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Eriksen AMA, Melhus M, Schei B, Skurtveit S, Broderstad AR. Opioid prescriptions among Sami and non-Sami with chronic pain: The SAMINOR 2 Questionnaire Survey and the Norwegian Prescription Database. Int J Circumpolar Health 2023; 82:2241202. [PMID: 37506380 PMCID: PMC10392314 DOI: 10.1080/22423982.2023.2241202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
This study is the first to investigate the prevalence of filled opioid prescriptions among indigenous Sami people with self-reported chronic musculoskeletal pain (CMSP) and compare it with that of non-Sami living in the same area. Baseline data from the SAMINOR 2 Questionnaire Survey (2012) was linked prospectively to the Norwegian Prescription Database. Information on filled opioid prescriptions during 2012-2019 was collected for 4767 persons who reported CMSP in SAMINOR 2. Gender-stratified chi-square tests, two-sample t-tests, Kruskal - Wallis tests, and multinomial logistic regression was applied. Two out of three CMSP respondents received no or only one prescription of opioids during 2012-2019. In each year, 80% of women received no opioids, 7-10% received one prescription of ≤ 180 defined daily doses (DDD), 8-9% received in total ≤ 180 DDD in two or more prescriptions, and 2-3% received > 180 DDD of opioids. Among men, 81-83% received no opioids, 8-11% received one prescription with ≤ 180 DDD, 5-9% received ≤ 180 DDD in two or more prescriptions, and 1-2% received > 180 DDD of opioids in a single year. There were no overall ethnic differences, which indicates a similar prescription policy for opioids for Sami and non-Sami with CMSP.
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Affiliation(s)
- Astrid M A Eriksen
- Centre for Sami Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Marita Melhus
- Centre for Sami Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
| | - Berit Schei
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Norwegian University of Science and Technology (NTNU), Department of Obstetrics and Gynecology, Trondheim, Norway
| | - Svetlana Skurtveit
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ann-Ragnhild Broderstad
- Centre for Sami Health Research, Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway
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Protudjer JLP, Olén O, Vetander M, Kull I, Melén E, van Hage M, Wickman M, Bergström A. Milk-Related Symptoms and Immunoglobulin E Reactivity in Swedish Children from Early Life to Adolescence. Nutrients 2018; 10:nu10050651. [PMID: 29883392 PMCID: PMC5986530 DOI: 10.3390/nu10050651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/01/2018] [Accepted: 05/01/2018] [Indexed: 11/16/2022] Open
Abstract
Cow’s milk often causes symptoms in infants. Whereas, some continue to experience symptoms through childhood, others become tolerant. Yet, the ages at which persistence and tolerance occur are less clear. Thus, we examined the age of onset and persistence of milk-related symptoms from early life to adolescence, and Immunoglobulin E (IgE) milk reactivity, focusing on gender differences in a large, population-based birth cohort. Overall, 20.0% (537/2985) of children, with a comparable gender distribution, had early life milk-related symptoms. At 16y, approximately 2% (62/2985) children had persistent symptoms and high milk IgE levels (e.g., median at 4 years: 1.5 kUA/L) that were beginning in early life. In contrast, 94% had transient symptoms and low median IgE levels (early life: 0.63 kUA/L, 8y: 0.72 kUA/L; 16 years: 1.1 kUA/L). Also, at 16 years, approximately 6% of females and 3% of males without any previously reported symptoms reported adolescent-onset of symptoms (p < 0.001). Such symptoms were almost exclusively gastrointestinal symptoms and were not associated with detectable IgE. In conclusion, early life milk-related symptoms are common, although most cases are transient by 16 years. Twice as many females vs. males report adolescent-onset symptoms, and particularly gastrointestinal symptoms. Children with persistent symptoms have both a higher prevalence and higher milk IgE levels, as compared to other phenotypes.
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Affiliation(s)
- Jennifer L P Protudjer
- Center for Occupational and Environmental Medicine, Stockholm County Council, 113 65 Stockholm, Sweden.
- Institute for Environmental Medicine, Karolinska Institutet, 171 11 Stockholm, Sweden.
| | - Ola Olén
- Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, 171 76 Stockholm, Sweden.
- Sachs' Children and Youth Hospital, The South General Hospital, 118 83 Stockholm, Sweden.
- Department of Clinical Science and Education, Sodersjukhuset, Karolinska Institute, 118 83 Stockholm, Sweden.
| | - Mirja Vetander
- Institute for Environmental Medicine, Karolinska Institutet, 171 11 Stockholm, Sweden.
- Sachs' Children and Youth Hospital, The South General Hospital, 118 83 Stockholm, Sweden.
| | - Inger Kull
- Institute for Environmental Medicine, Karolinska Institutet, 171 11 Stockholm, Sweden.
- Sachs' Children and Youth Hospital, The South General Hospital, 118 83 Stockholm, Sweden.
- Department of Clinical Science and Education, Sodersjukhuset, Karolinska Institute, 118 83 Stockholm, Sweden.
| | - Erik Melén
- Institute for Environmental Medicine, Karolinska Institutet, 171 11 Stockholm, Sweden.
- Sachs' Children and Youth Hospital, The South General Hospital, 118 83 Stockholm, Sweden.
| | - Marianne van Hage
- Department of Medicine Solna, Immunology and Allergy Unit, Karolinska Institutet, and Karolinska University Hospital, 171 76 Stockholm, Sweden.
| | - Magnus Wickman
- Institute for Environmental Medicine, Karolinska Institutet, 171 11 Stockholm, Sweden.
- Centre for Clinical Research Sörmland, Uppsala University, 751 85 Eskiltuna, Sweden.
| | - Anna Bergström
- Center for Occupational and Environmental Medicine, Stockholm County Council, 113 65 Stockholm, Sweden.
- Institute for Environmental Medicine, Karolinska Institutet, 171 11 Stockholm, Sweden.
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Eriksen AMA, Schei B, Hansen KL, Sørlie T, Fleten N, Javo C. Childhood violence and adult chronic pain among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study. Int J Circumpolar Health 2016; 75:32798. [PMID: 27802844 PMCID: PMC5090132 DOI: 10.3402/ijch.v75.32798] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 02/04/2023] Open
Abstract
Background Internationally, studies have shown that childhood violence is associated with chronic pain in adulthood. However, to date, this relationship has not been examined in any indigenous population. Objective The main objectives of this study were to investigate the association between childhood violence and reported chronic pain, number of pain sites and the intensity of pain in adulthood in indigenous Sami and non-Sami adults, and to explore ethnic differences. Design The study is based on the SAMINOR 2 questionnaire study, a larger population-based, cross-sectional survey on health and living conditions in multiethnic areas with both Sami and non-Sami populations in Mid- and Northern Norway. Our study includes a total of 11,130 adult participants: 2,167 Sami respondents (19.5%) and 8,963 non-Sami respondents (80.5%). Chronic pain was estimated by reported pain located in various parts of the body. Childhood violence was measured by reported exposure of emotional, physical and/or sexual violence. Results Childhood violence was associated with adult chronic pain in several pain sites of the body regardless of ethnicity and gender. Childhood violence was also associated with increased number of chronic pain sites and higher pain intensity compared to those not exposed to childhood violence. However, among Sami men, this association was only significant for pain located in chest, hips/legs and back, and non-significant for increased number of chronic pain sites (adjusted model), and higher pain intensity. Conclusion Respondents exposed to childhood violence reported more chronic pain in several parts of the body, increased number of chronic pain sites and more intense pain in adulthood than respondents reporting no childhood violence. However, among Sami men, this association was weaker and also not significant for increased number of chronic pain sites and higher pain intensity.
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Affiliation(s)
- Astrid M A Eriksen
- Sami National Centre for Mental Health and Substance Use (SANKS) Finnmarkssykehuset HF, Karasjok, Norway.,Faculty of Health Science, Oslo and Akershus University College of Applied Science, Oslo, Norway;
| | - Berit Schei
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Public Health, NTNU, Trondheim, Norway.,Department of Obstetrics and Gynecology, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ketil Lenert Hansen
- Regional Centre for Child and Youth Mental Health and Child Welfare, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Tore Sørlie
- Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway.,Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Nils Fleten
- Department of Community Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Cecilie Javo
- Sami National Centre for Mental Health and Substance Use (SANKS) Finnmarkssykehuset HF, Karasjok, Norway
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Melbøe L, Hansen KL, Johnsen BE, Fedreheim GE, Dinesen T, Minde GT, Rustad M. Ethical and methodological issues in research with Sami experiencing disability. Int J Circumpolar Health 2016; 75:31656. [PMID: 27396747 PMCID: PMC4938889 DOI: 10.3402/ijch.v75.31656] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 03/18/2016] [Accepted: 05/19/2016] [Indexed: 11/14/2022] Open
Abstract
Background A study of disability among the indigenous Sami people in Norway presented a number of ethical and methodological challenges rarely addressed in the literature. Objectives The main study was designed to examine and understand the everyday life, transitions between life stages and democratic participation of Norwegian Sami people experiencing disability. Hence, the purpose of this article is to increase the understanding of possible ethical and methodological issues in research within this field. The article describes and discusses ethical and methodological issues that arose when conducting our study and identifies some strategies for addressing issues like these. Methods The ethical and methodological issues addressed in the article are based on a qualitative study among indigenous Norwegian Sami people experiencing disability. The data in this study were collected through 31 semi-structured in-depth interviews with altogether 24 Sami people experiencing disability and 13 next of kin of Sami people experiencing disability (8 mothers, 2 fathers, 2 sister and 1 guardian). Findings and discussion The researchers identified 4 main areas of ethical and methodological issues. We present these issues chronologically as they emerged in the research process: 1) concept of knowledge when designing the study, 2) gaining access, 3) data collection and 4) analysis and accountability. Conclusion The knowledge generated from this study has the potential to benefit future health research, specifically of Norwegian Sami people experiencing disability, as well as health research concerning indigenous people in general, providing scientific-based insight into important ethical and methodological issues in research with indigenous people experiencing disability.
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Affiliation(s)
- Line Melbøe
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway;
| | - Ketil Lenert Hansen
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Bjørn-Eirik Johnsen
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Gunn Elin Fedreheim
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Tone Dinesen
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Gunn-Tove Minde
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
| | - Marit Rustad
- Department of Social Education, University of Tromsø - The Arctic University of Norway, Harstad, Norway
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