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Mergers in higher education are large-scale, complex organisational change processes seeking to integrate former independent institutions into a new organisational entity. Mergers are often justified by reference to broad overarching goals such as quality, relevance, and efficiency. In practice, mergers entail attempts at organisational integration which can be inhibited by several obstacles, increasing and large internal distances can be such a hindrance to integration. In this paper, we explore how different forms of distance to leadership in the context of higher education can be conceptualised, and how experiences of different forms of distance interrelate. This paper shows that geographical distance can also mask other conceptualisations of distances and that geographical distance can also interact with other forms of distances. The empirical basis consists of data from a large-scale research project addressing the organisational transformations taking place in Norwegian higher education due to mergers between 2016 and 2017.

Despite the fact that prison officers are close to the incarcerated persons in everyday life in prison, and therefore will have great impact and influence on the incarcerated persons' understanding of and motivation for education and training in prison, we still know little about prison officers understanding of their professional role regarding incarcerated persons' education. This article will investigate how Norwegian prison officers understand their importance as educational actors through the following research question: How do Norwegian prison officers understand their role as actors in incarcerated persons' education? Building on qualitative interviews with 16 Norwegian prison officers' the article analyses the role of prison officers from a broad educational perspective (Biesta, 2009; 2014; 2015; OECD, 2005; 2019). The analysis reveals that prison officers conduct work that enables incarcerated persons to master their own lives during the execution of and after completing their sentences. Although prison officers play a significant role in incarcerated persons' education in prison, they are partly unaware of this role, and find that their own role is not in a collaborative relationship with other actors who facilitate incarcerated persons' education.

Many recent higher education reforms worldwide have been legitimated by their potential impact on the performance of universities and colleges. However, we know less about the actual impact of the changes implemented. This article examines the extent to which research performance can be associated with specific organizational characteristics at the department level. The analysis is based on Norwegian university departments, where high- and low-performing departments have been selected as cases for further investigations. The policy context is the organizational reform in Norway from 2016 onwards aiming at reorganizing the higher education landscape through institutional mergers. The key findings indicate that there are few distinct departmental characteristics associated with research performance, such as elected or appointed leadership, single or multi-campus organization, or departmental size. However, the study reveals that highly productive individuals do matter and suggests that cultural dimensions and working conditions may be interesting factors to pursue in further research.

The induction period is a frequently discussed element in a teacher's career. While there is a recognised need for support during induction, the access to support is not available to all newly qualified teachers (NQTs). However, little is known about the micro-political processes of NQTs' access to support in the workplace. The purpose of this study is to investigate experiences of support during NQTs' first year in teaching, using concepts from micro-political theory. The findings show that NQTs experience reactive support, a lack of formal support, and self-initiated informal peer support. The findings are based on a thematic analysis of written accounts collected from 15 NQTs in Norwegian secondary schools every month during their first year, as well as individual interviews at the end of the year. The study concludes that the use of power in interactions among members of the school organisation impact NQTs' access to induction-support.

Succeeding at university can be a complex matter, and the barriers are manifold for students with disabilities (SwDs). Accommodations are available for those with needs, but these alone do not meet the political goals of inclusive educations. Student ambassadors act as experienced representatives on campuses, supporting others and gaining individual benefits themselves. Approaches building on SwDs' experiences and capacities can be a means to overcome the complex barriers often faced throughout education. This scoping review aimed to map research on student ambassador interventions for SwDs in higher education and identify the interventions' key concepts. The result will inform an ambassador intervention in higher education. Six electronic databases were searched for peer-reviewed articles of any design published between 2010 and December 2020. Six studies met the inclusion criteria. A thematic synthesis resulted in three key concepts: peer guidance and supportive relationships; building strategies and transferable skills; and advocating for change. However, no program utilises exclusively students with disabilities in ambassador roles. The results indicate a lack of research as well as awareness on the unexplored potential of actively involving SwDs in ambassador roles.

Background Quality improvement work is an essential feature of healthcare services, including general practice. In this study, we aimed to gain more knowledge regarding general practitioners’ (GPs) motivation for such work in their practices, as well as what kind of measures were considered motivating and feasible.Materials and methods We conducted five focus group interviews among Norwegian GPs between November 2021 and November 2022. We included 21 GPs of varying age, gender, experience, and geographic situation. The data were transcribed verbatim and analysed by Systematic Text Condensation, a thematic cross-case analysis.Results Many GPs had a diverse and imprecise understanding of the term quality improvement, and sound routines in everyday practice were often given as examples of quality improvement measures. There was a universal attitude that quality improvement initiatives should be close to practice, professionally relevant, and sufficiently small to be manageable. The availability of professional communities, either in the GP practices or in continuous medical education groups, was important for motivation. The role of nurses and health secretaries was highlighted as essential to achieve change. Participants commonly described negative reactions to programs that were imposed by external actors without regard for the GPs’ perceived needs.Conclusion GPs were motivated for quality improvement measures provided feasibility within the framework of general practice. Well-functioning professional communities, including involvement of nurses and health-secretaries, were emphasised as requisite for quality improvement. Small scale quality improvement programs suited for the needs of general practice were well received and should be further developed.

The here presented Virtual Campus project developed a 3D geodata modelling toolchain, and an open source software based technology stack for creating a Digital geoTwin of the University of Cologne (UoC). We also develop and present a reactjs based web application, a flutter and Unity based mobile app with AR features, as well as an UnrealEngine based VR application to access, browse and visualize the geoTwin data and models in the UoC CAVE 3D environment. The 3D models of the Universities Buildings will include indoor models based on 2D floorplans, which will facilitate indoor positioning in the mobile application of the project through geometry matching and simultaneous localization and mapping (SLAM) technology. For distribution and streaming the 3D building models, we utilze the OGC Standard 3D Tiles, for which we present a tool to georeference the glTF 3D models and assets accurately on the globe.

Kindergartens are institutional arenas for raising the nation through educating children in an every-day setting. With the implementation of the Framework Plan of 2017 (FP), the notion of "Sàmi culture" became part of the mandatory curriculum in all Norwegian kindergartens for the first time. All kindergartens are now expected to ensure that children develop respect for, and solidarity with, the diversity of Sàmi culture. This paper based on policy analysis and interviews in kindergartens investigates how the notion of "Sàmi culture" is part of the national Framework Plan (FP) for kindergartens and how it is understood and implemented in kindergartens. The concept of everyday nationalism sheds light on tensions involved in including indigenous rights and perspectives in a national Framework Plan. Including indigenous rights and cultures as part of a national Framework Plan can widen the content of what it means to belong in a national state as well as sharpen the lines and maintain boundaries. Conceptions of diversity are an integral part of the messiness involved in drawing boundaries and in the making of the everyday nationalism, suggesting that the relationship between diversity and everyday nationalism deserves more interrogation.

BackgroundA staff e-learning course was developed to prepare for scaling up a national take-home naloxone (THN) program in Norway. The aims of the study were to (a) describe participant characteristics for those that completed a THN e-learning course, (b) compare opioid overdose knowledge scores before and after e-learning course completion, and (c) to explore subsequent THN distribution by those trained.MethodsThis was a quasi-experimental pre-test, post-test longitudinal cohort study of individuals completing a THN e-learning course from April 2021 to May 2022. Frequency analyses were performed for participant characteristics and subsequent naloxone distributions at 1-week and 1-month follow-up. The opioid overdose knowledge scale (OOKS) was used to measure pre-test-post-test knowledge among participants. Wilcoxon signed-rank test was performed for comparison between pre-test and post-test. Effect size was calculated using Cohen criteria.ResultsIn total, 371 individuals were included in this study. Most were either nurses or social workers (n = 277, 75%). Participant knowledge increased by medium or large effect for all items measured. At 1-month follow-up, 15% reported naloxone distribution. During the study period, 94 naloxone kits were distributed. Major reasons for not distributing were “clients not interested”, “workplace not distributing” and “workplace in process of distributing”.ConclusionsOur findings suggest that an e-learning course is equally effective in terms of knowledge transfer as an in-person classroom setting, and may provide engagement in terms of naloxone distribution. However, our findings also emphasize the importance of clear implementation routines, including support from central coordinators to optimize the implementation process.

Hamas sitt terrorangrep mot Israel 7. oktober 2023 og den påfølgende krigen i Gaza, er en brutal påminnelse om at man ikke kan få fred og stabilitet i Midtøsten uten en løsning på Israel-Palestina-konflikten. Skal det bli varig fred i Midtøsten, må palestinerne få sin egen stat. Kun en tostatsløsning vil sikre palestinernes rett til å bestemme over egne liv og fremtid. Tostatsløsningen er også en forutsetning for sikkerhet for Israel og fred og stabilitet i hele regionen. Gjennom våren 2024 har det pågått aktivt diplomatisk samarbeid om behovet for en politisk prosess frem mot en tostatsløsning. De siste månedene har den arabiske fredsvisjonen, som Norge er en sterk støttespiller til, fått stadig mer oppslutning. Kjernen i fredsvisjonen er at det trengs en irreversibel prosess fram mot en palestinsk stat. Nøkkelpunkter er at den palestinske myndigheten må styrkes kraftig, at ikke-statlige væpnede grupper må demobiliseres, at Israel må få troverdige sikkerhetsgarantier og normalisering av forholdet mellom Israel og nabolandene. Norges anerkjennelse av staten Palestina er et konkret bidrag til å styrke en bærekraftig tostatsløsning på sikt, og et bidrag til den arabiske fredsvisjonen. Anerkjennelsen er også med på å styrke de moderate kreftene på palestinsk side. Men før vi kan komme videre med en tostatsløsning, trengs en varig våpenhvile, økt humanitær innsats i Gaza og løslatelse av gislene. Abstract in English: How Can Peace in the Middle East Be Achieved? Hamas’ terrorist attack against Israel on 7 October 2023 and the subsequent war in Gaza are brutal reminders that peace and stability in the Middle East cannot be achieved without a solution to the Israel-Palestine conflict. If there is to be lasting peace in the Middle East, the Palestinians must get their own state. Only a two-state solution will ensure the Palestinians’ right to determine their own lives and future. The two-state solution is also a prerequisite for security for Israel and peace and stability in the entire region. In recent months, there has been active diplomatic cooperation on the need for a political process towards a two-state solution. The Arab peace vision, of which Norway is a strong supporter, has gained increasing support. The core of the peace vision is that an irreversible process towards a Palestinian state is needed. Key points are that the Palestinian Authority must be greatly strengthened, that non-state armed groups must be demobilized, that Israel must receive credible security guarantees and the normalization of relations between Israel and neighboring countries. Norway’s recognition of the State of Palestine is a concrete contribution to strengthening a sustainable two-state solution in the long term, and a contribution to the Arab peace vision. The recognition also helps to strengthen the moderate forces on the Palestinian side. But before we can move forward with a two-state solution, a lasting ceasefire, increased humanitarian efforts in Gaza and the release of the hostages are needed.

The Entada landrace of enset (Ensete ventricosum (Welw.) Chessman) is probably the most unique indigenous crop in Ethiopia, being maintained and utilized by the Ari people in the South of Ethiopia. Here we describe genetic diversity, selection signatures and relationship of Entada with cultivated and wild enset using 117 Entada genotypes collected from three Entada growing regions in Ethiopia (Sidama, South and North Ari). A total number of 1,617 high-quality SNP markers, obtained from ddRAD-sequences, were used for the diversity studies. Phylogenetic analysis detected a clear distinction between cultivated enset, Entada and wild enset with Entada forming a completely separated clade. However, extremely short branch lengths among the Entada genotypes indicate very little molecular evolution in the Entada lineages. Observed and expected heterozygosities were high, 0.73 and 0.50, respectively. Overall, our results strongly indicate that the Entada genotypes we have studied originated from one or a few clonal lineages that have been propagated and spread among farmers as clones. Prolonged clonal propagation of heterozygous genotypes from a single or few founding lineages has led to populations with very little or no diversity between genotypes, and high heterozygosity within genotypes. Signatures of directional selection were identified at eight loci based on an FST outlier analysis. Four candidate genes detected are involved in axillary shoot growth and might be involved in controlling natural sucker formation in Entada.

BackgroundThe electrophysiological mechanism connecting mitral valve prolapse (MVP), premature ventricular complexes and life-threatening ventricular arrhythmia is unknown. A common hypothesis is that stretch activated channels (SACs) play a significant role. SACs can trigger depolarizations or shorten repolarization times in response to myocardial stretch. Through these mechanisms, pathological traction of the papillary muscle (PM), as has been observed in patients with MVP, may induce irregular electrical activity and result in reentrant arrhythmia.MethodsBased on a patient with MVP and mitral annulus disjunction, we modeled the effect of excessive PM traction in a detailed medical image-derived ventricular model by activating SACs in the PM insertion region. By systematically varying the onset of SAC activation following sinus pacing, we identified vulnerability windows for reentry with 1 ms resolution. We explored how reentry was affected by the SAC reversal potential (ESAC) and the size of the region with simulated stretch (SAC region). Finally, the effect of global or focal fibrosis, modeled as reduction in tissue conductivity or mesh splitting (fibrotic microstructure), was investigated.ResultsIn models with healthy tissue or fibrosis modeled solely as CV slowing, we observed two vulnerable periods of reentry: For ESAC of −10 and −30 mV, SAC activated during the T-wave could cause depolarization of the SAC region which lead to reentry. For ESAC of −40 and −70 mV, SAC activated during the QRS complex could result in early repolarization of the SAC region and subsequent reentry. In models with fibrotic microstructure in the SAC region, we observed micro-reentries and a larger variability in which times of SAC activation triggered reentry. In these models, 86% of reentries were triggered during the QRS complex or T-wave. We only observed reentry for sufficiently large SAC regions (>= 8 mm radius in models with healthy tissue).ConclusionStretch of the PM insertion region following sinus activation may initiate ventricular reentry in patients with MVP, with or without fibrosis. Depending on the SAC reversal potential and timing of stretch, reentry may be triggered by ectopy due to SAC-induced depolarizations or by early repolarization within the SAC region.

BackgroundRadiotherapy (RT) can be used to reduce symptoms and maintain open airways for patients with non-small cell lung cancer when systemic treatment is not sufficient. For some patients, tumor control is not achieved due to radioresistance. Concurrent inhibition of epidermal growth factor receptors has been proposed as a strategy to overcome radioresistance but may increase toxicity. We performed a randomized trial to assess the efficacy, tolerance, and quality of life of concurrent erlotinib and palliative thoracic RT for patients with advanced non-small cell lung cancer.MethodsPatients were randomized 1:1 to RT alone (arm A) or in combination with erlotinib (arm B). A computed tomography (CT) scan at baseline and one at 4–12 weeks after inclusion was used to evaluate treatment response. Adverse events were registered during treatment and the subsequent 30 days. Health-related quality-of-life questionnaires were completed by the patients at baseline, weeks 2, 6, and 20.ResultsA total of 114 patients were included. Of the 74 patients with CT scans available for evaluation of treatment effect, there were no significant differences in tumor size reduction between the two groups: median 14.5% reduction in the control arm A and 17.0% in the erlotinib arm B (p = 0.68). Overall survival was not significantly different between the two treatment arms: 7.0 and 7.8 months in arm A and arm B, respectively (log-rank p = 0.32). There was no significant increase in adverse events in the experimental arm, other than what is expected from erlotinib treatment alone. Overall, patients reported similar quality of life in both treatment arms.ConclusionConcurrent erlotinib and palliative thoracic RT for patients with advanced non-small cell lung cancer was well tolerated but did not improve the efficacy of the RT.Clinical trial registrationClinicalTrials.gov, identifier NCT02714530.

Abstract. Introduction:. Chronic pain affects a wide range of physical and psychological aspects of life for those impacted. Psychosocial treatment approaches may be of support, but outreach is still limited. Objectives:. To evaluate the efficacy of EPIO, an evidence-informed, user-centered digital self-management intervention for people with chronic pain, in a 12-month randomized controlled trial. Methods:. People living with chronic pain (N = 266) were randomized to the EPIO intervention (n = 132) or a usual-care control group (n = 134). The intervention was delivered in a simple blended care model, and outcome measures collected at baseline, 6 months, and 12 months. Generalized linear models for repeated measures were fitted to compare groups over time. Results:. Participants were primarily female (81%), median age 49 years (range 22–78), with heterogeneous pain conditions, and had lived with pain >5 years (77.6%). A mixed linear model with all timepoints included revealed no statistically significant group differences for the primary outcome of pain interference. Significant psychological benefits in favor of the intervention group were however detected for depression (P = 0.022), self-regulatory fatigue (P = 0.024), vitality (P = 0.016), and mental health (P = 0.047). Baseline to 12-month changes showed additional favorable effects for anxiety (between-group mean differences [MDs] = 0.79, P = 0.047), depression (MD = 1.08, P = 0.004), self-regulatory fatigue (MD = 2.42, P = 0.021), pain catastrophizing (MD = 2.62, P = 0.009), and health-related quality of life. Conclusions:. The EPIO program aims to improve outreach of evidence-based pain self-management interventions. Findings demonstrate how using EPIO can lead to sustainable psychological change, enhancing mental health and health-related quality of life for people suffering from pain, providing a chance to live well with the pain.

The Field Crop Disease and Invertebrate Loss Calculator Web Tool is an interactive online resource showcasing estimates of the yield reduction and economic impact of plant diseases and invertebrate pests over time and location. Accessible through the Crop Protection Network website (https://www.cropprotectionnetwork.org), this free online research tool was developed to inform agronomists and researchers across industry and academia, extension workers, commodity groups, and funding agencies about the impact of crop disease and invertebrate pests. The tool enables widespread user access through commonly used web browsers on computers, tablets, and mobile devices. Yield loss estimates are generally obtained through annual surveys of university-affiliated specialists or others with experience in crop protection. Production data are primarily obtained from U.S. and Canadian government agencies. A detailed understanding of the economic impacts of plant disease and invertebrate pests provides valuable information that can inform the allocation of resources to reduce losses in major field crops. [Figure: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license.

Abstract Background Helicopter Emergency Medical Services (HEMS) provide rapid and specialized care to critically ill or injured patients. Norwegian HEMS in Central Norway serves an important role in pre-hospital emergency medical care. To grade the severity of patients, HEMS uses the National Advisory Committee for Aeronautics’ (NACA) severity score. The objective of this study was to describe the short- and long term mortality overall and in each NACA-group for patients transported by HEMS Trondheim using linkage of HEMS and hospital data. Methods The study used a retrospective cohort design, aligning with the STROBE recommendations. Patient data from Trondheim HEMS between 01.01.2017 and 31.12.2019 was linked to mortality data from a hospital database and analyzed. Kaplan Meier plots and cumulative mortality rates were calculated for each NACA group at day one, day 30, and one year and three years after the incident. Results Trondheim HEMS responded to 2224 alarms in the included time period, with 1431 patients meeting inclusion criteria for the study. Overall mortality rates at respective time points were 10.1% at day one, 13.4% at 30 days, 18.5% at one year, and 22.3% at three years. The one-year cumulative mortality rates for each NACA group were as follows: 0% for NACA 1 and 2, 2.9% for NACA 3, 10.1% for NACA 4, 24.7% for NACA 5 and 49.5% for NACA 6. Statistical analysis with a global log-rank test indicated a significant difference in survival outcomes among the groups (p

Abstract Background Champions play a critical role in implementing technology within healthcare services. While prior studies have explored the presence and characteristics of champions, this review delves into the experiences of healthcare personnel holding champion roles, as well as the experiences of healthcare personnel interacting with them. By synthesizing existing knowledge, this review aims to inform decisions regarding the inclusion of champions as a strategy in technology implementation and guide healthcare personnel in these roles. Methods A systematic mixed studies review, covering qualitative, quantitative, or mixed designs, was conducted from September 2022 to March 2023. The search spanned Medline, Embase, CINAHL, and Scopus, focusing on studies published from 2012 onwards. The review centered on health personnel serving as champions in technology implementation within healthcare services. Quality assessments utilized the Mixed Methods Appraisal Tool (MMAT). Results From 1629 screened studies, 23 were included. The champion role was often examined within the broader context of technology implementation. Limited studies explicitly explored experiences related to the champion role from both champions’ and health personnel’s perspectives. Champions emerged as promoters of technology, supporting its adoption. Success factors included anchoring and selection processes, champions’ expertise, and effective role performance. Discussion The specific tasks and responsibilities assigned to champions differed across reviewed studies, highlighting that the role of champion is a broad one, dependent on the technology being implemented and the site implementing it. Findings indicated a correlation between champion experiences and organizational characteristics. The role’s firm anchoring within the organization is crucial. Limited evidence suggests that volunteering, hiring newly graduated health personnel, and having multiple champions can facilitate technology implementation. Existing studies predominantly focused on client health records and hospitals, emphasizing the need for broader research across healthcare services. Conclusions With a clear mandate, dedicated time, and proper training, health personnel in champion roles can significantly contribute professional, technological, and personal competencies to facilitate technology adoption within healthcare services. The review finds that the concept of champions is a broad one and finds varied definitions of the champion role concept. This underscores the importance of describing organizational characteristics, and highlights areas for future research to enhance technology implementation strategies in different healthcare settings with support of a champion.

Abstract Background Opioid agonist treatment (OAT) for patients with opioid use disorder (OUD) has a convincing evidence base, although variable retention rates suggest that it may not be beneficial for all. One of the options to include more patients is the introduction of heroin-assisted treatment (HAT), which involves the prescribing of pharmaceutical heroin in a clinical supervised setting. Clinical trials suggest that HAT positively affects illicit drug use, criminal behavior, quality of life, and health. The results are less clear for longer-term outcomes such as mortality, level of function and social integration. This protocol describes a longitudinal evaluation of the introduction of HAT into the OAT services in Norway over a 5-year period. The main aim of the project is to study the individual, organizational and societal effects of implementing HAT in the specialized healthcare services for OUD. Methods The project adopts a multidisciplinary approach, where the primary cohort for analysis will consist of approximately 250 patients in Norway, observed during the period of 2022–2026. Cohorts for comparative analysis will include all HAT-patients in Denmark from 2010 to 2022 (N = 500) and all Norwegian patients in conventional OAT (N = 8300). Data comes from individual in-depth and semi-structured interviews, self-report questionnaires, clinical records, and national registries, collected at several time points throughout patients’ courses of treatment. Qualitative analyses will use a flexible inductive thematic approach. Quantitative analyses will employ a wide array of methods including bi-variate parametric and non-parametric tests, and various forms of multivariate modeling. Discussion The project’s primary strength lies in its comprehensive and longitudinal approach. It has the potential to reveal new insights on whether pharmaceutical heroin should be an integral part of integrated conventional OAT services to individually tailor treatments for patients with OUD. This could affect considerations about drug treatment even beyond HAT-specific topics, where an expanded understanding of why some do not succeed with conventional OAT will strengthen the knowledge base for drug treatment in general. Results will be disseminated to the scientific community, clinicians, and policy makers. Trial registration The study was approved by the Norwegian Regional Committee for Medical and Health Research Ethics (REK), ref.nr.:195733.

Abstract Aim To evaluate placental pathology in term and post-term births, investigate differences in clinical characteristics, and assess the risk of adverse neonatal outcome. Methods This prospective observational study included 315 singleton births with gestational age (GA) > 36 weeks + 6 days meeting the local criteria for referral to placental histopathologic examination. We applied the Amsterdam criteria to classify the placentas. Births were categorized according to GA; early-term (37 weeks + 0 days to 38 weeks + 6 days), term (39 weeks + 0 days to 40 weeks + 6 days), late-term (41 weeks + 0 days to 41 weeks + 6 days), and post-term births (≥ 42 weeks + 0 days). The groups were compared regarding placental pathology findings and clinical characteristics. Adverse neonatal outcomes were defined as 5-minute Apgar score

Abstract The human subarachnoid space harbors the cerebrospinal fluid, which flows within a landscape of blood vessels and trabeculae. Functional implications of subarachnoid space anatomy remain far less understood. This study of 75 patients utilizes a cerebrospinal fluid tracer (gadobutrol) and consecutive magnetic resonance imaging to investigate features of early (i.e. within 2-3 h after injection) tracer propagation within the subarachnoid space. There is a time-dependent perivascular pattern of enrichment antegrade along the major cerebral artery trunks; the anterior-, middle-, and posterior cerebral arteries. The correlation between time of first enrichment around arteries and early enrichment in nearby cerebral cortex is significant. These observations suggest the existence of a compartmentalized subarachnoid space, where perivascular ensheathment of arteries facilitates antegrade tracer passage towards brain tissue. Periarterial transport is impaired in subjects with reduced intracranial pressure-volume reserve capacity and in idiopathic normal pressure hydrocephalus patients who also show increased perivascular space size.

Abstract Background Few studies have examined the use of concentrated and intensified cognitive behaviour therapy for treating social anxiety disorder (SAD). The aim of this study was to examine the feasibility of the Bergen 4-Day Treatment (B4DT) for treating SAD. Methods This study adopted an open trial design without a control group. Thirty consecutively referred patients who were diagnosed with SAD were treated and assessed at pre-treatment, at post-treatment, and at the 3-month follow-up. The Liebowitz Social Anxiety Scale was used to assess symptoms of SAD; the Generalized Anxiety Disorder-7 scale was used to assess anxiety symptoms; and the Patient Health Questionnaire-9 was used to assess symptoms of anxiety and depression. The Client Satisfaction Questionnaire-8 was administered posttreatment. Results Overall, patients reported a high level of satisfaction with the B4DT. Large effect sizes were observed for symptoms of SAD (d = 1.94–2.66) and for the secondary outcomes, i.e., generalized anxiety (d = 0.86–0.99) and depression (d = 0.62–0.83). The remission rate was 55.2% at follow-up, while the treatment response rate was 89.7%. Conclusions The B4DT is a promising treatment approach for patients with SAD. In the future, controlled trials should be performed to compare the efficacy of this treatment approach with standard outpatient treatment. Practical consequences, policy implications, and suggestions for future research are discussed herein.

We analyzed long-term measurements of organic carbon, elemental carbon, and source-specific organic tracers from 2017 to 2020 to constrain carbonaceous aerosol sources in the rapidly changing Arctic. Additionally, we used absorption photometer (Aethalometer) measurements to constrain equivalent black carbon (eBC) from biomass burning and fossil fuel combustion, using positive matrix factorization (PMF). Our analysis shows that organic tracers are essential for understanding Arctic carbonaceous aerosol sources. Throughout 2017 to 2020, levoglucosan exhibited bimodal seasonality, reflecting emissions from residential wood combustion (RWC) in the heating season (November to May) and from wildfires (WFs) in the non-heating season (June to October), demonstrating a pronounced interannual variability in the influence of WF. Biogenic secondary organic aerosol (BSOA) species (2-methyltetrols) from isoprene oxidation was only present in the non-heating season, peaking in July to August. Warm air masses from Siberia led to a substantial increase in 2-methyltetrols in 2019 and 2020 compared to 2017 to 2018. This highlights the need to investigate the contribution of local sources vs. long-range atmospheric transport (LRT), considering the temperature sensitivity of biogenic volatile organic compound emissions from Arctic vegetation. Tracers of primary biological aerosol particles (PBAPs), including various sugars and sugar alcohols, showed elevated levels in the non-heating season, although with different seasonal trends, whereas cellulose had no apparent seasonality. Most PBAP tracers and 2-methyltetrols peaked during influence of WF emissions, highlighting the importance of measuring a range of source-specific tracers to understand sources and dynamics of carbonaceous aerosol. The seasonality of carbonaceous aerosol was strongly influenced by LRT episodes, as background levels are extremely low. In the non-heating season, the organic aerosol peak was as influenced by LRT, as was elemental carbon during the Arctic haze period. Source apportionment of carbonaceous aerosol by Latin hypercube sampling showed mixed contributions from RWC (46 %), fossil fuel (FF) sources (27 %), and BSOA (25 %) in the heating season. In contrast, the non-heating season was dominated by BSOA (56 %), with lower contributions from WF (26 %) and FF sources (15 %). Source apportionment of eBC by PMF showed that FF combustion dominated eBC (70±2.7 %), whereas RWC (22±2.7 %) was more abundant than WF (8.0±2.9 %). Modeled BC concentrations from FLEXPART (FLEXible PARTicle dispersion model) attributed an almost equal share to FF sources (51±3.1 %) and to biomass burning. Both FLEXPART and the PMF analysis concluded that RWC is a more important source of (e)BC than WF. However, with a modeled RWC contribution of 30±4.1 % and WF of 19±2.8 %, FLEXPART suggests relatively higher contributions to eBC from these sources. Notably, the BB fraction of EC was twice as high as that of eBC, reflecting methodological differences between source apportionment by LHS and PMF. However, important conclusions drawn are unaffected, as both methods indicate the presence of RWC- and WF-sourced BC at Zeppelin, with a higher relative BB contribution during the non-heating season. In summary, organic aerosol (281±106 ng m−3) constitutes a significant fraction of Arctic PM10, although surpassed by sea salt aerosol (682±46.9 ng m−3), mineral dust (613±368 ng m−3), and typically non-sea-salt sulfate SO42- (314±62.6 ng m−3), originating mainly from anthropogenic sources in winter and from natural sources in summer.

The COVID-19 pandemic has necessitated essential modifications to the administration of psychotherapy for patients with panic disorder (PD) through the increased use of videoconferencing. However, the effect of this change on treatment efficacy remains unclear. The current study is a long-term (1.5 years) investigation of the Bergen 4-day treatment (B4DT) for PD delivered as a combination of videoconferencing and face-to-face therapy. This study reported the long-term outcomes of B4DT for PD when delivered in a hybrid format. The B4DT includes multiple components delivered over four consecutive days. As the pandemic unfolded, B4DT was adapted to include different levels of in-person versus videoconference delivery, depending on COVID-19 infection rates and public health recommendations. Outcome measures included clinician-rated illness severity on the Panic Disorder Severity Scale (PDSS) and patient-rated symptoms of PD, agoraphobia, generalized anxiety, and depression. Follow-up treatment, work status, and current medications were assessed. We used multilevel models to estimate whether clinical improvement was maintained over time. Treatment effects achieved at three months were maintained at the 1.5-year follow-up. Patients who completed the PDSS scored M = 14.78 (SD = 3.37) before treatment, M = 5.88 (5.28) at the three-month follow-up (d = 2.01), and M = 5.44 (SD = 5.12) at the long-term follow-up (d = 2.15). The reduction in generalized anxiety and depression symptoms was maintained over time. The current study suggests that B4DT can be delivered successfully in a combination of face-to-face and videoconference therapy sessions. Moreover, long-term effects are maintained, even during the challenging circumstances of the pandemic.