The aim of this study was to explore bachelor-level nursing students' experiences with concept cartoons as an active learning strategy and formative assessment to develop conceptual understanding in anatomy and physiology (A&P). Many first-year nursing students struggle to understand central concepts in A&P. Concept cartoons-cartoon characters proposing scientifically acceptable statements and misconceptions combined with an illustration-might facilitate active learning in lectures, overcome misconceptions and promote deep learning. Voting on the most precise statement using a student response system gives formative information about the students' conceptual understanding. Parallel mixed methods design with an emphasis on a qualitative approach. Nine concept cartoons were developed based on former students' written answers to exam items and applied in lectures at three universities/university colleges. Qualitative data of students' experiences were collected in three focus group interviews during November 2019, one focus group at each of the three universities/university colleges (n = 5, 8 and 8). A short questionnaire was also applied (n = 343) to all students at the three universities/university colleges. Qualitative data were analysed using qualitative content analyses, whereas frequency analysis and Chi-square statistics were applied for the quantitative data. The study was approved by the Norwegian Centre for Research Data, ref. 779586. Qualitative data analysis indicated that the use of concept cartoons addresses different learning styles and could promote deep learning and enhance the environment for learning. The concept cartoons were also seen as valuable for examination preparation. Regarding potential improvements, more information about concept cartoons, how they were developed and how they were supposed to be used would be beneficial, and the cartoons could be used in a more time-efficient manner during lectures. Quantitative data indicated that most of the students thought that concept cartoons were useful and inspiring in learning A&P, and they would recommend further use to increase their understanding of central concepts. There were no significant differences across sex, age, or entrance qualifications when it comes to the benefits of using concept cartoons in learning A&P. Compared to students born in Scandinavia, a larger proportion of students born outside Scandinavia found the use of concept cartoons inspiring for their learning in A&P. The use of concept cartoons was appreciated by the students to develop a conceptual understanding in A&P. Most students recommended future use. At point of submission put this on title page Tweetable Concept cartoons are appreciated as an active learning strategy and formative assessment in developing nursing students' conceptual understanding of anatomy and physiology.

Over the recent past, there has been an increase in nutrition information available to adolescents from various sources, which resulted into confusion and misinterpretation of the dietary advice. Results from international assessment frameworks such as PISA and TIMMS reflect the need for adolescents to critically appraise health information. While a number of scales measuring the critical health literacy of individuals exist; very few of these are devoted to critical nutrition literacy. More so, these scales target individuals with an advanced level of nutrition education, often gaging their proficiency in information appraisal in relation to principles of evidence-based medical research. The purpose of the present study was to examine the psychometric properties of a newly developed critical nutrition literacy scale (CNL-E) measuring adolescents’ perceived proficiency in ‘critically evaluating nutrition information from various sources’. During spring 2015, more than 1600 tenth graders aged 15–16 years from approximately 60 schools in Norway responded to the five-item questionnaire using an electronic survey system. Applying Rasch analysis approach, we examined the psychometric properties of the CNL-E scale employing the RUMM2030 statistical package. To further investigate the dimensionality of the scale and test the underlying structure, we applied multidimensional Rasch modelling using the ConQuest 4 software and confirmatory factor analysis (CFA) using the Lisrel 9.30 software. In our sample, the CNL-E stood out as a valid, reliable and well-targeted scale with good overall fit to the partial credit parameterization of the polytomous unidimensional Rasch model (PCM). All the items were sufficiently statistically independent, had ordered response categories and showed acceptable individual fit to the PCM. No item displayed within-item bias or differential item functioning (DIF). From the observed CNL-E sum score, it is possible to draw plausible conclusions about how individuals critically evaluate nutrition information. Efforts to improve communication of nutrition information could benefit from applying validated measures such as the CNL-E scale. The CNL-E scale provides insight into how individuals without an advanced level of nutrition education, such as adolescents, determine the validity and reliability of nutrition information from various sources.

Numerous conceptual models of health literacy have been proposed in the literature, but very few have been empirically validated in clinical contexts. The aim of this study was to test the effects of the conceptual model of health literacy as a risk in a clinical dental context. A convenience sample of 133 Norwegian-speaking adults was recruited. Participants were randomly allocated to an intervention group (n = 64, 54% women, mean age = 50 years) and a control group (n = 69, 49% women, mean age = 46 years). Clinical measurements were conducted pre-intervention and six months post-intervention. In the intervention group, communication regarding patients’ oral health was tailored to their health literacy levels using recommended communication techniques, whereas the control group received brief information not tailored to health literacy levels. The ANCOVA showed significant between-group effects, finding reduced post-intervention mean gingival (p < 0.000) and mean plaque (p < 0.000) indices in the intervention group when controlling for baseline index scores. The adjusted Cohen’s d indicated large effect sizes between the intervention group and the control group for both the mean gingival index (−0.98) and the mean plaque index (−1.33). In conclusion, the conceptual model of health literacy as a risk had a large effect on important clinical outcomes, such as gingival status and oral hygiene. The model may be regarded as a suitable supplement to patient education in populations.

The pathogenesis of the early development of atherosclerosis in sitosterolaemia is unknown. The effect of sitosterol on vascular endothelial cells in vitro was investigated by culturing human umbilical vein endothelial cells in the presence of up to 0.7 mmol l^-1 of sitosterol. Liposomes were used to supply the high sterol concentrations. Exposure to 0.7 mmol l^-1 of sitosterol for 72 h caused contraction of the endothelial cells and increased release of intracellular lactate dehydrogenase. After 96 h incubation the cells were partly detached from the substrate. At this time-point 0.35 mmol l^-l of sitosterol also caused perturbation of the endothelial cells. However, we could not confirm previous reports that tissue plasminogen activator production was enhanced by sitosterol.

Self-efficacy beliefs are significant predictors of achievement in education. However, majority of existing self-efficacy measures are rather ‘general’ and assess aggregated perceptions of students’ proficiencies within broad academic disciplines. Applying Rasch analysis, the present study explored the psychometric properties of the five-item ‘self-efficacy in body and health’ (SEBH) scale as administered to 1622 tenth-graders aged 15-16years in Norway. Based on our sample, the SEBH scale stood out as well targeted and reliable with acceptable overall fit to the partial credit parameterization of the polytomous unidimensional Rasch model. Except for a slightly reversed threshold in item 1, which could be explained by few persons located at low levels of self-efficacy, the locally independent items had ordered response categories and functioned in the same way for the different levels of relevant person factors. Adapting this scale to different fields of education would contribute to development of more specific measures of perceived capability.