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Stjernbrandt A, Pettersson H, Vihlborg P, Höper AC, Aminoff A, Wahlström J, Nilsson T. Raynaud's phenomenon in the feet of Arctic open-pit miners. Int J Circumpolar Health 2024; 83:2295576. [PMID: 38109321 PMCID: PMC10732197 DOI: 10.1080/22423982.2023.2295576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023] Open
Abstract
The literature on Raynaud's phenomenon (RP) in the feet is scarce, especially in the occupational setting. The primary aim of our study was to investigate the occurrence of RP in the feet of miners. As part of the MineHealth project, written surveys and clinical examinations were completed by 260 Arctic open-pit miners working in northern Sweden and Norway (participation rate 53.6%). Data on RP were collected using standardised colour charts and questionnaire items. Clinical examination included assessing the perception of vibration and pain in both feet. There were eight women and three men who reported RP in the feet. Four also had RP in their hands but none acknowledged any first-degree relatives with the condition. Nine reported exposure to foot-transmitted vibration and one to hand-arm vibration. Seven showed signs of neurosensory injury in the feet. To conclude, the occurrence of RP in the feet of miners was 4.4%. Most cases with RP in the feet did not report the condition in the hands and were exposed to vibration transmitted directly to the feet. There were no reports of a hereditary component. Most cases with RP in the feet also had clinical findings suggestive of peripheral neuropathy in the feet.
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Affiliation(s)
- Albin Stjernbrandt
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Hans Pettersson
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Per Vihlborg
- Department of Geriatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Anje Christina Höper
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Anna Aminoff
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Jens Wahlström
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Tohr Nilsson
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Emelyanova A, Blix BH, Larsson A, Olafsdottir SA, Rautio A. Age-inclusive Arctic outdoor spaces: a policy review in four Nordic countries. Int J Circumpolar Health 2024; 83:2339561. [PMID: 38615335 PMCID: PMC11017993 DOI: 10.1080/22423982.2024.2339561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 04/02/2024] [Indexed: 04/16/2024] Open
Abstract
In the last decade, policy strategies were adopted in response to population ageing in the Nordic countries. Governmental actions have to be evaluated in terms of their efficacy. The objective of this article is to identify and review the policies related to age-inclusive outdoor spaces in the Arctic regions of Nordic countries. Our analysis focuses on central government white papers that address the older adults in Finland, Norway, Sweden, and Iceland. A review of such policy documents provides insights into the predominant understandings of older adults and healthy ageing. Moreover, such analysis may identify "blind spots" in the national policies, especially regarding the sparsely researched northernmost and rural Arctic territories. Our results demonstrate how the older populations in the Nordic Arctic and their access to outdoor spaces are addressed in the policy documents. We found that with few exceptions, the older people of the rural Arctic is strikingly absent in the Nordic national governmental papers. Moreover, access to outdoor spaces is mentioned in general terms, and specific challenges of the rural Arctic context, such as the harsh climate, long winters and geographical distances are not addressed. The noticed omissions might be the result of "urban-rural", "south-north", "indoor-outdoor", and "generalisation" biases.
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Affiliation(s)
- Anastasia Emelyanova
- Thule Institute, University of Oulu, Oulu, Finland
- Arctic Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Bodil H. Blix
- Department of health and care sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Faculty of education, arts and sports, Western Norway University of Applied Science, Bergen, Norway
| | - Agneta Larsson
- Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Steinunn A. Olafsdottir
- Department of Physical Therapy, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Arja Rautio
- Arctic Health, Faculty of Medicine, University of Oulu, Oulu, Finland
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Fasting A, Hetlevik I, Mjølstad BP. Put on the sidelines of palliative care: a qualitative study of important barriers to GPs' participation in palliative care and guideline implementation in Norway. Scand J Prim Health Care 2024; 42:254-265. [PMID: 38289262 PMCID: PMC11003325 DOI: 10.1080/02813432.2024.2306241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/11/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Demographic changes, the evolvement of modern medicine and new treatments for severe diseases, increase the need for palliative care services. Palliative care includes all patients with life-limiting conditions, irrespective of diagnosis. In Norway, palliative care rests on a decentralised model where patient care can be delivered close to the patient's home, and the Norwegian guideline for palliative care describes a model of care resting on extensive collaboration. Previous research suggests that this guideline is not well implemented among general practitioners (GPs). In this study, we aim to investigate barriers to GPs' participation in palliative care and implementation of the guideline. METHODS We interviewed 25 GPs in four focus groups guided by a semi-structured interview guide. The interviews were recorded and transcribed verbatim. Data were analysed qualitatively with reflexive thematic analysis. RESULTS We identified four main themes as barriers to GPs' participation in palliative care and to implementation of the guideline: (1) different established local cultures and practices of palliative care, (2) discontinuity of the GP-patient relationship, (3) unclear clinical handover and information gaps and (4) a mismatch between the guideline and everyday general practice. CONCLUSION Significant structural and individual barriers to GPs' participation in palliative care exist, which hamper the implementation of the guideline. GPs should be involved as stakeholders when guidelines involving them are created. Introduction of new professionals in primary care needs to be actively managed to avoid inappropriate collaborative practices. Continuity of the GP-patient relationship must be maintained throughout severe illness and at end-of-life.
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Affiliation(s)
- Anne Fasting
- General Practice Research Unit, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Unit for Palliative Care and Chemotherapy Treatment, Oncology Department, Møre og Romsdal Hospital Trust, Kristiansund Hospital, Norway
| | - Irene Hetlevik
- General Practice Research Unit, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bente Prytz Mjølstad
- General Practice Research Unit, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Saksvik legekontor, Saxe Viks veg 4, N-7562 Hundhammeren, Norway
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Orangzeb S, Desalegn A, Trinh NTH, Zhao J, Nordeng H, Lupattelli A. COVID-19 vaccine uptake among children and adolescents in Norway: A comprehensive registry-based cohort study of over 800,000 individuals. Vaccine 2024:S0264-410X(24)00464-X. [PMID: 38641494 DOI: 10.1016/j.vaccine.2024.04.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/21/2024]
Abstract
Factors related with COVID-19 vaccine uptake in children and adolescents in Norway remain unclear, despite this being useful knowledge for future pandemic preparedness. This study aimed to comprehensively examine individual and familial factors associated with vaccine uptake in children and adolescents in Norway. We utilized nationwide registry-data from various health registries and Statistics Norway, encompassing all children and adolescents living in Norway during the pandemic, until 31-Dec-2022. Vaccine uptake is defined as receiving at least one dose of COVID-19 vaccine. We employed a forward stepwise logistic regression model and a random forest machine-learning algorithm to explore the relationship between vaccine uptake and socio-cultural, demographic, and health-related factors. We included 423,548 5-11-year-olds, 269,830 12-15-year-olds, and 120,854 16-17-year-olds. Vaccine uptake in these three groups was respectively 2.6 %, 73.3 %, and 87.3 %. Factors associated with vaccine uptake varied by age group. In youngest children, immigrant background (Odds-ratio (OR) = 1.58, 95 % confidence interval (CI) (1.14-2.19)), born extremely preterm (OR = 2.38, 95 % CI (1.60-3.54)), having risk of severe COVID-19 (OR = 5.40, 95 % CI (4.69-6.23) and maternal COVID-19 vaccination (OR = 6.34, 95 % CI (5.35-7.53)) were positively associated with vaccine uptake. The latter two factors were also strongly, positively associated with vaccine uptake in 12-15-year-olds, while previous SARS-CoV-2 infection was negatively associated (OR = 0.12, 95 % CI (0.11-0.14). Similar findings were observed in 16-17-year-olds. COVID-19 vaccine uptake differed markedly by age group, and major associated factors included socio-demographics and parental COVID-19 vaccination status, prior SARS-CoV-2 infection, but also being born premature and having moderate or high risk of severe COVID-19.
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Affiliation(s)
- Saima Orangzeb
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Anteneh Desalegn
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Nhung T H Trinh
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Jing Zhao
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Hedvig Nordeng
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway; Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Angela Lupattelli
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
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Mikalsen MP, Simonsen GS, Sørbye SW. Impact of HPV Vaccination on the Incidence of High-Grade Cervical Intraepithelial Neoplasia (CIN2+) in Women Aged 20-25 in the Northern Part of Norway: A 15-Year Study. Vaccines (Basel) 2024; 12:421. [PMID: 38675803 PMCID: PMC11054067 DOI: 10.3390/vaccines12040421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/03/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Human papillomavirus (HPV), the most prevalent sexually transmitted infection globally, is a key risk factor for high-grade cervical lesions and cervical cancer. Since 2009, HPV vaccination has been part of the national immunization program for girls in 7th grade in Norway (women born 1997 and later). This study aimed to assess the impact of HPV vaccination on the incidence of high-grade cervical precursors (CIN2+) among women aged 20-25 in Troms and Finnmark over a 15-year period. MATERIALS AND METHODS In this time series study, we analyzed cervical screening data from 15,328 women aged 20-25 in Troms and Finnmark, collected between 2008 and 2022. Statistical methods, including linear and logistic regression, were employed to evaluate changes in cervical intraepithelial neoplasia grade 2 and worse (CIN2+) incidence and compare risks between vaccine-offered cohorts and pre-vaccine cohorts. RESULTS The incidence of CIN2+ initially increased from 31 cases per year in 2008 to 110 cases in 2018, then significantly decreased to 44 cases per year by 2022 (p < 0.01). Women in pre-vaccine cohorts had a substantially higher risk of CIN2+ (OR 9.02, 95% CI 5.9-13.8) and CIN3+ (OR 19.6, 95% CI 7.3-52.6). Notably, no vaccinated women with CIN2+ tested positive for HPV types 16 or 18. Furthermore, none of the 13 cervical cancer cases recorded during the study were from the vaccinated cohorts. INTERPRETATION The findings suggest a significant reduction in the incidence of high-grade cervical precursors following the introduction of the HPV vaccine in Norway's national immunization program, highlighting its effectiveness in cervical cancer prevention among young women in Northern Norway.
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Affiliation(s)
- Marte Pettersen Mikalsen
- Department of Medical Biology, UiT The Arctic University of Norway, 9019 Tromsø, Norway; (M.P.M.); (G.S.S.)
| | - Gunnar Skov Simonsen
- Department of Medical Biology, UiT The Arctic University of Norway, 9019 Tromsø, Norway; (M.P.M.); (G.S.S.)
- Department of Microbiology and Infection Control, University Hospital of North Norway, 9019 Tromsø, Norway
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Holvik K, Abel MH, Holmen J, Krokstad S, Totland TH, Meyer HE. No change in 24-h sodium intake estimated from spot urine in Norwegian adults from 2006 to 2019: the population-based Trøndelag Health Study (HUNT). Public Health Nutr 2024; 27:e117. [PMID: 38602104 PMCID: PMC11036440 DOI: 10.1017/s136898002400082x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 03/06/2024] [Accepted: 04/03/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE Monitoring time trends in salt consumption is important for evaluating the impact of salt reduction initiatives on public health outcomes. There has so far not been available data to indicate if salt consumption in Norway has changed during the previous decade. We aimed to assess whether average 24-h salt intake estimated from spot urine samples in the adult population of mid-Norway changed from 2006-2008 to 2017-2019 and to describe variations by sex, age and educational level. DESIGN Repeated cross-sectional studies. SETTING The population-based Trøndelag Health Study (HUNT). PARTICIPANTS In each of two consecutive waves (HUNT3: 2006-2008 and HUNT4: 2017-2019), spot urine samples were collected from 500 men and women aged 25-64 years, in addition to 250 men and women aged 70-79 years in HUNT4. Based on spot urine concentrations of Na, K and creatinine and age, sex and BMI, we estimated 24-h Na intake using the International Cooperative Study on Salt and Blood Pressure (INTERSALT) equation for the Northern European region. RESULTS Mean (95 % CI) estimated 24-h salt intakes in men were 11·1 (95 % CI 10·8, 11·3) g in HUNT3 and 10·9 (95 % CI 10·6, 11·1) g in HUNT4, P = 0·25. Corresponding values in women were 7·7 (95 % CI 7·5, 7·9) g and 7·7 (95 % CI 7·5, 7·9) g, P = 0·88. Mean estimated salt intake in HUNT4 decreased with increasing age in women, but not in men, and it did not differ significantly across educational level in either sex. CONCLUSIONS Estimated 24-h salt intake in adult men and women in mid-Norway did not change from 2006-2008 to 2017-2019.
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Affiliation(s)
- Kristin Holvik
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
| | - Marianne Hope Abel
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
| | - Jostein Holmen
- HUNT Research Center, Department of Public Health and Nursing,
Norwegian University of Science and Technology (NTNU),
Trondheim, Norway
| | - Steinar Krokstad
- HUNT Research Center, Department of Public Health and Nursing,
Norwegian University of Science and Technology (NTNU),
Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust,
Levanger, Norway
| | - Torunn Holm Totland
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
| | - Haakon E Meyer
- Department of Physical Health and Ageing, Norwegian Institute
of Public Health, 0213Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health
and Society, University of Oslo, Oslo,
Norway
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Oftung B, Tyssen R. Occupational stress among Norwegian physicians: A literature review of long-term prospective studies 2007-2019. Scand J Public Health 2024:14034948241243164. [PMID: 38600437 DOI: 10.1177/14034948241243164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
AIMS There are signs of increased stress at work among Norwegian physicians over the last decades, not least among general practitioners (GPs). In this review, we identify trends in both occupational stress and adverse work-related predictors of such stress and burnout in Norwegian physicians. METHODS We performed an extensive literature search using MEDLINE, Embase and PsycINFO. We included prospective and repeated cross-sectional studies of work stress among Norwegian physicians published in 2007-2019. RESULTS Nine studies with observation periods of 1-20 years were included. Occupational stress (global measure) among all doctors decreased gradually from medical school to 20 years later. The prevalence of an effort-reward imbalance increased fourfold among GPs during the period 2010-2019. Five studies reported higher levels of occupational stress among female physicians than among their male colleagues. Work-home conflict levels increased after graduation until 10 years after leaving medical school and plateaued thereafter. Physicians who graduated in a later cohort reported lower levels of work-home conflict and less workplace violence. Work-home conflict, low colleague support, number of work hours and workload/low autonomy were all independent predictors of occupational stress. CONCLUSIONS The reduction in occupational stress during the years after leaving medical school may result from increased competency in clinical work and decreased on-call work. The Co-ordination Act implemented in 2012 may explain the increase in occupational stress among GPs. These findings suggest that both reducing work-home conflict and increasing colleague support are important for doctors' well-being.
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Affiliation(s)
- Bendik Oftung
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Reidar Tyssen
- Department of Behavioural Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
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Radisic V, Grevskott DH, Junghardt N, Øvreås L, Marathe NP. Multidrug-resistant Enterococcus faecium strains enter the Norwegian marine environment through treated sewage. Microbiologyopen 2024; 13:e1397. [PMID: 38441345 PMCID: PMC10913173 DOI: 10.1002/mbo3.1397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/17/2024] [Accepted: 01/22/2024] [Indexed: 03/07/2024] Open
Abstract
This study aimed to understand the antibiotic resistance prevalence among Enterococcus spp. from raw and treated sewage in Bergen city, Norway. In total, 517 Enterococcus spp. isolates were obtained from raw and treated sewage from five sewage treatment plants (STPs) over three sampling occasions, with Enterococcus faecium as the most prevalent (n = 492) species. E. faecium strains (n = 307) obtained from the influent samples, showed the highest resistance against quinupristin/dalfopristin (67.8%). We observed reduced susceptibility to erythromycin (30.6%) and tetracycline (6.2%) in these strains. E. faecium strains (n = 185) obtained from the effluent samples showed highest resistance against quinupristin/dalfopristin (68.1%) and reduced susceptibility to erythromycin (24.9%) and tetracycline (8.6%). We did not detect resistance against last-resort antibiotics, such as linezolid, vancomycin, and tigecycline in any of the strains. Multidrug-resistant (MDR) E. faecium strains were detected in both influent (2.3%) and effluent (2.2%) samples. Whole genome sequencing of the Enterococcus spp. strains (n = 25) showed the presence of several antibiotic resistance genes, conferring resistance against aminoglycosides, tetracyclines, and macrolides, as well as several virulence genes and plasmid replicons. Two sequenced MDR strains from the effluents belonged to the hospital-associated clonal complex 17 and carried multiple virulence genes. Our study demonstrates that clinically relevant MDR Enterococcus spp. strains are entering the marine environment through treated sewage.
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Affiliation(s)
- Vera Radisic
- Department of Contaminants and BiohazardsInstitute of Marine Research (IMR)BergenNorway
- Department of Biological SciencesUniversity of Bergen (UiB)BergenNorway
| | - Didrik H. Grevskott
- Department of Contaminants and BiohazardsInstitute of Marine Research (IMR)BergenNorway
| | - Nadja Junghardt
- Department of Contaminants and BiohazardsInstitute of Marine Research (IMR)BergenNorway
| | - Lise Øvreås
- Department of Biological SciencesUniversity of Bergen (UiB)BergenNorway
| | - Nachiket P. Marathe
- Department of Contaminants and BiohazardsInstitute of Marine Research (IMR)BergenNorway
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Milford AB, Muiruri SW. The impact of consumers' preferences for domestic food on dietary sustainability. Appetite 2024; 195:107206. [PMID: 38224838 DOI: 10.1016/j.appet.2024.107206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/09/2024] [Accepted: 01/09/2024] [Indexed: 01/17/2024]
Abstract
A sustainable dietary transition requires knowledge of the drivers and barriers of dietary choices. We investigate the role of preferences for domestic food, as well as environmental and health concerns, as drivers for the consumption of red and white meat, fish, ready-made plant-based food products and self-identification as some type of meat reducer (flexitarian, vegetarian, or vegan). A survey of 1102 consumers was conducted in Norway with questions about food attitudes, beliefs and preferences regarding health, the environment and domestic food as well as dietary habits and demographics. The results from interval and logistic regression analyses show that stronger preferences for domestic food are associated with higher consumption of red meat and a lower likelihood of eating plant-based food and identifying as a meat reducer. Health concerns are associated with higher consumption of white meat and fish, and environmental concern is associated with lower consumption of white meat and a higher likelihood of eating plant-based food. The results also confirm previous research results that disbelief regarding the negative health and environmental impacts of meat correlate with higher meat consumption and a lower likelihood of eating plant-based food. In addition, we find that people who believe that Norway is a country primarily suited for livestock production have higher consumption of meat and a lower likelihood of eating plant-based food. We conclude that to make certain consumers transition away from meat, it is important to provide domestically produced, plant-based alternatives and to implement policy measures that will generate positive storylines of improved farmer livelihoods.
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Affiliation(s)
- Anna Birgitte Milford
- Division of Food Production and Society, Norwegian Institute of Bioeconomy Research (NIBIO), Bergen, Norway.
| | - Sarah Wangui Muiruri
- Division of Food Production and Society, Norwegian Institute of Bioeconomy Research (NIBIO), Ås, Norway
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10
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Zahl PH, Hemström Ö, Johansen R, Mamelund SE. Mortality in Norway and Sweden during the COVID-19 pandemic 2020-22: A comparative study. J Infect Public Health 2024; 17:719-726. [PMID: 38262870 DOI: 10.1016/j.jiph.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/31/2023] [Accepted: 10/29/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Norway and Sweden picked two different ways to mitigate the dissemination of the SARS-CoV-2 virus. Norway introduced the strictest lockdown in Europe with strict border controls and intense virus tracking of all local outbreaks while Sweden did not. That resulted in 477 COVID-19 deaths (Norway) and 9737 (Sweden) in 2020, respectively. METHODS Weekly number of COVID-19 related deaths and total deaths for 2020-22 were collected as well as weekly number of deaths for 2015-19 which were used as controls when calculating excess mortality. During the first 12-18 months with high rate of virus transmission in the society, excess mortality rates were used as substitute for COVID-19 deaths. When excess mortality rates later turned negative because of mortality displacement, COVID-19 deaths adjusted for bias due to overreporting were used. RESULTS There were 17521 COVID-19 deaths in Sweden and 4272 in Norway in the study period. The rate ratio (RR) of COVID-19 related deaths in Sweden vs. Norway to the end of week 43, 2022, was 2.11 (95% CI 2.05-2.19). RR of COVID-19 related deaths vs. excess number of deaths were 2.5 (Sweden) and 1.3 (Norway), respectively. RR of COVID-19 deaths in Sweden vs. Norway after adjusting for mortality displacement and lockdown, was 1.35 (95% CI 1.31-1.39), corresponding to saving 2025 life in Norway. If including all deaths in 2022, RR= 1.28 (95% CI 1.24-1.31). CONCLUSIONS Both COVID-19 related mortality and excess mortality rates are biased estimates. When adjusting for bias, mortality differences declined over time to about 30% higher mortality in Sweden after 30 months with pandemics.
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Affiliation(s)
- Per-Henrik Zahl
- Norwegian Institute of Public Health, Division of Mental and Physical Health Oslo, Norway.
| | - Örjan Hemström
- Mälardalens University, Social Statistics and Analysis Population and Living Conditions, Statistics Sweden, Solna, Sweden; Public Health Agency of Sweden, Solna, Sweden
| | - Rune Johansen
- Norwegian Institute of Public Health, Division of Mental and Physical Health Oslo, Norway
| | - Svenn-Erik Mamelund
- Centre for Research on Pandemics & Society, Oslo Metropolitan University, Norway
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Moreno-Martos D, Zhao J, Li H, Nyberg F, Bjørndal LD, Hajiebrahimi M, Wettermark B, Aakjær M, Andersen M, Sessa M, Lupattelli A, Nordeng H, Morales DR. Impact of the early COVID-19 pandemic on adult mental health-related dispensed medications, hospitalizations and specialist outpatient visits in Norway and Sweden: Interrupted time series analysis. Br J Clin Pharmacol 2024. [PMID: 38555909 DOI: 10.1111/bcp.16044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/20/2024] [Accepted: 01/25/2024] [Indexed: 04/02/2024] Open
Abstract
AIMS Norway and Sweden had different early pandemic responses that may have impacted mental health management. The aim was to assess the impact of the early COVID-19 pandemic on mental health-related care. METHODS We used national registries in Norway and Sweden (1 January 2018-31 December 2020) to define 2 cohorts: (i) general adult population; and (ii) mental health adult population. Interrupted times series regression analyses evaluated step and slope changes compared to prepandemic levels for monthly rates of medications (antidepressants, antipsychotics, anxiolytics, hypnotics/sedatives, lithium, opioid analgesics, psychostimulants), hospitalizations (for anxiety, bipolar, depressive/mood, eating and schizophrenia/delusional disorders) and specialist outpatient visits. RESULTS In Norway, immediate reductions occurred in the general population for medications (-12% antidepressants to -7% hypnotics/sedatives) except for antipsychotics; and hospitalizations (-33% anxiety disorders to -17% bipolar disorders). Increasing slope change occurred for all medications except psychostimulants (+1.1%/month hypnotics/sedatives to +1.7%/month antidepressants); and hospitalization for anxiety disorders (+5.5%/month), depressive/mood disorders (+1.7%/month) and schizophrenia/delusional disorders (+2%/month). In Sweden, immediate reductions occurred for antidepressants (-7%) and opioids (-10%) and depressive/mood disorder hospitalizations (-11%) only with increasing slope change in psychostimulant prescribing of (0.9%/month). In contrast to Norway, increasing slope changes occurred in specialist outpatient visits for depressive/mood disorders, eating disorders and schizophrenia/delusional disorders (+1.5, +1.9 and +2.3%/month, respectively). Similar changes occurred in the pre-existing mental health cohorts. CONCLUSION Differences in early COVID-19 policy response may have contributed to differences in adult mental healthcare provision in Norway and Sweden.
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Affiliation(s)
- David Moreno-Martos
- Division of Population Health and Genomics, University of Dundee, Dundee, UK
| | - Jing Zhao
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Huiqi Li
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Nyberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ludvig Daae Bjørndal
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
- PROMENTA Research Center, University of Oslo, Oslo, Norway
| | | | - Björn Wettermark
- Department of Pharmacy, Pharmacoepidemiology & Social Pharmacy, Uppsala University, Uppsala, Sweden
- Pharmacy Center, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Mia Aakjær
- Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Morten Andersen
- Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Maurizio Sessa
- Pharmacovigilance Research Center, Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Angela Lupattelli
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Daniel R Morales
- Division of Population Health and Genomics, University of Dundee, Dundee, UK
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Bringedal BH, Rø KI. How stable are moral judgements? A longitudinal study of context dependency in attitudes towards patient responsibility. BMC Med Ethics 2024; 25:36. [PMID: 38528534 DOI: 10.1186/s12910-024-01035-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 03/11/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Whether patients' life-style should involve lower priority for treatment is a controversial question in bioethics. Less is known about clinicians' views. AIM To study how clinical doctors' attitudes to questions of patient responsibility and priority vary over time. METHOD Surveys of doctors in Norway in 2008, 2014, 2021. Questionnaires included statements about patients' lifestyle's significance for priority to care, and vignettes of priority cases (only in 2014). RESULTS Attitudes were fairly stable between 2008 and 2021. 17%/14% agreed that patients' lifestyle should count, while 19%/22% agreed that it should involve lower priority to scarce organs. 42/44% agreed that smokers should have lower priority. Substantially more agreed in 2014. Regression analyses showed that being male, working in hospital, and younger age increased the likelihood of agreeing. CONCLUSION A substantial minority of doctors agreed that lifestyle should be a priority criterion, possibly contrary to Norwegian legislation and professional ethics. The finding might be explained by the unspecified meaning of priority, increased scarcity-awareness, or socio-cultural trends towards individualism. The 2014 results indicate a framing effect; the vignettes may have primed the respondents towards accepting lifestyle as a criterion. We conclude that attitudes to normative questions are unstable and depend on context. A substantial minority of doctors seems to be positive to deprioritizing patients allegedly responsible for their illness. However, what deprioritization implies in practice is not clear.
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Affiliation(s)
- Berit H Bringedal
- The Institute for Studies of the Medical Profession, PO Box 1152, Oslo, 0107, Norway.
| | - Karin Isaksson Rø
- The Institute for Studies of the Medical Profession, PO Box 1152, Oslo, 0107, Norway
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Islam MK, Kjerstad E, Rydland HT. The chronically ill in the labour market - are they hierarchically sorted by education? Int J Equity Health 2024; 23:66. [PMID: 38528545 DOI: 10.1186/s12939-024-02148-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The chronically ill as a group has on average lower probability of employment compared to the general population, a situation that has persisted over time in many countries. Previous studies have shown that the prevalence of chronic diseases is higher among those with lower levels of education. We aim to quantify the double burden of low education and chronic illness comparing the differential probabilities of employment between the chronically ill with lower, medium, and high levels of education and how their employment rates develop over time. METHODS Using merged Norwegian administrative data over a 11-year period (2008-2018), our estimations are based on multivariable regression with labour market and time fixed effects. To reduce bias due to patients' heterogeneity, we included a series of covariates that may influence the association between labour market participation and level of education. To explicitly explore the 'shielding effect' of education over time, the models include the interaction effects between chronic illness and level of education and year. RESULTS The employment probabilities are highest for the high educated and lowest for chronically ill individuals with lower education, as expected. The differences between educational groups are changing over time, though, driven by a revealing development among the lower-educated chronically ill. That group has a significant reduction in employment probabilities both in absolute terms and relative to the other groups. The mean predicted employment probabilities for the high educated chronic patient is not changing over time indicating that the high educated as a group is able to maintain labour market participation over time. Additionally, we find remarkable differences in employment probabilities depending on diagnoses. CONCLUSION For the chronically ill as a group, a high level of education seems to "shield" against labour market consequences. The magnitude of the shielding effect is increasing over time leaving chronically ill individuals with lower education behind. However, the shielding effect varies in size between types of chronic diseases. While musculoskeletal, cardiovascular and partly cancer patients are "sorted" hierarchically according to level of education, diabetes, respiratory and mental patients are not.
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Affiliation(s)
- M Kamrul Islam
- NORCE Health and Society, Nygårdsgaten 112, Bergen, 5008, Norway
| | - Egil Kjerstad
- NORCE Health and Society, Nygårdsgaten 112, Bergen, 5008, Norway.
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14
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Ishaq B, Diaz E, Østby L. Discrimination and health: A cross-sectional study comparing Muslims with other-religious. Scand J Public Health 2024:14034948231225561. [PMID: 38517101 DOI: 10.1177/14034948231225561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
AIMS The aim of this study is to report perceived discrimination among Muslims living in Norway and to address and compare associations between perceived discrimination and health among Muslims with an immigrant background and other-religious with an immigrant background. METHOD A representative sample of individuals with an immigrant background in Norway was used in a cross-sectional study design that included 5484 respondents aged 16 to 74 years. The respondents were sub-grouped after religious affiliation, and as immigrants and Norwegian-born. This sample is from 'The Survey on living conditions among persons with an immigrant background 2016', conducted by Statistics Norway. Multivariate logistic regression analyses were conducted to investigate the relationship between perceived discrimination and self-rated health and between perceived discrimination and mental health problems. RESULTS Our findings show that Muslims with an immigrant background are more likely to report perceived discrimination than non-Muslims with an immigrant background. Perceived discrimination was associated with poor self-rated health and mental health problems among immigrant Muslims and Norwegian-born Muslims. Among other-religious with an immigrant background, perceived discrimination had an inverse relationship with mental health problems among immigrants, while an association between perceived discrimination and poor self-rated health was found among Norwegian-born. CONCLUSIONS Our findings suggest that perceived discrimination does play a role in health among minorities with an immigrant background in Norway, regardless of religion. However, the association between perceived discrimination and poor health seems to be stronger among Muslims, especially Norwegian-born Muslims.
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Affiliation(s)
- Bushra Ishaq
- Centre for Medical Ethics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Norway
- MF Norwegian School of Theology, Religion and Society, Norway
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Lars Østby
- Statistics Norway, Oslo-Kongsvinger, Norway
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15
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Kristiansen AL, Myhre JB, Paulsen MM, Totland TH, Lande B, Andersen LF. Secular trends in infant feeding practices during the first year of life in Norway: findings from 1998 to 2019 - the Spedkost surveys. Br J Nutr 2024; 131:851-859. [PMID: 37822223 PMCID: PMC10864993 DOI: 10.1017/s0007114523002246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/22/2023] [Accepted: 10/04/2023] [Indexed: 10/13/2023]
Abstract
The aims of the present study were to assess secular trends in breast-feeding and to explore associations between age at introduction of solid foods and breast-feeding duration. Data from three national dietary surveys in Norway were used, including infants born in 1998 (Spedkost 1, n 1537), 2006 (Spedkost 2, n 1490) and 2018 (Spedkost 3, n 1831). In all surveys, around 80 % of the infants were breastfed at 6 months of age. At 12 months of age, breast-feeding rate was 41 % in Spedkost 1, increasing to 48 % in Spedkost 2 and 51 % in Spedkost 3. Compared with earlier introduction, introduction of solid foods at ≥ 5 months of age was associated with a lower risk of breast-feeding cessation during the first year of life in the two most recent Spedkost surveys. In Spedkost 2, the adjusted hazard ratio for breast-feeding cessation during the first year of life for those introduced to solid foods at ≥ 5 months of age was 0·43 (95 % CI (0·31, 0·60)), P < 0·001, while the corresponding number in Spedkost 3 was 0·44 (95 % CI (0·29, 0·67)), P < 0·001. In conclusion, breast-feeding at infant age 12 months increased over time. Introduction of solid foods at ≥ 5 months of age was positively associated with breast-feeding duration in the two most recent Spedkost surveys. As breast-feeding contributes to numerous health benefits for infant and mother, and possibly improved dietary sustainability in infancy, findings point to the importance of continued protection, support and promotion of breast-feeding.
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Affiliation(s)
- Anne Lene Kristiansen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Sports, Physical Education and Outdoor Studies, Faculty of Humanities, Sports and Educational Science, University of South-Eastern Norway, Bakkenteigen, Norway
| | - Jannicke Borch Myhre
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Mari Mohn Paulsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Food Safety, Norwegian Institute of Public Health, Oslo, Norway
| | - Torunn Holm Totland
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Britt Lande
- Division for Prevention and Public Health, Norwegian Directorate of Health, Oslo, Norway
| | - Lene Frost Andersen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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16
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Novy C, Busk ØL, Tysnes OB, Landa SS, Aanjesen TN, Alstadhaug KB, Bjerknes TL, Bjørnå IK, Bråthen G, Dahl E, Demic N, Fahlström M, Flemmen HØ, Hallerstig E, HogenEsch I, Kampman MT, Kleveland G, Kvernmo HB, Ljøstad U, Maniaol A, Morsund AH, Nakken O, Olsen CG, Schlüter K, Utvik MS, Yaseen R, Holla ØL, Holmøy T, Høyer H. Repeat expansions in AR, ATXN1, ATXN2 and HTT in Norwegian patients diagnosed with amyotrophic lateral sclerosis. Brain Commun 2024; 6:fcae087. [PMID: 38585669 PMCID: PMC10998343 DOI: 10.1093/braincomms/fcae087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/23/2024] [Accepted: 03/12/2024] [Indexed: 04/09/2024] Open
Abstract
Genetic repeat expansions cause neuronal degeneration in amyotrophic lateral sclerosis as well as other neurodegenerative disorders such as spinocerebellar ataxia, Huntington's disease and Kennedy's disease. Repeat expansions in the same gene can cause multiple clinical phenotypes. We aimed to characterize repeat expansions in a Norwegian amyotrophic lateral sclerosis cohort. Norwegian amyotrophic lateral sclerosis patients (n = 414) and neurologically healthy controls adjusted for age and gender (n = 713) were investigated for repeat expansions in AR, ATXN1, ATXN2 and HTT using short read exome sequencing and the ExpansionHunter software. Five amyotrophic lateral sclerosis patients (1.2%) and two controls (0.3%) carried ≥36 repeats in HTT (P = 0.032), and seven amyotrophic lateral sclerosis patients (1.7%) and three controls (0.4%) carried ≥29 repeats in ATXN2 (P = 0.038). One male diagnosed with amyotrophic lateral sclerosis carried a pathogenic repeat expansion in AR, and his diagnosis was revised to Kennedy's disease. In ATXN1, 50 amyotrophic lateral sclerosis patients (12.1%) and 96 controls (13.5%) carried ≥33 repeats (P = 0.753). None of the patients with repeat expansions in ATXN2 or HTT had signs of Huntington's disease or spinocerebellar ataxia type 2, based on a re-evaluation of medical records. The diagnosis of amyotrophic lateral sclerosis was confirmed in all patients, with the exception of one patient who had primary lateral sclerosis. Our findings indicate that repeat expansions in HTT and ATXN2 are associated with increased likelihood of developing amyotrophic lateral sclerosis. Further studies are required to investigate the potential relationship between HTT repeat expansions and amyotrophic lateral sclerosis.
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Affiliation(s)
- Camilla Novy
- Department of Medical Genetics, Telemark Hospital Trust, 3710 Skien, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
| | - Øyvind L Busk
- Department of Medical Genetics, Telemark Hospital Trust, 3710 Skien, Norway
| | - Ole-Bjørn Tysnes
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, 5009 Bergen, Norway
| | - Sigve S Landa
- Department of Medical Genetics, Telemark Hospital Trust, 3710 Skien, Norway
| | - Tori N Aanjesen
- Department of Neurology, Akershus University Hospital, 1478 Lørenskog, Norway
| | | | - Tale L Bjerknes
- Neuro-SysMed, Department of Neurology, Haukeland University Hospital, 5009 Bergen, Norway
- Institute of Clinical Medicine, University of Bergen, 5007 Bergen, Norway
| | - Ingrid K Bjørnå
- Department of Neurology, Vestre Viken Hospital Trust, 3004 Drammen, Norway
| | - Geir Bråthen
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, 7030 Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, 7034 Trondheim, Norway
| | - Elin Dahl
- Department of Neurology, Telemark Hospital Trust, 3710 Skien, Norway
| | - Natasha Demic
- Department of Neurology, Vestfold Hospital Trust, 3103 Tønsberg, Norway
| | - Maria Fahlström
- Department of Medical Genetics, Telemark Hospital Trust, 3710 Skien, Norway
| | - Heidi Ø Flemmen
- Department of Neurology, Telemark Hospital Trust, 3710 Skien, Norway
| | - Erika Hallerstig
- Department of Neurology, Østfold Hospital Trust, 1714 Grålum, Norway
| | - Ineke HogenEsch
- Department of Neurology, Fonna Hospital Trust, 5528 Haugesund, Norway
| | - Margitta T Kampman
- Department of Neurology, University Hospital of North Norway, 9019 Tromsø, Norway
| | - Grethe Kleveland
- Department of Neurology, Innlandet Hospital Trust, 2609 Lillehammer, Norway
| | - Helene B Kvernmo
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, 7030 Trondheim, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, 7034 Trondheim, Norway
| | - Unn Ljøstad
- Institute of Clinical Medicine, University of Bergen, 5007 Bergen, Norway
- Department of Neurology, Sørlandet Hospital Trust, 4615 Kristiansand, Norway
| | - Angelina Maniaol
- Department of Neurology, Oslo University Hospital, 0450 Oslo, Norway
| | | | - Ola Nakken
- Department of Neurology, Akershus University Hospital, 1478 Lørenskog, Norway
| | - Cathrine G Olsen
- Department of Medical Genetics, Telemark Hospital Trust, 3710 Skien, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
| | - Katrin Schlüter
- Department of Neurology, Stavanger University Hospital, 4019 Stavanger, Norway
| | - May-Sissel Utvik
- Department of Neurology, Namsos Hospital Trust, 7803 Namsos, Norway
| | - Ryaz Yaseen
- Department of Neurology, Oslo University Hospital, 0450 Oslo, Norway
| | - Øystein L Holla
- Department of Medical Genetics, Telemark Hospital Trust, 3710 Skien, Norway
| | - Trygve Holmøy
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
- Department of Neurology, Akershus University Hospital, 1478 Lørenskog, Norway
| | - Helle Høyer
- Department of Medical Genetics, Telemark Hospital Trust, 3710 Skien, Norway
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Kjøllesdal MKR, Indseth T. Smoking among immigrants in Norway: a cross-sectional study. Scand J Public Health 2024:14034948231221178. [PMID: 38465847 DOI: 10.1177/14034948231221178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
BACKGROUND Smoking among immigrants varies by country background and is high in some groups. More detailed information about smoking prevalence by country background and sociodemographic factors is needed to target interventions. METHODS Data from the Survey on Living Conditions among immigrants 2016 were used, including immigrants from 12 countries and with ⩾2 years of residence (N = 3565). Data on smoking (daily and occasional) by country of birth, sex, age group, education, duration of residence, age at immigration, proficiency in the Norwegian language, and social support were reported. RESULTS The highest proportions of daily smokers were seen among immigrants from Turkey (36%), Poland (34%), and Vietnam (29%) for men, and from Turkey (22%), Bosnia-Herzegovina (18%), and Poland (17%) for women. Differences in smoking by sociodemographic factors varied with country background, but for several groups of men, the lowest proportions of smokers were seen among those with the highest educational level, those who were employed, and those who immigrated during childhood or adolescence. CONCLUSIONS Policies are warranted that target smoking among immigrant men in general, and particularly among men from Turkey, Poland, and Vietnam, as well as for women from Turkey, Bosnia-Herzegovina, and Poland.
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Affiliation(s)
- Marte K R Kjøllesdal
- Norwegian Institute of Public Health, Health Services Research, Skøyen, Oslo, Norway
- Norwegian University of Lifesciences, Institute of Public Health Science, NMBU, Ås, Norway
| | - Thor Indseth
- Norwegian Institute of Public Health, Health Services Research, Skøyen, Oslo, Norway
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Methi F, Nes RB, Skirbekk V, Hansen T. The double-edged sword of becoming a caregiver: dynamic impact on four dimensions of well-being in Norway. BMC Psychol 2024; 12:120. [PMID: 38439109 PMCID: PMC10913458 DOI: 10.1186/s40359-024-01623-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/25/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Becoming a caregiver can be a transformative journey with profound, multifaceted implications for well-being. However, existing research predominantly emphasizes the negative aspects of caregiving, paying less attention to the positive sides. This study aims to explore the impact of transitioning into a caregiving role on various well-being indicators, such as negative hedonic, positive hedonic, eudaimonic, and social well-being. METHODS We use Norwegian panel data (2019-2021) and employ a combination of nearest-neighbour matching and a difference-in-differences approach to analyse well-being trajectories among new caregivers (n = 304) and non-caregivers (n = 7822). We assess ten items capturing the dimensions of negative hedonic (anxiousness, sadness, and worriedness), positive hedonic (happiness and life satisfaction), eudaimonic (contributing to others' happiness, engagement, and meaning), and social (strong social relations and loneliness) well-being. RESULTS Our results show a general increase in negative hedonic well-being and a decline in positive hedonic well-being for new caregivers. These impacts are larger for caregivers providing daily care, compared to those providing weekly and monthly care, and for those providing care inside rather than outside their own household. We observe only minor differences regarding gender and age. Interestingly, we also notice neutral or beneficial changes for eudaimonic aspects of well-being; of note, caregivers generally experience an increased sense of contributing to others' happiness. CONCLUSION Our study reveals that adopting a caregiving role often leads to significant psychosocial challenges, especially in intensive caregiving situations. However, it also uncovers potential positive influences on eudaimonic aspects of well-being. Future research should explore underlying explanatory mechanisms, to inform strategies that enhance caregivers' well-being.
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Affiliation(s)
- Fredrik Methi
- Department of Health Services, Norwegian Institute of Public Health, Postboks 222, Skøyen, N-0213, Oslo, Norway.
| | - Ragnhild Bang Nes
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, University of Oslo, Oslo, Norway
- Department of Philosophy, Classics, and History of Arts and Ideas, University of Oslo, Oslo, Norway
| | - Vegard Skirbekk
- Center for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
- Promenta Research Center, University of Oslo, Oslo, Norway
- Oslo Metropolitan University, Oslo, Norway
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Vázquez Fernández L, Diz-Lois Palomares A, Vicedo Cabrera AM, Freiesleben De Blasio B, Di Ruscio F, Wisløff T, Rao S. Short-term association between air temperature and mortality in seven cities in Norway: A time series analysis. Scand J Public Health 2024:14034948241233359. [PMID: 38439134 DOI: 10.1177/14034948241233359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
BACKGROUND The association between ambient air temperature and mortality has not been assessed in Norway. This study aimed to quantify for seven Norwegian cities (Oslo, Bergen, Stavanger, Drammen, Fredrikstad, Trondheim and Tromsø) the non-accidental, cardiovascular and respiratory diseases mortality burden due to non-optimal ambient temperatures. METHODS We used a historical daily dataset (1996-2018) to perform city-specific analyses with a distributed lag non-linear model with 14 days of lag, and pooled results in a multivariate meta-regression. We calculated attributable deaths for heat and cold, defined as days with temperatures above and below the city-specific optimum temperature. We further divided temperatures into moderate and extreme using cut-offs at the 1st and 99th percentiles. RESULTS We observed that 5.3% (95% confidence interval (CI) 2.0-8.3) of the non-accidental related deaths, 11.8% (95% CI 6.4-16.4) of the cardiovascular and 5.9% (95% CI -4.0 to 14.3) of the respiratory were attributable to non-optimal temperatures. Notable variations were found between cities and subgroups stratified by sex and age. The mortality burden related to cold dominated in all three health outcomes (5.1%, 2.0-8.1, 11.4%, 6.0-15.4, and 5.1%, -5.5 to 13.8 respectively). Heat had a more pronounced effect on the burden of respiratory deaths (0.9%, 0.2-1.0). Extreme cold accounted for 0.2% of non-accidental deaths and 0.3% of cardiovascular and respiratory deaths, while extreme heat contributed to 0.2% of non-accidental and to 0.3% of respiratory deaths. CONCLUSIONS Most of the burden could be attributed to the contribution of moderate cold. This evidence has significant implications for enhancing public-health policies to better address health consequences in the Norwegian setting.
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Affiliation(s)
- Liliana Vázquez Fernández
- Norwegian Institute of Public Health, Norway
- Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Norway
| | | | - Ana M Vicedo Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Switzerland
- Oeschger Centre for Climate Change Research, University of Bern, Switzerland
| | - Birgitte Freiesleben De Blasio
- Norwegian Institute of Public Health, Norway
- Oslo Centre for Biostatistics and Epidemiology, Institute of Basic Medical Sciences, University of Oslo, Norway
| | | | - Torbjørn Wisløff
- Health Services Research Unit, Akershus University Hospital, Norway
- Institute of Clinical Medicine, University of Oslo, Norway
| | - Shilpa Rao
- Norwegian Institute of Public Health, Norway
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20
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Gautun H, Bratt C. Caring for older parents in Norway - How does it affect labor market participation and absence from work? Soc Sci Med 2024; 346:116722. [PMID: 38498960 DOI: 10.1016/j.socscimed.2024.116722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 01/25/2024] [Accepted: 02/23/2024] [Indexed: 03/20/2024]
Abstract
As the population ages, younger generations will increasingly be called upon to provide informal care to their aging parents. To prepare for this development, it is essential to understand how employees combine the dual responsibilities of work and caring for aging parents. By analyzing data collected in Norway in 2022 from a nationally representative sample of 6049 respondents, aged 35 to 67, we investigated how caring for older parents affects labor market participation and work absence. We provide descriptive statistics and conduct analyses with structural equation modeling. These analyses indicated that caregiving had no substantial impact on overall participation in the workforce. However, employees did use work absences to assist their parents. We differentiate between using holidays, compensatory time, and three types of formal leave: paid, unpaid, and sick leave. More than a third of the formal leave was taken as sick leave. Women were moderately more likely to use work absence to care for their parents. We conclude that caregiving for older parents currently has little effect on work participation in Norway and attribute the favorable situation in Norway to its comprehensive public elderly care system. However, a contributing factor is Norway's generous sick leave policy. Although intended for use when employees are sick themselves, sick leave is used by employees to provide care to aging parents. Sick leave seems to act as a safety valve. To mitigate the effects of informal care on work participation, welfare states may create conditions that allow employees to combine work and informal care without resorting to unauthorized sick leave. A solution could be to extend the existing support scheme for employees with young children to those providing care for their aging parents.
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Affiliation(s)
- Heidi Gautun
- Norwegian Social Research - NOVA, Department of Ageing Research and Housing Studies, Oslo Metropolitan University, Stensberggata 26, 0170 Oslo, Norway.
| | - Christopher Bratt
- Department of Psychology, Inland Norway University of Applied Sciences, Vormstuguvegen 2, 2624, Lillehammer, Norway; School of Psychology, University of Kent, Canterbury, UK.
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Solberg H, Devik SA, Bell HT, Olsen RM. Thinking strategies used by registered nurses during drug administration in nursing homes-An observational study. J Clin Nurs 2024; 33:1150-1160. [PMID: 38044582 DOI: 10.1111/jocn.16945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/18/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023]
Abstract
AIM To explore registered nurses' thinking strategies during the drug administration process in nursing homes. DESIGN An exploratory qualitative design. METHODS Eight registered nurses, one male and seven female, in five nursing home wards in Mid-Norway were observed during 15 drug dispensing rounds (175 drug dispensing episodes). Think Aloud sessions with follow-up individual interviews were conducted. The Think Aloud data were analysed using deductive qualitative content analysis based on Marsha Fonteyn's description of 17 thinking strategies. Interview data were used to clarify missing information and validate the content of Think Aloud data. RESULTS The registered nurses used all 17 thinking strategies described by Fonteyn, including several variants of each strategy. The three most frequent were 'providing explanations', 'setting priorities' and 'drawing conclusions'. In addition, we found two novel thinking strategies that did not fit into Fonteyn's template, which were labelled 'controlling' and 'interacting'. Among all strategies, 'controlling' was by far the most used, serving as a means for the registered nurses to stay on track and navigate through various interruptions, while also minimising errors during drug dispensing. CONCLUSION The study highlights the diverse thinking strategies employed by registered nurses in nursing homes during medication administration. The findings emphasise the multifaceted nature of medication administration and underscore the importance of skilled personnel in ensuring medication safety. Recognising the significance of these findings is crucial for maintaining patient well-being and upholding medication safety standards in healthcare settings. RELEVANCE TO CLINICAL PRACTICE Understanding the thinking strategies employed by registered nurses can inform training programmes and enhance the clinical judgements of health care professionals involved in medication administration, ultimately leading to improved patient outcomes and reduced medication errors in practice. PATIENT OR PUBLIC CONTRIBUTION Patients were involved in this study as recipients of drugs which the nurses distributed during the observations. The patients were involved as a third party and consent to the observations was either given by the patients themselves or relatives in cases where the patient was not competent to consent. No personal information was collected about the patients. REPORTING METHOD The reporting of this study adhered to the COREQ checklist.
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Affiliation(s)
- Hege Solberg
- Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway
| | - Siri Andreassen Devik
- Centre for Care Research Mid-Norway, Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway
| | - Hege Therese Bell
- Department of clinical and molecular medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Trondheim Municipality, Trondheim, Norway
| | - Rose Mari Olsen
- Centre for Care Research Mid-Norway, Faculty of Nursing and Health Sciences, Nord University, Namsos, Norway
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Wyatt S, Kvalvik LG, Singh A, Klungsøyr K, Østbye T, Skjærven R. Heterogeneity in the risk of cardiovascular disease mortality after the hypertensive disorders of pregnancy across mothers' lifetime reproductive history. Paediatr Perinat Epidemiol 2024; 38:230-237. [PMID: 38380741 DOI: 10.1111/ppe.13059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/16/2024] [Accepted: 02/07/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Prior studies on maternal cardiovascular disease (CVD) mortality and hypertensive disorders of pregnancy (HDP) have focused only on a woman's first birth and have not accounted for successive affected pregnancies. OBJECTIVES The objective of this study is to identify mothers' risk of CVD mortality considering lifetime reproductive history. METHODS We used data from the Medical Birth Registry of Norway, the Norwegian Cause of Death Registry, and the Norwegian National Population Register to identify all mothers who gave birth from 1967 to 2020. Our outcome was mothers' CVD death before age 70. The primary exposure was the lifetime history of HDP. The secondary exposure was the order of HDP and gestational age at delivery of pregnancies with HDP. We used Cox regression models to estimate hazard ratio (HR) and 95% confidence interval (CI), adjusting for education, mother's age, and year of last birth. These models were stratified by the lifetime number of births. RESULTS Among 987,378 mothers, 86,294 had HDP in at least one birth. The highest CVD mortality, relative to mothers without HDP, was among those with a pre-term HDP in their first two births, although this represented 1.0% of mothers with HDP (HR 5.12, 95% CI 2.66, 9.86). Multiparous mothers with term HDP in their first birth only had no increased risk of CVD relative to mothers without HDP (36.9% of all mothers with HDP; HR 1.12, 95% CI 0.95, 1.32). All other mothers with HDP had a 1.5- to 4-fold increased risk of CVD mortality. CONCLUSIONS This study identified heterogeneity in the risk of CVD mortality among mothers with a history of HDP. A third of these mothers are not at higher risk compared to women without HDP, while some less common patterns of HDP history are associated with severe risk of CVD mortality.
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Affiliation(s)
- Sage Wyatt
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Liv Grimstvedt Kvalvik
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Aditi Singh
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Truls Østbye
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina, USA
| | - Rolv Skjærven
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway
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Sulo G, Lycke Ellingsen C, Sulo E, Naghavi M, Vollset SE. Heart failure describing the underlying cause of death: a misconception, lack of information on the true underlying causes, or both? Scand J Public Health 2024; 52:152-158. [PMID: 36468773 DOI: 10.1177/14034948221137123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
AIM The underlying cause of death represents the most important information on death certificates. Often, conditions that cannot represent a true underlying cause of death are listed as such. This phenomenon affects the quality of vital statistics and results of studies using cause-specific mortality as endpoints. We aimed at exploring the magnitude and factors associated with the use of heart failure to describe the underlying cause of death. METHODS In this cross-sectional, register based study we linked data from the Norwegian Cause of Death Registry and the Norwegian Patient Registry. We used logistic regression models to analyse the association between external factors and heart failure listed as the underlying cause of death. RESULTS Heart failure was listed as the underlying cause of death in 3.6% of all deaths. The odds of heart failure increased: (a) by 35% for 5-year increment in age; (b) by 78% for deaths occurring at nursing homes (compared with in-hospital deaths); and (c) by 602% for deaths not followed by an autopsy (compared with those followed by an autopsy). Deceased with a previous hospitalisation with heart failure as the discharge diagnosis had 514% higher odds of having heart failure listed as their underlying cause of death. Of the deceased with heart failure listed as the underlying cause of death, 9.4% did not have any, and 69.2% had only irrelevant additional information for assessing the true underlying cause of death in their death certificates. CONCLUSIONS Heart failure listed as the underlying cause of death was associated with age, place of death, autopsy and previous hospitalisations - all factors that should not influence coding procedures. Better completion of death certificates in accordance with the World Health Organization rules will help reduce the use of heart failure to describe the underlying cause of death.
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Affiliation(s)
- Gerhard Sulo
- Centre for Disease Burden, Division of Mental and Physical Health, Norwegian Institute of Public Health, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Christian Lycke Ellingsen
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Department of Pathology, Stavanger University Hospital, Norway
| | - Enxhela Sulo
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation (IHME), University of Washington, Washington, USA
| | - Stein Emil Vollset
- Institute for Health Metrics and Evaluation (IHME), University of Washington, Washington, USA
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Madar AA, Kurniasari A, Marjerrison N, Mdala I. Breastfeeding and Sleeping Patterns Among 6-12-Month-Old Infants in Norway. Matern Child Health J 2024; 28:496-505. [PMID: 37980699 PMCID: PMC10914878 DOI: 10.1007/s10995-023-03805-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Parental behavior and infant sleep patterns can vary widely both within and between cultures and settings. Breastfeeding during the second half-year of infancy has been associated with frequent night waking, which is perceived as sleep problem among the Western societies. An understanding of sleeping patterns among breastfed infants during the second half-year of infancy is important in supporting continued breastfeeding. OBJECTIVES The study aimed to investigate the sleeping patterns among breastfed infants during second half-year of infancy. METHODS This is a cross-sectional study. Three hundred and forty-two mothers of 6-12 months old breastfed infants completed the questionnaires on socio-demographic factors, breastfeeding practices, and infant sleeping patterns, which were assessed by using the Brief Infant Sleep Questionnaire (BISQ). The Cox regression model was used to assess the factors that were associated with night sleep duration whereas demographic factors and breastfeeding practices that were associated with night waking frequency were investigated using the Poisson regression model. RESULTS On average, the breastfed infants slept for 11 h during the night and most infants were reported to have night waking (96.8%) and were breastfed at least once at night (93.5%). In the adjusted analyses, infants in the age group 9-12 months were less likely to sleep longer compared to infants in the 6-8 months age group [HR 1.52 95% CI (1.17, 1.98)]. A one-hour increase in daytime sleep and in night wakefulness increased the likelihood of waking up at night by 19% and 24%, respectively. Infants who had been vaccinated within the last 7 days and infants who were breastfed to sleep were more likely to have a shorter nighttime sleep duration. Nighttime breastfeeding frequency was significantly associated with a 17% increase in the likelihood of night waking [IRR 1.17 95% CI (1.13, 1.22)]. Infants who slept on their parents' bed were 1.28 times more likely to wake up at night compared to infants who slept in a separate room [IRR 1.28 95% CI (1.05, 1.59)]. Infants of parents who reported that their infants' sleep was not a problem were 34% less likely to wake up compared to infants of parents who reported that their infants' sleep was a problem [IRR 0.66 95% CI (0.49, 0.87)]. CONCLUSIONS FOR PRACTICE: Frequent night waking, bed sharing and night breastfeeding were common among 6-12 months old breastfed infants. Frequent night breastfeeding may lengthen an infant's nighttime sleep duration. The study findings indicate that adequate information and support should be given to breastfeeding mothers in relation to the sleeping pattern of breastfed infants in order to promote continued breastfeeding practices.
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Affiliation(s)
- Ahmed A Madar
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Astrid Kurniasari
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Niki Marjerrison
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
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Heggebø K, Elstad JI. Health-related exit from employment before and during the COVID-19 pandemic in Norway: Analysis of population-wide register data 2013-2021. SSM Popul Health 2024; 25:101598. [PMID: 38283540 PMCID: PMC10818249 DOI: 10.1016/j.ssmph.2023.101598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/13/2023] [Accepted: 12/30/2023] [Indexed: 01/30/2024] Open
Abstract
People with health problems experience various labor market disadvantages, such as hiring discrimination and heightened risk of firing, but the impact of deteriorating economic conditions on health-related labor market mobility remains poorly understood. The strength of the downturn/crisis will most likely make a difference. During minor downturns, when few employees are made redundant, health-related exit may occur frequently since employers prefer to keep those with good health on the payroll. However, during major economic crises, when large-scale downsizing and firm closures abound, there will be less discretionary room for employers. Thus, some mechanisms that usually are damaging for people with health problems (e.g., seniority rules and negative connotations), can be neutralized, ultimately leading to smaller health differentials in labor market outcomes. The current study used population-wide administrative register data, covering the years 2013-2021, to examine health-related exit from employment (to unemployment/social assistance) before and during the COVID-19 pandemic in Norway. The pandemic spurred a major crisis on the Norwegian labor market and led to a record-high unemployment rate of 10.6 percent in March 2020. Restricting the analytical samples to labor market insiders, linear probability models showed that previous recipients of health-related benefits had a higher unemployment likelihood in the pre-crisis year 2019. The relative importance of poor health changed non-negligibly, however, during the COVID-19 pandemic. When identical statistical analyses were run on the crisis year 2020, health-related exit from employment was dampened. Yet, this labor market equalization was not followed by smaller health differentials in work income in 2021, mainly because people with good health retained or regained decent-paying jobs when the economic conditions improved again. In conclusion, major economic crises can lead to an equalization of labor market disadvantages for people with health problems, but health-related inequalities may reemerge when the economy recovers.
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Affiliation(s)
- Kristian Heggebø
- NOVA, OsloMet – Oslo Metropolitan University, P.O. Box 4, St. Olavs Plass, N-0130, Oslo, Norway
| | - Jon Ivar Elstad
- NOVA, OsloMet – Oslo Metropolitan University, P.O. Box 4, St. Olavs Plass, N-0130, Oslo, Norway
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Falk MT, Hagsten E, Lin X. Importance of temporary and permanent snow for new second homes. Int J Biometeorol 2024; 68:581-593. [PMID: 36607447 PMCID: PMC9816543 DOI: 10.1007/s00484-022-02420-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 12/15/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
This study investigates empirically how natural snow depth and permanent snow affect the number of new second homes in Norway. One out of four Norwegian municipalities is partly covered by glaciers and permanent snow. In the winter seasons of 1983-2020, there is a decline in snow depth from 50 to 35 cm on average (based on 41 popular second-home areas in the mountains). Results of the fixed effects Poisson estimator with spatial elements show that there is a significant and positive relationship between natural snow depth in the municipality and the number of second homes started. There is also a significant and negative relationship between the number of new second homes in the municipality and a scarcity of snow in the surrounding municipalities. However, the magnitude of both effects is small. Estimates also show a strong positive relationship between the proportion of surface covered by permanent snow or glaciers in the municipality and new second homes. This implies that a decline in permanent snow and glaciers may make these areas less attractive for the location of second homes.
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Affiliation(s)
| | - Eva Hagsten
- University of South-Eastern Norway, Bø, Norway
| | - Xiang Lin
- Södertörn University, Huddinge, Sweden.
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Cano‐Martínez R, Thorsen NH, Hofmeester TR, Odden J, Linnell J, Devineau O, Angoh SYJ, Odden M. Bottom-up rather than top-down mechanisms determine mesocarnivore interactions in Norway. Ecol Evol 2024; 14:e11064. [PMID: 38463636 PMCID: PMC10920318 DOI: 10.1002/ece3.11064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/22/2024] [Accepted: 02/06/2024] [Indexed: 03/12/2024] Open
Abstract
Interactions among coexisting mesocarnivores can be influenced by different factors such as the presence of large carnivores, land-use, environmental productivity, or human disturbance. Disentangling the relative importance of bottom-up and top-down processes can be challenging, but it is important for biodiversity conservation and wildlife management. The aim of this study was to assess how the interactions among mesocarnivores (red fox Vulpes vulpes, badger Meles meles, and pine marten Martes martes) were affected by large carnivores (Eurasian lynx Lynx lynx and wolf Canis lupus), land cover variables (proportion of agricultural land and primary productivity), and human disturbance, as well as how these top-down and bottom-up mechanisms were influenced by season. We analyzed 3 years (2018-2020) of camera trapping observations from Norway and used structural equation models to assess hypothesized networks of causal relationships. Our results showed that land cover variables were more strongly associated with mesocarnivore detection rates than large carnivores in Norway. This might be caused by a combination of low density of large carnivores in an unproductive ecosystem with strong seasonality. Additionally, detection rates of all mesocarnivores showed positive associations among each other, which were stronger in winter. The prevalence of positive interactions among predators might indicate a tendency to use the same areas and resources combined with weak interference competition. Alternatively, it might indicate some kind of facilitative relationship among species. Human disturbance had contrasting effects for different species, benefiting the larger mesocarnivores (red fox and badger) probably through food subsidization, but negatively affecting apex predators (wolf and lynx) and smaller mesocarnivores (pine marten). In a human-dominated world, this highlights the importance of including anthropogenic influences in the study of species interactions.
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Affiliation(s)
- Rocío Cano‐Martínez
- Department of Forestry and Wildlife ManagementInland Norway University of Applied SciencesKoppangNorway
| | | | - Tim R. Hofmeester
- Department of Wildlife, Fish and Environmental StudiesSwedish University of Agricultural SciencesUmeåSweden
| | - John Odden
- Norwegian Institute for Nature ResearchOsloNorway
| | - John Linnell
- Department of Forestry and Wildlife ManagementInland Norway University of Applied SciencesKoppangNorway
- Norwegian Institute for Nature ResearchLillehammerNorway
| | - Olivier Devineau
- Department of Forestry and Wildlife ManagementInland Norway University of Applied SciencesKoppangNorway
| | - Siow Yan Jennifer Angoh
- Department of Forestry and Wildlife ManagementInland Norway University of Applied SciencesKoppangNorway
| | - Morten Odden
- Department of Forestry and Wildlife ManagementInland Norway University of Applied SciencesKoppangNorway
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Hamnøy IL, Kjelsvik M, Baerug AB, Dahl BM. A balancing act-midwives' and public health nurses' experiences with breastfeeding counselling. Scand J Caring Sci 2024; 38:92-103. [PMID: 37496198 DOI: 10.1111/scs.13198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/14/2023] [Accepted: 07/12/2023] [Indexed: 07/28/2023]
Abstract
AIMS AND OBJECTIVES To explore midwives' and public-health nurses' experiences of breastfeeding counselling in order to provide a deeper insight into breastfeeding counselling. METHODOLOGICAL DESIGN AND JUSTIFICATION A qualitative design was used, and qualitative content analysis was conducted to analyse the data in accordance with the phenomenological hermeneutic tradition. ETHICAL ISSUES AND APPROVAL The Norwegian Centre for Research Data approved this study. All participants provided written consent. RESEARCH METHODS Four focus-group interviews were conducted on a sample of eight midwives and 13 public-health nurses in Norway. RESULTS Three interrelated themes describing the meaning of midwives' and public-health nurses' experiences with breastfeeding counselling emerged from the analysis: Breastfeeding Counselling Means Responsibility for Collaboration and Facilitation, Being Confident as a Breastfeeding Counsellor Means Striving for Professional Competence and Supporting the Individual Breastfeeding Family Means Being Sensitive and Adapting to Novel Situations. STUDY LIMITATIONS The focus groups comprised a mix of midwives and public-health nurses, which may have inhibited honest declaration of these professionals' opinions of each other. CONCLUSION Midwives and public-health nurses regard structural factors and prioritising breastfeeding support in society as important for providing good breastfeeding counselling. Midwives and public-health nurses strive to find a balance between relying on their own competence, promoting breastfeeding in accordance with guidelines and respecting mothers' choices. Healthcare professionals require knowledge about breastfeeding, good clinical judgement, a listening attitude and openness to how breastfeeding affects mother's everyday life to provide good breastfeeding care.
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Affiliation(s)
- Ingvild Lande Hamnøy
- Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, NTNU- Norwegian University of Science and Technology, Ålesund, Norway
| | - Marianne Kjelsvik
- Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, NTNU- Norwegian University of Science and Technology, Ålesund, Norway
| | | | - Berit Misund Dahl
- Department of Health Sciences in Ålesund, Faculty of Medicine and Health Sciences, NTNU- Norwegian University of Science and Technology, Ålesund, Norway
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Skyberg H, Jenssen D. What professionals say and do: the tension between egalitarianism and hierarchy in interprofessional teamwork. J Interprof Care 2024; 38:200-208. [PMID: 38117647 DOI: 10.1080/13561820.2023.2289512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/27/2023] [Indexed: 12/22/2023]
Abstract
This study aimed to explore the power dynamics in interprofessional teamwork by conducting an ethnographic study of three interprofessional teams working in mental health and substance use services in Norway. Data were collected through 14 observation sessions and 18 in-depth interviews with health and social work professionals. Given the potential difference between "what people say and what people do," we explored how ideas of power were articulated by health and social care professionals and how such structures were observed to be played out in practice. The findings suggest a presence of contrasting egalitarian and hierarchical structures, and that professionals were aware of the resulting tension and operated within it. This study contributes to the literature on interprofessional health and social care through providing an analysis of the power dynamics of teamwork interaction and how professionals relate to such structures. The results are relevant to a broad context of interprofessionalism as they provide valuable insight into how power should be understood as a continuum of changeable positions and motivations.
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Affiliation(s)
- Henriette Skyberg
- Faculty of Social Science, Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
| | - Dag Jenssen
- Faculty of Social Science, Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
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Gabeyre RM, Hussein M, Salih S, Amir S, Gazerani P. Social Prescribing Competence among Community Pharmacists and Pharmacy Students in Norway. Pharmacy (Basel) 2024; 12:43. [PMID: 38525723 PMCID: PMC10961744 DOI: 10.3390/pharmacy12020043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/26/2024] Open
Abstract
Background and aim: Social prescribing, which links patients to non-clinical services and involves general physicians, has been gaining traction. Community pharmacists, who are integral to primary healthcare, have untapped potential in social prescribing. This study explores social prescribing competence among Norwegian community pharmacists and pharmacy students. Method: A cross-sectional study utilizing an anonymous online questionnaire to collect quantitative data was conducted. Inspired by the limited relevant literature, the questionnaire was constructed, pilot-tested, and distributed in a one-week window within a Facebook group for Norwegian pharmacists. The questionnaire comprised 23 questions categorized into demographic details and competence assessment, covering general knowledge, attitude, and barriers/facilitators related to social prescribing. Statistical analyses were employed to determine the competence of the participants. Results: The online questionnaire collected data from 96 participants, primarily females (79.2%), aged 25-34 (40.6%), who were identified as community pharmacists (49.0%). Most (91.7%) worked in community pharmacies, with 31.3% having over 10 years of experience. Despite positive client relationships (93.8%), statistical analysis revealed no significant associations between competence and variables such as work experience, education, or gender. The custom scoring system yielded an average competence score of 1.98 on a 5-point scale, with attitudes and perceptions of participants scoring 3.82. Overall competence was calculated at 3.4, indicating a moderate level. Conclusions: The findings of this study reveal that the participants had limited knowledge regarding social prescribing, emphasizing the need for education. However, the participants showed strong enthusiasm for competence development. This groundwork paves the way for future investigations centered on pilot-testing strategies to boost social prescribing knowledge and engagement among Norwegian community pharmacists and pharmacy students.
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Affiliation(s)
- Riyaan Mahamud Gabeyre
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Misbah Hussein
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Siedra Salih
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Salia Amir
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Parisa Gazerani
- Department of Life Sciences and Health, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9260 Gistrup, Denmark
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Erkinaro J, Orell P, Kytökorpi M, Pohjola JP, Power M. Active feeding of downstream migrating juvenile pink salmon (Oncorhynchus gorbuscha) revealed in a large Barents Sea river using diet and stable isotope analysis. J Fish Biol 2024; 104:797-806. [PMID: 37986023 DOI: 10.1111/jfb.15625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 11/16/2023] [Accepted: 11/18/2023] [Indexed: 11/22/2023]
Abstract
The recent, rapid spreading of non-native pink salmon Oncorhynchus gorbuscha in the North Atlantic area has raised concerns about their possible negative impacts on native salmonid species. Potential interactions include competition for food resources during the short freshwater phase of juvenile O. gorbuscha, but little is known about their feeding behavior in the newly occupied North Atlantic rivers. Using stable isotope and stomach content analyses, patterns of freshwater feeding of non-native O. gorbuscha fry were studied in a large Fennoscandian river, the Teno, that discharges to the Barents Sea. Changes in stable isotope values (δ13 C, δ15 N, δ34 S) and stomach contents from the period of emergence (April to mid-May) to estuarine entry (late May/June) were examined and provided both temporally integrated and short-term indicators of freshwater feeding dependency. In addition, the occurrence of juvenile O. gorbuscha and changes in their length and weight during their emergence/migration period were investigated. Juvenile O. gorbuscha were at the spawning grounds from April through to mid-May with abundance peaking in mid-May. Fish moved to the estuary by late May and their abundance decreased toward June, and their body size increased concurrently. Stomach analyses indicated no feeding activity in April-early May in the spawning areas, but the stomach fullness indices increased markedly in fish sampled in the estuary in May and June. The most important prey items in stomachs were Chironomidae and Ephemeroptera larvae. Significant changes in all analysed stable isotopes were detected among sample periods, with a peak in mid-May and June showing significantly lower values than other sample periods. A change from the higher values reflective of parental marine feeding to the lower values reflective of freshwater feeding indicated active in-river feeding by juveniles during the study period. The documented active freshwater feeding of non-native juvenile O. gorbuscha suggests potential resource competition with native fluvial fishes, particularly salmonids.
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Affiliation(s)
| | - Panu Orell
- Natural Resources Institute Finland (Luke), Oulu, Finland
| | - Mikko Kytökorpi
- Natural Resources Institute Finland (Luke), Teno Fisheries Research Station, Utsjoki, Finland
| | - Jan-Peter Pohjola
- Natural Resources Institute Finland (Luke), Teno Fisheries Research Station, Utsjoki, Finland
| | - Michael Power
- Department of Biology, University of Waterloo, Waterloo, Canada
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Vik E, Hansson L. Contingency and paradoxes in management practices-development plan as a case. J Health Organ Manag 2024; 38:72-88. [PMID: 38448231 PMCID: PMC10986774 DOI: 10.1108/jhom-06-2022-0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/06/2023] [Accepted: 12/11/2023] [Indexed: 03/08/2024]
Abstract
PURPOSE As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country's hospital clinics are tasked with constructing development plans. Using the development plan as a case, the paper analyzes how managers navigate and legitimize the planning process among central actors and deals with the contingency of decisions in such strategy work. DESIGN/METHODOLOGY/APPROACH This study applies a qualitative research design using a case study method. The material consists of public documents, observations and single interviews, covering the process of constructing a development plan at the clinical level. FINDINGS The findings suggest that the development plan was shaped through a multilevel translation process consisting of different contending rationalities. At the clinical level, the management had difficulties in legitimizing the process. The underlying tension between top-down and bottom-up steering challenged involvement and made it difficult to manage the contingency of decisions. PRACTICAL IMPLICATIONS The findings are relevant to public sector managers working on strategy documents and policymakers identifying challenges that might hinder the fulfillment of political intentions. ORIGINALITY/VALUE This paper draws on a case from Norway; however, the findings are of general interest. The study contributes to the academic discussion on how to consider both the health authorities' perspective and the organizational perspective to understand the manager's role in handling the contingency of decisions and managing paradoxes in the decision-making process.
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Affiliation(s)
- Erlend Vik
- Faculty of Business Administration and Social
Sciences, Molde University College,
Molde, Norway
| | - Lisa Hansson
- Faculty of Logistics, Molde
University College, Molde, Norway
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Magnuson JT, Sydnes MO, Ræder EM, Schlenk D, Pampanin DM. Transcriptomic profiles of brains in juvenile Atlantic cod (Gadus morhua) exposed to pharmaceuticals and personal care products from a wastewater treatment plant discharge. Sci Total Environ 2024; 912:169110. [PMID: 38065506 DOI: 10.1016/j.scitotenv.2023.169110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 01/18/2024]
Abstract
Pharmaceuticals and personal care products (PPCPs) are frequently detected in marine environments, posing a threat to aquatic organisms. Our previous research demonstrated the occurrence of neuroactive compounds in effluent and sediments from a wastewater treatment plant (WWTP) in a fjord North of Stavanger, the fourth-largest city in Norway. To better understand the influence of PPCP mixtures on fish, Atlantic cod (Gadus morhua) were caged for one month in 3 locations: site 1 (reference), site 2 (WWTP discharge), and site 3 (6.7 km west of discharge). Transcriptomic profiling was conducted in the brains of exposed fish and detection of PPCPs in WWTP effluent and muscle fillets were determined. Caffeine (47.8 ng/L), benzotriazole (10.9 ng/L), N,N-diethyl-meta-toluamide (DEET) (5.6 ng/L), methyl-1H-benzotriazole (5.5 ng/L), trimethoprim (3.4 ng/L), carbamazepine (2.1 ng/L), and nortriptyline (0.4 ng/L) were detected in the WWTP effluent. Octocrylene concentrations were observed in muscle tissue at all sites and ranged from 53 to 193 ng/g. Nervous system function and endocrine system disorders were the top enriched disease and function pathways predicted in male and female fish at site 2, with the top shared canonical pathways involved with estrogen receptor and Sirtuin signaling. At the discharge site, predicted disease and functional responses in female brains were involved in cellular assembly, organization, and function, tissue development, and nervous system development, whereas male brains were involved in connective tissue development, function, and disorders, nervous system development and function, and neurological disease. The top shared canonical pathways in females and males were involved in fatty acid activation and tight junction signaling. This study suggests that pseudopersistent, chronic exposure of native juvenile Atlantic cod from this ecosystem to PPCPs may alter neuroendocrine and neuron development.
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Affiliation(s)
- Jason T Magnuson
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger 4036, Norway; U.S. Geological Survey, Columbia Environmental Research Center, Columbia, MO 65201, USA.
| | - Magne O Sydnes
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger 4036, Norway
| | - Erik Magnus Ræder
- Norwegian University of Life Sciences, Faculty of Veterinary Medicine, Ås 1433, Norway
| | - Daniel Schlenk
- Department of Environmental Sciences, University of California, Riverside, Riverside, CA 92521, USA
| | - Daniela M Pampanin
- Department of Chemistry, Bioscience and Environmental Engineering, University of Stavanger, Stavanger 4036, Norway
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Bringaker AO, Dahl BM. Public health nurses' experiences with mental health promotion for adolescent immigrants in schools: A qualitative study. Scand J Caring Sci 2024. [PMID: 38369587 DOI: 10.1111/scs.13248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/18/2024] [Accepted: 02/04/2024] [Indexed: 02/20/2024]
Abstract
AIMS AND OBJECTIVES This study aimed to explore public health nurses' experiences with mental health promotion for adolescent immigrants in lower secondary and high school, aiming to enhance knowledge and insights for effective mental health promotion. METHODOLOGICAL DESIGN AND JUSTIFICATION A qualitative design employing a hermeneutic approach was chosen. Thirteen public health nurses were selected using purposive criterion sampling and snowballing. Thematic analysis was applied, adhering to COREQ guidelines for transparency. ETHICAL ISSUES AND APPROVAL The research was approved by the Norwegian Centre for Research Data. The guidelines of the National Committee for Research Ethics in the Social Sciences and the Humanities were followed. RESEARCH METHODS, INSTRUMENTS, AND/OR INTERVENTIONS Data were collected through three focus-group interviews (n = 13), using semi-structured interview guides to explore the experiences of public health nurses in promoting mental health among adolescent immigrants. OUTCOME MEASURES This study identified three key themes: (i) Striving to understand adolescent immigrants' mental health aspects, including both positive and negative aspects; (ii) Different strategies for promoting mental health, viewing adolescents as both recipients and contributors to their well-being; and (iii) Barriers to public health nurses' promotion of mental health, including language, cultural, and knowledge-related obstacles and trust issues. RESULTS Public health nurses noted that language barriers and trust issues often delayed adolescent immigrants from seeking help for mental health concerns. Cultural competence and empathy were deemed crucial. To meet these needs, public health nurses must build rapport with parents, collaborate with professionals, implement follow-up programmes, and advocate for policy changes. STUDY LIMITATIONS Limitations of this qualitative study include potential bias from the authors' background and non-generalizability of results to other contexts. CONCLUSIONS In conclusion, public health nurses' experiences reveal the need for enhanced cultural competence, language proficiency, and trust-building to better serve adolescent immigrants. Collaborative efforts, follow-up programmes, and policy advocacy are essential to improve mental health promotion in school settings.
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Affiliation(s)
| | - Berit Misund Dahl
- Department of Public Health, University of Stavanger, Stavanger, Norway
- Department of Health Sciences in Ålesund, NTNU-Norwegian University of Science and Technology, Ålesund, Norway
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Oommen H, Esse L, Sajer S, Lukasse M. Somali women's perceptions and experiences of pain and pain relief during childbirth in Norway: A qualitative study. Eur J Midwifery 2024; 8:EJM-8-05. [PMID: 38323166 PMCID: PMC10845056 DOI: 10.18332/ejm/176034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/27/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024] Open
Abstract
INTRODUCTION Research shows that Somali women are less likely to receive epidural analgesia for labor pain compared to non-immigrant women in Norway. It is unclear why. This study aimed to explore the perceptions and experiences of Somali women regarding pain relief during childbirth. METHODS In January 2023, semi-structured interviews were conducted with 10 Somali women who had lived in Norway for at least ten years and given birth within the past 12 months. Data were analyzed using thematic content analysis as described by Graneheim and Lundman. RESULTS Three themes emerged from the data: a cultural understanding of epidural analgesia, religious and cultural coping strategies, and the midwife's role during labor. The participants expressed that there is a prevalent understanding in the Somali community that epidural analgesia in childbirth subsequently causes physical problems. Participants felt the influence of friends and family, expressed the need for culturally adapted information prior to labor, and concluded that, ultimately, what they decided upon was their own choice. They emphasized the belief that women were designed by God for childbirth. Prayer and placing oneself in God's hands were mentioned as pain management strategies. Nevertheless, the Somali women highlighted the importance of having a culturally competent midwife who is present when needed, creates trust, and provides information and access to different methods of pain relief, including epidural analgesia. CONCLUSIONS Understanding Somali women's cultural and religious background while listening to individual needs for information and pain relief is essential to ensure a positive birth experience for women from a Somali background.
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Affiliation(s)
- Hanna Oommen
- Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway
- Center for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Leila Esse
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Sanabel Sajer
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Division of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Mirjam Lukasse
- Center for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Aasbø G, Staff AC, Blix E, Pay ASD, Waldum Å, Rivedal S, Solbrække KN. Expectations related to home-based telemonitoring of high-risk pregnancies: A qualitative study addressing healthcare providers' and users' views in Norway. Acta Obstet Gynecol Scand 2024; 103:276-285. [PMID: 37983832 PMCID: PMC10823400 DOI: 10.1111/aogs.14726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/18/2023] [Accepted: 11/04/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION A pregnancy can be evaluated as high-risk for the woman and/or the fetus based on medical history and on previous or ongoing pregnancy characteristics. Monitoring high-risk pregnancies is crucial for early detection of alarming features, enabling timely intervention to ensure optimal maternal and fetal health outcomes. Home-based telemonitoring (HBTM) is a marginally exploited opportunity in antenatal care. The aim of this study was to illuminate healthcare providers' and users' expectations and views about HBTM of maternal and fetal health in high-risk pregnancies before implementation. MATERIAL AND METHODS To address diverse perspectives regarding HBTM of high-risk pregnancies, four different groups of experienced healthcare providers or users were interviewed (n = 21). Focus group interviews were conducted separately with midwives, obstetricians, and women who had previously experienced stillbirth. Six individual interviews were conducted with hospitalized women with ongoing high-risk pregnancies, representing potential candidates for HBTM. None of the participants had any previous experience with HBTM of pregnancies. The study is embedded in a social constructivist research paradigm. Interviews were analyzed using a thematic approach. RESULTS The participants acknowledged the benefits and potentials of more active roles for both care recipients and providers in HBTM. Concerns were clearly addressed and articulated in the following themes: eligibility and ability of women, availability of midwives and obstetricians, empowerment and patient safety, and shared responsibility. All groups problematized issues crucial to maintaining a sense of safety for care recipients, and healthcare providers also addressed issues related to maintaining a sense of safety also for the care providers. Conditions for HBTM were understood in terms of optimal personalized training, individual assessment of eligibility, and empowerment of an active patient role. These conditions were linked to the importance of competent and experienced midwives and obstetricians operating the monitoring, as well as the availability and continuity of care provision. Maintenance of safety in HBTM in high-risk pregnancies was crucial, particularly so in situations involving emerging acute health issues. CONCLUSIONS HBTM requires new, proactive roles among midwives, obstetricians, and monitored women, introducing a fine-tuned balance between personalized and standardized care to provide safe, optimal monitoring of high-risk pregnancies.
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Affiliation(s)
- Gunvor Aasbø
- Department of Interdisciplinary Health ResearchUniversity of OsloOsloNorway
| | - Anne Cathrine Staff
- Division of Obstetrics and GynecologyOslo University HospitalOsloNorway
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
| | - Ellen Blix
- Department of Nursing and Health PromotionOslo Metropolitan UniversityOsloNorway
| | - Aase S. D. Pay
- Department of Nursing and Health PromotionOslo Metropolitan UniversityOsloNorway
- Department of Gynecology and ObstetricsBærum Hospital, Vestre Viken Hospital TrustGjettumNorway
| | - Åsa Waldum
- Division of Obstetrics and GynecologyOslo University HospitalOsloNorway
| | - Sunniva Rivedal
- Center for Diaconia and Professional PracticeVID Specialized UniversityOsloNorway
| | - Kari N. Solbrække
- Department of Interdisciplinary Health ResearchUniversity of OsloOsloNorway
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Chen G, Olsen JA, Lamu AN. The influence of parents' and partner's education on own health behaviours. Soc Sci Med 2024; 343:116581. [PMID: 38242029 DOI: 10.1016/j.socscimed.2024.116581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/21/2023] [Accepted: 01/08/2024] [Indexed: 01/21/2024]
Abstract
The link between educational attainment and multiple health behaviours has been explained in various ways. This paper provides new insights into the social patterning in health behaviours by investigating the influence of parents' and partners' educational attainments on a composite indicator that integrates the four commonly studied lifestyle behaviours (smoking, alcohol, physical activity and BMI). Two key outcome indicators of interests were created to reflect both ends of the "healthy - unhealthy spectrum". Data was drawn from The Tromsø Study, conducted in 2015/16 (N = 21,083, aged 40-93 years). We controlled for two indicators of early life human capital and one personality trait variable. Partners' education attainments are relatively more important for avoiding unhealthy behaviour than choosing healthy behaviour; on the contrary, parents' education is more important for healthy behaviour. Heterogeneity by sex and age was also evident. The influences of partner's education on widening the socioeconomic contrasts in health behaviours were much stronger in the younger (40-59 years) age group. In conclusion, our results support the hypothesis that own health behaviour is affected by the educational attainments of our 'nearest and dearest' (i.e. spouse, mother, and father), net of own education. This study facilitates a better understanding of education-health behaviours nexus from a life course perspective and supports the importance of family-based interventions to improve healthy behaviours.
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Affiliation(s)
- Gang Chen
- Centre for Health Economics, Monash University, Melbourne, Australia
| | - Jan Abel Olsen
- Centre for Health Economics, Monash University, Melbourne, Australia; Department of Community Medicine, UiT - the Arctic University of Norway, Tromsø, Norway; Division for Health Services, Norwegian Institute of Public Health, Oslo, Norway.
| | - Admassu N Lamu
- Department of Community Medicine, UiT - the Arctic University of Norway, Tromsø, Norway; NORCE - Norwegian Research Centre, Bergen, Norway
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Skogen V, Langseth R, Rohde GE, Rysstad O, Sørlie T, Lie B. Prevalence of mental distress and factors associated with symptoms of major depression among people living with HIV in Norway. AIDS Care 2024; 36:173-180. [PMID: 37909108 DOI: 10.1080/09540121.2023.2275043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 10/17/2023] [Indexed: 11/02/2023]
Abstract
For people living with HIV (PLHIV) who can access lifesaving treatment, HIV has become a chronic lifelong condition; however, PLHIV have more mental and somatic comorbidities than their HIV-negative peers. In this cross-sectional study, we assessed the prevalence of mental distress and identified factors associated with major depression among 244 well-treated PLHIV residing in Norway. Participants completed validated questionnaires covering mental and somatic health. The prevalence of mental distress, defined as a score on the Hopkins Symptom Check List-25 >1.75, was 32%, and that of symptoms of major depression, defined as a score on the Beck Depression Inventory-II ≥20, was 15%. The factors associated with major depressive symptoms identified using logistic regression were risk of drug abuse (adjusted odds ratio (AOR) 15.1, 95% confidence interval (CI) 3.28, 69.3), fatigue (AOR 12.5, 95% CI 3.90, 40.0), trouble sleeping (AOR 7.90, 95% CI 2.85, 21.9), African origin (AOR 3.90, 95% CI 1.28, 11.9), low education (AOR 3.31, 95% CI 1.18, 9.30), and non-disclosure (AOR 3.22, 95% CI 1.04, 10.0). Our findings indicate that the prevalence rates of mental distress and major depressive symptoms are higher among well-treated PLHIV residing in Norway than in the general population. These conditions are under-diagnosed and under-treated, and increased awareness is needed.
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Affiliation(s)
- Vegard Skogen
- Department of Infectious Diseases, Medical Clinic, University Hospital of North Norway, Tromso, Norway
- Institute for Clinical Medicine, University of Tromso - The Arctic University of Norway, Tromso, Norway
| | - Ranveig Langseth
- Department of Infectious Diseases, Medical Clinic, University Hospital of North Norway, Tromso, Norway
| | - Gudrun E Rohde
- Department of Clinical Research, Hospital of Southern Norway, Kristiansand, Norway
- Faculty of Health & Sport Sciences, University of Agder, Kristiansand, Norway
| | - Ole Rysstad
- Department of Internal Medicine, Hospital of Southern Norway, Kristiansand, Norway
| | - Tore Sørlie
- Institute for Clinical Medicine, University of Tromso - The Arctic University of Norway, Tromso, Norway
- Department of Mental Health and Substance Abuse, University Hospital of North Norway, Tromso, Norway
| | - Birgit Lie
- Department of Psychosomatic and Trauma, Hospital of Southern Norway, Kristiansand, Norway
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Delsett LL. Collecting whales: processes and biases in Nordic museum collections. PeerJ 2024; 12:e16794. [PMID: 38288462 PMCID: PMC10823993 DOI: 10.7717/peerj.16794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/24/2023] [Indexed: 02/01/2024] Open
Abstract
Whales are unique museum objects that have entered collections in many ways and for different reasons. This work studies three Nordic natural history museum collections in Norway and Denmark with more than 2,500 whale specimens in total, and gathers the available biological and collection data on the specimens, which include skeletal elements, foetuses and organs preserved in ethanol or formalin, and a few dry-preserved organs. It finds that influx of specimens, which were mainly locally common species that were hunted, to the collections, mainly happened in the latest 1800s and earliest 1900s, fuelled by research trends, nation building, local whaling, and colonial mechanisms. Norway was a major whaling nation, but the largest hunt for whales in the Southern Ocean in the mid-1900s is not reflected in the Norwegian museum collections, probably because of the commercial focus of the whaling industry and logistical challenges, combined with limited research interest in zoological specimens at that time. The results demonstrate that it is important to understand these processes and the resulting biases for future research, outreach, and conservation.
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Affiliation(s)
- Lene Liebe Delsett
- Department of Archaeology, Conservation and History, University of Oslo, Oslo, Norway
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40
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Seppälä E, Dahl J, Veneti L, Rydland KM, Klüwer B, Rohringer A, Meijerink H. Covid-19 and influenza vaccine effectiveness against associated hospital admission and death among individuals over 65 years in Norway: A population-based cohort study, 3 October 2022 to 20 June 2023. Vaccine 2024; 42:620-628. [PMID: 38142215 DOI: 10.1016/j.vaccine.2023.12.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/04/2023] [Accepted: 12/17/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Co-circulation of SARS-CoV-2 and influenza virus can lead to double epidemics and increased pressure on health systems. To evaluate the effect of both vaccines, we estimated the adjusted vaccine effectiveness (aVE) of influenza and Covid-19 vaccines against related severe disease in the elderly population in Norway during the 2022/2023 season. METHODS In this population-based cohort study, we included data from the Emergency preparedness register for Covid-19 (Beredt C19) on all individuals ≥ 65 years living in Norway between 3 October 2022 and 20 June 2023. Using Cox-proportional hazard models, we estimated aVE of both influenza and Covid-19 vaccines (bivalent BA.1 and BA.4-5) against associated hospitalisation and death. Vaccine status was included as a time-varying covariate and all models were adjusted for potential confounders, including the other vaccine. RESULTS We identified 2,437 influenza-associated hospitalisations and 178 deaths, alongside 5,824 Covid-19-associated hospitalisations and 621 deaths. The aVE was highest in the first three months after receiving either vaccine. Against influenza-associated hospitalisation the aVE was 34 % (26 %-42 %) among 65-79-year-olds and 40 % (30 %-48 %) among ≥ 80-year-olds, and 6.6 % (-64 %-47 %) and 37 % (0.5 %-61 %) against influenza-associated death, respectively. The aVE against Covid-19-associated hospitalisation was 65 % (61 %-69 %) among 65-79-year-olds and 55 % (49 %-60 %) among ≥ 80-year-olds (compared to having received the vaccine ≥ 180 days ago). Similarly, the aVE against Covid-19-associated death was 68 % (48 %-80 %) and 78 % (65 %-86 %), respectively. For Covid-19 we show a reduction in aVE with time since dose. CONCLUSION Covid-19 and influenza vaccines reduced the risk of severe disease in the same high-risk population. Ensuring high uptake of both vaccines could thus limit the overall health care burden.
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Affiliation(s)
- Elina Seppälä
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Jesper Dahl
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Lamprini Veneti
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Birgitte Klüwer
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway
| | - Andreas Rohringer
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Hinta Meijerink
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway.
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Raknes G, Fagerås SJ, Sveen KA, Júlíusson PB, Strøm MS. Excess non-COVID-19 mortality in Norway 2020-2022. BMC Public Health 2024; 24:244. [PMID: 38254068 PMCID: PMC10801945 DOI: 10.1186/s12889-023-17515-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Causes of death other than COVID-19 seem to contribute significantly to the excess mortality observed during the 2020-2022 pandemic. In this study, we explore changes in non-COVID-19 causes of death in Norway during the COVID-19 pandemic from March 2020 to December 2022. METHODS We performed a population-based cross-sectional study on data from the Norwegian Cause of Death Registry. All recorded deaths from 1st January 2010 to 31st December 2022 were included. The main outcome measures were the number of deaths and age-standardised death rate (ASMR) per 100000 population from the major cause of death groups in 2020, 2021 and 2022. The predicted number of deaths and ASMRs were forecasted with a 95% prediction interval constructed from a general linear regression model based on the corresponding number of deaths and rates from the preceding ten prepandemic years (2010-2019). We also examined whether there were deviations from expected seasonality in the pandemic period based on prepandemic monthly data from 2010-2019. The cumulative number of deaths and ASMR were estimated based on monthly mortality data. RESULTS There was significant excess mortality (number of deaths) in 2021 and 2022 for all causes (3.7% and 14.5%), for cardiovascular diseases (14.3% and 22.0%), and for malignant tumours in 2022 (3.5%). In terms of ASMR, there was excess mortality in 2021 and 2022 for all causes (2.9% and 13.7%), and for cardiovascular diseases (16.0% and 25,8%). ASMR was higher than predicted in 2022 for malignant tumours (2.3%). There were fewer deaths than predicted from respiratory diseases (except COVID-19) in 2020 and 2021, and from dementia in 2021 and 2022. From March 2020 to December 2022, there were cumulatively 3754 (ASMR 83.8) more non-COVID-19 deaths than predicted, of which 3453 (ASMR: 79.6) were excess deaths from cardiovascular disease, 509 (ASMR 4.0) from malignant tumours. Mortality was lower than predicted for respiratory diseases (-1889 (ASMR: -44.3)), and dementia (-530 (ASMR -18.5)). CONCLUSIONS There was considerable excess non-COVID-19 mortality in Norway from March 2020 until December 2022, mainly due to excess cardiovascular deaths. For respiratory diseases and dementia, mortality was lower than predicted.
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Affiliation(s)
- Guttorm Raknes
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Postboks 973 Sentrum, NO-5808, Bergen, Norway.
- Raknes Research, Ulset, Norway.
- Regional Medicines Information and Pharmacovigilance Centre (RELIS), University Hospital of North Norway, Tromsø, Norway.
| | | | - Kari Anne Sveen
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Postboks 973 Sentrum, NO-5808, Bergen, Norway
| | - Pétur Benedikt Júlíusson
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Postboks 973 Sentrum, NO-5808, Bergen, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Children and Youth Clinic, Haukeland University Hospital, Bergen, Norway
| | - Marianne Sørlie Strøm
- Department of Health Registry Research and Development, Norwegian Institute of Public Health, Postboks 973 Sentrum, NO-5808, Bergen, Norway
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Torland V, Thomassen Ø, Østerås Ø. Kitesurfing and snowkiting injuries in Norway: a retrospective study. BMC Sports Sci Med Rehabil 2024; 16:26. [PMID: 38254180 PMCID: PMC10804644 DOI: 10.1186/s13102-024-00812-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/08/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Kiteboarding (kitesurfing on water and snowkiting) is a fairly new sport and is defined as a high-risk sport. The injury rate has been reported to be between 6 and 9 per 1000 h. The aim of the study was to identify and describe kiteboarding-related injuries in Norway over a five-year period. METHODS We used "snowball sampling" to identify kiteboarding accidents in a retrospective study. In addition, we conducted structural searches in the National Air Ambulance Service and Search and Rescue Helicopter patient record databases. All included informants were interviewed. Descriptive methods were used to characterise the sample. RESULTS Twenty-nine kiteboarders were included, with a total of 33 injuries. One half of the injuries to head, face and neck were cerebral concussions (n = 12). The most common type of injury was bone fractures (n = 28), followed by soft tissue injuries (n = 24). Most injuries were of moderate severity (51%) and falling from less than 5 m was the most common mechanism of injury. Operator error and lack of experience were the most frequently reported causes of accidents (82%). CONCLUSIONS Serious injuries occured during kiteboarding. The majority of kiteboarders reported operator error or lack of experience as the cause of their accident. Prior to kiteboarding, a course highlighting the importance in using helmet for snowkiting and both helmet and life vest in kitesurfing, should be mandatory.
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Affiliation(s)
- Venke Torland
- Dept of Anaesthesia and intensive Care, Stavanger University Hospital, 4068, Stavanger, PO Box 8100, Norway
| | - Øyvind Thomassen
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, 5021, Bergen, PO Box 1400, Norway
- Mountain Medicine Research Group, University of Bergen, 5020, Bergen, PO Box 7804, Norway
- Norwegian Air Ambulance Foundation, PO Box 414 Sentrum, 0184, Oslo, Norway
| | - Øyvind Østerås
- Department of Anaesthesia and Intensive Care, Haukeland University Hospital, 5021, Bergen, PO Box 1400, Norway.
- Mountain Medicine Research Group, University of Bergen, 5020, Bergen, PO Box 7804, Norway.
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Herrero-Arias R, Halbostad IV, Diaz E. Norwegian "dugnad" as a rhetorical device in public health communication during the COVID-19 pandemic. A qualitative study from immigrant's perspectives. Arch Public Health 2024; 82:11. [PMID: 38238794 PMCID: PMC10797926 DOI: 10.1186/s13690-024-01237-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, the Norwegian government appealed to the term "national dugnad" in the communication of containment measures as a call for collective action to fight the spread of infection. "Dugnad" is traditionally associated with solidarity, social responsibility, and a communal spirit in the form of volunteer work carried out by a local community. Although the word "dugnad" is difficult to translate to other languages, it was used as a rhetorical device by the government to communicate health-related information during the pandemic. This study aims to explore how immigrants understood and related to the term "dugnad" as used in the context of the COVID-19 pandemic in Norway. METHODS We conducted 55 semi-structured interviews in 2020 with immigrants from Poland (10), Syria (15), Somalia (10), Sri Lanka (10), and Chile (10). Interviews were conducted in participants' mother-tongues. We used systematic text condensation following Malterud's four steps to analyze the data. RESULTS The results are organized into three themes corresponding to: (1) meaning making of the term "dugnad"; (2) attitudes towards the term "dugnad"; and (3) reactions to the use of "dugnad" in a public health context. Overall, participants were familiar with the term "dugnad" and positively associated it with volunteering, unity, and a sense of community. However, we found a variety of reactions towards using this term in a public health context, ranging from agreement to disagreement and irritation. CONCLUSION Health communication during pandemics is crucial for maximizing compliance and gaining control of disease spread. In multicultural societies, governments and authorities should be aware of the linguistic and cultural barriers to public health communication if they are to effectively reach the entire population. The use of culturally specific concepts in this context, specially as rhetorical devices, may hinder effective health communication and increase health inequalities.
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Affiliation(s)
- Raquel Herrero-Arias
- Department of Health Promotion and Development, University of Bergen, Bergen, Norway
| | | | - Esperanza Diaz
- Pandemic Center, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
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Bonsaksen T, Steigen AM, Granrud MD, Dangmann CR, Stea TH. Sexual harassment exposure among junior high school students in Norway: prevalence and associated factors. Front Public Health 2024; 12:1307605. [PMID: 38304183 PMCID: PMC10830835 DOI: 10.3389/fpubh.2024.1307605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
Background Sexual harassment is common in most countries and cultures. Less is known about sexual harassment, its risk factors, and psychosocial outcomes among young adolescents. The aim of the study was to examine the 12-month prevalence of sexual harassment exposure, and sociodemographic and psychosocial factors associated with exposure among junior high school students in Norway. Methods A comprehensive cross-sectional study was completed by 83,297 Norwegian adolescents in junior high school in 2021. Data on exposure to sexual harassment were used in combination with sociodemographic measures and psychosocial outcomes: depressive symptoms, loneliness, self-esteem, and well-being. Group differences were analyzed with Chi Square tests, and sociodemographic risk factors were analyzed with logistic regression. Psychosocial outcomes were assessed with multivariate and univariate ANOVAs, and dose-response relationships were assessed with linear regression. Results Among the adolescents, 32.6% had experienced sexual harassment during the past year. Girls had higher odds of exposure (OR: 1.90, 95% CI: 1.84-1.96), whereas adolescents whose parents had higher education had lower odds (OR: 0.95, 95% CI: 0.90-0.99). Exposure was associated with higher levels of depressive symptoms (partial η2 [ES] = 0.11) and loneliness (ES = 0.07), and with lower self-esteem (ES = 0.06) and well-being (ES = 0.06). Among exposed adolescents, more frequent exposure was associated with poorer outcomes. Conclusion Exposure to sexual harassment affects one third of junior high school students in Norway. Those who are exposed have poorer psychosocial outcomes, and there is a dose-response relationship between exposure and outcomes. Awareness of sexual harassment among young adolescents, and interventions to prevent and reduce it, are needed.
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Affiliation(s)
- Tore Bonsaksen
- Department of Health and Nursing Science, Faculty of Social and Health Science, Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Health, Faculty of Health Science, VID Specialized University, Stavanger, Norway
| | - Anne Mari Steigen
- Department of Health and Nursing Science, Faculty of Social and Health Science, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Marie Dahlen Granrud
- Department of Social Sciences and Guidance, Faculty of Social and Health Science, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Cecilie Ruud Dangmann
- Department of Social Sciences and Guidance, Faculty of Social and Health Science, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Tonje Holte Stea
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
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Meijerink H, Shelil M, Jani-Bølstad J, Dvergsdal ET, Madslien EH, Wilberg M, Gundersen RB, Sæbø JI, Thorseng AA, Iversen BG. Does integration with national registers improve the data completeness of local COVID-19 contact tracing tools? A register-based study in Norway, May 2020 - September 2021. BMC Health Serv Res 2024; 24:96. [PMID: 38233812 PMCID: PMC10795336 DOI: 10.1186/s12913-023-10540-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 12/30/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND During the COVID-19 response in Norway, many municipalities used the Fiks contact tracing tool (FiksCT) to register positive individuals and follow-up contacts. This tool is based on DHIS2, an open source, web-based platform. In this study we examined if data completeness in FiksCT improved after integration with national registers between May 2020 and September 2021. METHODS Data from municipalities using FiksCT was extracted from the Norwegian Emergency Preparedness Register for COVID-19 (Beredt C19). We linked FiksCT data to the Norwegian Surveillance System for Communicable Diseases (MSIS), the National Population Register (FREG), and the Norwegian Vaccine Registry (SYSVAK) using unique identification numbers (ID). Completeness for each variable linked with a national register was calculated before and after integration with these registers. RESULTS Of the 125 municipalities using FiksCT, 87 (69.6%) agreed to share and upload their data to Beredt C19. Data completeness for positive individuals improved after integration with national registers. After integration with FREG, the proportion of missing values decreased from 12.5 to 1.6% for ID, from 4.5 to 0.9% for sex, and from 1.2 to 0.4% for date of birth. Missing values for vaccine type decreased from 63.0 to 15.2% and 39.3-36.7% for first and second dose, respectively. In addition, direct reporting from FiksCT to MSIS increased the proportion of complete records in MSIS (on the selected variables) from 68.6% before to 77.0% after integration. CONCLUSION The completeness of local contact tracing data can be improved by enabling integration with established national registers. In addition, providing the option to submit local data to the national registers could ease workload and reduce the need to collect duplicate data.
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Affiliation(s)
- Hinta Meijerink
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Oslo, Norway.
| | - Mohamed Shelil
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Evy Therese Dvergsdal
- Department of Infectious Disease Registries, Norwegian Institute of Public Health, Oslo, Norway
| | - Elisabeth Henie Madslien
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | - Madeleine Wilberg
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | | | | | | | - Bjørn Gunnar Iversen
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
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Bøås H, Storm ML, Tapia G, Kristoffersen AB, Løvlie AL, Størdal K, Lyngstad TM, Bragstad K, Hungnes O, Veneti L. Frequency and risk of SARS-CoV-2 reinfections in Norway: a nation-wide study, February 2020 to January 2022. BMC Public Health 2024; 24:181. [PMID: 38225588 PMCID: PMC10789014 DOI: 10.1186/s12889-024-17695-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/08/2024] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND SARS-CoV-2 reinfection rates have been shown to vary depending on the circulating variant, vaccination status and background immunity, as well as the time interval used to identify reinfections. This study describes the frequency of SARS-CoV-2 reinfections in Norway using different time intervals and assesses potential factors that could impact the risk of reinfections during the different variant waves. METHODS We used linked individual-level data from national registries to conduct a retrospective cohort study including all cases with a positive test for SARS-CoV-2 from February 2020 to January 2022. Time intervals of 30, 60, 90 or 180 days between positive tests were used to define potential reinfections. A multivariable Cox regression model was used to assess the risk of reinfection in terms of variants adjusting for vaccination status, demographic factors, and underlying comorbidities. RESULTS The reinfection rate varied between 0.2%, 0.6% and 5.9% during the Alpha, Delta and early Omicron waves, respectively. In the multivariable model, younger age groups were associated with a higher risk of reinfection compared to older age groups, whereas vaccination was associated with protection against reinfection. Moreover, the risk of reinfection followed a pattern similar to risk of first infection. Individuals infected early in the pandemic had higher risk of reinfection than individuals infected in more recent waves. CONCLUSIONS Reinfections increased markedly during the Omicron wave. Younger individuals, and primary infections during earlier waves were associated with an increased reinfection risk compared to primary infections during more recent waves, whereas vaccination was a protective factor. Our results highlight the importance of age and post infection waning immunity and are relevant when evaluating vaccination polices.
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Affiliation(s)
- Håkon Bøås
- Department of Infection Control and Vaccines, Norwegian Institute of Public Health, Lovisenberggata 8, 0456, Oslo, Norway.
| | | | - German Tapia
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Astrid Louise Løvlie
- Department of Infectious Disease Registries, Norwegian Institute of Public Health, Oslo, Norway
| | - Ketil Størdal
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Trude Marie Lyngstad
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
| | - Karoline Bragstad
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Olav Hungnes
- Department of Virology, Norwegian Institute of Public Health, Oslo, Norway
| | - Lamprini Veneti
- Department of Infection Control and Preparedness, Norwegian Institute of Public Health, Oslo, Norway
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Enden MR, Møen K, Igland J, Diaz E. Trends in cervical cancer screening in Norway 2012-2017: a comparison study of non-immigrant and immigrant women. Scand J Public Health 2024:14034948231217636. [PMID: 38166571 DOI: 10.1177/14034948231217636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
AIMS Immigrant women in Norway have lower cervical cancer screening participation than non-immigrant women. Our aim in this study was to assess whether the observed increase in screening participation during 2012-2017 was different between Norwegian-born women and immigrant women. METHODS Data were collected from three national registries. The study included 1,409,561 women, categorized according to country of birth and immigrant background: (i) Norway, Norwegian parents; (ii) Norway, immigrant parent(s); (iii) Europe, excluding Norway; (iv) Africa; (v) Asia, including Turkey; and (vi) other countries. Trends and differences between groups were analyzed using Poisson regression analyses with adjustments for variables other studies have found to influence screening participation. Trends were assessed by including half-years as a continuous variable in the models and reported as prevalence ratios with 95% confidence intervals. RESULTS Screening participation increased in all groups, but was not statistically significant among women from Africa in the adjusted model. The highest increase was among Norwegian women, with a 2.2% increase per year. Interaction tests showed significantly smaller increases in screening among women born in Europe (p interaction < 0.0001), Africa (p interaction < 0.0001), Asia (p interaction < 0.0001), and countries in the "Other" category (p interaction = 0.004). There was also a smaller increase among Norwegian-born women with one or more immigrant parent(s), but this was not significant (p interaction = 0.178). CONCLUSIONS The gap in screening participation and the increasing differences in trends suggest that healthcare services do not reach all women in Norway to the same extent. One should attempt to improve this while working toward further increasing screening participation for all.
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Affiliation(s)
- Marta Røttingen Enden
- Institute of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
| | - Kathy Møen
- Institute of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
| | - Jannicke Igland
- Institute of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
| | - Esperanza Diaz
- Institute of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Norway
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Randby JS, Ogden T, Lien N. Implementation and effectiveness of a school-based intervention to increase adherence to national school meal guidelines: a non-randomised controlled trial. Public Health Nutr 2024; 27:e25. [PMID: 38164650 PMCID: PMC10830359 DOI: 10.1017/s1368980023002938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/26/2023] [Accepted: 12/17/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Implementation of school meal guidelines is often inadequate, and evidence for effective implementation strategies for school-based nutrition interventions is limited. The aim of the present study was to examine the implementation and effectiveness of a multi-strategy implementation intervention to increase adherence to the Norwegian national school meal guideline. DESIGN The study was a school-based hybrid implementation effectiveness trial with a pre-post non-equivalent control group design, testing three implementation strategies: internal facilitation, training and an educational meeting. SETTING Primary schools and after-school services in two counties in south-east Norway. PARTICIPANTS School principals, after-school leaders and class teachers from thirty-three schools in the intervention county and principals and after-school leaders from thirty-four schools in a comparison county. RESULTS There was a significant difference of 4 percentage points in change scores between the intervention and the comparison groups at follow-up, after adjusting for baseline adherence (B = 0·04, seB = 0·01, t = 3·10, P = 0·003). The intervention effect was not associated with the school's socio-economic profile. School-level fidelity was the implementation dimension that was most strongly correlated (r s = 0·48) with the change scores in the intervention group, indicating that principals' support is important for gaining the largest intervention effects. CONCLUSIONS A school-based intervention with low intensity, based on trained teachers as internal facilitators, can increase adherence to the national school meal guideline among Norwegian primary schools, irrespective of local socio-economic conditions. Implementation fidelity, at an organisational level, may be a useful predictor for intervention outcomes in schools.
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Affiliation(s)
- Jorunn Sofie Randby
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Pb. 1046 Blindern, 0317Oslo, Norway
- Department of Child and Adolescent Health, Norwegian Directorate of Health, Pb. 220 Skøyen, 0213Oslo, Norway
| | - Terje Ogden
- Norwegian Center for Child Behavioral Development, P.b. 7053 Majorstuen, 0306Oslo, Norway
| | - Nanna Lien
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Pb. 1046 Blindern, 0317Oslo, Norway
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Gugushvili A, Dokken T, Grue J, Finnvold JE. Early-life impairments, chronic health conditions, and income mobility. Br J Sociol 2024; 75:56-64. [PMID: 37955958 DOI: 10.1111/1468-4446.13064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/25/2023] [Accepted: 10/29/2023] [Indexed: 11/14/2023]
Abstract
Individuals who have congenital conditions or become disabled early in life tend to have poorer educational and occupational outcomes than non-disabled individuals. Disability is known to be a complex entity with multiple causations, involving, inter alia, physiological, social, economic, and cultural factors. It is established that social factors can influence educational and occupational attainment for disabled people, and current disability policy in many countries, particularly in the Global North, stress the importance of equality of opportunity. However, there is a scarcity of research that explores the specific degrees to which advanced welfare states contribute to the equalization of life chances for individuals with early-life impairments and chronic health conditions. In this study, we use a Norwegian sample of high-quality register data on individuals with vision loss, hearing loss, physical impairment, type 1 diabetes, asthma, and Down syndrome diagnosed early in life and compare their intergenerational income mobility trajectories with a random sample drawn from the country's entire population. We find that individuals' early-life diagnoses are linked to significantly worse income outcomes in adulthood than what is observed among the general population. We conclude that even in one of the most advanced egalitarian welfare states, such as Norway, much remains to be done to equalize life chances for individuals with early-life impairments and chronic health conditions.
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Affiliation(s)
- Alexi Gugushvili
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
| | - Therese Dokken
- Centre for Welfare and Labour Research, Oslo Metropolitan University, Oslo, Norway
| | - Jan Grue
- Department of Sociology and Human Geography, University of Oslo, Oslo, Norway
| | - Jon Erik Finnvold
- Centre for Welfare and Labour Research, Oslo Metropolitan University, Oslo, Norway
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Solheim K, Hegg Reime M, Eide LSP. How Do Persons Who Inject Drugs Experience Care From Nurses in Hospital Settings? A Qualitative Study. Glob Qual Nurs Res 2024; 11:23333936241240795. [PMID: 38577493 PMCID: PMC10993672 DOI: 10.1177/23333936241240795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 04/06/2024] Open
Abstract
People who inject drugs (PWID) are at increased risk of acute and chronic health outcomes and in need of in-hospital healthcare services. This study aims to give insight into how PWID experience care from nurses in hospital settings. We used a qualitative descriptive design and applied reflexive thematic analysis to 11 individual semi-structured interviews with PWID. Our analysis generated the following main themes: (1) diminishment and distance-always just a drug addict, (2) gratitude-equal care not taken for granted, and (3) vulnerability-already carrying a heavy burden. Our findings reveal a complex, nuanced narrative regarding participants' experiences of nursing care and highlight the importance of enhancing knowledge, understanding, empathy, and communication skills when nurses encounter PWID. Our research suggests that patients' vulnerability resulting from previous experiences defined their perception of quality of care. Insight from this study provides valuable knowledge about how to enhance nursing care for PWID.
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Affiliation(s)
| | - Marit Hegg Reime
- Western Norway University of Applied Sciences, Bergen, Hordaland, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Leslie S. P. Eide
- Western Norway University of Applied Sciences, Bergen, Hordaland, Norway
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