Development and validation of a framework for the assessment of school curricula on the presence of evolutionary concepts (FACE).

Evolution is a key concept of biology, fundamental to understand the world and address important societal problems, but research studies show that it is still not widely understood and accepted. Several factors are known to influence evolution acceptance and understanding, but little information is available regarding the impacts of the curriculum on these aspects. Very few curricula have been examined to assess the coverage of biological evolution. The available studies do not allow comparative analyses, due to the different methodologies employed by the authors. However, such an analysis would be useful for research purposes and for the development of appropriate educational policies to address the problem of a lack of evolution acceptance in some countries. In this paper we describe the steps through which we developed a valid and reliable instrument for curricula analysis known as FACE: "Framework to Assess the Coverage of biological Evolution by school curricula." This framework was developed based on the "Understanding Evolution Conceptual Framework" (UECF). After an initial pilot study, our framework was reformulated based on identified issues and experts' opinions. To generate validity and reliability evidence in support of the framework, it was applied to four European countries' curricula. For each country, a team of a minimum of two national and two foreign coders worked independently to assess the curriculum using this framework for content analysis. Reliability evidence was estimated using Krippendorf's alpha and resulted in appropriate values for coding the examined curricula. Some issues that coders faced during the analysis were discussed and, to ensure better reliability for future researchers, additional guidelines and one extra category were included in the framework. The final version of the framework includes six categories and 34 subcategories. FACE is a useful tool for the analysis and the comparison of curricula and school textbooks regarding the coverage of evolution, and such results can guide curricula development.

Emergency hospitalisation in six municipalities in the Sunnmøre district.

BACKGROUND: Providing better and more cost-efficient health services is a goal for health policy. It is seen as desirable to provide health services close to the patient's home. From 2016, all municipalities must provide emergency hospitalisation (EH). The objective of this study was to develop experience-based knowledge from medium-sized municipalities that operate such services without any inter-municipal collaboration. MATERIAL AND METHOD: Focus-group interviews with 25 health workers who are responsible for this service in six small and medium-sized municipalities in Western Norway were conducted in the autumn of 2013 and the spring of 2014. Additional information on bed utilisation was also collected. RESULTS: The informants reported that their municipalities had chosen emergency hospitalisation as a measure to reinforce the professional communities in the nursing homes. They described this as a patient-centred and flexible treatment option. In their opinion, the programme would help ensure competence enhancement in the municipalities. Bed utilisation increased from the introduction of EH until 31 August 2014. INTERPRETATION: The health workers reported that emergency hospitalisation in the municipality fulfilled key intentions of the Interaction Reform, in terms of providing treatment to patients locally and close to their homes.

Development and validation of Neonatal Satisfaction Survey--NSS-13.

AIMS: The purpose of this study was to develop and validate a survey to investigate parents' satisfaction with neonatal wards in a population of parents of children with a gestation age of ≥24 weeks to 3 months after full-term birth. METHOD: We explored the literature and conducted three focus groups: two with expert health personnel and one with parents. We tested the survey in a parent population (N = 105) and report the different stages in the validation process along with the full survey, the Neonatal Satisfaction Survey - 13 categories (NSS-13). RESULTS: We found 13 subcategories in the Neonatal Satisfaction Survey. The subcategories measure parents' satisfaction with neonatal units based on staff, admission, nurses, anxiety, siblings (parents' perceptions of caring for the siblings of the newborn), information, timeout, doctors, facilities, nutrition, preparation for discharge, trust and visitors. Each subcategory showed acceptable internal consistency. The full version of the Neonatal Satisfaction Survey presents 69 items, and each subcategory contains two to eleven items. CONCLUSION: The Neonatal Satisfaction Survey seems suitable to measure parents' satisfaction with neonatal units and can be used in full, but it can also measure subcategories. Parents' satisfaction with neonatal units can be used to improve the quality in such wards. We consider this study as the first in a series to validate the NSS-13. The full survey with subcategories is presented in this paper.

Laminarthrectomy as a surgical approach for decompressing the spinal canal: assessment of preoperative versus postoperative dural sac cross-sectional areal (DSCSA).

INTRODUCTION: Surgery for lumbar spinal stenosis (LSS) is today the most frequently performed procedure in the adult lumbar spine. Long-term benefit of surgery for LSS is well documented both in randomized and in non-randomized trials. In this paper, we present the results from laminarthrectomy as an alternative surgical approach, which have theoretical advantages over other approaches. In this study, we wanted to study the clinical and radiological results of laminarthrectomy. Dural sac cross-sectional areal (DSCSA) is an objective method to quantify the degree of central stenosis in the spinal canal, and was used to measure whether we were able to achieve an adequate decompression of the spinal canal with laminarthrectomy as a surgical approach. MATERIALS AND METHODS: All patients operated on with this approach consecutively in the period 1 January 2008 to 31 March 2009 were included in the study. All perioperative complications were noted. Clinical results were measured by means of a questionnaire. The patients that agreed to attend the study had an MRI taken of the operated level. DSCSA before and after surgery of the actual level were measured by three observers. We then performed a correlation test between increase of area and clinical results. We also tested for inter- and intra-observer reability. RESULTS: Fifty-six laminarthrectomy were performed. There were 17% complications, none of them were life-threatening or disabling. 46 patients attended the study and answered the questionnaire. Thirty-four patients (83%) reported clinical improvement, whereas six (13%) patients reported no improvement, and two (4%) patients reported that they were worse. Mean ODI was 23.0. Mean EQ-5D was 0.77. Mean VAS-score for back-pain was 3.1 and mean VAS-score for leg-pain was 2.8. Mean DSCSA were measured to 80 mm(2) before surgery and 161 mm(2) after surgery. That gave an increase of DSCSA of 81 mm(2) (101%). We found a significant positive correlation between increase of area and clinical results. We also found consistent inter- and intra-observer reability. DISCUSSION: In this study, the clinical results of laminarthrectomy were good, and comparable with other reports for LSS. The rates of complications are also comparable with other reports in spinal surgery. A significant increase in the spinal canal diameter was achieved. Within the limitations a retrospective study gives, we conclude that laminarthrectomy seems to be a safe and effective surgical approach for significant decompressing the adult central spinal canal, and measurement of DSCSA, before and after surgery seems to be a good way to quantify the degree of decompression.