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‘Level the playing field’–pupils’ experiences of inclusion and social justice in physical education and health
Get PDFSchool physical education and health (PEH) has an important role to play in the physical, cognitive, emotional and social development of young people [Opstoel, K., Chapelle, L., Prins, F. J., De Meester, A., Haerens, L., van Tartwijk, J., & De Martelaer, K. (2020). Personal and social development in physical education and sports: A review study. European Physical Education Review, 26(4), 797–813] which, in turn, can enhance interpersonal relations and help build more socially cohesive and just societies [Benn, T., Dagkas, S., & Jawad, H. (2011). Embodied faith: Islam, religious freedom and educational practices in physical education. Sport, Education and Society, 16(1), 17–34; Smith, W., Philpot, R., Gerdin, G., Schenker, K., Linnér, S., Larsson, L., Mordal Moen, K., & Westlie, K. (2021). School HPE: Its mandate, responsibility and role in educating for social cohesion. Sport, Education and Society, 26(5), 500–513]. Unfortunately, research continues to highlight the inability of PEH to realize these important outcomes and the pervasiveness of practices that instead contribute to exclusion and inequality. The aim of this study was to add our understanding of school PEH practices by exploring pupils’ experiences of inclusion and social justice. Data were generated through a survey, observations, interviews and critical reflective texts. Participants in the study were pupils from three different upper-secondary schools (age 16–19) located in southern Sweden. The analysis of data involved a six-phase thematic analysis approach [Braun, B., & Clarke, V. (2013). Successful qualitative research: A practical guide for beginners. Sage] informed by theories of critical and dialogical pedagogy [Freire, P. (1970). Pedagogy of the oppressed. Seabury]. The results are presented in relation to four central themes: (1) care and relationships, (2) pupil involvement, (3) use of modified and non-traditional activities and spaces; and (4) learning about and acting on social inequities. In order to promote more inclusive and socially just PEH practice, a [Freire, P. (1970). Pedagogy of the oppressed. Seabury] analysis of the pupils’ experiences draws attention to the importance of: establishing horizontal teacher–pupil relationships built on trust and love: engaging pupils in an ongoing dialogue where the pupils practice choice and decision-making with their peers; inviting the pupils into critically reflecting on issues of positionality and power and; pupils learning to act on social inequities. To conclude, the paper calls for future studies where teachers and pupils collaborate to develop PEH practices underpinned by inclusion and social justice.publishedVersio
Holistic vibrational spectromics assessment of human cartilage for osteoarthritis diagnosis
Get PDFOsteoarthritis (OA) is the most common degenerative joint disease, presented as wearing down of articular cartilage and resulting in pain and limited mobility for 1 in 10 adults in the UK [Osteoarthr. Cartil. 28(6), 792 (2020) [CrossRef] ]. There is an unmet need for patient friendly paradigms for clinical assessment that do not use ionizing radiation (CT), exogenous contrast enhancing dyes (MRI), and biopsy. Hence, techniques that use non-destructive, near- and shortwave infrared light (NIR, SWIR) may be ideal for providing label-free, deep tissue interrogation. This study demonstrates multimodal “spectromics”, low-level abstraction data fusion of non-destructive NIR Raman scattering spectroscopy and NIR-SWIR absorption spectroscopy, providing an enhanced, interpretable “fingerprint” for diagnosis of OA in human cartilage. This is proposed as method level innovation applicable to both arthro- or endoscopic (minimally invasive) or potential exoscopic (non-invasive) optical approaches. Samples were excised from femoral heads post hip arthroplasty from OA patients (n = 13) and age-matched control (osteoporosis) patients (n = 14). Under multivariate statistical analysis and supervised machine learning, tissue was classified to high precision: 100% segregation of tissue classes (using 10 principal components), and a classification accuracy of 95% (control) and 80% (OA), using the combined vibrational data. There was a marked performance improvement (5 to 6-fold for multivariate analysis) using the spectromics fingerprint compared to results obtained from solely Raman or NIR-SWIR data. Furthermore, clinically relevant tissue components were identified through discriminatory spectral features – spectromics biomarkers – allowing interpretable feedback from the enhanced fingerprint. In summary, spectromics provides comprehensive information for early OA detection and disease stratification, imperative for effective intervention in treating the degenerative onset disease for an aging demographic. This novel and elegant approach for data fusion is compatible with various NIR-SWIR optical devices that will allow deep non-destructive penetration.publishedVersio
Yearly intrasubject variability of hematological biomarkers in elite athletes for the Athlete Biological Passport
Get PDFConfounding factors including exercise and environments challenge the interpretation of individual Athlete Biological Passports (ABPs). This study aimed to investigate the natural variability of hematological ABP parameters over 1 year in elite athletes compared with healthy control subjects and the validity of a multiparametric model estimating plasma volume (PV) shifts to correct individual ABP thresholds. Blood samples were collected monthly with full blood counts performed by flow cytometry (Sysmex XN analyzers) in 20 elite xc-skiers (ELITE) and 20 moderately trained controls. Individual ABP profiles were generated through Anti-Doping Administration & Management System Training, a standalone version of the ABP's adaptive model developed by the World Anti-Doping Agency. Additionally, eight serum parameters were computed as volume-sensitive biomarkers to run a multiparametric model to estimate PV. Variability in ELITE compared with controls was significantly higher for the Abnormal Blood Profile Scores (P = 0.003). Among 12 Atypical Passport Findings (ATPF) initially reported, six could be removed after correction of PV shifts with the multiparametric modeling. However, several ATPF were additionally generated (n = 19). Our study outlines a larger intraindividual variability in elite athletes, likely explained by more frequent exposure to extrinsic factors altering hematological biomarkers. PV correction for individual ABP thresholds allowed to explain most of the atypical findings while generating multiple new ATPF occurrences in the elite population. Overall, accounting for PV shifts in elite athletes was shown to be paramount in this study outlining the opportunity to consider PV variations with novel approaches when interpreting individual ABP profiles.publishedVersio
A validation of register-derived diagnoses of interstitial lung disease in patients with inflammatory arthritis: data from the NOR-DMARD study
Get PDFObjective
There is a lack of knowledge concerning the validity of the interstitial lung disease (ILD) diagnoses used in epidemiological studies on rheumatic diseases. This paper seeks to verify register-derived ILD diagnoses using chest computed tomography (CT) and medical records as a gold standard.
Method
The Norwegian Anti-Rheumatic Drug Register (NOR-DMARD) is a multicentre prospective observational study of patients with inflammatory arthritis who start treatment with disease-modifying anti-rheumatic drugs. NOR-DMARD is linked to the Norwegian Patient Registry (NPR) and Cause of Death Registry. We searched registers for ILD coded by ICD-10 J84 or J99 among patients with rheumatoid arthritis, psoriatic arthritis, or spondyloarthritis. We extracted chest CT reports and medical records from participating hospitals. Two expert thoracic radiologists scored examinations to confirm the ILD diagnosis. We also searched medical records to find justifications for the diagnosis following multidisciplinary evaluations. We calculated the positive predictive values (PPVs) for ILD across subsets.
Results
We identified 71 cases with an ILD diagnosis. CT examinations were available in 65/71 patients (91.5%), of whom ILD was confirmed on CT in 29/65 (44.6%). In a further 10 patients, medical records confirmed the diagnosis, giving a total of 39/71 verified cases. The PPV of a register-derived ILD diagnosis was thus 54.9%. In a subset of patients who had received an ILD code at two or more time-points and had a CT scan taken within a relevant period, the PPV was 72.2%.
Conclusion
The validity of register-based diagnoses of ILD must be carefully considered in epidemiological studies.publishedVersio
Clinical outcomes and outcome predictors of two-year assertive community treatment in Norway: an explorative prospective pre–post study
Get PDFBackground
Assertive Community Treatment (ACT) teams have become a part of mental health services for people with severe mental illness in many high-income countries. Studies in several countries have investigated the outcomes of ACT, and knowledge is also needed about outcomes of ACT teams in Norway. Our aims were to study clinical outcomes of ACT, how the outcomes were associated with characteristics of patients and treatment, and whether they differed across ACT teams.
Methods
Our explorative, prospective, pre–post multicenter study involved 142 patients who received ACT for two years from the first 12 ACT teams established in urban and rural areas of Norway. There was no control group. The primary outcome was change in clinician-rated psychiatric symptoms. Secondary outcomes were clinician-rated change in functioning and engagement and change in community tenure compared with 2 years prior to ACT. We measured fidelity to the ACT model using the Tool for Measurement of Assertive Community Treatment. We performed linear mixed-effects modeling to analyze outcomes and their associations with characteristics of patients and treatment.
Results
After two years, psychiatric symptoms were significantly reduced with a small effect size. Negative symptoms, anxiety and depression, and agitation and mania had significant reductions, while positive symptoms had nonsignificant changes. Functioning, engagement, and community tenure all significantly increased with small effect sizes. Age, difficulty to engage, problematic use of alcohol, frequent previous use of inpatient services, total number of sessions, and team’s fidelity to the ACT model were associated with different groups of symptoms. Less improvement in functioning was associated with team fidelity and number of sessions. Change in engagement was not associated with any predictors. Increased community tenure was greater for younger patients and patients who were on community treatment orders at treatment start.
Conclusions
ACT for two years led to significant positive outcomes with small effect sizes for psychiatric symptoms, functioning, engagement, and community tenure. The outcomes were associated with some potential predictors, and some team-level variance emerged. Positive significant outcomes after two years indicate that larger improvements may be achieved from longer-term treatments by ACT teams.publishedVersio
Work-Aged Family Caregivers’ Experiences in Severe Neurological Diseases and Sustainability in Future Local Healthcare Workforce: A Qualitative Metasynthesis
Get PDFFamily caregivers play an important role as an unpaid part in the health care workforce in the communities. Without family caregivers’ contribution, sustainability in the health care workforce may be severely challenged. This metasynthesis identifies the experiences of work-aged family caregivers, related to care for persons living with Amyotrophic Lateral Sclerosis, Multiple Sclerosis, Huntington’s Disease and Parkinson’s Disease to uphold a sustainable health care workforce. Eleven original qualitative studies concerning family caregiving in severe, degenerative neurological diseases were included and analysed based on an elaborated, four steps strategy. The results revealed the three following themes: The practical and emotional impact on family caregiver, Balancing own needs and family obligations and A price to pay for family caregivers providing long-term care. These findings implicate that family caregivers’ contribution depends on tailored information from the health care regarding the disease and the development of the disease. Work-aged family caregivers’ needs should be clarified and valued, regarding their own personal time, economic situation, social activity, work, and family situation. The health authorities should discuss the financial framework for family caregivers’ contribution and role. It is further necessary that the health care workforce invites to dialogue about prerequisites for health care and how health care tasks could be distributed to uphold a sustainable health care both for the work force and the work-aged family caregivers in the future.publishedVersio
The use of spent mushroom substrate as biologically pretreated wood and its fibrillation
Get PDFUtilization of biomass and reuse of industrial by-products and their sustainable and resource-efficient development into products that are inherently non-toxic is important to reduce the use of hazardous substances in the design, manufacture and application of biomaterials. The hypothesis in this study is that spent mushroom substrate (SMS), a by-product from mushroom production, has already undergone a biological pretreatment and thus, can be used directly as a starting material for fibrillation into value-added and functional biomaterial, without the use of toxic substances. The study show that SMS can be effectively fibrillated at a very high concentration of 6.5 wt % into fibrils using an energy demand of only 1.7 kWh kg−1, compared to commercial and chemically pretreated wood pulp at 8 kWh kg−1, under same processing conditions. SMS is a promising resource for fibrillation with natural antioxidant activity and network formation ability, which are of interest to explore further in applications such as packaging. The study shows that biological pretreatment can offer lower environmental impact related to toxic substances emitted to the environment and thus contribute to reduced impacts on categories such as water organisms, human health, terrestrial organisms, and terrestrial plants compared to chemical pretreatments.publishedVersio
Social Media use and Associations with Psychological Distress among Older Adults during the COVID-19 Pandemic
Get PDFSocial media may have the double potential to support and undermine mental health, and research is needed to investigate these relationships in age-specified populations. The purpose of this study was to investigate associations between the use of social media and psychological distress among older adults (60 years and above) both nine and 19 months after the outbreak of the COVID-19 pandemic. An online repeated cross-sectional survey was conducted in Australia, Norway, the United Kingdom, and the United States. Participants (9 months: n = 679; 19 months: n = 238) reported the extent of social media use, motives for using social media, and level of psychological distress using the 12-item version of the General Health Questionnaire (GHQ-12). The data were analysed with descriptive analyses, independent t-tests and multiple linear regression analyses. Time spent on social media was not associated with psychological distress. Higher psychological distress was associated with higher scores on using social media to ‘reduce loneliness’ at both measurement points. At nine months, higher psychological distress was associated with higher scores on using social media for ‘entertainment’, but the association was not statistically significant at 19 months. Psychological distress was associated with the motive to ‘maintain relationships’ at 19 months, but not at nine months. Guidance for older adults’ use of social media should emphasise how they can be used to promote communication and maintain existing relationships.publishedVersio
‘The fourth most important school subject’–Norwegian school principals’ perceptions of physical education
Get PDFAlthough many studies have explored teachers’ and students’ perceptions of physical education (PE), the voices and beliefs of school principals about PE remain scarce in existing literature [Ní Chróinín, D., Fletcher, T., Jess, M., & Corr, M. (2020). A major review of stakeholder perspectives on the purposes of primary physical education. European Physical Education Review, 26(2), 322–336]. In Norway, a new national curriculum for PE was introduced in 2020 [Norwegian Directorate for Education and Training. (2019). Læreplan i kroppsøving. [The curriculum for physical education]] making it timely to examine how key stakeholders, such as principals, understand and attempt to enact these new curricular objectives. In this paper, we draw on interviews conducted with five participant principals from schools located in Eastern Norway that explored their perceptions of PE. Based on our reflexive thematic analysis [Braun, B., & Clarke, V. (2022). Thematic Analysis a Practical Guide] of the interview data, we present the findings in relation to three main themes: (i) ‘PE is a very important subject’, (ii) ‘PE creates other pedagogical opportunities and has extrinsic values’ and (iii) ‘PE as friluftsliv [“outdoor activities”], swimming and social aspects – but not sports … ’. However, by also utilizing Foucauldian understandings of discourse [Foucault, M. (1972). The Archaeology of Knowledge and Discourse on Language ([1st American ed). Pantheon Books], we draw attention to how the principals’ perceptions of PE are largely constituted within dominant discourses of activation, fitness and (physical) health. To conclude, we call for further studies on what principals’ value and talk about in relation to PE but also what they do not talk about such as PE as a subject for learning and where other dimensions of health are promoted.publishedVersio
Update on assessment of risk of introduction of Echinococcus multilocularis to mainland Norway
Get PDFBackground. The VKM Panel on Biological Hazards has updated the Scientific Opinion regarding introduction and establishment of the parasite Echinococcus multilocularis (EM) in mainland Norway. The previous risk assessment was published in 2012 and is, therefore, in need of updating, as the situation may have changed, and new information has become available.
Methods. Data was collected through a literature search and examination of published surveillance reports, providing an update on existing literature on monitoring for introduction of EM into mainland Norway, the spread of EM, particularly in Sweden,and contamination of imported fresh produce with EM. The effects of different control measures, as described in the literature, were also investigated. The feasibility and advantages of adopting a more quantitative approach to assess the spread of EM in
Norway were also evaluated.
Results. A decade after its first identification in Sweden in 2011, the prevalence of EM in the country is still low, with a limited distribution. This indicates a slow rate of spread, with no indications that the parasite has spread closer to the border with Norway. EM has not been detected in mainland Norway and analysis of imported fresh produce has not detected EM DNA. Control measures, such as mandatory treatment of
dogs entering Norway with appropriate anthelminthics (containing praziqunantel) are in place. However, the extent to which treatment compliance is checked and enforced at land and maritime borders is not documented. The possibility for modelling was explored and quantitative methods, like general episystems modelling (GEpMs), were identified as potentially relevant.
Conclusion. Conclusions reached in the previous Scientific Opinion were valid at that time and remain valid now for EM in Norway. Infected dogs can introduce the parasite, and even a single infected dog may result in local establishment. This depends on various factors, such as whether suitable rodent hosts, and subsequently foxes preying on those rodents, occur locally and are exposed and susceptible. Spread of EM from Sweden to Norway by foxes is likely a question of time. Estimation of introduction-time
distribution is, however, currently impossible. Increased border controls, to ensure dogs entering Norway have been suitably treated to eliminate the parasite, and, potentially, risk-dependent surveillance of foxes in areas bordering Sweden are identified as preventative measures. In addition, use of deworming bait, rather than culling of foxes, in areas where parasite is detected, could be important aspects of EM control in wildlife should the parasite be introduced. Uncertainties and data gaps. The main uncertainties are linked to the limited size of the Swedish outbreak and thus the data available from Sweden, the lack of
information regarding the number of dogs entering Norway untreated, and the nature of sampling and surveillance in Norway. This means there is a substantial risk for introductions of EM to Norway becoming established in wildlife before they are detected by surveillance.publishedVersio