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Background: Research suggests that people with intellectual disabilities have a higher risk for cardiovascular disease than the general population. The aim of this study was to identify barriers for the prevention, diagnosis, and treatment of cardiovascular disease for people with intellectual disabilities. Method: We conducted individual interviews with relatives and general practitioners and focus group interviews with staff working at an assisted home facility, a cardiac ward, an obesity clinic and two rehabilitation centres (n = 33) in Norway. Inductive approach and thematic analysis were used to analyse the data. Results: We identified barriers on an individual and a structural level. The underlying reason for these barriers is that health problems, such as cardiovascular disease, are regularly overlooked as the condition of intellectual disability "overshadows" other possible diagnoses. Conclusion: This focus on intellectual disability rather than other explanations leads to shortcomings in the prevention, diagnoses, and treatment of cardiovascular disease in this group.

This paper will investigate how specific "narratives on the inclusion of minority language students" (MLSs) are constructed in Norwegian and Italian educational policy documents. We will employ the Narrative Policy Framework's (NPF) analytical categories with an interpretative narrative approach to reconstruct the two national policy narratives and compare their salient features. In response to international trends of inclusive education, Norway and Italy have developed two different educational policy models for the inclusion of MLSs. Norway operationalised inclusion through 'adapted education' for all students, while Italian policy defined an 'Italian path towards the intercultural school'. The results will show that the Norwegian approach to inclusive education is sustained by what we define as a "technocratic" (efficiency-oriented) narrative, while the Italian intercultural education employs a "normative" (ideologically-based) narrative. Despite the differences, the two policy narratives share an unresolved tension between a "universalistic" and "particularistic" stance. In the policy documents, the inclusive/intercultural education for all students is ambiguously complemented by integration measures designed explicitly for MLSs. The study will illustrate the travelling nature of inclusive and intercultural education in the policy domain and show that the policy shift towards inclusion needs to be understood as an ongoing and non-linear process.

This article explores children's self-initiated outdoor play and holistic learning in a Norwegian kindergarten. While children's self-initiated play is valued in Nordic ECEC, it is rarely analyzed in relation to holistic learning. To explore how children's self-initiated outdoor play contributes to children's holistic learning in ECEC, we observed a group of twenty-four-five-year-old children during outdoor play in a Norwegian kindergarten, taking field notes and photographs. We analyzed it with a biosocial approach, where learning is understood as produced through an assemblage of social and biological forces. We found that with a creative and imaginative attitude, children sought intense and novel physical experiences and interactions with each other, other species, and things, while also navigating rules, relationships, and their own and others' emotions. We discussed the strategies we observed in relation to 'indirect pedagogy' and teacher-led pedagogy, challenges relating to risk, and young children's opportunities for holistic learning through self-initiated play in ECEC.

Disagreement exists about how to best spark young children's motivation to learn natural science. Both curiosity and wonder are considered important motivational factors for learning during early childhood (0-8 years). This systematic literature review explores research about scientific curiosity and wonder in early childhood education and care published from 2010-2020. The review outlines the population of interest (participants in the study, age of children, study location), methodological trends, and how curiosity and/or wonder are included in the research. The search yielded 300 peer-reviewed articles, of which 33 were included for analysis based on eligibility criteria. The main results showed that: (a) the term "curiosity" was more commonly used than the term "wonder," (b) few studies elaborated on their understanding of the two terms beyond them being naturally present in children, and (c) curiosity and/or wonder were emphasized as means to learn natural science or considered as stimulated by it, although few studies discussed how children's curiosity and wonder can be observed and nurtured. With a better understanding of what defines the terms curiosity and wonder and how to foster these qualities in early childhood education and care, we can learn to better support children's intrinsic motivation for science learning.

This paper reports on a study investigating the implementation of peer support groups (PSGs) for the purpose of supervisor development in higher education. The context for the study is a national doctoral programme in Norway, where PSGs were introduced as an important part of measures aimed at the development of PhD supervisors. The aim of the PSGs was to establish forums for discussions of specific challenges that the supervisors faced in their supervision. Furthermore, our aim was to contribute to supervision development via meaning-making, problem-structuring and problem-solving. The supervisors discuss challenges from their own supervision practices according to a specific five-phase model. Using a combination of thematic analysis and interaction analysis, we found that the discussions enabled by the PSGs resulted in altered comprehensions of the challenging situations the supervisors faced, as well as thoroughly considered strategies with which to progress.

This article reports on a collective learning project with the aim of integrating indigenous perspectives in a teacher education program in Norway. The Norwegian educational system is legally obliged to emphasize Sámi perspectives, a strategy that has been described as indigenization. However, inclusion of Sámi perspectives is often done without challenging colonial power-relations. Our project was based on a reading circle engaging with texts by indigenous authors, performing a collaborative autoethnography. The purpose of collaborative autoethnography is not the self-narrative, but a relational process of reflexively critiquing the situatedness of the self. Our collaborative autoethnographic work aimed at disidentifying with ongoing coloniality in academia. Through the article, we share our learnings on how performing autoethnographic work can be a path toward moving ourselves to action for decolonization. We argue that if teacher education is to move toward an indigenization that is decolonial, "unlearning" of epistemological monocultures is vital.

This paper address how we may understand inclusion strategies designed to reduce the gender gap in higher education in engineering and ICT engineering in particular. Based on a case study of a long-term inclusion effort and statistics on recruitment and retainment, we argue that inclusion initiatives which address important inclusion needs and put down a substantial effort are likely to be successful. However, such changes seem to be not very sustainable, and need continuous effort. Based on our findings and a review of previous research we argue that inclusion efforts are instrumental in gaining a higher share of women in ICT, but that the win may be short-lived. We suggest that there is a need also to work for a higher share of women faculty to obtain more sustainable recruitment and retainment of women in ICT. Moreover, we found that the probability of dropout among men students was systematically reduced with increased gender balance, which indicates that more gender-balanced programs are more attractive to remain in for both men and women.

Some might fear that the local flavours of education will evaporate when encountering the hegemony of global, cognitive standards of the knowledge economy. This paper, however, shows that the evolution of curriculum can emerge in surprising directions, creating hybrid forms of education. We will investigate forms of meaning that emerge in Norwegian curriculum in the timespan 1988-2020, and show how systems theory can contribute to studying curriculum changes in a temporal perspective. The empirical case for investigation, is a diverse range of material, documenting curriculum changes in the mentioned period. Concepts from the late Luhmann's 'theory of distinctions' will thus be used to give meaning to the emergence of school reforms in Norway. The paper shows that Norwegian policy makers use increasingly complex deparadoxification strategies to deal with an uncertain future, conceptualized as externalization, oscillation, asymmetrisation, and internalization (re-entry). This is most pertinently demonstrated in the latest Norwegian reform LK20, in which a new, hybrid, 'temporal' construct of education, called "new-old-curriculum" or 'competence-Bildung' emerges. We thus contribute to the field of curriculum studies by observing how changing observations of the past and future fuel and legitimize the evolution of new reforms.

Trust is essential in any kind of peer-based mentoring. Taking a sociocultural view, this study focuses on how trust emerges relationally in a higher education context where colleagues observe and give feedback on one another's teaching. The term peer mentoring refers here to a collaborative approach in which faculty staff observe and give feedback on one another's teaching. The data in the study draw on video observations of and interviews with a four-member (senior faculty) peer group observed over a 5-month period. The analysis of the group interactions shows how the members made themselves vulnerable during peer review and reveals the implication of trust in this collaborative setting. The sociocultural perspective draws here attention to the key role of turn-taking rhythms in the interactions constituting the development of trust. This paper also discusses the significance of developing suitable conditions for trust when arranging peer-based review of teaching in higher education.

Children with attention deficit hyperactivity disorder (ADHD) often experience co-occurring emotional problems. ADHD with this comorbidity is associated with poorer outcomes than ADHD without comorbidity. Better understanding of the etiology of comorbidity could improve prevention of negative outcomes for children with ADHD. The sample consisted of 567 twin pairs, 3,632 sibling pairs, and 2,340 cousin pairs from the Norwegian Mother, Father and Child Cohort Study. Mothers rated offspring symptoms of ADHD, anxiety, and depression at 8 years of age. Biometric modeling was performed to examine genetic and environmental contributions to co-occurring symptoms of ADHD and emotional problems in the children. We fitted four variable (inattention, hyperactivity/impulsivity, anxiety, and depression) covariance matrices of additive genetic, common environmental, twin- and individual-specific environmental effects. Genetic, shared environmental, and individual-specific environmental factors contributed to the correlation between ADHD and depression. The pattern was similar for both inattention and hyperactivity/impulsivity. Familial risk factors (genetic and shared environment), but not individual-specific environmental factors contributed to the positive correlations between each of the two ADHD subdomains and anxiety. The genetic contributions to ADHD-depression comorbidity only partly overlapped with genetic contributions to ADHD-anxiety comorbidity. Our findings indicate that shared risk factors for ADHD and comorbid depression were familial as well as individual-specific, while shared risk factors for ADHD and comorbid anxiety were primarily familial.

Over the past decades, peer review of teaching has become commonplace at many universities around the world. Though research on the topic is expanding, much of the literature is composed of qualitative studies that offer relevant empirical findings but often have limited foundations in theory. Using a framework synthesis approach, we synthesize the empirical findings of 48 qualitative articles on peer review of teaching into a comprehensive conceptual framework drawing on sociocultural perspectives of learning. We propose the term "collegial faculty development" (CFD) to encompass all practices that support faculty in developing their teaching quality by drawing on the expertise of their colleagues. Our framework conceptualizes the main elements of CFD and shows how different contextual, individual, and relational factors shape the way CFD unfolds. Based on these theoretical considerations, we discuss issues of intersubjectivity, materiality, and temporality as potential avenues for further research.

This paper reports on a study of Teacher Support Teams (TSTs) established to generate peer support and collaboration among teacher and nurse educators at a Norwegian university. In TST groups, educators share experiences from their own teaching practices and support one another in solving work-related problems. By the use of interaction analysis, three types of support were identified: (1) sharing solutions to teaching-related problems, (2) providing personal and emotional support and (3) creative problem-solving. The findings show that the participants' dissimilar professional backgrounds and their positioning as "peers" rather than "experts" functioned as important drivers for creative problem-solving processes.

The main focus of the study was active learning in courses in which field trips traditionally has been important, by the use of 360° photos and videos -- known as either 360° or spherical media. The aim of the project was to generate knowledge about how rich media content can enable students to actively explore situations or localities and to acquire knowledge of them. Through technology testing, pilot study implementation and a student survey, we experienced that spherical media can give students an audio-visual experience of exploring places and situations they might not otherwise be able to access, and in a way that is one step closer to the real-world experience than can be conveyed by text or by ordinary photos and videos. On the negative side, the quality of 360° photos and videos is not sufficiently good for all applications. In our project, the students' feedback on the use of 360° videos in graded assignments indicates that caution should be exercised in this respect, and our experience indicates that virtual field trips cannot replace real field activities. Nevertheless, spherical media can undoubtedly add value to learning processes in the classroom, such as preparation for field trips, repetition and reflection.

In numerous countries, the widening participation of underrepresented groups in higher education has become an official part of education policies. However, inequalities continue in some areas, including refugees' participation. Norway hosts many refugees, but little is known about the social inclusion of refugees into higher education in the country. In this paper, three documents representing Norwegian higher education and integration policies are analysed using an integrated analytical framework constructed from social inclusion and its three main dimensions (access, participation and empowerment) and from a critical discourse analysis. The analysis is conducted to address how social inclusion into higher education is conceptualized, which major discourses underpin the conceptualization and what implications these have for the social inclusion of refugees into higher education in Norway. The article argues that social inclusion is conceptualized from an access dimension signifying the dominance of neoliberal principles in the policy documents. On the contrary, social justice discourses are marginalized and human potential principles are absent from the documents signalling the disempowerment of refugees in relation to higher education. Future policies should incorporate conscious and clear strategies informed by social justice and empowerment principles to ensure the social inclusion of refugees into higher education.

Emerging evidence suggests that prenatal stress does not solely undermine child functioning but increases developmental plasticity to both negative and positive postnatal experiences. Here we test this proposition using the Norwegian Mother and Child Cohort study while implementing an extreme-group (i.e., high vs. low prenatal stress) design (n = 27,889 children for internalizing and n = 27,892 for externalizing problems). To measure prenatal stress, mothers reported on depressive and anxiety symptoms at gestational weeks 17 and 30 and of stressful life events at gestational week 30. We then evaluated whether, collectively, such prenatal stress amplified the effect of mothers' postnatal depressive and anxiety symptoms on children's internalizing and externalizing behavior problems at age 5 years. Results showed prenatal stress amplified effects of postnatal maternal depression/anxiety on child internalizing but not externalizing behavior, with some indication that this Prenatal-Stress-X-Postnatal-Maternal-Depression interaction proved more consistent with differential susceptibility than diathesis stress thinking: Children exposed to prenatal stress evinced greater internalizing problems if exposed to more postnatal maternal depressive/anxiety symptoms and, somewhat less strongly, displayed less internalizing problems if they experienced lower postnatal maternal depressive/anxiety symptoms. However, analyses using the whole sample instead of extreme groups yielded opposing results with children exposed to the least prenatal stress evincing greater sensitivity to postnatal maternal depressive/anxiety symptoms with regards to externalizing and internalizing behavior. Taken together, it appears that prenatal stress may have differing effects on plasticity depending on prenatal stress severity.

The development of new types of doctoral education in the last decades is part of a comprehensive trend in higher education. This trend has increased the number of research students, developed new markets, and consolidated links between research and practice. This article explores the experiences of candidates and supervisors in doctoral programmes in Sweden, Denmark, and Norway. The study draws on empirical information from interviews, survey data and document analysis. It shows how the new doctorates are heralded as instruments for strengthening the links between researchers and practitioners and between theory and practice. The study also displays how doctoral programmes are plagued by structural, organisational, and conceptual vagueness; tensions embedded in the theory-practice dimension are left to the candidates to be solved. This study discusses how these tensions may affect the professional identity formation of the candidates and its implications for the development of new directions in doctoral education.

21st century skills is a global network of corporate and governmental influences that promotes competences suited to fit the future knowledge economy. Through a discourse analysis of an influential Official Norwegian Report, 'The School of the Future. Renewal of Subjects and Competences' (NOU 2015:8), this paper explores how ideas of 21st century skills are translated into the Norwegian education policy context. Firstly, the paper analyses the context-specific reasons for receptiveness by investigating "discursive warrants." Secondly, the paper identifies how the policy document constructs a set of preferred "subject positions" that constitute an image of an ideal student. Thirdly, the paper investigates the "discursive framing" of these subject positions. We find that the policy document constructs an image of an ideal student who is creative, responsible, cooperative, engaged, self-regulated and in complete control of herself, her learning and her future. This image draws on more pronounced neo-liberal discourses, but also well-established discourses in the Norwegian context, such as social democratic progressivism. This intertwining of discourses shows how traits of homogeneity related to global ideas, as well as heterogeneity related to the Norwegian policy context, are both visible in the Norwegian translation of 21st century skills.

This article addresses writing in higher education with the primary aim of conceptualizing writing as a mediational tool. The conceptual framework consists of three concepts: "learning trajectories," "mediation," and "recontextualization." The article describes how writing can work as a mediational tool and suggests possible implications for higher education. An empirical study from the context of initial teacher education in Norway is used for the purpose of illustration. Writing activities can mediate learning in important ways. However, design elements that make students explore, contrast, and compare different meaning potentials and position themselves within disciplinary or professional discourse are crucial when considering the potential of writing as a mediational tool in higher education.

Living in complex knowledge societies requires citizens who master multiple literacies involving both cognitive and social skills. Thus, all individuals should be offered relevant educational opportunities and teachers capable of integrating subject expertise with relational aspects. This paper demonstrates a teaching design for mathematics that student teachers have indicated integrates both these dimensions. Drawing on theoretical perspectives that conceptualize academic literacy as a socially situated discourse practice, we investigate one teacher educator's teaching design for mathematics. The evidence indicates that the teaching approaches in this design are highly student centered and process oriented. Student teachers report that the approach supports both individual and collective learning of the discipline of mathematics while also modeling how to teach mathematics as a school subject. The teaching design comprises varied and exploratory approaches to teaching mathematics and represents an alternative to more traditional mathematics pedagogy. In this way, the study contributes to an empirically informed understanding of how the goal of learning to master academic literacy may be facilitated by a varied repertoire of writing, reading, and oral activities. The study indicates challenges for traditional teaching and teacher education more broadly.

Based upon fieldwork in two upper secondary schools in Norway, this article offers an analysis of inclusion and exclusion processes for newly arrived minority language students. Minority language students are defined by policy as students who have a different mother tongue than the Norwegian and Sami languages, and students who are newly arrived in Norway are considered especially at risk for marginalisation. This article explores processes of inclusion and exclusion in two schools with segregated classes for this group, called introductory classes. The analytical framework is Niklas Luhmann's theory of autopoietic social systems, where inclusion is defined as the requirements for participation set by a system, and exclusion accordingly as being unable to meet these requirements. The article displays different constellations of inclusions and exclusions for newly arrived students in the educational system: in school organisations, organisation-based interactions and informal networks of students. It will be showed that introductory classes erect several barriers towards newly arrived students' inclusion, especially towards those students who are placed at the basic level of the schools' hierarchy of performances. As a consequence of multiple educational exclusions, informal networks emerge as alternative socialities that include and exclude students on the basis of mother tongue.

This article will show how the global educational policy expectations of being a "self-managing learner" unfold in the context of two school organisations in Norway, and contribute to the exclusion of so-called newly arrived minority language students. The theoretical framework is Niklas Luhmann's theory of the global educational system, and the article offers a semantic analysis of inclusion and exclusion processes, where inclusion is operationalised as fulfilling educational expectations and exclusion as the failure to meet these expectations. The findings are based on ethnographic fieldwork in two upper secondary schools with introductory classes for newly arrived students in Norway, but will be interpreted in light of recent policy initiatives from the Organisation for Economic Co-operation and Development (OECD). The article will show similarities between expectations in the schools and the ones embodied in the so-called 21st century skills. The article argues that the knowledge-economic ideal of the self-managing learner demonstrates a reductionist notion of the student role and constitutes a risk for newly arrived students' educational careers.

Background: It has been suggested that public awareness of aphasia is vital for extending services, research support, social inclusion and targeted raising of awareness. Earlier studies show that knowledge of aphasia varies across a range of variables, but is very low compared with other conditions. Aims: To report a series of surveys of public awareness of aphasia from six countries, the largest study conducted this far. Methods & Procedures: Surveys were conducted in Argentina (N = 800), Canada (N = 831), Croatia (N = 400), Greece (N = 800), Norway (N = 251) and Slovenia (N = 400) using the same methodology requesting information on age, sex and occupation, asking whether respondents had heard of aphasia and where they had heard of it. Respondents were tested on their levels of knowledge of aphasia. Outcomes & Results: Results revealed low levels of awareness of aphasia in countries surveyed with marked variability that appeared to interact with occupation, country, age and sex. We surveyed 3483 respondents (mean age = 43.16; SD = 17.68). Between 60% (Croatia) and 16% (Slovenia) said they had heard of aphasia (37.1% overall), but those with actual knowledge ranged from 13.9% (Norway) to 1.0% (Argentina). The combined mean of those with basic knowledge was 9.2%. Those who had heard of aphasia were younger; and females had higher levels of awareness. We also found associations between socio-economic status and awareness. Those working in health, social and educational spheres had the highest levels. Respondents mainly heard about aphasia through the media and work or personal contact with aphasia. Conclusions & Implications: Levels of awareness are low everywhere in absolute terms, and relative to the awareness of other conditions, with significant variability between countries, sex and socio-economic status. We examine how surveys can be utilized to plan ways to increase understanding and discuss the comparison of awareness of aphasia with other conditions.

This article offers an analysis of four Norwegian policy documents on inclusion of minority language pupils. The main concepts of this policy will be reconstructed and re-described, applying Niklas Luhmann's systems theory at different levels of the analysis. Luhmann's theory about society as a conglomerate of self-referential social systems investigates how these systems construct meaning and what consequences these constructions have for inclusion and exclusion processes. This article will focus on the Norwegian educational policy towards minority language pupils, defined by the policy as pupils who have a different mother tongue than Norwegian and Sami language. It is argued that this inclusion policy is excluding in its social form, and that it exhibits an increased emphasis on education when it comes to inclusion in society. Re-descriptions based on logic of forms will show how binary distinctions such as "inclusion/exclusion", "majority language pupil/minority language pupil" and "early intervention/wait and see" emerge in the timespan of 2004-2012. Based on this, it is claimed that descriptions of inclusion and exclusion are mutually constituted in the policy, thus giving rise to the question of whether the policy goal--"full" inclusion in society--is realisable. A paradox will be uncovered: minority language pupils are being "included as excluded" as well as "excluded as included" in the documents, displaying how inclusion and exclusion are two sides of the same coin. The strategy "early intervention" is introduced to remedy exclusions, thus converting the problem of inclusion into a problem of time.

This article explores some dimensions of how the role of the English language in Norway has been discursively constructed in newspapers during recent years, based on the analysis of data from the five-year period 2008-2012. The analysis is conducted using a specialised corpus containing 3,743 newspaper articles which were subjected to corpus-based macro-analyses and techniques, as well as manual micro-level analyses and categorisation. The main focus of the analysis is on the manifestation of attitudes through various ways of expression, such as the occurrence of lexical sequences and conceptual metaphors related to language. The results show that even though positive perceptions of English were quite frequent in the data, the main part consisted of expressions where English is seen in a negative light. Hence, a fairly negative attitude towards the role of English is predominant, as illustrated by the most frequent conceptual metaphor, "language is an invading force," where English is at war with and seen as representing a threat to the Norwegian language.

This article examines how the self-determination of pupils with intellectual disabilities is practised in secondary school in Norway and discusses possible challenges connected to this practice. The argumentation builds on the fieldwork of qualitative interviews (N?=?55) and participant observations in schools in Norway (pupils 13-16?years old). The pupils attend a variety of educational settings, including ordinary classes at mainstream schools, the department of special education at mainstream schools and special education schools. The study reveals considerable variations in the pupils' opportunities to practise self-determination. While the self-determination of pupils with intellectual disabilities is rather extensive when it comes to their influence over informal and minor decisions in everyday life at school, it is very limited when it comes to formal and major decisions. Furthermore, the implementation of the pupils' self-determination is primarily spontaneous and seldom anchored in the pupils' Individual Education Plans. Such an implementation practice limits the pupils' opportunities to participate in democratic processes, learning and social interaction.

Treatment irregularity may complicate therapy for patients with personality disorders (PD). In Norway, Covid-19 restrictions led to a shutdown of outpatient mental health services from March 12th, 2020. The article aims to investigate how patients with PD experience Covid-19 related changes in their everyday life and treatment. A multi-center survey was performed in June–October 2020 at 12 PD treatment units. Thematic analysis was chosen for data-analysis of the open questions. Data-analysis resulted in two meta-themes: 1) Treatment changes as good enough emergency solutions – continuing personal change and care during the crisis, and 2) An overwhelming experience of unpredictability in everyday life and treatment – a feeling of being lost and lonely. The two meta-themes encompass themes organized to show diverse experiences of changes in social contact, treatment adjustments, and mental health problems. The two meta-themes could be understood along a dimension of "safety – vulnerability" more than separated experiences. The experiences are discussed concerning technological, social, and individual resources and vulnerability. The therapist should explore the patient's experience of the treatment adjustments several times through the treatment process during a crisis to increase safety and continue treatment. [ABSTRACT FROM AUTHOR]

The development of artificial intelligence (AI) technology for radiology has accelerated in the past decade, but its deployment in radiology practices has been slow. We take a sociotechnical approach and suggest that the limited use of AI in radiology practices can be attributed to a recurring tension between planned and emergent change. The paper contributes with a conceptualization and understanding of the tension during the procurement of AI for radiology. To balance this tension, we suggest that health organizations need to redefine the concept and scope of traditional procurement projects, with well-defined goals and project time. Instead, we propose that health organizations need to conceptualize their procurement and implementation projects of AI technology as evolving change processes. The study is based on an interpretive research approach and informed by the Information Infrastructure framework. Empirically, we study the procurement of AI solutions for radiology at a large health trust in Norway. [ABSTRACT FROM AUTHOR]

Purpose: Videoconferencing between general practitioners and hospitals has been developed to provide higher quality health care services in Norway by promoting interaction between levels of care. This article aims to explore the use of videoconferencing for information exchange and consultation throughout the patient trajectory and to investigate how collaboration affects learning and the patient's treatment. Design/methodology/approach: The approach was interaction analysis supplemented by interviews. Medical discussions concerning the patient were observed for 15 days, creating a trajectory of seven videoconferences. Interviews were conducted to examine the collaboration. Findings: General practitioners and specialists use a different repertoire of knowledge and experiences to report and consult throughout the course of treatment. Over time, new medical problems arose, and the treatment had to be adjusted. The activity remained continuous and contributed to an integrated knowledge and information exchange. Collaboration using videoconferencing across levels of care created opportunities for workplace learning in health services and can lead to continuity, improved coordination, and a higher quality of care. Originality/value: In contrast to other studies, which state effects, the need for continuity and cooperation in health care, and the ways in which individual differences make it difficult to achieve seamless health care services, this study offers insight into how continuity and cooperation can be achieved. It includes both observations of interactions and interviews of the participants, providing analysis of collaborative work "in situ." This provides insight into the content of the interaction over time as a resource for understanding the outcome of the use of technology and improving health care. (Contains 8 tables.)

Background: A previous study reported a negative association between perfluorooctane sulfonamide (PFOSA) concentrations and fecundability.Methods: We examined this association among women enrolled in the Norwegian Mother and Child Cohort Study (MoBa), in 2003-2004. This analysis was restricted to 451 primiparous women to avoid bias due to previous pregnancy. Self-reported time-to-pregnancy (TTP) and plasma were obtained around 18 weeks of gestation. Approximately half of the women had measurable PFOSA levels; missing values were multiply imputed. We used the logistic analogue of discrete-time survival analysis to examine the adjusted association between PFOSA, other perfluoroalkyl substances, and TTP.Results: The median-measured PFOSA concentration was 0.03 ng/ml (interquartile range = 0.02, 0.07). The age and body mass index-adjusted association between an interquartile distance increase in PFOSA and TTP was 0.91 (95% confidence interval = 0.71, 1.17). Imputation of missing PFOSA resulted in similar estimates. No association was observed with other perfluoroalkyl substances.Conclusion: Based on a weakly decreased fecundability odds ratio, we found only limited support for an association between plasma PFOSA concentrations and TTP among primiparous women. See Video Abstract at http://links.lww.com/EDE/B79. [ABSTRACT FROM AUTHOR]

Transmission lines are critical infrastructures, but frequently contested especially at the local level, by local communities. The role of public engagement in processes pertaining to specific transmission line projects is an under-researched, yet important topic that this paper seeks to discuss by investigating how inhabitants perceive these processes and to what extent they find the processes just and fair. This paper addresses the participatory aspects of the planning process, as perceived by the local inhabitants in four Norway and UK cases, by using a qualitative comparative case study design. We further analyse this issue through frameworks of public engagement and procedural justice. In both countries public engagement is largely characterized by perceptions of insufficient information, and insufficient influence on the process. In sum, the findings indicate that the informants generally perceive the opportunities for involvement as insufficient and unjust. The findings are quite similar across all cases and both countries. Local inhabitants represent diverse groups who often have different levels of knowledge, time and engagement to bring to the planning process. Their requests for improved processes thus underline the serious public engagement challenges that applicants and decision-makers face. [ABSTRACT FROM AUTHOR]

The article discusses the participation of Muslim women in the mosque and in public debate, and the various opportunities and constraints that they are confronted with in these arenas. Muslim women have to relate to a religiously given patriarchal structure, but they are also actors that can make choices and take advantage of possibilities that challenge patriarchal gender regimes. The article analyses how different processes in the mosque and in the public sphere may be interpreted as contradictory and complex. At times, these processes increase the participation of women and promote liberation, while at other times they constrain women through various forms of discipline and control. The study shows that the presence of immigrant women is decisive for the building of religious institutions among Muslim migrants in diaspora, and that women tend to achieve greater space and be included in more varied forms of participation in the mosque after migration. The study also reveals that many Muslim women find the mosque to be important in their social life and religious education. Despite signs of increased participation by women, the mosque may be described as a patriarchal gender regime where women's participation to a large degree depends on the goodwill of men. The article also discusses the increased participation of Muslim women in public debate, which illustrates that Muslim women in Norway take very different views when it comes to the nature and degree of changes deemed necessary in relation to patriarchal practices. Moreover, participation in public debate creates both possibilities and costs for those involved. The article is based on qualitative interviews with Muslim women and with male imams in Oslo, and on clippings from major Norwegian newspapers. [ABSTRACT FROM AUTHOR]

• Afforestation of marginal agricultural land did not increase soil carbon stocks. • Only minimal build-up of organic horizon 50 years after planting Norway spruce. • 50 years after afforestation, soil still shows legacy from former cultivation. Afforestation of marginal cultivated land is an internationally approved climate mitigation strategy, however, with uncertain implications for soil organic carbon (SOC) storage. We examined the effect of forest planting by measuring SOC at two adjacent sites: one with a Norway spruce forest planted in 1968 and one actively grazed pasture. Both sites had similar land-use history before forest planting, and they were as similar as possible in all other edaphic factors. There were no significant differences in SOC stocks down to 30 cm mineral soil, 7.15 and 8.51 kg C m−2 in the forest plantation and pasture respectively. Only a minimal build-up of an O horizon, less than 2 cm, was observed in the plantation. The SOC stocks of the plantation and pasture were not significantly different from that of a nearby old forest, 7.17 kg C m−2. When comparing these three land-uses we found that there were significant differences in the upper 10 cm of the soil with regard to other soil properties. Nitrogen (N) stock and pH were significantly lower in the old forest compared to the plantation, which again was significantly lower than that of the pasture. The opposite was the case for the C/N ratio. We conclude that there were no significant differences in SOC stocks in the upper 30 cm 50 years after afforestation with Norway spruce, but that there is still a legacy from the former cultivation that may influence both productivity and organic matter dynamics. [ABSTRACT FROM AUTHOR]

Abstract Background In order to meet the increasing demand for donor organs, the concept of donation after circulatory death (DCD) was reintroduced in Norway, first as a pilot study, followed by the use of DCD as institutional practice. We report the current Norwegian experience with liver transplant after DCD. Methods After acceptance from next of kin, life support was withdrawn from patients with devastating brain injury and cardiac arrest observed. After a 5-minute "no-touch" period, extracorporeal membrane oxygenation for post mortem normothermic regional perfusion (NRP) by extracorporeal membrane oxygenator circuit was established. Data from all liver transplant recipients receiving controlled DCD (cDCD) livers in Oslo were analyzed. Results From 2015 to 2017, a total of 8 patients underwent liver transplant with cDCD and NRP liver grafts in Norway. Median Model for End-Stage Liver Disease score was 26 (range, 6–40). There were no cases of delayed graft function or graft loss. Seven patients have reached 1 year of follow-up, and 1 patient has reached 6 months. Two patients have recurrence of primary disease (primary sclerosing cholangitis and steatohepatitis). All patients had normalized liver function at last follow-up. Two patients underwent procedures for biliary complications. In 1 patient, leakage from the cystic duct was successfully handled endoscopically by stenting. In the other patient, a suspected stricture on magnetic resonance imaging led to an endoscopic retrograde cholangiopancreatography, which did not confirm signs of biliary stenosis. There was 1 instance of hepatic artery stenosis, which was managed with endovascular technique. Conclusion The results after liver transplant using cDCD with NRP are good. The rate of complications seems to be within the same range as when using conventional donation after brain death grafts. [ABSTRACT FROM AUTHOR]

Background: Patients with metastatic colorectal cancer receiving palliative chemotherapy have a 5-year survival rate of approximately 10 per cent. Liver transplantation using strict selection criteria in patients with colorectal cancer and unresectable liver-only disease will result in a 5-year survival rate of 56-83 per cent. The aim of this study was to evaluate survival of patients with colorectal liver metastases (CRLM) after liver transplantation using extended criteria for both patients and donors., Methods: This was a prospective single-arm study. Patients with synchronous unresectable CRLM who were not suitable for arms A, B or C of the SEcondary CAncer (SECA) II study who had undergone radical resection of the primary tumour and received chemotherapy were included; they underwent liver transplantation with extended criteria donor grafts. Patients who had resectable pulmonary metastases were eligible for inclusion. The main exclusion criteria were BMI above 30 kg/m 2 and liver metastases larger than 10 cm. Survival was estimated using Kaplan-Meier analysis., Results: Ten patients (median age 54 years; 3 women) were included. They had an extensive liver tumour load with a median of 20 (range 1-45) lesions; the median size of the largest lesion was 59 (range 15-94) mm. Eight patients had (y)pN2 disease, six had poorly differentiated or signet ring cell-differentiated primary tumours, and five had primary tumour in the ascending colon. The median Fong clinical risk score was 3 (range 2-5) and the median Oslo score was 1 (range 1-4). The median plasma carcinoembryonic antigen level was 4·3 (range 2-4346) μg/l. Median disease-free and overall survival was 4 and 18 months respectively., Conclusion: Patients with unresectable liver-only CRLM undergoing liver transplantation with extended patient and donor criteria have relatively short overall survival., (© 2020 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of British Journal of Surgery Society.)

Over a period of ten years, from 1980 to 1989, 701 hernioplasties were performed in 592 patients. 582 of these patients were available for follow-up examination (83%). The average follow-up was 10.3 years, median 10.2 years. The recurrence rate was 12%, 8% of the recurrences occurred after hernioplasties performed by specialists, and 13% after operations performed by surgeons in training. The results are discussed. The authors briefly review recent developments in hernia surgery.

During recent decades the number of operations for peptic ulcer has decreased significantly. The incidence of operations for peptic ulcer or related complications during the period 1975-89 in persons older than 15 years was investigated in the Nord-Trøndelag region of Norway, with a population of approximately 100,000. The number of elective surgical procedures decreased by 72% from 1975 to 1989. The greatest reduction was found for duodenal ulcers. The incidence of acute operations decreased by 35%. The main reason was fewer surgical interventions in patients with haemorrhage, since the number of operations for perforation remained almost constant during the period of 15 years. The reduction in surgical treatment can be explained mainly by the introduction of new H2-antagonists in the seventies, leading to more successful pharmacological treatment of peptic ulcer.