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This comparative study of everyday life in Norwegian and French preschools explores how 'risk' related to children's body practices is understood, practised and negotiated by teachers and how this may regulate educational practices in a short- and long-term perspective. Studying educational institutions in two different societies illuminates institutional constraints, normative principles and cultural values influencing everyday practices. Using a polyphonic ethnographic approach, the staff of five settings were invited to react to edited videos of daily life in these settings, and to critically reflect on their own and others' practices. The results show how the teachers articulated the handling of risks and challenges according to the frames and resources related to children and the adults' responsibilities. Six different risk-related themes were identified: the risk of illness, injury, restricting children's bodies and the inability to cope, and risks related to teachers and to pedagogy. These themes also elucidated the different perceptions and values of indoor and outdoor activities through the identification of these risks. Body practices in ECEC appear as socio-political tools to either support or restrict children's experiences.

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.

Abstract Background Sex differences in neuroinflammation could contribute to women’s increased risk of Alzheimer’s disease (AD), providing rationale for exploring sex-specific AD biomarkers. In AD, dysregulation of the kynurenine pathway (KP) contributes to neuroinflammation and there is some evidence of sex differences in KP metabolism. However, the sex-specific associations between KP metabolism and biomarkers of AD and neuroinflammation need to be explored further. Methods Here we investigate sex differences in cerebrospinal fluid concentrations of seven KP metabolites and sex-specific associations with established AD biomarkers and neopterin, an indicator of neuroinflammation. This study included 311 patients with symptomatic AD and 105 age-matched cognitively unimpaired (CU) controls, followed for up to 5 years. Results We found sex differences in KP metabolites in the AD group, with higher levels of most metabolites in men, while there were no sex differences in the CU group. In line with this, more KP metabolites were significantly altered in AD men compared to CU men, and there was a trend in the same direction in AD women. Furthermore, we found sex-specific associations between kynurenic acid and the kynurenic acid/quinolinic acid ratio with neopterin, but no sex differences in the associations between KP metabolites and clinical progression. Discussion In our cohort, sex differences in KP metabolites were restricted to AD patients. Our results suggest that dysregulation of the KP due to increased inflammation could contribute to higher AD risk in women.

Introduction: Ureteroscopy has become increasingly chosen as a treatment of choice for patients with kidney stone disease and laser as the energy source for stone lithotripsy is a key part of this. Our aim was to analyse a national database to evaluate the burden of adverse events related to laser fibers and laser machines. Methods: Search was performed of the Manufacturer User and Facility Device Experience (MAUDE) database in the United States for all events related to holmium laser fibers and holmium laser machines during ureteroscopy between 2012-2021. Information collected included the following: problem, timing, prolonged anaesthesia, early termination of procedure, injury and retained parts. Results: 699 holmium laser fiber events were reported and these had been manufactured by 13 different companies. The commonest problems were breakage outside the patient while in use (26.3%) and breakage of the laser fiber tip (21.2%). Manufacturers concluded root cause to be device failure in 8.9%. 29% of issues occurred before the laser had been activated. 5.2% of cases had to be cancelled as a result of an event. Significantly more injuries were sustained intra-operatively by operating staff compared to patients (6% vs. 0.2%, p < 0.001). All these injuries were superficial burns to the skin with the hand being the most affected body part (88.1%). Zero ocular injuries were reported. Only eight events were related to laser machines and all involved sudden hardware failure but no patient injury. Conclusions: Laser fibers are fragile. Most adverse events are due to operator error. Direct patient injury from laser fiber is scarce but operating staff should be aware of the risk of sustaining minor burns. Laser machines rarely incur problems and, in this study, did not result in any safety issues beyond need to abort the procedure due to lack of spare equipment.

Objective Chronic chemotherapy-induced peripheral neuropathy (CIPN) is a long-lasting side-effect of oxaliplatin. Vitamin B6 might play a role in the pathogenesis of CIPN. Therefore, we investigated associations between plasma vitamin B6 markers and the occurrence and severity of chronic CIPN in patients with non-metastatic colorectal cancer (CRC).Methods and analysis 242 patients with CRC receiving oxaliplatin-based chemotherapy were included. Blood samples were collected at diagnosis (ie, before chemotherapy), and 6 and 12 months after diagnosis (ie, during and after chemotherapy, respectively). Pyridoxal 5′-phosphate (PLP), pyridoxal (PL) and xanthurenic acid:3-hydroxykynurenine (XA:HK) ratio were measured as vitamin B6 markers using liquid chromatography tandem mass spectrometry. Chronic CIPN was assessed 12 months after diagnosis using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN twenty-item scale questionnaire. Prevalence ratios (PRs) and restricted cubic splines (RCSs) were used to assess associations with chronic CIPN occurrence, and linear regressions were used to assess associations with chronic CIPN severity. Analyses were adjusted for age, sex, smoking, alcohol consumption, diabetes and timing of chemotherapy (neoadjuvant/adjuvant/both).Results Chronic CIPN was found in 80% (n=194) of patients. Higher PLP levels and XA:HK ratios during chemotherapy were associated with lower occurrence of chronic CIPN (PRperdoubling 0.75, 95% CI 0.62 to 0.91 and PRCS

Student teachers have been found to be critical toward the research approaches they learned from their master's-based teacher education programmes. Our aim is to discuss how certain research approaches learnt during a 5-year academic master's level teacher education, may bring student teachers close to practice and provide them with conceptual and practical tools for a thorough understanding of the practice of teaching. The argumentation is based on an elaboration of master's-based teacher education programs in Finland and Norway and the essential characteristics of teachers' work. We elaborate on student teachers' need to understand constative, critical and constructive research approaches. This includes critical approaches such as observations and interviews for understanding and interpretation, and constructive approaches such as action research and lesson studies. Finally, we argue that, through these approaches, student teachers make use of research knowledge in teachers' work with an inquiring orientation as well as develop and change their practice.

Abstract Objectives The objective of this study was to evaluate adverse events and device events related to accessories used during ureteroscopy (URS). Materials and methods Analysis was performed of the records available in the Manufacturer and User Facility Device Experience database in the United States. Information was collected on characteristics of problem, timing, manufacturer verdict, successful completion of planned surgery, prolonged anaesthesia and injury to patient or staff. Results Five‐hundred seventy‐one events related to URS accessories were recorded. These were associated with the following devices: baskets (n = 347), access sheath (n = 86), guidewires (n = 78), balloon dilators (n = 27), ARDs (n = 17) and ureteral catheters (n = 16). Of the events, 12.7% resulted in patient injuries. Forty‐eight per cent of the events resulted in prolonged anaesthesia, but the planned surgery was successfully completed in 78.4% of all cases. Collectively, the manufacturers accepted responsibility due to actual device failure in only 0.5% of cases. Common problems for baskets were failure to deploy (39.5%) and complete detachment of basket head (34.6%) and partial breakage of the basket head (12.4%). Of the basket group, 4.3% required open or percutaneous surgery to remove stuck basket. Full break of the body of the access sheath occurred in 41.9% and complete ureteral avulsion in 3.5%. For balloon dilators, there was a burst in 37% of cases. Broken guidewires were associated with 11.5% requiring repeat intervention for retrieval and 6.4% required JJ stent due to perforation to the collecting system. No injuries to operating staff were recorded with accessory usage. Conclusion Accessories used during URS are fragile. Potential for serious injury does exist as a direct result of their use. Surgeons should familiarise themselves with these events and how they can be prevented.

An integrated part of teaching is to face unexpected situations. Teachers have to make immediate decisions, and these decisions may have a great impact on many people. An important question is how teacher education can prepare students for unexpected situations. The aim of this practitioner research study is to investigate if case-based teaching can contribute to reducing the perceived gap in teacher education. A step-wise model was introduced for the students and data based on the student teachers' experiences was collected through questionnaire and focus-group conversations. The findings show three main arguments for why teacher education should be case-based. First, analysing cases helps students to understand that every situation in practice is unique. Second, cases link to practice and theory, and finally, a case opens for different perspectives depending on how the diagnosis is made.

The present study asks what challenges student teachers meet in today's school and how they present, respond to, and reflect on these challenges in an online discussion forum. The study explores these questions by analysing cases written by student teachers in their last practice placement in a one-year post-graduate teacher education programme for secondary school in Norway. The findings show that the cases centre around students and classroom management, and that student teachers take on a role as either participant or observer. The responses are a mix of advice, descriptions of similar experiences, and support. They tend to normalise the situations rather than explore them. Learning from challenging incidents does not happen by itself. Timing is crucial, and so is space for reframing, reflection, and for considering alternative perspectives. This means that there is a need for distance to the situation and a process of interaction with various perspectives.

Background: Ureteropelvic junction obstruction (UPJO) is characterised by stenosis of the ureteral lumen at the level of the renal pelvis and proximal ureter. At Haukeland University Hospital, robotic-assisted laparoscopic pyeloplasty (RLP) for UPJO has been performed since 2014. The aim of this study was to evaluate the results of the treatment and consider what determines treatment success. Materials and methods: Retrospective review was performed of consecutive patients undergoing RLP between 2014-2022. Outcomes of interest included symptom relief, complication rates and renographic findings at follow-up. Treatment success was defined in terms of symptom improvement and/or improvement as well as relief of obstruction on renography. Results: In total, 95 RLPs were performed in 54 women and 41 men, with a mean age of 40 years (IQR: 21-58). Flank pain was the most frequent presenting complaint (n = 81, 85%) followed by infection (n = 33, 35%). More than one indication for surgery was present in 1/3 of the patients. Urodynamic relevant obstruction on renography was found in 62 patients (65%) preoperatively. Mean operative time was 123 minutes (range 60-270). Two patients experienced minor intraoperative complications. At three months follow-up, 91% of patients had symptom relief, and no obstruction on renography was recorded in 64%. There was no significant association between improvement in symptoms and renography findings at follow-up, p = 1. Conclusions: RLP can deliver a high success rate in terms of symptom relief and few complications. There was no association between renography findings and symptom relief at follow-up. Success after surgery should be determined by symptom relief rather than renography findings.

Abstract Introduction Single use ureteroscopes are a technological innovation that have become available in the past decade and gained increased popularity. To this end, there are now an increasing number of both benchside and clinical studies reporting outcomes associated with their use. Our aim was to deliver a narrative review in order to provide an overview of this new technology. Methods A narrative review was performed to gain overview of the history of the technology's development, equipment specifications and to highlight potential advantages and disadvantages. Results Findings from preclinical studies highlight potenial advantages in terms of the design of single use ureteroscopes such as the lower weight and more recent modifications such as pressure control. However, concerns regarding plastic waste and environmental impact still remain unanswered. Clinical studies reveal them to have a non inferior status for outcomes such as stone free rate. However, the volume of evidence, especially in terms of randomised trials remains limited. From a cost perspective, study conclusions are still conflicting and centres are recommended to perform their own micro cost analyses. Conclusions Most clinical outcomes for single use ureteroscopes currently match those achieved by reusable ureteroscopes but the data pool is still limited. Areas of continued debate include their environmental impact and cost efficiency.

Abstract Changes in kynurenine metabolites are reported in users of estrogen containing contraception. We have assessed kynurenines, vitamin B6, vitamin B2 and the inflammation markers, C-reactive protein (CRP) and neopterin, in healthy, never-pregnant women between 18 and 40 years (n = 123) and related this to their use of hormonal contraception. The population included 58 women, who did not use hormonal contraceptives (non-users), 51 users of estrogen-containing contraceptives (EC-users), and 14 users of progestin only contraceptives (PC-users). EC-users had significantly lower plasma kynurenic acid (KA) and higher xanthurenic acid (XA) levels compared to non-users. Serum CRP was significantly higher and negatively associated with both vitamin B6 and B2 status in EC-user compared to non-users. No significant differences in any parameters were seen between PC-users and non-users (p > 0.1). The low KA and high XA concentration in users of estrogen containing contraception resemble the biochemical profile observed in vitamin B6 deficiency. The hormonal effect may result from interference with the coenzyme function of vitamin B6 and B2 for particular enzymes in the kynurenine metabolism. KA has been suggested to be neuroprotective and the significantly reduced concentration in EC-users may be of importance in the observed increased risk of mood disorders among users of oral contraceptives.

Ureteroscopy is increasingly being used for urolithiasis. Technological innovations have been accompanied by wide variations in practice patterns. At the same time, a common finding in many studies, especially systematic reviews, is that the heterogeneity of outcome measurements and lack of standardisation can limit both the reproducibility and generalisability of study findings. While many checklists are available to improve study reporting, there are no ureteroscopy-specific ones. The Adult-Ureteroscopy (A-URS) checklist is a practical aid for both researchers and reviewers for studies in this field. It contains five main sections (study details, preoperative, operative, postoperative, and long term data) and a total of 20 items. Patient summary: We developed a checklist to improve how studies on ureteroscopy (insertion of a telescope through the urethra to inspect the urinary tract) in adults are reported. This could help in advancing the field and improving patient outcomes, as all the key information is captured.

Introduction: We have previously shown that cytokines, the complement system, neopterin, the kynurenine pathway, and vitamin B6-indexes were associated with post-stroke cognitive impairment. In this study, we aimed to investigate whether these biomarkers and metabolites are associated with different trajectories of cognitive function post-stroke using Montreal Cognitive Assessment (MoCA) scale. Methods: The Norwegian Cognitive Impairment After Stroke study (Nor-COAST) is a prospective multicentre cohort study of patients with acute stroke, recruited from 2015 through 2017. The present study included participants with ischemic stroke and measurements of inflammatory biomarkers and metabolites in plasma. Included participants had performed MoCA at baseline and at least one additional follow-up. Trajectories of post-stroke cognitive function was modelled utilizing MoCA scores from baseline, 3 months, 18 months, and 36 months post-stroke. We used multinominal logistic regression with trajectory groups as dependent variable and inflammatory biomarkers and metabolites (cytokines, a complement marker, neopterin, metabolites from the kynurenine pathway, and vitamin-B6-indexes) at baseline as covariates in a model adjusted for age, sex, creatinine and hospital. Results: 401 participants were included. Mean age (SD) 71.3 (11.6) years, 59 % males, and mean (SD) NIHSS score at day 1 after hospital admission 2.5 (3.3). We identified three trajectory groups of post-stroke cognitive function: “Low and declining” (11 %), “Moderate and stable” (33%), and “High and increasing” (56 %). High baseline levels of neopterin, quinolinic acid, the PAr-index, the terminal complement complex, interleukin 6 and macrophage inflammatory protein 1α were associated with increased risk of being in group “Low and declining” compared to “High and increasing” (p

Background: Ureteroscopy (URS) in patients with urinary diversion is technically challenging. Common difficulties include anastomotic strictures, tortuosity, and failure to cannulate the ureteric orifice. There are few studies reporting outcomes in this special population. Objective: Our aim was to report outcomes at two tertiary centres in Europe. Design, setting, and participants: A multicentre retrospective cohort study was conducted between 2010 and 2022. Intervention: URS (antegrade and retrograde) procedures carried out in patients with urinary diversions. Outcome measurements and statistical analysis: Outcomes of interest included success at cannulating the ureteric orifice, stone-free rate (SFR), and complications. A logistic regression analysis was performed to identify potential predictors for success at cannulating the ureteric orifice and success at completing the intended procedure in a single session. Results and limitations: Fifty patients underwent 72 URS procedures, with most (86%) undergoing a retrograde approach. The majority (82%) of patients had undergone ileal conduit. Wallace was the commonest anastomosis type (64%). Ureteric anastomosis was cannulated successfully in 81% of cases. The most common reason for cannulation failure was the inability to identify the ureteric orifice (11%). A multivariable analysis revealed that an endourologist performing the case was associated with a significantly greater likelihood of cannulation success compared with consultants (odds ratio 25.9, p

This paper explores parents’ perspectives on their involvement in their children’s transitions to adult life and services in the context of young adults with disabilities in Norway. Based on semi-structured interviews, the accounts of seven parents were analyzed by applying a sociocultural framework. Informed by reflexive thematic analysis and considering personal, interpersonal, and cultural-institutional aspects of the parents’ accounts, six themes of parental involvement were generated. It was shown how these parents operate within current cultural norms and practices of prolonged, intensive and autonomy-supportive parenting, and how these practices can come into conflict with norms of increased youth independence practiced in demanding institutional transitions. The findings also illustrate how sociocultural practices of stigmatization and marginalization can pose a particular challenge for youth with disabilities and their parents. Finally, we argue that a contextualized conception of parental involvement could widen the space for collaboration between youth with disabilities, parents, and professionals.

Abstract. Background. The management of suspected kidney stone disease in pregnancy is challenging. In cases of persistent flank pain and where investigations may have rendered equivocal results, ureteroscopy (URS) is a recognized diagnostic and therapeutic intervention. This study aimed to investigate the safety and outcomes associated with performing URS during pregnancy, as the technique has evolved over the past 4 decades at our center. Materials and Methods. We performed a retrospective analysis of pregnant patients who underwent URS at our tertiary center between 1984 and 2022. Outcomes of interest included anesthetic approach, operative time, hospital stay, and complications. Results. Eighty-seven pregnant patients underwent 96 URS procedures, and 60% (n = 57) of these procedures were performed during the third trimester. Overall, 58% (n = 56) of the procedures were achieved with local anesthesia and light sedation. During the most recent decade, the latter was successfully carried out in 97% of the procedures, with the remainder occurring under spinal anesthesia as per patient choice. Overall, 57% (n = 50) of the whole study group had ureteral calculi found at the time of surgery and in 88% (n = 44) of these cases, fragmentation/extraction was performed. The remainder had insertion of ureteral stent with definitive clearance deferred until postpartum. Mean operative time and postprocedure hospital stay was 33 minutes (range, 7–100 minutes) and 2.2 days (range, 0–16 days), respectively. The overall intraoperative and postoperative complication rates were 2% and 11%, respectively. During the final decade, the latter improved to 6% and all adverse events were minor (Clavien I/II), with the exception of a single case. Regarding exit strategy, ureteral stent was placed in 42% (n = 40) of the procedures, 23% (n = 22) had ureteral catheter inserted, and the remainder (35%, n = 34) had none. Conclusions. Ureteroscopy can be safely performed during pregnancy using anesthetic approach with local anesthesia and light sedation. Development of a local protocol and multidisciplinary management algorithm are instrumental in enabling the delivery of such a service.

The current study is a collective self-study on how we as 15 teacher educators at a university in Norway tried to improve our teaching through working with cases with the aim of better supporting student teachers in making links between theory and practice. We wanted to address the common criticism in teacher education concerning a perceived gap between practice and theory. Our presupposition was that one way to prepare student teachers for work and bring together theoretical and practical knowledge would be through case-based teaching. We agreed that we wanted to try different ways of working with cases and to follow our own actions with research and conduct a self-study. Throughout the project, each teacher educator experienced to learn about case-based teaching, but our joint learning was limited due to practical issues and lack of time. With teacher education as a shared responsibility, our conclusion is that teacher educators need time to develop as a team, not only as individual teachers.

Recent development in policy and learning theory encourages higher education institutions to send their students out of campus and into work placements. In this paper, we report on students' engagement with various aspects of knowing through practice in work placements. We employed focus group discussions to gather students' accounts of their knowing in the three higher education programmes: Teacher Education, Aqua Medicine, and Music Performance. The students' accounts of knowing were analysed as personal epistemologies. Thereby, we aimed to focus on how enacted practices in work develop students' appraisals of knowing and subjectivities. Three prominent epistemologies were present across all three student groups: professional judgment, professional practice, and professional identity. After the work placements, the students better understand how to enact their knowledge and what knowledge to pursue further. Based on these findings, we hold that there are key educational processes that arise in the interplay between students' situated enactment of practices, knowing, and personal epistemologies through work placements, and propose a conceptual model to frame students' learning in work placements.

Ureteroscopy has become an increasingly popular surgical intervention for conditions such as urinary stone disease. As new technologies and techniques become available, debate regarding their proper use has risen. This includes the role of single use ureteroscopes, optimal laser for stone lithotripsy, basketing versus dusting, the impact of ureteral access sheath, the need for safety guidewire, fluoroscopy free URS, imaging and follow up practices are all areas which have generated a lot of debate. This review serves to evaluate each of these issues and provide a balanced conclusion to guide the clinician in their practice.

Abstract Circulating concentrations of metabolites (collectively called kynurenines) in the kynurenine pathway of tryptophan metabolism increase during inflammation, particularly in response to interferon-gamma (IFN-γ). Neopterin and the kynurenine/tryptophan ratio (KTR) are IFN-γ induced inflammatory markers, and together with C-reactive protein (CRP) and kynurenines they are associated with various diseases, but comprehensive data on the strength of associations of inflammatory markers with circulating concentrations of kynurenines are lacking. We measured circulating concentrations of neopterin, CRP, tryptophan and seven kynurenines in 5314 controls from 20 cohorts in the Lung Cancer Cohort Consortium (LC3). The associations of neopterin, KTR and CRP with kynurenines were investigated using regression models. In mixed models, one standard deviation (SD) higher KTR was associated with a 0.46 SD higher quinolinic acid (QA), and 0.31 SD higher 3-hydroxykynurenine (HK). One SD higher neopterin was associated with 0.48, 0.44, 0.36 and 0.28 SD higher KTR, QA, kynurenine and HK, respectively. KTR and neopterin respectively explained 24.1% and 16.7% of the variation in QA, and 11.4% and 7.5% of HK. CRP was only weakly associated with kynurenines in regression models. In summary, QA was the metabolite that was most strongly associated with the inflammatory markers. In general, the inflammatory markers were most strongly related to metabolites located along the tryptophan–NAD axis, which may support suggestions of increased production of NAD from tryptophan during inflammation.

Abstract Background Epidemiological studies often investigate amino acids and their metabolites as biomarkers, but do not always consistently use fasting or non-fasting blood samples, or may lack information on the prandial status of the study participants. Since little information is available on the effects of the prandial status on many biomarkers, and since blood is typically sampled early in the day with participants in a fasting state or after having consumed a light meal in many trials, the main purpose of this study was to investigate the short-term effects of a light breakfast on serum concentrations of amino acids and related metabolites. Methods Blood was collected from sixty-three healthy adults (36 women) in the fasting state and at set times for 120 min after intake of a light breakfast with low protein content (14 g protein, 2218 kJ). Relative changes in serum biomarker concentrations from fasting to postprandial serum concentrations were tested using T test. Results The serum concentrations of 13 of the 20 measured amino acids were significantly changed 60 min following breakfast intake, with the most marked effects seen as increases in alanine (34%) and proline (45%) concentrations. The response did not reflect the amino acid composition of the breakfast. The concentrations of seven kynurenine metabolites were significantly decreased after breakfast. Conclusion Consumption of a light breakfast affected serum concentrations of several amino acids and related metabolites, underlining the importance of having information regarding the participants’ prandial state at the time of blood sampling in studies including these biomarkers. Trial registration This trial was registered at clinicaltrials.gov as NCT02350595 (registered January 2015).