Abstract Background and Objective Increasing screening volumes, combined with global shortage of radiologists and a high proportion of normal mammograms, challenge the efficiency and sustainability of breast cancer screening. Artificial intelligence (AI) has the potential to improve resource allocation, workflow efficiency and diagnostic performance by supporting and partially replacing radiologists in the interpretation process. This randomized, controlled, parallel-group, non-inferiority, single-blinded trial evaluates whether an AI-supported reading strategy, involving one or two radiologists depending on AI risk stratification, is non-inferior to standard independent double reading. The primary outcome is the number of screen-detected breast cancer cases in each group. Methods Women invited to BreastScreen Norway in the Western, Central, and Northern Norway Regional Health Authorities are eligible for inclusion. Following written informed consent, participants are randomized 1:1 to the control group (standard independent double reading by two radiologists) or the intervention group. In the intervention group, mammograms are analyzed using Transpara. Examinations with AI scores of 1–7 are interpreted by a single radiologist, whereas examinations with scores of 8–10 undergo independent double reading. Radiologists are blinded to AI scores and AI image markings during the initial interpretation; this information is disclosed during consensus meetings. Non-inferiority will be assessed by estimating confidence interval for the difference in screen-detected cancer rates between groups. Non-inferiority will be concluded if the upper bound of the confidence interval does not exceed the predefined non-inferiority margin. Conclusions The trial addresses a critical challenge in breast cancer screening: maintaining diagnostic performance while improving efficiency in the context of workforce constraints and a high prevalence of normal examinations. By evaluating a risk-stratified AI-supported reading strategy within a population-based screening program, the study will provide important evidence on whether AI can be safely integrated to optimize workload distribution while preserving cancer detection rates. Trial registration The ClinicalTrials.gov registry ( NCT06032390 )
Bringing new approaches to science teaching such as interdisciplinary, problem-based teaching into schools has proved a slow and difficult process. One of the means to bring about the change is through teacher education. This study is a qualitative study inspired by constructivist Grounded Theory which explores how four new teachers educated from programmes with an explicit focus on changing science teaching in schools, experience the transition from being a teacher student to being a teacher. The study found that new teachers were able to transfer approaches to science teaching from education to profession in the cases where 1) their teaching profile gave them the flexibility to plan interdisciplinary science teaching, 2) education and discourse in the schools aligned, 3) they were supported by management and 4) they experienced support in a community of practice with people they had studied with.
This article suggests to reflect on the philosophical foundations of Open Education. It reaches out to Bergson’s and Popper’s respective understandings of Open Society; ontology of immanence, not-yetness; and post-inquiry. It invites to revisit ethos, eidos and praxis in Open Education to move away from a prevailing Western, dominant, unsustainable paradigm and explore a holistic approach, the inclusion of indigenous knowledge systems, the shift from an overall domesticating to a liberating education, and the making visible of what has been made invisible. This discussion precedes the presentation of a roadmap drafted for Open Education in the Swiss Higher Education landscape, explaining why it has been deliberately prepared at the epistemic level and how relevant this is in relation to the sustainability process, providing a horizon for the first of three steps - survival, security, sustainability.
The gill is an important organ in fish that is involved in various physiological functions, including respiration, filter-feeding, ammonia nitrogen excretion, and osmoregulation. The physiological functions of gills are closely related to their structure, external feeding conditions, and environmental factors. Herein, we first briefly summarize the basic structure and functions of the gills of teleosts, then explain the structure and function of the gill barrier (as a microbial barrier, a chemical barrier, a physical barrier, and an immune barrier) in detail. Finally, we introduce the regulation of fish gill barrier health by ubiquitous feeding factors and environmental factors, and provide an outlook on the prospects of gill barrier health. We found that improving health through modulating feed factors is more convenient than improving environmental factors. This review increases our understanding of how nutrient composition and level in fish diet influences gill health and overall growth performance of fish.
Dustin Tahisin Gómez Rodríguez, Miguel Arturo Aguirre Nieto
The Department of Caquetá is located in the Amazon region of the Colombian state. Since its creation in the 19th century, it has been neglected by institutions, which has contributed, among other variables, to socio-economic and socio-environmental problems that have increased with the incursion of coca cultivation. Quantitative data on competitiveness and poverty reduction are among the lowest among the other departments of the South American country. Therefore, the general objective of the article was to characterize the results of the intervention of a pro-ject carried out by Pastoral Social Caritas Colombia and Caritas Norway in 5 municipalities of the department in the period 2018-2022 to develop food sovereignty and security in 400 farming families. The methodology, methods, and instruments are based on the Theory of Change and MEAL: Monitoring, Evaluating, All Counts and Learning used by Pastoral Social Caritas Colombia. The main conclusion is that the project's contribution to civil society focuses on strengthening organizations to enable them to move forward in spaces that can transform productivity and the recognition of rights by the department's population.
Economic growth, development, planning, Human settlements. Communities
Stine Borgen Lund, John-Arne Skolbekken, Laura Mosqueda
et al.
Abstract Introduction Residents in nursing homes do not always get qualitatively good nursing care, and research shows that residents’ basic care needs are sometimes neglected. Neglect in nursing homes is a challenging and complex issue, yet a preventable one. Nursing home staff are at the frontline of detecting and preventing neglect but may also be the ones causing it. It is essential to understand why and how neglect happens in order to recognize, expose, and prevent its occurrence. Our aim was to generate new knowledge on the processes leading to and allowing neglect to continue in Norwegian nursing homes, by studying how nursing home staff perceive and reflect on when nursing home residents are neglected in their daily practice. Methods A qualitative exploratory design was used. The study was based on five focus group discussions (20 participants, total) and ten individual interviews with nursing home staff from 17 different nursing homes in Norway. The interviews were analysed according to Charmaz constructivist grounded theory. Results In order to make neglect an acceptable practice, nursing home staff apply different strategies. These strategies were identified as when the staff legitimize neglect by neglecting neglect, when the staff are not recognizing their own behaviour as neglectful, as expressed in their actions and language, and normalizing missed care when resources are lacking and nursing staff are rationing care. Conclusions The gradual shift between judging actions as neglectful or not are made possible when nursing home staff legitimize neglect by not recognizing their practice as neglective, thus neglecting neglect or when they are normalizing missed care. Increased awareness and reflections on these processes may be a way of reducing the risk of and preventing neglect in nursing homes.
Mariusz Tyrański, Jakub Michał Bujalski, Wojciech Orciuch
et al.
Ammonia synthesis by the Haber–Bosch method is a typical and effective implementation of the chemical process in the large-scale fertiliser industry. Due to the growing demand for fertilisers and food, it is desirable to study this process thoroughly using modern numerical methods to improve the operation of existing devices and facilitate the design of new devices in industrial installations. This manuscript focuses on the influence of the catalyst bed parameters on the ammonia synthesis process. Variants with different sizes of catalyst particles and modifications of the geometry of catalytic beds were considered. The axial-radial Topsoe converter with magnetite as a catalyst, commonly used in modern fertiliser industry beds, was investigated using Computational Fluid Dynamics. As a result, contours of velocity, pressure, concentration, and rate of ammonia formation were obtained. The analysis of the obtained results made it possible to determine the gradient of ammonia production rate in the catalyst bed and designate zones with negligible reaction rates. The authors also proposed possible bed geometry modifications to reduce bed volumes without affecting the converter’s performance.
We investigate the potential for greenhouse gas (GHG) emission cuts for the Norwegian short-sea (domestic) maritime segments of express boats, offshore support vessels, and aquaculture support vessels in comparison to ferries in Norway. Public procurement conditional on climate-friendly operation is catalyzing a transition to battery-electric operation, where most ferries will be battery-electric or fueled by hydrogen by 2030. The comparison to ferries is performed with the help of a methodology inspired by the multi-attribute utility method, which contains 11 features related to technology, operation, and acceptance. This score is used to adjust the 70% CO2 emission reduction achieved by ferries. Based on this methodology, the CO2 emission reduction potential for express boats, offshore support vessels, and aquaculture support vessels is estimated to be 46%. Consequently, these short-sea shipping segments could reduce CO2 emissions by 0.8 million tonnes from 2017 to 2030, which is equivalent to 1.5% of Norwegian emissions in 2017. Norway's experience indicates that there is a sizable potential for reducing CO2 emissions for public procurement conditional on climate-friendly solutions for short-sea shipping in other shipping nations.
Abstract Background and aims Identification of high-risk patients in secondary cardiovascular prevention may be challenging, although risk stratification tools are available. Cardiac troponins might have predictive value in identification of high-risk patients. The aim of this study was to investigate the association between cardiac Troponin T (cTnT) levels following a coronary event and long-term outcomes. Methods This study was carried out as a subanalysis from a randomized controlled trial conducted at Sørlandet Hospital, Norway, where patients hospitalized with myocardial infarction (MI) or scheduled percutaneous coronary intervention (PCI)/coronary artery bypass grafting (CABG) were included between 2007 and 2017. Participants were followed-up for up to 10 years after the index event through out-patient consultations. cTnT was assessed at each consultation as well as information regarding new cardiovascular events or death. Results A total of 1278 patients (18–80 years) with complete measurements of cTnT were included. cTnT was elevated (≥ 14 ng/L) one year after the primary event in 241 (19%) of participants. Median follow-up was 5.7 [SD 2.7] years. Cox regression analyses showed reduced survival (adjusted HR 0.37, 95% CI 0.19–0.72; p = 0.003) and composite endpoint-free survival (adjusted HR 0.73, 95% CI 0.55–0.98; p = 0.04) in participants with elevated cTnT versus participants with low cTnT after adjustment for risk factors at inclusion and randomization assignment. Conclusions Assessment of cTnT after coronary heart events may help identify patients at high risk of poor outcomes and might contribute to more focused secondary preventive treatment. Trial registration The study is registered in ClinicalTrials.gov (NCT00679237).
Diseases of the circulatory (Cardiovascular) system
In 2015, the Finnish Ministry of Education and Culture launched a digitalisation project called the “digital leap.” The objective of this project was to help schools quickly modernise their information and communication technology (ICT) infrastructure and pedagogy. Finnish schools have had many digitalisation projects, but the use of ICT in teaching and learning has been relatively small scale compared with other Nordic countries. Finnish teachers have autonomy for pedagogical decisions and have even abstained from top-down governing and “dumping” digital technology to schools. This article examines the challenges of school digitalisation in Finland, obstacles the teachers face in the use of ICT in education, and some perspectives on the teachers’ possibility to participate in the digitalisation process. This article is based on research done in Educating for Future Literacies Research Group (EduLit) at Tampere University. The research indicates that teachers’ professional capital plays an important role in the digitalisation process.
Tre tiår etter det ble etablert, står Barentssamarbeidet overfor en politisk kontekst preget av økende spenning og et Russland i krig. Ved starten i 1993 signaliserte det en ny politisk linje i Arktis, Nordområdene og norsk Russland-politikk. I et område som utgjorde Vestens nordligste grense mot Sovjetunionen under den kalde krigen og der militariseringen var sterk, skisserte Norge sammen med Finland, Sverige og Russland et felles utenrikspolitisk engasjement der fred og stabilitet stod øverst på agendaen. Utviklingen bidro til nye internasjonale roller og aktiviteter for regionale og lokale aktører. I denne artikkelen har vi deres erfaringer i fokus når vi undersøker legitimeringspraksiser. Vi spør: Hvordan har legitimeringen av Barentssamarbeidet blitt påvirket av endringer i det sikkerhetspolitiske klimaet? Ved å fremheve lokale aktører i Barentssamarbeidet tar vi et steg inn i et utenrikspolitisk felt preget av politiske spenninger, ulike argumenter og et mangfold av meninger. Vi har en diskursanalytisk og praksisorientert tilnærming når vi identifiserer tre legitimeringsdiskurser: en geopolitisk oppdatert legitimering, en motvekt til dominerende representasjon av Russland, og en representasjon av aktøregenskapene til Barentssamarbeidet i lys av framtidig norsk-russiske relasjoner.
The purpose of this paper is to contribute to the discussion of technology in music therapy and public health, focusing on the human–computer interaction and the cocreation of mental health. Foundational theory explaining the possible therapeutic dynamics that can occur when engaged in digital technology is presented, along with two case vignettes that illustrate how adolescents interact with digital music technology to promote mental health and wellbeing. The discussion includes reflections concerning actor-network theory, agency, and affordance-theory, and it argues that the iPad should be considered a valuable co-agent in the agent-network functioning to promote adolescents’ mental health.
When the Danish corona lockdown was announced 11 March 2020 everyday life suddenly changed for many Danes, including the taken-for-granted temporalities of daily life. The everyday micro-practices that normally sequence and materialize the multiple, competing, and entangled temporalities of the everyday came to a standstill. The lockdown in Denmark as a state of exception gave rise to new kinds of rituals, and ambivalent moods, and unlocked ideas about pasts and futures to reshaping. Based on ethnographic material the article investigates how well-known and new temporalities were practiced, materialized, and affectively experienced during the Spring 2020 lockdown, especially among university students in the Copenhagen area. It explores how the multiple temporalities of contemporary Denmark - time for work and leisure, family time, me-time, public ritual time, biographic time, hopes and fears for the future etc. - were attempted attuned to a new pandemic time of crisis. As a state of exception, the lockdown made the otherwise taken-for-granted everyday micro-practices of multiple temporalities visible and open to investigation.
Arne Johan Jensen, Bengt Finstad, Peder Fiske
et al.
Abstract Consistent individual differences in behavior have been demonstrated for many animals, but there are few studies of consequences of such repeated behavior in the wild. We tested consistency in migration timing to and from the sea among anadromous Arctic char (Salvelinus alpinus) and brown trout (Salmo trutta), using data from a study period of about 25 years, including more than 27,000 uniquely Carlin‐tagged individuals that migrated to sea for feeding in the spring and returned to the river in late summer for up to 13 successive years. Consistency was found between individuals across time in timing of the seaward migration. Individuals migrating early during their first migration tended to migrate early the following years, and late migrants tended to migrate late. The same pattern was found also at ascent to freshwater. Hence, this study demonstrated that individual fish in nature can differ in behavior related to migration timing and that these differences can be consistent during their lifetime. Early migrants increased their mass more than late migrants and had a higher specific growth rate. Early migrating Arctic char, but not brown trout, experienced a longer life after the first migration to sea than late migrants. In both species, maturity occurred earlier in individuals that migrated early. For brown trout, but not for Arctic char, fecundity was significantly correlated to the timing of smolt migration. Hence, the repeatable individual variation in migration timing seemed to have ecological and fitness consequences in terms of growth, longevity, timing of maturity, and lifetime fecundity.
Elin Salemonsen, Georg Førland, Britt Sætre Hansen
et al.
Abstract Background In light of the high prevalence of overweight and obesity among adults and the subsequent stigmatization and health consequences, there is a need to develop effective interventions to support lifestyle change. The literature supports the key role of healthcare professionals (HPs) in facilitating self-management through lifestyle interventions for those with chronic conditions. However, there is a lack of knowledge about how HPs practice self-management support (SMS) and user involvement for persons afflicted by overweight or obesity in lifestyle interventions in primary care Healthy Life Centres (HLC). The aim of this study was to explore how HPs provide SMS and what user involvement implies for HPs in HLCs. Methods An interpretative exploratory design, using qualitative thematic analysis of data from two focus group interviews with ten HPs from eight different HLCs, was conducted. Results The analysis resulted in one overall theme; A partnership based on ethical awareness, non-judgemental attitude, dialogue and shared responsibility, comprising four interrelated themes: 1) Supporting self-efficacy, self-worth and dignity through an attitude of respect, acknowledgement and generosity, 2) Promoting self-belief and self-perceived health, 3) Collaborating and sharing responsibility, and 4) Being flexible, adjusting and sharing time. Conclusion HPs in HLCs see service users as equal partners in a collaboration based on shared responsibility, acknowledgement and generosity. In order to help, their practice involves a heightened level of ethical awareness, including a non-judgemental attitude and dialogue. HPs in HLCs have something to teach us about ethical acting and helping persons who are struggling with overweight or obesity to change their lifestyle and regain dignity. They seem to see the service users’ existential needs and have learned the art of meeting the other in her/his most vulnerable situation i.e., seeking help for a “wrong lifestyle”. It may be time to highlight the need for SMS and user involvement to focus on shared responsibility in partnership rather than personal responsibility. More research is required to explore the conditions for such practice.
Barnomsorgen i Finland har en gemensam historia med övriga Norden, dels genom Fröbeltraditionen, dels genom de värderingar som ligger till grund för det nordiska välfärdssamhället. Under en lång tid har daghem och skola utvecklats utifrån olika utgångspunkter och styrprocesser. Men under de senaste åren har dessa kommit att konsolideras i en politiskt underbyggd reform. En tradition av omsorg och fostran för barn mellan 0–6 år omskrivs till småbarnspedagogik, och i den nya läroplanen som tagits i bruk 2017 betonas barns perspektiv och barns delaktighet som centrala utgångspunkter för verksamheten, som en ny ideologisk värdegrund för den moderna småbarnspedagogiken i Finland. I artikeln analyseras vilka uttryck för barns perspektiv och delaktighet som framträder i de finländska styrdokumenten. Vi lyfter också fram olika faktorer som bidragit till att orienteringen mot barns perspektiv och delaktighet etablerats senare i Finland jämfört med de övriga nordiska länderna.
«All that glitters is not gold» - broadaxes with brass banded hafts from the late Viking age
Traditionally, the sword was regarded as a weapon of personal prestige and a symbol of the privileged landowning elite. The axe, on the other hand, was a farming tool and symbolic of the landless but free men that went into service under this privileged elite. These men were called housecarls (ON: húskarl). As the Viking age drew toward its end, the axe seemed to gain a higher status as a weapon of prestige in the shape of two-handed broadaxes (dane-axe). Their elongated edge but thin and light body made them a fearsome and formidable weapon.
Six broadaxes with haft bandings of copper-alloy have been identified in the archaeological collection at the Museum of Cultural History in Oslo. The alloys have been analyzed and the results show that they are all made of brass with a high level of zinc. This suggests that the brass is of high quality, which further enhances these broadaxes as prestigious weapons. The results are presented in this article along with comparative material from Europe. The appearance of these broadaxes at the end of the Viking Age is further discussed in light of literary sources relating to Canute the Great and his retinue of housecarls called the Thinglid.