acknowledge that the current evidence on effective treatments remains limited and inconclusive, highlighting the need for further research in this field. [ABSTRACT FROM AUTHOR]

Background: Pain in adolescence is considered a worldwide concern. Adolescents' pain affects family functioning. However, bidirectional associations should be considered as parental determinates such as pain, stress, and sociodemographic factors are also shown to influence pain in adolescence. Objectives: This study explored the associations between maternal and paternal sociodemographic factors, pain, and stress and adolescents' pain, and stress on adolescents' pain. Methods: In total, 508 school-based Norwegian adolescents with a corresponding parent were included. All adolescents completed an electronic survey during school hours, and their respective parents responded electronically. The survey included sociodemographic data, the Perceived Stress Questionnaire, and the Brief Pain Inventory. Results: Herein, 385 adolescents reported an average pain of 2.1 (SD, 1.9), and 308 of the participating parents reported an average pain of 1.6 (SD, 1.8). Regressions stratified by parental gender revealed nonsignificant associations in fathers' study variables predicting adolescents' pain. However, having the highest maternal educational level (p ≤ 0.01) and working part-time (p ≤ 0.01) were associated with lower pain in adolescents. Conclusions: The findings of this study demonstrated that sociodemographic factors such as high educational status in mothers and mothers working part-time were associated with lower pain in Norwegian adolescents. These findings highlight the importance of a holistic approach to pain management in adolescence. [ABSTRACT FROM AUTHOR]

Background: Although, studies from Norway indicate a reduction in dental caries experience, in Northern-Norway this non-communicable oral condition is still prevalent. There is conflicting evidence of presence of social inequalities in dental caries in an adult population. Therefore, the aim of this study was to assess an association between educational level and dental caries experience in adults in urban Tromsø municipality, Northern-Norway, using The World Health Organization (WHO) Commission on Social Determinants of Health (CSDH) framework of health determinants. Methods: Data from 3752 participants having recorded dental caries status and educational level in the seventh survey of the Tromsø Study: Tromsø7 were included. Dental status was examined clinically as decayed-, missing-, filled-teeth (DMFT score). For statistical analyses DMFT score was grouped into lower (DMFT < 19) and higher (DMFT ≥ 20). Educational level was obtained from a questionnaire and categorized as primary/partly secondary education, upper secondary education, tertiary education, short and tertiary education, long. Data on social and intermediary determinants was also self-reported. Univariable and multivariable binary logistic regression analyses were applied. Result: This study included 1939 (52%) women and the mean age of the participants was 57.11. The mean DMFT score was 18.03. The odds of having higher DMFT score followed a gradient based on educational level. Participants who reported lower than secondary education had 2.06 -fold increased odds of having higher DMFT score than those with tertiary education, long (OR: 2.06, 95% CI: 1.50–2.83). Those with upper secondary education had 60% higher odds of having higher DMFT score (OR: 1.60, 95% CI: 1.21–2.11), and those with tertiary education, short had 66% higher odds of having higher DMFT score (OR: 1.66, 95% CI: 1.24–2.22). Conclusion: The current cross-sectional study suggested an educational gradient in dental caries experience in an adult population of Northern- Norway. Further studies validating our results and investigating mechanisms of educational inequalities in oral health are warranted. [ABSTRACT FROM AUTHOR]