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Objective To develop a general and internationally applicable template of data variables for reporting interhospital neonatal intensive care transports.Design A five-step Delphi method.Setting A group of experts was guided through a formal consensus process using email.Subjects 12 experts in neonatal intensive care transports from Canada, Denmark, Norway, the UK and the USA. Four women and eight men. The experts were neonatologists, anaesthesiologists, intensive care nurse, anaesthetic nurse, medical leaders, researchers and a parent representative.Main outcome measures 37 data variables were included in the final template.Results Consensus was achieved on a template of 37 data variables with definitions. 30 variables to be registered for each transport and 7 for annual registration of the system of the transport service. 11 data variables under the category structure, 20 under process and 6 under outcome.Conclusions We developed a template with a set of data variables to be registered for neonatal intensive care transports. To register the same data will enable larger datasets and comparing services.

Abstract Aims and objectives To explore students' experiences from a pilot project testing out a model for active, collaborative learning in first‐year placement at a nursing home. Background There is a need for innovative learning activities and projects to improve clinical education in nursing homes. Active, collaborative approaches in placement learning may enhance students learning outcome. Design The study had a qualitative and explorative design, in which the experiences of students participating in the pilot were investigated through paired interviews at the end of their placement. Methods Twenty‐two students participated in the study, and data from paired interviews were analysed using qualitative content analysis. COREQ reporting guidelines were used. Results Three themes emerged from the analysis: (1) The learning cell as facilitator for learning; (2) Discovering learning possibilities in nursing homes and (3) Applying tools and resources for learning. Conclusions The model could reduce tension and anxiety while helping the students focus on learning options and use their environment more actively for learning. Working with a learning partner seems to increase student learning through common planning, feedback and reflection. The study emphasises the importance of facilitating active learning through the scaffolding structures and configuration of the students' learning space. Relevance to clinical practice This study indicates the potential for introducing active and collaborative pedagogical models in clinical placement. The model can promote nursing homes as a conducive learning arena for nursing students and help prepare students for a future work role in a rapidly changing health care field. Patient or public contribution The result of the research is shared and discussed with stakeholders prior to finalising the article.

Abstract Background In health care, the work of keeping the patient safe and reducing the risk of harm is defined as safety work. In our digitised and technology-rich era, safety work usually involves a relationship between people and technologies. Telecare is one of the fastest-growing technology-domains in western health care systems. In the marketing of telecare, the expectation is that safety is implicit simply by the presence of technology in patients’ homes. Whilst both researchers and health authorities are concerned with developing cost-benefit analyses and measuring effects, there is a lack of attention to the daily work needed to ensure that technologies contribute to patient safety. This paper aims to describe how patient safety in home care is addressed through and with telecare. We base our exploration on the social alarm, an established technology that care workers are expected to handle as an integrated part of their ordinary work. Methods The study has a qualitative explorative design where we draw on empirical data from three case studies, involving five Norwegian municipalities that use social alarm systems in home care services. We analyse observations of practice and interviews with the actors involved, following King’s outline of template analysis. Results We identified three co-existing work processes that contributed to patient safety: “Aligning people and technologies”; “Being alert and staying calm”; and “Coordinating activities based on people and technology”. Attention to these work processes exposes safety practices, and how safety is constructed in relational practices involving multiple people and technologies. Conclusions We conclude that the three work processes identified are essential if the safety alarm is to function for the end user’s safety. The safety of home-dwelling patients is reliant on the person-technology interface. The efforts of care workers and their interface with technology are a central feature of creating safety in a patient’s home, and in doing so, they utilise a repertoire of skills and knowledge.

Assessment has become a routine feature of school life, internationally. Little is known, however, about the consequences for young people of assessment and grading in physical education (PE) -- a subject often associated with physical recreation. This paper explores young Norwegian's perceptions of assessment and grading in PE from a sociological perspective. In doing so, it contemplates the penetration of neo-liberal discourses as part of wider processes of globalization and Europeanization in school PE in Norway. The study utilizes data generated by 31 focus groups involving 148 youngsters from the 10th grade (15-16-year-olds) in eight purposively sampled secondary schools in Norway. Norwegian PE teachers continue to use tests in order to set grades in PE. The upshot is that students' enjoyment of and engagement in PE, as well as their self-identities and self-esteem, can be compromised by apprehension towards assessment and grading. These processes seem likely to undermine or even erode the potential sociopsychological benefits of PE for some young people by reinforcing the impression that the subject is fast becoming just one more outcome-oriented subject on an academic treadmill. In this regard, the ascendancy of neo-liberalism -- associated with the twin challenges of globalization and European integration -- appears to merely reinforce the hegemony of competitive individualism within PE in Norway, as elsewhere.

ABSTRACT: This study examines a representative sample of adults in California (USA) and Norway, and their attitudes toward adoption versus foster care in a child protection case. The results show that a majority of people favour adoption for a child who has been removed due to maltreatment and cannot be reunified with birth parents. The study examines if people's rights orientation, favouring children or adults, or favouring birth parents or adoptive parents, or their institutional context explain their preferences about long‐term care options. Data material consist of representative samples of the population in California (USA) and Norway (n = 2222), using a vignette survey design. Findings suggest that individuals with a child rights position favour adoption, but attitudes about birth parents' and adoptive parents' rights are not related to care option choices. Institutional context, anchored in policy feedback literature, partly explains the preference for adoption and the population's rights orientation. Further studies are necessary to confirm the role of rights attitudes and institutional context.

Objectives Sleep disturbances and delirium are frequently observed complications after surgical aortic valve replacement (SAVR) and transcutaneous aortic valve implantation (TAVI), especially in octogenarian patients. However, a knowledge gap exists on patient experiences of sleep and delirium. In particular, patients’ long-term sleep and delirium experiences are unknown. This article explores and describes how octogenarian patients suffering from delirium after aortic valve replacement experience their sleep and delirium situation.Design An explorative and descriptive design with a longitudinal qualitative approach was applied. Qualitative content analysis following the recommended steps of Graneheim and Lundman was performed.Setting Patients were included at a tertiary university hospital with 1400 beds. Delirium and insomnia screening was performed at baseline and five postoperative days after aortic valve treatment. For qualitative data, 10 patients were interviewed 6–12 months after treatment with focus on delirium. Five of these patients were reinterviewed 4 years after treatment, with focus on their sleep situation.Participants Inclusion criteria; age 80+, treated with SAVR or TAVI and had experienced delirium after treatment.Results For the initial interview, we included five men and five women, four following TAVI and six following SAVR, mean age 83. One overarching theme revealed from the content analyses; Hours in bed represented emotional chaos. Whereas three subthemes described the patients’ experiences with sleep and delirium, a cascade of distressful experiences disturbing sleep, the struggle between sleep and activity and elements influencing sleep. Four years after the treatment, sleep disturbances persisted, and patients still remembered strongly the delirium incidences.Conclusions For octogenarian patients, sleep disturbances and delirium are long-term burdens and need a greater attention in order to improve patient care.

Abstract Background Reliable methods are needed to identify patients with early-stage cancer or high-grade precancerous lesions in the pancreas. Analysis of pancreatic juice to detect somatic mutations could represent one such approach. Here we investigated the concordance between mutations found in the primary tumor and pancreatic juice from the same patient. Methods Amplicon-based targeted deep sequencing was performed on samples from 21 patients with pancreatic ductal adenocarcinoma (PDAC) who had undergone Whipple’s operation. Mutation profiles were determined in formalin-fixed sections of the primary tumor and in pancreatic juice sampled from the main pancreatic duct during surgery. Results Using a cut-off of 3% for variant allele frequency, KRAS mutations were detected in 20/21 primary tumors (95%) and in 15/21 (71%) juice samples. When also considering low-frequency variants, KRAS mutations were found in 20/21 juice samples. Most juice samples exhibited multiple KRAS variants not seen in the primary tumor, and only in 11 cases (52%) did the most abundant variant of the juice correspond to the KRAS mutation detected in the tumor. TP53 mutations were found in 16 tumors (76%) and six juice samples (29%). Among the positive juice samples, only one exhibited more than a single TP53 mutation. Detection of both KRAS and TP53 mutations was fully concordant in the primary tumor and juice sample in 7/21 cases (33%). Conclusions Pancreatic juice from PDAC patients is rich in KRAS mutations often not seen in the primary tumor and possibly reflecting precancerous lesions in other regions of the pancreas. The inclusion of TP53 mutation detection and additional markers must therefore be considered for fully exploiting the clinical potential of pancreatic juice samples in early cancer detection.

Mathematics teachers' beliefs are central to mathematics teaching and student learning. Because different aspects of motivation and affect--particularly enjoyment--primarily develop within the classroom context, examining how different teachers' beliefs may affect student outcomes in mathematics is imperative. The current study examines teachers' beliefs about the nature and learning of mathematics in connection to students' motivation (i.e. intrinsic value, utility value and perceived competence) and enjoyment of mathematics across different settings by considering students' mathematics achievement, gender and classroom composition (i.e. socioeconomic and behavioural). Data were collected from 3rd- and 4th-grade mathematics teachers (N = 686) and their students (N = 11,782) in six countries (i.e. Norway, Finland, Sweden, Portugal, Estonia and Serbia). A two-level structural equation modelling technique (TSEM) (i.e. student level and classroom level) with random slopes was employed to address our research questions. The results indicate that students' intrinsic value and perceived competence positively relate to their enjoyment of mathematics in all six countries. Teachers' beliefs about the nature and learning of mathematics moderate the within-classroom relationship between boys and girls and the motivation and enjoyment of learning mathematics in Portugal and Norway. Unlike boys, girls consistently perceive themselves as less competent in mastering mathematics, even in primary school. Classroom socioeconomic composition had a more pronounced influence on teachers' beliefs in Sweden, Norway and Serbia. In relation to teachers' beliefs, classroom behavioural composition was relevant in Estonia and Sweden. In Finland and Norway, classroom composition was essential to boys' and girls' differential motivation and enjoyment of mathematics learning.

Background: We explored the experiences of staff working in Norwegian community-based living facilities, caring for people with intellectual disabilities during the Covid-19 pandemic, and what self-regulatory strategies staff used to maintain health and care service delivery and contribute to organisational resilience. Methods: A qualitative design was utilized. Data were collected from September 2021 to April 2022 with individual and focus group interviews. In this study, 25 staff members participated. Thematic analysis was conducted. Findings: Five main themes were identified regarding the experiences of staff during the pandemic: Lockdown of facilities, social isolation of residents, lack of health follow-up, high sick leave rates and communication challenges. Only some of the strategies to mitigate pandemic-related challenges were based on current Norwegian infection control guidelines. Some strategies were successful while others were not and some were negligent and challenged the delivery of health and care services for the residents. Conclusions: Our study shows that people with intellectual disabilities living in the community-based living facilities were subjected to human rights violations and violations of the Norwegian infection control law. This was caused by a lack of several important organisational qualities in the facilities.