OsloMet – Oslo Metropolitan University

Children’s drawings are central in children’s meaning-making and can say something about their thoughts and feelings. 43 drawings from Norwegian children (7–8 years) depicting school during the pandemic lockdown in 2020, were studied. Results show that students primarily depicted the ‘official school’ which was represented by their workplace such as large tables not intended for schoolwork, underscoring children’s diminished size. Drawings of ‘Informal school’ were illustrated in colorful outdoor settings whereas ‘Physical school’ showed buildings functioning as school. Unclear boundaries between school life and private life dominated the children’s drawings. Their drawings are presented and discussed in this article.

Introduction Virtual reality (VR) has been suggested as a promising technology for delivering cognitive training to persons with traumatic brain injury (TBI), as it can provide situations resembling everyday activities. Studies have demonstrated that persons with TBI manage utilizing VR in clinical settings; however, no studies have investigated VR use in home settings. The aim of this study was to explore how persons with TBI experience utilizing VR for rehabilitation at home and how they experience VR as cognitive training. Methods Individual qualitative interviews were conducted with ten persons with TBI, aged 18–65. Participants had experience using VR, as they were recruited from the intervention group in a randomized controlled trial investigating VR in cognitive training. The data were analyzed using thematic analysis. Results Participants highlighted the importance of creating new routines when fitting VR into everyday life. They addressed how being in a virtual world contributes to their motivation for cognitive training. Three themes were developed: ‘Fitting VR-training into everyday life’, ‘Navigating through change’ and ‘Being in two worlds at the same time’. Conclusion This study shows that participants experienced VR as motivating, engaging, and easy to use, regardless of prior experiences with VR. The participants demonstrated how they included VR in everyday life by creating new routines when they performed cognitive training. Therewere few reports of adverse events. However, some experienced that VR had a negative impact on their energy level. Participants described the importance of therapeutic involvement for individual tailoring of the intervention.

Implicit motives, nonconscious needs that influence individuals’ behaviors and shape their emotions, have been part of personality research for nearly a century but differ from personality traits. The implicit motive assessment is very resource-intensive, involving expert coding of individuals’ written stories about ambiguous pictures, and has hampered implicit motive research. Using large language models and machine learning techniques, we aimed to create high-quality implicit motive models that are easy for researchers to use. We trained models to code the need for power, achievement, and affiliation (N = 85,028 sentences). The person-level assessments converged strongly with the holdout data, intraclass correlation coefficient, ICC(1,1) = .85, .87, and .89 for achievement, power, and affiliation, respectively. We demonstrated causal validity by reproducing two classical experimental studies that aroused implicit motives. We let three coders recode sentences where our models and the original coders strongly disagreed. We found that the new coders agreed with our models in 85% of the cases (p < .001, ϕ = .69). Using topic and word embedding analyses, we found specific language associated with each motive to have a high face validity. We argue that these models can be used in addition to, or instead of, human coders. We provide a free, user-friendly framework in the established R-package text and a tutorial for researchers to apply the models to their data, as these models reduce the coding time by over 99% and require no cognitive effort for coding. We hope this coding automation will facilitate a historical implicit motive research renaissance.

Background International research suggests that immigrants face poorer access to antenatal care, but comprehensive nationwide studies identifying variations across immigrant groups are lacking. Using national registries like the Medical Birth Registry, we compared antenatal care utilization among immigrant women by country/region of origin to Norwegian women. Methods We included 348,547 singleton births between 2012–2018 by women aged ≥ 16 years registered with ≥ 1 antenatal consultation in primary care, including 79,671 (22.9%) births by immigrant women. We calculated odds ratios (OR) and 95% confidence intervals (CI) using both crude and adjusted logistic regression models, assessing the likelihood of immigrant women having fewer consultations than recommended by national guidelines compared to Norwegian women per trimester. Estimates were adjusted for relevant sociodemographic variables. Results Large country-specific differences in estimates were noted across all trimesters. In the crude models, Eritrean (OR 3.01 [95%CI: 2.76–3.28]), Somali (OR 2.63 [95%CI: 2.48–2.79]) and Ethiopian (OR 1.90 [95%CI: 1.67–2.16]) women, and women from other Sub-Saharan countries (OR 1.92 [95%CI: 1.77–2.08]), had the highest odds of initiating antenatal care later than the first trimester. In later trimesters, care utilization by immigrants and Norwegian women were more similar, except for lower utilization among Somali women. Sociodemographic variables explained much of the observed differences. Conclusion Late initiation and substandard utilization of antenatal care among certain immigrant groups exists in Norway. Timely access to antenatal care is important for maternal and child health. Efforts should be initiated to facilitate earlier initiation of antenatal care, particularly among Eritrean, Somali, Ethiopian and other Sub-Saharan women.

Background The Norwegian health care system has a mandatory program for close and systematically follow-up on all children, starting in early infancy through the Child Health Care Centers in the municipalities. Additionally, some infants are referred to physiotherapists and manual therapists for several reasons. Little is known about who is referring them and the cause for the referral. In Norway, physiotherapists working with infants can be employed in the communities or work in outpatient clinics, both are within the primary health care system. The main purpose of the present study was to explore the referral practice of infants to physiotherapy and compare those treated by physiotherapists and manual therapists in primary health care in Norway. Furthermore, to describe the planned interventions. Methods Cross-sectional study including 444 infants (age under 12 months) referred to physiotherapists or manual therapists working in primary health care in Norway. Results Median age (range) of the infants was 14 (1, 52) weeks and 344 were born at due date. Most infants examined by a physiotherapist were referred from other health personnel and more of the referrals to manual therapists were from parents due to their concern. Age at examination was between week 1–12 for 42% of the participants. Infants referred for motor development problems were equally distributed between the physiotherapists and manual therapists. All premature infants were referred to the physiotherapists. Concerning the interventions, both physiotherapists and manual therapists planned to use advice, handling, and stimulation. More of the physiotherapists reported to focus on advice related to motor development and the use of prone play. Conclusion The infants in Norway are referred to physiotherapists and/or manual therapists for numerous reasons, and the distribution of diagnoses between the therapists seem reasonable. Infants are mostly referred by other health personnel but also because of parents’ own concern. Based on recommendations, some infants with asymmetries should be examined earlier. Trial registration ClinicalTrials.gov Identifier NCT03626389. Registered on August 13th, 2018 (retrospectively registered).

Purpose Given the lack of robust prognostic models for early identification of individuals at risk of work disability, this study aimed to develop and externally validate three models for prolonged work absence among individuals on sick leave due to musculoskeletal disorders. Methods We developed three multivariable logistic regression models using data from 934 individuals on sick leave for 4–12 weeks due to musculoskeletal disorders, recruited through the Norwegian Labour and Welfare Administration. The models predicted three outcomes: (1) > 90 consecutive sick days, (2) > 180 consecutive sick days, and (3) any new or increased work assessment allowance or disability pension within 12 months. Each model was externally validated in a separate cohort of participants (8–12 weeks of sick leave) from a different geographical region in Norway. We evaluated model performance using discrimination (c-statistic), calibration, and assessed clinical usefulness using decision curve analysis (net benefit). Bootstrapping was used to adjust for overoptimism. Results All three models showed good predictive performance in the external validation sample, with c-statistics exceeding 0.76. The model predicting > 180 days performed best, demonstrating good calibration and discrimination (c-statistic 0.79 (95% CI 0.73–0.85), and providing net benefit across a range of decision thresholds from 0.10 to 0.80. Conclusions These models, particularly the one predicting > 180 days, may facilitate secondary prevention strategies and guide future clinical trials. Further validation and refinement are necessary to optimise the models and to test their performance in larger samples.

Background Rehabilitation of persons with lower limb loss generally report on outcome measures related to gait and mobility, but little is known how an inpatient exercise intervention influences health-related quality of life (HRQoL). Objective This study compared the effect of a 4-week rehabilitation intervention (INT) on the HRQoL of new (NEW) prosthetic users that received their prosthesis at the inpatient facility (NEW-INT) to experienced prosthetic users with several previous inpatient stays (EXP-INT). Study Design Nonrandomized intervention trial. Methods In this nonrandomized intervention trial, the NEW-INT completed the EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) questionnaire at Admission, when they became Independent in walking and at Discharge. The EXP-INT completed the questionnaire at Admission and Discharge. A control group of experienced prosthetic users (EXP-CON) not partaking in the intervention completed the EQ-5D-5L questionnaire at 4-week intervals. The participants health state was recorded at all time points using a visual analog scale (EQ-VAS). An EQ-index was calculated based on the 5 dimensions of the EQ-5D-5L. Results At Admission, the EQ-index score of the NEW-INT (n = 18) was significantly lower compared to the EXP-INT (n = 19) ( P = 0.014). The NEW-INT improved the median [interquartile range] EQ-index scores significantly from Admission to Discharge; 0.23 [0.55] vs. 0.73 [0.20], P = 0.001, whereas the EXP-INT showed no change from Admission to Discharge; 0.71 [0.23] vs. 0.65 [0.26]. At Discharge, the EQ-index scores of the NEW-INT and EXP-INT were similar. Only the NEW-INT showed significant improvements in the mean ± standard deviation EQ-VAS values from Admission (55.8 ± 20.2) to Discharge (66.4 ± 15.7), P = 0.018. The mobility dimension was the most responsive EQ-5D-5L dimension but improved significantly only for the NEW-INT from Admission to Discharge ( P = 0.001). For the EXP-CON (n = 19), there were no significant changes from Test 1 to Test 2. Conclusion Four weeks of inpatient rehabilitation improves HRQoL in new, but not experienced prosthetic users.

Introduction Greater trochanteric pain syndrome (GTPS) is a common and disabling condition characterised by lateral hip pain. The condition often persists for several months, and there is low evidence for any superior treatment. The aim of this study protocol is to describe a randomised controlled trial (RCT) investigating the effectiveness of a self-management programme versus usual care for patients with GTPS. Methods and analysis The study is designed as an observer-blinded, parallel group, superiority RCTcomparing a self-management programme (n=55) with usual care (n=55). Eligible patients with GTPS will be included based on reproduction of pain on palpation in the greater trochanteric region and at least one positive clinical provocation test. The self-management programme includes 3–5 individual sessions with a physiotherapist over 12 weeks, addressing physical, emotional and behavioural factors deemed relevant by the patient. Usual care will receive general information about GTPS, activity management and are free to seek further treatment in primary care as wanted. The primary outcome measure is the Norwegian version of the Victorian Institute of Sports Assessment for gluteal tendinopathy questionnaire (VISA-G-Norwegian). Outcomes will be assessed at baseline, 3, 6 and 12 months. A longitudinal mixed effects model will be used to assess the effectiveness of treatment on pain and disability across all time points, with the primary endpoint at 6 months. Cost-effectiveness will be expressed by mean incremental cost-effectiveness ratios (ICERs) from a societal and healthcare perspective. Bootstrapping will be used to estimate ICER uncertainty. Ethics and dissemination The Norwegian Regional Committees for Medical and Health Research Ethics have approved the project (2023/590816), and it will be in accordance with recommendations from the Data Inspectorate at Oslo University Hospital (22/26396). The results from the study will be disseminated through publications in peer-reviewed journals, in conference presentations and through the user representative. Trial registration number NCT06297148 .

Predicting user satisfaction for chatbots in customer service operations is important for their successful uptake. Based on chatbot conversation logs and corresponding satisfaction scores from a much used intent-based customer service chatbot, we developed models for predicting user satisfaction on the basis of conversation log data. We found significant covariation between satisfaction and conversation characteristics reflecting in the log data, suggesting efficient chatbot interactions. We found a prediction model including data on generic conversation characteristics, such as the number of user messages and predicted intents, to explain 10% of the variation in user satisfaction. A model also including domain-specific information in addition to generic conversation characteristics, specifically on the types of predicted chatbot intents, explained 27% of the variation. Substantial variation in prediction model performance was identified between different areas of support, suggesting the need to tailor prediction models to different areas of support provided. We conclude by discussing the implications of our findings and suggesting further research.

Microbes respond to changes in their environment by adapting their physiology through coordinated adjustments to the expression levels of functionally related genes. To detect these shifts in situ, we developed a sparse tensor decomposition method that derives gene co-expression patterns from inherently complex whole community RNA sequencing data. Application of the method to metatranscriptomes of the abundant marine cyanobacteria Prochlorococcus and Synechococcus identified responses to scarcity of two essential nutrients, nitrogen and iron, including increased transporter expression, restructured photosynthesis and carbon metabolism, and mitigation of oxidative stress. Further, expression profiles of the identified gene clusters suggest that both cyanobacteria populations experience simultaneous nitrogen and iron stresses in a transition zone between North Pacific oceanic gyres. The results demonstrate the power of our approach to infer organism responses to environmental pressures, hypothesize functions of uncharacterized genes, and extrapolate ramifications for biogeochemical cycles in a changing ecosystem.

Background Health-related conspiracy theories undermine trust in healthcare, exacerbate health inequities, and contribute to harmful health behaviors such as vaccine hesitancy and reliance on unproven treatments. These theories disproportionately impact marginalized populations, further widening health disparities. Their rapid spread, amplified by social media algorithms and digital misinformation networks, exacerbates public health challenges, highlighting the urgency of understanding their prevalence, key drivers, and mitigation strategies. Methods This scoping review synthesizes research on health-related conspiracy theories, focusing on their prevalence, impacts on health behaviors and outcomes, contributing factors, and counter-measures. Using Arksey and O’Malley’s framework and the Joanna Briggs Institute guidelines, a systematic search of six databases (PubMed, Embase, Web of Science, CINAHL, PsycINFO, and Scopus) was conducted. Studies were screened using predefined inclusion and exclusion criteria, with thematic synthesis categorizing findings across diverse health contexts. Results The review revealed pervasive conspiracy beliefs surrounding HIV/AIDS, vaccines, pharmaceutical companies, and COVID-19, linked to reduced vaccine uptake, increased mistrust in health authorities, and negative mental health outcomes such as anxiety and depression. Key drivers included sociopolitical distrust, cognitive biases, low scientific literacy, and the unchecked proliferation of misinformation on digital platforms. Promising countermeasures included inoculation messaging, media literacy interventions, and two-sided refutational techniques. However, their long-term effectiveness remains uncertain, as few studies assess their sustained impact across diverse sociopolitical contexts. Conclusion Health-related conspiracy theories present a growing public health challenge that undermines global health equity. While several interventions show potential, further research is needed to evaluate their effectiveness across diverse populations and contexts. Targeted efforts to rebuild trust in healthcare systems and strengthen critical health literacy are essential to mitigate the harmful effects of these conspiracy beliefs.

Purpose Comorbidity between mental disorders and somatic diseases exacerbates health outcomes and contributes to premature mortality. However, differences in this comorbidity among immigrant groups compared to the majority population are unclear. This study aims to examine disparities in the risk relationship between common mental disorders (CMDs) and somatic diseases among the majority population (Norwegians) and various immigrant groups. Methods This national register study uses information from 3 142 925 residents aged 18+on diagnosed CMDs and selected somatic diseases for years 2008–2016. Poisson regression models were used to study the association between CMD and somatic diseases (i.e., cardiovascular diseases (CVDs), endocrine and metabolic diseases, cancer, and infectious diseases). Differences in risk between Norwegians and immigrant groups were investigated by introducing interaction terms between CMD and immigrant background. Results Individuals with CMDs had a higher risk for all somatic diseases compared to those without, regardless of immigrant status. Immigrant groups varied in comorbidity, with those without CMDs showing similar or lower risk compared to Norwegians. However, immigrants with CMDs from non-Western countries (i.e., Eastern Europe, sub-Saharan Africa, South Asia) had a significantly higher probability of developing CVD, hypertension, and diabetes mellitus than Norwegians with CMDs. Additionally, SSA immigrants with CMDs also had a higher risk for viral hepatitis. Conclusion Findings suggest that immigrant groups experience varying degrees of comorbidity, which underscores the need for tailored healthcare interventions to address these disparities effectively.

Background Gestational diabetes (GDM) is a strong risk factor for later development of diabetes. However, data are scarce on the long-term risk for diabetes or prediabetes diagnosed by HbA1c, in non-selected, multi-ethnic populations universally screened for GDM using the WHO2013 criteria. We aimed to investigate the development of diabetes or prediabetes eleven years after the index pregnancy and identify risk factors in pregnancy or shortly after. Methods A population-based cohort study of 360 women with complete eleven years follow-up data for diabetes (HbA1c ≥ 48 mmol/mol) or prediabetesADA (HbA1c 39–47 mmol/mol). Women were enrolled in gestational week 15 and universally screened with an oral glucose tolerance test in week 28. We performed least absolute shrinkage and selection operator (LASSO) regression to identify predictors of future diabetes or prediabetesADA and constructed a nomogram to predict individual risks. Results Diabetes or prediabetesADA combined, was found in 26.9%, and the prevalence was slightly higher in previous GDM compared with non-GDM women (35.6% versus 23.5%; p = 0.019). The relative risk (RR) for developing diabetes or prediabetesADA was moderately elevated in GDM compared with non-GDM women (1.4 [1.0, 1.9], p = 0.035). Seven women (1.9%) had diabetes and all of these except for one, had previous GDM. Hence, the crude prevalence was 5.8% among GDM women vs. 0.4% among non-GDM women. The RR for developing diabetes was substantially higher in GDM vs. non-GDM women (14.8 [2.6, 277.1], p = 0.012). PrediabetesADA was found in 25% and the RR for prediabetesADA was not significantly increased for GDM compared to non-GDM women (1.3 [0.9, 1.8], p = 0.143). Among Europeans, 17.0% had diabetes or prediabetesADA, compared to 43.0% among South Asians (p < 0.001) and 34.4% among other ethnicities (p = 0.002). The most significant predictors identified from the LASSO were HbA1c measured in early pregnancy, ethnicity, and a family history of diabetes. Conclusions The risk for developing diabetes was low, overall and among GDM women. Still GDM represented a strong risk for diabetes, but not for prediabetesADA. HbA1c early in pregnancy, non-European ethnicity, and a family history of diabetes were the strongest risk factors for developing diabetes or prediabetesADA. Trial registration STORK G2 Women and Risk of Diabetes. NCT03870724 (ClinicalTrials.gov). February 27th, 2019.

Background Amid the SARS-CoV-2 pandemic, laboratories faced the challenge of maintaining diagnostic operations while adhering to infection prevention and control (IPC) guidelines. We investigated the impact of implementing rapid molecular testing of employees of a large medical laboratory to prevent workplace transmission. Aim/objective To evaluate if fast-track PCR diagnostics, alongside local infection control measures, could reduce internal transmission and workplace sickness absence. Methods Employees with respiratory symptoms, but testing negative for SARS-CoV-2, were allowed to work if clinically healthy. All included employees completed a questionnaire and underwent SARS-CoV-2 antibody testing post-pandemic. Data on sickness absence were retrieved from local human resources systems, and comparative analyses were conducted between the pre-pandemic and pandemic periods. Findings/results Of 153 participants, 84 (55%) reported having had COVID-19, with 12 (14%) suspecting workplace transmission. Six (4%) tested positive for SARS-CoV-2 IgG nucleocapsid despite no COVID-19 diagnosis. Among 101 (66%) reporting respiratory symptoms and negative SARS-CoV-2 tests, 80 (79%) were allowed to return to the workplace. Mean workplace sickness absence during the pandemic 2020 (3.74%) and 2021 (4.19%) was significant lower compared with sickness absence in the laboratory before the pandemic in 2019 (4.54%). No larger outbreaks in the laboratory were recorded. Discussion SARS-CoV-2 infections in the laboratory were mostly symptomatic and acquired outside the workplace. The combination of local IPC and rapid and frequent testing of employees facilitated an effective infection control and minimized workplace absence, maintain diagnostic operations.

Although cocaine use is rising among youth in many countries, little is known about the social context and its influence on this new pattern of use. Drawing on a theoretical framework of class, gender, and peer‐status dynamics and extensive data from personal interviews, we investigate how cocaine use is culturally situated and socially organised in certain Norwegian high school cultures. The focal sample consists of study participants who stated that they had used cocaine. They totalled 32 persons, of whom 28 were boys. We identify four key cultural characteristics linked to cocaine use: (i) affluence : users often had backgrounds rich in economic capital; (ii) a party‐centred culture : cocaine was introduced in contexts with excessive partying and binge drinking; (iii) top‐level networks : cocaine use was linked to exclusive social networks, based in Norwegian high school graduation celebrations; and (iv) masculinity : boys used more cocaine than girls, to boost their energy and self‐confidence. We conclude that the key driver of cocaine use is a structurally determined socialisation pattern, which we theorise as a ‘top‐boy’ culture. This culture is anchored in status‐seeking elite school milieus characterised by affluence, heavy partying, and exclusive homosocial networks. Boys invested in this culture may engage in cocaine use to signal membership and to mimic the hallmark of ‘ease’, in accordance with a rather orthodox type of masculinity. Whereas youth cultures often represent pockets of resistance to traditional hierarchies, this culture instead seems to strengthen such established hierarchical arrangements.

Introduction Digital technology continues to reshape health professions education, yet little is known about the relative effectiveness of synchronous online versus in-person collaborative learning in strengthening clinical placement experiences for physiotherapy students. This study examined physiotherapy students’ expectations, perceptions, and preferences regarding online and in-person small-group seminars. Methods A quasi-randomized crossover design was used in two course iterations (I-1, I-2) involving 106 final-semester physiotherapy students. Participants were split into groups of 5–6 to engage in ten seminars discussing complex clinical cases drawn from their prior placements, with half of the groups starting online and later switching to in-person, and vice versa. A third iteration (I-3; n=77) alternated between online and in-person sessions following two initial in-person seminars. Data were gathered through anonymous electronic surveys containing Likert-scale ratings and open-text responses. Quantitative data were analyzed with t-tests and chi-square tests; qualitative comments underwent thematic analysis. Results Mid-course evaluations revealed no significant differences in perceived effectiveness when students had experienced only one format. By the course’s end, however most students ultimately favored in-person seminars for richer social interaction (I-2: 80%; I-1: 38%; I-3: 54%), although they consistently recognized online sessions as time-efficient and flexible. Notably, students’ initial expectations (I-1 and I-2) strongly mirrored their final evaluations. Qualitative feedback highlighted that in-person seminars provided higher-quality social interactions, while online seminars offered greater efficiency and flexibility. Most students indicated a preference for a blended format in future courses. Conclusion By blending in-person and online sessions, collaborative seminars can give physiotherapy students the best of both worlds for their clinical placement learning. Meeting in-person fosters richer discussions and deeper social connections, while online sessions offer efficiency, flexibility and help students develop essential digital competence. Together, these formats create a more adaptable, forward-looking learning environment that aligns with the evolving demands of professional practice.

Permafrost in marine sediments exhibits a lower freezing point and significant unfrozen water content. This paper investigates the role of the soil freezing characteristic curve (SFCC) in permafrost degradation. Three SFCCs, representing thawing–freezing characteristics of soils with varying clay content and salinity, were established based on experiments and existing data. These SFCCs were then applied in numerical analyses to simulate permafrost thawing under various warming scenarios, using measured ground temperatures and permafrost profiles for a site at Longyearbyen in Svalbard (Norway). It is shown that the ground temperature in non-saline permafrost soil increases more rapidly than saline permafrost, due to a greater downward net heat flux to the permafrost in the former case. Conversely, the thawing rate is more pronounced for saline permafrost soil, attributed to its lower freezing point and latent heat consumption. A more nonlinear ice-melting process is observed for permafrost soil with a lower salinity. The temperature rise follows three stages: a constant-rising, a damp-rising, and an accelerated-rising rates. The duration of the damp-rising rate becomes shorter for saline permafrost under a great warming condition. The study underscores the high significance of the soil-freezing characteristic curve for accurate estimations of permafrost degradation.

Drawing on perspectives of care work as a collaborative and negotiated practice, this paper aims to explore how older service users actively contribute to care work and situations of care in the reablement policy context of homecare. The study analyses how service users in Danish and Norwegian municipal homecare settings place their bodies at disposal and how care workers' responses to service users' embodied contributions shape care practice and situations of care. Four ways of placing service users' bodies at disposal were identified: proactively, dependently, reluctantly and instructively. Care workers' capacity to attentively respond to service users' physical and emotional needs and their flexibility and adaptiveness in dealing with service users placing their bodies at disposal in various ways, seem to be key for care work as a collaborative practice that promotes dignity in care. The study applies affective ethnography as a methodological and analytical approach.