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Annual Report 2024 National Quality Register for Spinal Surgery (NORSpine)
No full textThe Norwegian Registry for Spine Surgery (NORSpine) consists of three sub-registers for surgical treatment of degenerative conditions in the lumbar- and cervical spine, and deformity surgery (idiopathic scoliosis). All Norwegian surgical units performing these types of surgery report to the NORspine (100 % coverage). The capture rate (case completeness) is > 80 % for both lumbar and cervical spine surgery, and > 80 % of the patients respond at the 3- and 12 months follow up. However, at some hospitals the regitstration completeness should be increased. For the newly started registry for deformity (2023), completeness analyses are currently not available.
The average frequency of surgery for degenerative spine conditions is stable. However, only 68 % of the lumbar and 82 % of the cervical spine cases originating from residential area of the Northern Norway regional health authority, were operated at hospitals located inside this region.
Surgical outcomes vary according to diferences in patient populations. Importantly, comparison of results across surgical units, presented in this report, have not been adjusted for case-mix, even though diferences in patient populations may be large, especially between private and public hospitals.
Waiting time before surgery has impact on treatment quality, but it is too long in many hospitals. From 2022 NORspine has focused on unwarranted practice variation in the use of prophylactic anti thrombotic treatment, and this has been reduced according to national recommendations. In 2024, only < 5 % could have received such medication inappropriately.
After many years working with research driven quality improvement by NORspine, the use complex fusion surgery for lumbar spinal stenosis with concomitant degenerative spondylolisthesis has decreased and has now stabilized at a rate of only 7 %. The clinical outcomes 12 months after surgery remain stable, while costs have been reduced.
Endoscopic spine surgery is being implemented at fve hospitals and is under consideration at several other hospitals. The number of endoscopic procedures has increased from 0 in 2019, to 83 lumbar- and to 33 cervical spine operations in 2024. A mini-Health Technology Assessment (HTA) of endoscopic spine surgery is being conducted at Telemark Hospital Trust, and possibly, also a national HTA will be developed. The NORspine is monitoring the implantation of endoscopic surgery prospectively. So far it seems to be safe compared to standard microsurgical techniques.
Despite an aging patient population (30 % > 70 years), the main clinical outcomes are stable. In 2024, the proportion of patients experiencing substantial improvement 12 months after surgery (“success rate”) was 67 % for lumbar disc herniation, 63 % for lumbar spinal stenosis surgery and 59 % for anterior cervical discectomy. However, the results vary between hospitals. Better patient selection for surgery seems to be the key to further improvements. Therefore, the advisory board of the NORspine recommended several hospitals to critically appraise surgical indications and to initiate clinical audits and action at the hospitals. In 2024, seven local quality projects were ongoing.
In addition, the NORspine is working with integrating the registry into the electronic patient record (DIPS), so that data concerning treatment quality can be made accessible in the clinicians’ work-fow. This enables use of artifcial intelligence-based decision support, which is expected to facilitate patient selection for surgery. This has can potentially improve patient outcomes. Clinical testing will start in 2025. The Norwegian Registry for Spine Surgery (NORSpine) consists of three sub-registers for surgical treatment of degenerative conditions in the lumbar- and cervical spine, and deformity surgery (idiopathic scoliosis). All Norwegian surgical units performing these types of surgery report to the NORspine (100 % coverage). The capture rate (case completeness) is > 80 % for both lumbar and cervical spine surgery, and > 80 % of the patients respond at the 3- and 12 months follow up. However, at some hospitals the regitstration completeness should be increased. For the newly started registry for deformity (2023), completeness analyses are currently not available.
The average frequency of surgery for degenerative spine conditions is stable. However, only 68 % of the lumbar and 82 % of the cervical spine cases originating from residential area of the Northern Norway regional health authority, were operated at hospitals located inside this region.
Surgical outcomes vary according to diferences in patient populations. Importantly, comparison of results across surgical units, presented in this report, have not been adjusted for case-mix, even though diferences in patient populations may be large, especially between private and public hospitals.
Waiting time before surgery has impact on treatment quality, but it is too long in many hospitals. From 2022 NORspine has focused on unwarranted practice variation in the use of prophylactic anti thrombotic treatment, and this has been reduced according to national recommendations. In 2024, only < 5 % could have received such medication inappropriately.
After many years working with research driven quality improvement by NORspine, the use complex fusion surgery for lumbar spinal stenosis with concomitant degenerative spondylolisthesis has decreased and has now stabilized at a rate of only 7 %. The clinical outcomes 12 months after surgery remain stable, while costs have been reduced.
Endoscopic spine surgery is being implemented at fve hospitals and is under consideration at several other hospitals. The number of endoscopic procedures has increased from 0 in 2019, to 83 lumbar- and to 33 cervical spine operations in 2024. A mini-Health Technology Assessment (HTA) of endoscopic spine surgery is being conducted at Telemark Hospital Trust, and possibly, also a national HTA will be developed. The NORspine is monitoring the implantation of endoscopic surgery prospectively. So far it seems to be safe compared to standard microsurgical techniques.
Despite an aging patient population (30 % > 70 years), the main clinical outcomes are stable. In 2024, the proportion of patients experiencing substantial improvement 12 months after surgery (“success rate”) was 67 % for lumbar disc herniation, 63 % for lumbar spinal stenosis surgery and 59 % for anterior cervical discectomy. However, the results vary between hospitals. Better patient selection for surgery seems to be the key to further improvements. Therefore, the advisory board of the NORspine recommended several hospitals to critically appraise surgical indications and to initiate clinical audits and action at the hospitals. In 2024, seven local quality projects were ongoing.
In addition, the NORspine is working with integrating the registry into the electronic patient record (DIPS), so that data concerning treatment quality can be made accessible in the clinicians’ work-fow. This enables use of artifcial intelligence-based decision support, which is expected to facilitate patient selection for surgery. This has can potentially improve patient outcomes. Clinical testing will start in 2025.
Ringtunet på Rødskjær
No full textUnder utgrävningar utförda av Arktiska universitetsmuseet år 2023, upptäcktes et ringtun med ett tillhörande kokgropfält vid Rødskjær.
Kokgropsfältet bestod av över 155 kokgropar anlagda på en yta på över 3500 m2, då kokgropsfältet sträcker sig utanför lokalitetsavgränsningen. De äldsta groparna grävdes under slutet av förromersk järnålder och den yngsta i tidig vikingatid, med en övervikt av groparna daterade till mellan 100 och 500 evt.
Ringtunet bestod av minst 16 hus, där de flesta var flerfasiga. Husen tycktes överlag vara förhållandevis lika i utseende. De var små treskeppiga långhus, med en längd på runt 11 meter och en bredd på runt 4 meter. Alla hus tycks ha haft ett flertal eldstäder, men bara två av husen hade andra typer av strukturer, och i båda dessa fall var det tal om ugnsanläggningar. Ringtunets aktivitesfas bör ha varit mellan ca 250 evt till någon gång i slutet på 500-talet /början av 600-talet. Även om spridd, senare aktivitet påträffades.
Väldigt få fynd blev gjorda på lokaliteten, och det mesta som blev funnet låg i matjorden.
Däremot blev en stor mängd med ben insamlade vilka har visat sig främst vara får/get och en del nötkreatur. Troligen så har dessa djur blivit slaktade på lokaliteten.
En stor mängd med naturvetenskapliga prover samlades in under utgrävningen. Dessa var en större mängd C14, makrofossil, fosfat och sedaDNA vilka har blivit analyserade och ligger med rapporten som vederlägg.During excavations performed by The Arctic University Museum in 2023, a courtyard site with an associated cooking pit field was discovered at Rødskjær.
The cooking pit field consisted of over 155 cooking pits spread across an area of more than 3,500 m², beyond the boundaries of the excavation site. The oldest pits were dug during the late Pre-Roman Iron Age, while the youngest dated to the early Viking Age, with the majority of the pits dated to between AD 100 and 500.
The courtyard site consisted of at least 16 houses, most of which were multi-phased. The houses appeared to be relatively similar in design overall. They were small three-aisled longhouses, approximately 11 meters in length and 4 meters in width. All the houses seemed to have had multiple hearths, but only two of the houses contained other types of structures, both of which featured oven installations. The activity phase of the courtyard site is estimated to have been between approximately AD 250 and sometime in the late 6th century or early 7th century, although traces of scattered, later activity were also found.
Very few artifacts were discovered at the site, and most of what was found was located in the topsoil. However, a large quantity of bones was collected, primarily from sheep/goats and some cattle. It is likely that these animals were slaughtered at the site.
A significant number of scientific samples were collected during the excavation. These included a large number of C14 samples, macrofossils, phosphate, and sedaDNA, all of which have been analyzed and are included in the accompanying report.Under utgrävningar utförda av Arktiska universitetsmuseet år 2023, upptäcktes et ringtun med ett tillhörande kokgropfält vid Rødskjær.
Kokgropsfältet bestod av över 155 kokgropar anlagda på en yta på över 3500 m2, då kokgropsfältet sträcker sig utanför lokalitetsavgränsningen. De äldsta groparna grävdes under slutet av förromersk järnålder och den yngsta i tidig vikingatid, med en övervikt av groparna daterade till mellan 100 och 500 evt.
Ringtunet bestod av minst 16 hus, där de flesta var flerfasiga. Husen tycktes överlag vara förhållandevis lika i utseende. De var små treskeppiga långhus, med en längd på runt 11 meter och en bredd på runt 4 meter. Alla hus tycks ha haft ett flertal eldstäder, men bara två av husen hade andra typer av strukturer, och i båda dessa fall var det tal om ugnsanläggningar. Ringtunets aktivitesfas bör ha varit mellan ca 250 evt till någon gång i slutet på 500-talet /början av 600-talet. Även om spridd, senare aktivitet påträffades.
Väldigt få fynd blev gjorda på lokaliteten, och det mesta som blev funnet låg i matjorden.
Däremot blev en stor mängd med ben insamlade vilka har visat sig främst vara får/get och en del nötkreatur. Troligen så har dessa djur blivit slaktade på lokaliteten.
En stor mängd med naturvetenskapliga prover samlades in under utgrävningen. Dessa var en större mängd C14, makrofossil, fosfat och sedaDNA vilka har blivit analyserade och ligger med rapporten som vederlägg
Finland has a New National Declaration for Open Science and Research – and the Keyword is Community
No full textFinland’s 2025 revision of the National Declaration for Open Science and Research demonstrates a community-driven approach to policy-making. The research community led by over 400 experts from diverse research organisations contributed through workshops, public hearings, and ongoing expert panels. By emphasising co-creation, the process strengthened academic freedom, fostered shared ownership, and produced a Declaration focused on active commitments, guiding principles, and contemporary challenges such as research security and responsible openness. Finland’s model shows how structured coordination can turn broad participation into robust, actionable, and widely supported open science policy
Present participles without and with -s in The Nordic Dialect Corpus
No full textArtikkelen beskriver bruken av presens partisipp uten og med -s (som i ståane og ståanes) i den norske delen av Nordisk dialektkorpus. Korpuset består av samtaler mellom og intervju med unge og eldre informanter av begge kjønn fra 111 ulike steder. Undersøkelsen av den geografiske fordelinga i korpuset viser at kjerneområdet for presens partisipp uten -s er Vestlandet, men at slike former også er mer eller mindre vanlige på Østlandet og i Trøndelag, mens partisipp med -s har sitt kjerneområde i Nord-Norge, og dessuten er ganske vanlige i sørvestlig del av Østlandet og Agder. Dialektbeskrivelser støtter langt på veg dette, men tyder på at s-former er eller har vært noe mer utbredt enn i det undersøkte korpuset. Undersøkelsen viser videre at det i materialet fra mange steder er veksling mellom presens partisipp uten og med -s. Det er vanskelig å påvise klar intraindividuell veksling, men det er tydelige eksempel på veksling på grunn av påvirkning fra en annen muntlig eller skriftlig varietet. I materialet sett under ett kan en ellers se en tendens til at unge bruker mer partisipp med -s enn eldre, og til at bruken av -s er minst vanlig i attributiv og adverbial bruk og mest vanlig når partisippa brukes som subjekts- eller objektspredikativ.The article describes the use of present participles without and with -s (as in ståane and ståanes) in the Norwegian part of The Nordic Dialect Corpus. The corpus consists of conversations between and interviews with young and older informants of both genders from 111 different locations. The study of the geographical distribution in the corpus shows that the central area of present participles without -s is Western Norway, but that such forms are also more or less common in Eastern Norway and the Trøndelag area, while participles with -s have their central area in Northern Norway, and in addition are quite common in the southwestern part of Eastern Norway and the Agder area. Dialect descriptions go a long way towards supporting this, but they additionally indicate that s-forms may be or have been little more common than in the studied corpus. Furthermore, the study shows that there is variation in the material from many locations between present participles without and with -s. It is difficult to prove clear intraindividual variation, but there are obvious examples of variation caused by influence from another oral or written variety. In addition, in the corpus considered as a whole, there is a tendency that young people use more participles with -s than older people, as well as a tendency that participles with -s are least common in attributive and adverbial use and most common when the participle functions as a subjective or objective predicative
Systematic review and classification of: International Child Development Programme (ICDP) (3.ed)
No full textBackground: This article is a revision of two previous descriptions of the International Child Development Programme (ICDP) published in Ungsinn (Reedtz, 2012; Reedtz & Lauritzen, 2017) and provides an updated review of the effects of ICDP in Norway. ICDP is a low-threshold, time-limited, and structured parenting guidance program designed to support children’s psychosocial development by strengthening caregivers’ competence in their caregiving practices. The program targets caregivers of children aged 0–18 years and was developed by Karsten Hundeide and Henning Rye. In Norway, the intervention is owned by Bufdir and ICDP Norway. ICDP is implemented in local community settings and, when relevant, in prisons for incarcerated caregivers.
Methods: This knowledge review is based on a systematic literature search in the following databases: Embase, Medline, PsycINFO, Norart, Cochrane, Cristin, Nora, Scopus, and SweMed. Five articles, partly based on the same Norwegian sample, met the inclusion criteria. In total, six studies were included in this review.
Results: The results summarize ICDP’s goals, arenas, design, and methods, as well as the outcomes of effectiveness studies, methodological quality, and implementation quality. Overall, there were no effects for most outcome variables measured across the included studies. For all positive findings, the effects of the intervention were consistently small. However, results from the most recent study document that parents’ perceived mastery and improved regulation of the child’s emotions were strengthened after completing the program. ICDP has robust routines for quality assurance in implementation and a comprehensive strategy for dissemination.
Conclusion: According to Ungsinn’s classification criteria, ICDP is classified at evidence level 4 – Intervention with satisfactory documentation of effect.Bakgrunn: Denne artikkelen er en kunnskapsoppsummering om effektene av tiltaket International Child Development Programme (ICDP) i Norge. Artikkelen er en revisjon av to tidligere beskrivelser av det samme tiltaket i Ungsinn (Reedtz, 2014; Reedtz & Lauritzen, 2017). ICDP er et foreldreveiledningsprogram som søker å støtte barns psykososiale utvikling gjennom styrking av omsorgsgiveres kompetanse i deres omsorgsutøvelse for barn. Tiltaket er et lavterskel, tidsavgrenset og strukturert veiledningstiltak for omsorgspersoner for barn i alderen 0–18 år og er utviklet av Karsten Hundeide og Henning Rye. Tiltakseier i Norge er Bufdir og ICDP Norge. ICDP blir gjennomført på arenaer i familiers lokalmiljø samt i fengsel dersom omsorgsgiver/e er fengslet.
Metode: Denne kunnskapsoppsummeringen bygger på et systematisk litteratursøk i databasene Embase, Medline, PsycINFO, Norart, Cochrane, Cristin, Nora, Scopus og Swemed. Fem artikler basert på delvis samme utvalg tilfredsstilte inklusjonskriteriene.
Resultater: Resultatene omfatter en oppsummering av tiltakets beskrivelse, inkluderte effektstudier, forskningsmetodisk kvalitet og implementeringskvalitet. ICDPs målsettinger, tiltaksarenaer, utforming og metoder er beskrevet. Totalt seks studier ble inkludert i denne kunnskapsoppsummeringen. Totalt sett var det ingen effekt for de fleste utfallsvariabler som ble målt på tvers av de inkluderte studiene. For alle positive funn var effektene av tiltaket i studiene gjennomgående små. Resultatene i den siste studien dokumenterer imidlertid at foreldrenes opplevde mestring og regulering av barnets emosjoner ble styrket etter gjennomført tiltak. Tiltaket har gode rutiner for å kvalitetssikre implementeringen og en helhetlig strategi for spredning av tiltaket.
Konklusjon: Basert på Ungsinns kriterier klassifiseres ICDP på evidensnivå 4 – Tiltak med tilfredsstillende dokumentasjon på effekt
Emergent ecological dynamics in videogames: What player paratexts reveal
No full textVideogames invite players to inhabit virtual worlds that often represent or simulate ecologies. Existing conceptual frameworks for understanding these dynamics and experiences as they arise from play emphasise the role of the videogame text in structuring such meaning. This article introduces the concept of emergent ecological dynamics to explain how, within the situated and ephemeral experience of playing a videogame, new ecocritical meaning can emerge, and can be captured in user-created paratexts. Undertheorised in ecocritical game studies are player experiences of ecologies and environments that emerge in ways unanticipated and unintended by gamemakers. By drawing on explanations of assemblage, emergence, and the materiality of digital media, this article suggests a latent potential for all videogame texts to convey ecocriticality. The methodological value of addressing player paratexts—as a means for scholars to access and analyse otherwise transitory emergent ecological dynamics—is also explored. The capacity of such user-created artefacts to manifest players’ revelations of ecological entanglement, development of ecological awareness and encounters with potent sensations of affect drawn upon as examples
Metroidvania ecologies: Exploration and the environmental imagination in Hollow Knight and Rain World
No full textMetroidvania games are characterized by highly interconnected levels that open up as the player acquires new skills or knowledge of the game world. In this article, we argue that the spatial interconnectedness of the Metroidvania genre strongly resonates with ecological theories foregrounding human–nonhuman enmeshment as well as nonhuman autonomy. Discussing two recent Metroidvania titles, Hollow Knight (Team Cherry, 2017) and Rain World (Videocult, 2017), we show how these games consistently challenge the player’s environmental imagination, and particularly notions of human mastery over the nonhuman world. They do so on multiple levels: by evoking rich postapocalyptic settings that resist the player’s attempts to project anthropocentric assumptions onto the games; by confronting players with nonhuman characters and lore that remain unreadable and opaque; and by creating dynamically evolving game worlds in which nonhuman behavior feels unruly and unpredictable. Most importantly, though, the two games suggest ecosystemic interconnectedness by defamiliarizing the players’ understanding of exploration as the linear traversal of spaces that can be fully controlled and depleted. Through this discussion, we aim to situate Metroidvania games within the growing archive of ecogaming, explaining what is so unique about the genre’s approach to the environmental imagination
A longitudinal investigation of third-person subject expression in additional-language Spanish
No full textThe goal of the present investigation was to examine the variable use of third-person subject forms in additional-language Spanish over a period of 21 months that included an academic year in Spain or Mexico. The data came from the additional-language learners of Spanish in the LANGSNAP corpus (N = 27). We analyzed production data from three points in time: before the participants went abroad, at the end of their nine-month stay, and nine months after the sojourn abroad ended. We coded all contexts of third-person subject forms (K = 9,379) for the subject form used, seven linguistic variables, and five extralinguistic variables. The analysis revealed that learners used a diverse inventory of subject forms, namely unexpressed subjects, five types of pronouns, lexical noun phrases, and verbal phrases. The mixed-effects model demonstrated that learners’ variable use of third-person subjects is complex. In brief, four linguistic factors (referent continuity, clause type, specificity, and perseveration) and one extralinguistic factor (task) predicted use. We moreover observed stability in their use of third-person subject forms over time, meaning that no significant changes occurred while learners were abroad
If agreement is pronominal there is no pro-drop
No full textUsing Irish, Spanish and English data, I argue that the null subject phenomenon is modulated by the presence/absence of unvalued φ-features in the clausal structure. This analysis is contrasted with the two most influential analyses so far: (i) The ellipsis analysis, according to which a null subject is a deleted pronoun and (ii) the rich inflection analysis, according to which an inflection with overt exponents for person and number can license and identify a silent pronoun. I discuss both analyses and present some empirical and conceptual criticisms vis-à-vis my own approach. One additional advantage of my approach is that we conclude that there are no silent subjects in Irish or Spanish-type languages.