Norway

Choline and betaine are nutrients involved in one-carbon metabolism. Choline is essential for neurodevelopment and brain function. We studied the associations between cognitive function and plasma concentrations of free choline and betaine. In a cross-sectional study, 2195 subjects (55 % women), aged 70-74 years, underwent extensive cognitive testing including the Kendrick Object Learning Test (KOLT), Trail Making Test (part A, TMT-A), modified versions of the Digit Symbol Test (m-DST), Block Design (m-BD), Mini-Mental State Examination (m-MMSE) and Controlled Oral Word Association Test (COWAT). Compared with low concentrations, high choline (.8·4 mmol/l) was associated with better test scores in the TMT-A (56·0 v. 61·5, P¼ 0·004), m-DST (10·5 v. 9·8, P¼ 0·005) and m-MMSE (11·5 v. 11·4, P¼ 0·01). A generalised additive regression model showed a positive dose -response relationship between the m-MMSE and choline (P¼0·012 from a corresponding linear regression model). Betaine was associated with the KOLT, TMT-A and COWAT, but after adjustments for potential confounders, the associations lost significance. Risk ratios (RR) for poor test performance roughly tripled when low choline was combined with either low plasma vitamin B 12 (# 257 pmol/l) concentrations (RR KOLT ¼ 2·6, 95 % CI 1·1, 6·1; RR m-MMSE ¼ 2·7, 95 % CI 1·1, 6·6; RR COWAT ¼ 3·1, 95 % CI 1·4, 7·2) or high methylmalonic acid (MMA) ($3·95 mmol/l) concentrations (RR m-BD ¼ 2·8, 95 % CI 1·3, 6·1). Low betaine (# 31·1 mmol/l) combined with high MMA was associated with elevated RR on KOLT (RR KOLT ¼ 2·5, 95 % CI 1·0, 6·2). Low plasma free choline concentrations are associated with poor cognitive performance. There were significant interactions between low choline or betaine and low vitamin B 12 or high MMA on cognitive performance.

Dependence on a vast shared resource built up the economies of herring towns around the north-central and northeastern Atlantic during the first half of the 20th century. During the postwar years, culminating in the early-1960s spike, the fishery rapidly drew down its resource. This killer spike disastrously coincided with an adverse climatic event, collapsing the fishery in the late 1960s. That pattern, of collapse resulting from climatic variation on top of overfishing, has characterized other fisheries crises (for example see Hamilton et al., 2004b). The fisheries events reflect a more general proposition: climate changes tend to impact human affairs largely through interactions with resource use and distribution behaviour, which can reduce or exacerbate climate impacts. We should not expect to see simple, physical impacts from climate alone, unmitigated by social factors.

We describe the finding of a novel viral haemorrhagic septicaemia virus (VHSV) Genotype III strain that caused disease of both a neurological and septicaemic nature in seawater-farmed rainbow trout Oncorhynchus mykiss in Storfjorden, Norway. In November 2007, an outbreak of VHS associated with slightly elevated mortality was confirmed at a seawater site rearing rainbow trout (90 to 440 g). Within 3 to 4 mo, the disease was recognised in 3 neighbouring sea sites with ongrowing rainbow trout. The clinical, gross pathological and histopathological findings were in accordance with VHS, and the diagnosis was confirmed by the detection of VHSV in brain and internal tissues by immunohistochemistry, cell culture and reverse transcriptase PCR (RT-PCR). Sequence analysis of the G-gene revealed that the isolated virus clustered with VHSV Genotype III and that the Norwegian isolate represents a unique strain of VHSV. The pathogenicity of the virus strain to rainbow trout and Atlantic salmon Salmo salar was examined using infection experiments. In immersion trials, the Norwegian isolate produced a cumulative mortality of 70% in rainbow trout, while nearly 100% mortality was obtained after intraperitoneal injection of the virus. For Atlantic salmon, no mortality was observed in immersion trials, whereas 52% mortality was observed after intraperitoneal injection. The Norwegian isolate thus represents the first VHSV of Genotype III pathogenic to rainbow trout.

Objective There have been conflicting reports on the relationship between thyroid function and mood between studies in subjects on T4 and the general population not on T4. We investigated this relationship in a large catchment area-based study. Design We analysed data on serum TSH levels and Hospital Anxiety and Depression Scale (HADS) scores from the HUNT 2 study (age ‡ 40 years). Following a test for interaction, analyses were performed separately in females on T4 (n ¼ 1265) and in people not on T4 (males n ¼ 9319 and females n ¼ 17 694). Results More females on T4 had high depression and anxiety scores than females not on T4 (depression 18AE4% vs. 13AE0%, P < 0AE001, anxiety 23AE4% vs. 18AE7%, P < 0AE001). In those not on T4, there was an inverse association between serum TSH and depression score in males (B coefficient ¼ -0AE61, 95% CI -0AE91 to -0AE24, P ¼ 0AE001) though not in females (B coefficient ¼ -0AE07, -0AE33 to 0AE19), and an inverse association between TSH and anxiety score in both genders (B coefficient for males ¼ 0AE68, 95% CI -1AE04 to -0AE32, P < 0AE001; females -0AE37, 95% CI -0AE67 to -0AE08, P ¼ 0AE01). In contrast, in females on T4, TSH was positively associated with both depression (B coefficient ¼ +0AE27, 95% CI 0AE02 to 0AE51, P < 0AE05) and anxiety (B coefficient ¼ +0AE29, 95% CI 0AE01 to 0AE56, P < 0AE05). Conclusions There is a different relationship between thyroid function and depression and anxiety in females on T4 compared with individuals with no thyroid disease. This group also has a higher prevalence of depression and anxiety.

Transfer of 137 Cs in the soileplant/lichenereindeer food chain was studied in central (Østre Namdal) and southern Norway (Va˚ga˚) during 2000e2003. Reindeer from these areas have been continuously subjected to countermeasure application since the 1986 Chernobyl accident. In both areas no decline in 137 Cs concentrations was detectable in reindeer slaughtered in autumn since 1995, or in reindeer slaughtered in winter since 1998e1999. Seasonal differences in 137 Cs concentrations in reindeer have been less pronounced in recent years, with 137 Cs concentrations occasionally higher in autumn than in winter. Soil-to-plant 137 Cs transfer was significantly higher in Østre Namdal than in Va˚ga˚. Climatic influences on lichen growth and abundance, and on soil properties that influence the availability of 137 Cs for plant uptake, are hypothesized to have a larger impact on long-term transfer of radiocaesium in the soileplant/ lichenereindeer food chain than has been previously observed. Journal of Environmental Radioactivity 83 (2005) 231e252 www.elsevier.com/locate/jenvrad 232 L. Skuterud et al. / J. Environ. Radioactivity 83 (2005) 231e252 233 L. Skuterud et al. / J. Environ. Radioactivity 83 (2005) 231e252 234 L. Skuterud et al. / J. Environ. Radioactivity 83 (2005) 231e252 248 L. Skuterud et al. / J. Environ. Radioactivity 83 (2005) 231e252

Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them. To assess national models and methods for financing and reimbursing palliative care. Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms. Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following: Pr...

The purposes of this study were to examine the percentage of female elite athletes and controls with disordered eating (DE) behavior and clinical eating disorders (EDs), to investigate what characterize the athletes with EDs, and to evaluate whether a proposed method of screening for EDs in elite athletes does not falsely classify sport-specific behaviors as indicators of EDs. All athletes representing the national teams at the junior or senior level, aged 13-39 years (n 5 938), and age-group matched, randomly selected population-based controls (n 5 900) were invited to participate. From the screening data, a random sample of athletes (n 5 186) and controls (n 5 145) were subjects for a clinical interview. More athletes in leanness sports (46.7%) had clinical EDs than athletes in non-leanness sports (19.8%) and controls (21.4%) (Po0.001). Variables predicting clinical EDs, and thus candidates for valid screening procedures, were menstrual dysfunction in leanness athletes, selfreported EDs in non-leanness athletes, and self-reported use of pathogenic weight control methods in controls. Hence, statistically based risk factors are not universally valid, but specifically related to athletes and non-athletes, respectively. EDs. Indeed, a recent controlled study identified a range of DE behaviors that predicted future EDs, like eating in secret, laxative abuse and a fear of losing control over eating.

Objective: To examine the prevalence of dieting, reasons for dieting and prevalence of disordered eating among adolescent elite athletes and age-matched controls, and to examine the differences between athletes competing in leanness and non-leanness sports. Methods: First-year students of 16 different Norwegian Elite Sport High Schools (athlete group, n = 682) and two randomly selected ordinary high schools from a county representative of the general Norwegian population (control group, n = 423) were invited to participate in this cross-sectional study. A total of 606 athletes and 355 controls completed the questionnaire, giving a response rate of 89% and 84%, respectively. The questionnaire contained questions regarding training patterns, menstrual status and history, dieting, use of pathogenic weight control methods and the drive for thinness (DT) and body dissatisfaction (BD) subscales from the Eating Disorders Inventory. Main outcome measure: Disordered eating, defined as meeting one or more of the following criteria: DT score >15 (girls) and >10 (boys), BD score >14 (girls) and >10 (boys), body mass index ,17.9 kg/m 2 (girls) and ,17.5 kg/m 2 (boys), current and/or >3 previous efforts to lose weight, use of pathogenic weight control methods and self-reported menstrual dysfunction. Results: A higher prevalence of control subjects were dieting and classified with disordered eating compared with the athletes. An improvement of appearance was a more common reason for dieting among controls compared with athletes. No differences in dieting or disordered eating were found between leanness and nonleanness sports athletes. Conclusions: Self-reported disordered eating is more prevalent among controls than adolescent elite athletes, and losing weight to enhance performance is an important reason for dieting among adolescent elite athletes.

Regionality, in the specific archaeological sense of the spatial distribution of differences in material culture, has not been a central concern for Iron Age specialists in Norway for several decades. But with its varied topography, its mountains, fjords, rivers and lakes, the country is an obvious place to look for such differences. In the present paper, I have turned my attention to burial customs. As one would expect, there is a myriad of local and regional rites to be found, and some traits might occur all over Norway, and indeed over the whole Germanic area. However, some of these ritual traditions might be limited to a single farm, or even to a single family in some cases, while others are probably associated with distinct tribes or other larger groups. But then there are some ritual traditions which cover substantially larger areas than nature-given settlement districts, but still have a rather limited distribution. I have tried to show that these larger areas concur with the major regions met with in later, written sources dealing with the origins of the Medieval kingdom of Norway.

The present paper deals with a minority of burials in Roman (B-C) and Migration period (D) Norway, namely the ones containing weapons. Its aim is two-folded: 1) to present an overview of this material to non-Norwegian colleagues, and 2) to discuss the significance of the weapon burial rite in its Scandinavian and North European context. Regarding the first, I intend to focus on the chronology, regional distribution and typology of burials with weapons. As for the latter, the emphasis will be on weapon graves as evidence both of the militarisation of barbarian society in general and more specific of warlike relations between the Roman Empire and the northern Germans, particularly the question of Scandinavian auxiliaries in the Roman army.

Objective: The objectives of the study were to examine the prevalence of anorexia nervosa (AN), bulimia nervosa (BN), anorexia athletica (AA), and eating disorders not otherwise specified (ED-NOS) in both male and female Norwegian elite athletes and a representative sample from the general Norwegian population.

Through a multilevel approach, the study explores the relationships of dental attendance and self-rated oral health (SROH) to individual and structural factors among adults in Norway. The individual factors include various sociodemographic characteristics. The structural ones are population density and dentist density. The sample was recruited from three counties that represent three different combinations of population density and dentist density. There were significant differences in both dental attendance and SROH between the counties. The findings support the theory of a structural explanation of the observed differences and indicate evidence of supplier-suppressed demand. Access to dental services could be improved either by regulating the supply side of dentistry or by compensating patients for travel costs incurred in accessing dental services. r

Background: Violence against women has long been considered a hidden health burden. Questions about violence have not been included in health surveys; hence, little is known about prevalence and the consequences for health in the general population. No national study has been conducted in Norway. Aims: To estimate the prevalence of partner violence in Norway and the relationship between victimization and somatic health and depression and anxiety and post-traumatic stress symptoms. Methods: Data collection was performed by Statistics Norway. Among a random sample of women aged 20—55 years, 2,407 women returned the questionnaire (63.3%), of whom 2,143 were ever-partnered. Selected demographic characteristics were obtained from registers. Results: In total, 26.8% of 2,143 ever-partnered women had experienced any violence by their partner during their lifetime, and 5.5% in the year before the study. Low educational level, being unmarried, separated or divorced, currently being unemploye...

Objective: Depression and insomnia are closely linked, yet our understanding of their prospective relationships remains limited. The aim of the current study was to investigate the directionality of association between depression and insomnia. Methods: Data were collected from a prospective population-based study comprising the most recent waves of the Nord-TrLndelag Health Study (HUNT) (the HUNT2 in 1995Y1997 and the HUNT3 in 2006Y2008). A total of 24,715 persons provided valid responses on the relevant questionnaires from both surveys. Study outcomes were onset of depression or insomnia at HUNT3 in persons not reporting the other disorder in HUNT2. Results: Both insomnia and depression significantly predicted the onset of the other disorder. Participants who did not have depression in HUNT2 but who had insomnia in both HUNT2 and HUNT3 had an odds ratio (OR) of 6.2 of developing depression at HUNT3. Participants who did not have insomnia in HUNT2 but who had depression in both HUNT2 and HUNT3 had an OR of 6.7 of developing insomnia at HUNT3. ORs were only slightly attenuated when adjusting for potential confounding factors. Conclusions: The results support a bidirectional relationship between insomnia and depression. This finding stands in contrast to the previous studies, which have mainly focused on insomnia as a risk factor for the onset of depression.

The mutual influences of wheat selenium (Se) and n-3 polyunsaturated fatty acids (n-3 PUFA) on plasma Se and indicators of increased oxidative stress were investigated in a randomized, double-blind study with 31 women (23.5 +/- 3.4 yr). Groups 1 and 2 ingested 5.4 g n-3 PUFA daily (as ethyl esters), whereas groups 3 and 4 received placebo capsules. Groups 2 and 3 received 3 slices of high-Se bread daily, providing 115 micrograms Se, in addition to the 77 +/- 26 micrograms Se in the diet. Groups 1 and 4 received placebo slices. Blood samples were drawn at baseline and at 3 and 6 wk. Serum Se concentrations increased in both groups given Se-enriched bread, but significantly less in subjects given n-3 PUFA (group 2). There were no changes in the plasma ratio alpha-tocopherol:mg cholesterol or plasma ascorbic acid levels. In group 1, plasma-conjugated dienes and thiobarbituric acid-reactive substances (TBARS) rose by 130% (p &lt; 0.005) and 126% (p &lt; 0.005), respectively. Two-way ANO...

Abstract: RAPD markers were used to measure the genetic diversity of 119 individuals of Ixodes ricinus collected from Lithuania and Norway. The samples were analysed within and also between the populations. We analysed 74 loci in each of 6 populations. Our results show high levels of diversity within the populations. The percentage of polymorphic loci of the six analysed populations: Birzai, Vilnius, Kretinga, Tjore, Kjosvik and Odderoya were 68.9%, 58.1%, 78.38%, 62.2%, 44.6 % and 68.9%, respectively. The percentage of polymorphic loci in the Lithuanian populations was 93.2%, and in the Norwegian populations 81.08%. The genetic distance ranged from 0.019 to 0.079 within Norwegian populations and from 0.005 to 0.0967 within Lithuanian populations and between the countries from 0.022 to 0.146. The genetic variation of I. ricinus among Norwegian populations was lower than among Lithuanian populations. The highest part of genetic variation in I. ricinus ticks depends on variation withi...

To investigate the effect of a seven-month, school-based cluster-randomized controlled trial on academic performance in 10-year-old children. In total, 1129 fifth-grade children from 57 elementary schools in Sogn og Fjordane County, Norway, were cluster-randomized by school either to the intervention group or to the control group. The children in the 28 intervention schools participated in a physical activity intervention between November 2014 and June 2015 consisting of three components: 1) 90min/week of physically active educational lessons mainly carried out in the school playground; 2) 5min/day of physical activity breaks during classroom lessons; 3) 10min/day physical activity homework. Academic performance in numeracy, reading and English was measured using standardized Norwegian national tests. Physical activity was measured objectively by accelerometry. We found no effect of the intervention on academic performance in primary analyses (standardized difference 0.01-0.06, p&gt...

Background: Attitudes to, and practices of, scientific authorship vary. We have studied this variation among researchers in a university hospital and medical school in Norway. Methods: We invited all faculty, researchers and PhD students at Oslo University Hospital and the Faculty of Medicine, University of Oslo (approximately 2700) by e-mail to answer a web-based questionnaire in January 2013. We asked the researchers to report their authorship experiences and to score their agreement with, and ability to practice according to, 13 statements on authorship qualifications and criteria on a five-point Likert scale (1 = completely agree, 5 = completely disagree). The statements were taken from the International Committee of Medical Journal Editors (ICMJE) and other recommendations on authorship. Results: 654 questionnaires were returned (response rate 24%); 25% of the respondents had published less than five scientific articles, 43% five to 49, and 32% more than 50 articles. 97% reported knowledge of defined authorship criteria, and 68% regarded breaches of these as scientific misconduct. 36% had experienced pressure to include undeserved authors in their papers, more in basic science (46%) than in community medicine (25%). 29% reported that they had been denied authorship they believed they deserved. Researchers with less than six years of research experience found authorship decisions more difficult than more experienced researchers (48% vs 30%). The respondents' agreement with the statements on authorship was higher than their self-reported ability to follow them for all statements. Average scores for agreement and practice for all statements combined were 1.4 vs 2.3. The discrepancy between attitude and practice declined with publishing experience. For the core ICMJE authorship requirements the average difference between attitude and practice was 1.2 among those who had published less than 5 articles and 0.7 among those who had published 50 articles or more (p < 0.05). Conclusions: Almost all the responding researchers had knowledge of formal authorship requirements. Most of them agreed with the criteria, but found it harder to put them into practice. More experienced researchers found decisions on authorship and about the order of authors easier than less experienced researchers.

Introduction: Studies show that patients' perception of their illness has a direct influence both on their utilization of health services and their adherence to treatment plans. This may be particularly relevant to the treatment of Anorexia Nervosa (AN). Previous studies on AN have typically explored single psycho-social factors that patients with AN relate to the emergence of their illness. There is a need for more coherent systematic descriptions of the complexity of the patients' narratives about how their illness emerged. In this study we sought to identify common components in the participants' narratives. By identifying different combinations of these components in the narratives, we sought to describe differences in patients' perceived pathways to AN. Methods: Participants were 36 women aged 18-51 years who had been treated for AN within the past two years at five clinical institutions in Norway. Semi-open qualitative interviews were conducted, tape-recorded, transcribed and analysed using grounded theory techniques. Results: We identified the following four distinct perceived pathways into AN: "The Avoidant", "The Achiever", "The Transformer", and "The Punisher". The pathways could be regarded as four different projects for mastering life's challenges. Discussion: Our results suggest that there seem to be at least four pathways into AN. This indicates that a common array of symptoms might cover very different psychological dynamics. These might need to be treated therapeutically in different ways and should probably be taken into account during the refinement of diagnostic tools. Key Practitioner Message:  Although patients with AN might present similar symptoms, patients' perspectives on the emergence of their problems indicate that a common array of symptoms cover a variety of subjective psychological dynamics.

Over the past 15-20 years, domestic cultivation of cannabis has been established in a number of European countries. New techniques have made such cultivation easier; however, the bulk of growers remain small-scale. In this study, we explore the factors that prevent small-scale growers from increasing their production. The study is based on 1 year of ethnographic fieldwork and qualitative interviews conducted with 45 Norwegian cannabis growers, 10 of whom were growing on a large-scale and 35 on a small-scale. The study identifies five mechanisms that prevent small-scale indoor growers from going large-scale. First, large-scale operations involve a number of people, large sums of money, a high work-load and a high risk of detection, and thus demand a higher level of organizational skills than for small growing operations. Second, financial assets are needed to start a large &#39;grow-site&#39;. Housing rent, electricity, equipment and nutrients are expensive. Third, to be able to sell...

Objective To examine the practice of concealing drugs in patients' foodstuff in nursing homes. Design Cross sectional study with data collected by structured interview. Setting All five health regions in Norway. Participants Professional carers of 1362 patients in 160 regular nursing home units and 564 patients in 90 special care units for people with dementia. Main outcome measures Frequency of concealment of drugs; who decided to conceal the drugs; how this practice was documented in the patients' records; and what types of drugs were given this way. Results 11% of the patients in regular nursing home units and 17% of the patients in special care units for people with dementia received drugs mixed in their food or beverages at least once during seven days. In 95% of cases, drugs were routinely mixed in the food or beverages. The practice was documented in patients' records in 40% (96/241) of cases. The covert administration of drugs was more often documented when the physician took the decision to hide the drugs in the patient's foodstuff (57%; 27/47) than when the person who made the decision was unknown or not recorded (23%; 7/30). Patients who got drugs covertly more often received antiepileptics, antipsychotics, and anxiolytics compared with patients who were given their drugs openly. Conclusions The covert administration of drugs is common in Norwegian nursing homes. Routines for such practice are arbitrary, and the practice is poorly documented in the patients' records.

In this introductory essay, we build on the articles in this special issue to provide a novel theoretical framework for the understanding of current and future trends in the digitalisation of teaching and learning in Nordic higher education (HE). We highlight three key elements. Context is critical and should be systematically expanded to include not only the immediate context of the virtual and blended classroom, but also the broader organisational and national contexts within which digital learning takes place. The involvement of individual actors, higher education institutions and national policy-making agencies in the development and implementation of digitalisation policy ideas and practices is also shaped by multiple mediations, which include the mediating role of technology itself, but also of other human, organisational and policy actors, ideas and practices. Finally, digitalisation of HE teaching and learning can lead to a variety of gradual or more radical digital transformations, operating at multiple scales and with multiple potential positive or negative effects. This framework helps put into focus the key question of how to go about searching for a flexible set of "Nordic characteristics" that might affect digitalisation of teaching and learning in the Nordic region, albeit in uneven and diverse ways. While it is too early to provide a systematic analysis of the impact of the rapid digitalisation of Nordic HE teaching and learning spurred by the Covid-19 pandemic, we make some preliminary observations that offer this emerging theoretical framework as a way to assess these trends both before and after the pandemic.

In most Western countries, a compulsory education system plays a key role in societal integration. This article discusses how the Norwegian model of education, its values base and religious education, contribute to integration in the broad sense. Approximately 98 per cent of all children between the ages of six and sixteen participate in a common, compulsory and public course of education regulated by a curriculum
approved by the parliament. Both the schools’ values base and the obligatory subject of religious education are best understood as contributions to integration in contemporary Norwegian society that is characterised by secularisation and disintegration of the Christian hegemony on the one hand, and by the emergence of cultural and religious diversity on the other. In this case, secularism is identified not with distance from religion but with equity towards religions, in education and in society, based on the assumption that everyone can unite around human rights, regardless of religious or cultural affiliation.

To assess oral health and oral health associated factors in 12-year-olds and to establish determinants explaining variation in oral health among children representing two areas in the Barents region - Arkhangelsk in North-West Russia and Tromsø in Northern Norway. The samples consisted of Russian (N=590) and Norwegian (N=264) 12-year-olds and their parents selected according to stratified one-stage cluster design. The study included clinical examination (children) and self-reports (children and parents). The child&#39;s oral health was recorded under field conditions. Statistical analyses were conducted on pooled samples of subjects. The mean DMFT/S-scores were 3.0/4.4 for the Russian and 1.2/1.5 for the Norwegian children (p&lt;0.001). In multiple logistic regressions, country of origin (OR=3.8) and filling obtained during last dental visit (OR=5.0) were showing the strongest association with child&#39;s dental caries (χ(2)=87; p&lt;0.001). Among parent&#39;s variables showing the ...

Background and purpose: Studies on the comorbidity of migraine and epilepsy have shown conflicting results. We wanted to explore the epidemiological association between migraine and seizure disorders in a population-based material where case ascertainment was enhanced by individual specialist assessments. Methods: Information concerning migraine and seizure disorders was collected from 1793 participants in an interviewbased survey in a circumscribed community. Mixed headache, with features both of migraine without aura and tension-type headache, was excluded from further analyses because of its ambiguous character (n = 137). Thus, data from 1656 participants were included in the study. Results: The number of subjects with epilepsy was small, and a statistically significant association between migraine and the diagnosis of epilepsy was not found. There was a tendency to more active epilepsy in subjects with migraine (1.0%, 5/524), particularly for migraine with aura (1.8%, 3/168), compared with subjects without migraine (0.5%, 6/1132). Migraine was present in five of 11 subjects with active epilepsy (45%) and in four of 28 (14%) with epilepsy in remission (P = 0.09). Conclusions: An overall association between migraine and seizure disorders could not be demonstrated, but there was a tendency to more migraine in individuals with active epilepsy.

The purpose was to examine cigarette smoking, use of snus, alcohol, and performance-enhancing illicit drugs among adolescent elite athletes and controls, and possible gender and sport group differences. First-year students at 16 Norwegian Elite Sport High Schools (n = 677) and two randomly selected high schools (controls, n = 421) were invited to participate. Totally, 602 athletes (89%) and 354 (84%) controls completed the questionnaire. More controls than athletes were smoking, using snus, and drinking alcohol. Competing in team sports was associated with use of snus [odds ratio = 2.8, 95% confidence interval (CI) 1.6 to 4.7] and a similar percentage of male and female handball (22.2% vs 18.8%) and soccer players (15.7% vs 15.0%) reported using snus. For controls, not participating in organized sport was a predictor for smoking (odds ratio = 4.9, 95% CI 2.2 to 10.9). Female athletes were more prone to drink alcohol than males (46.3% vs 31.0%, P < 0.001). Only, 1.2% athletes and 2.8% controls reported use of performance-enhancing illicit drugs. In conclusion, use of legal drugs is less common among athletes, but this relationship depends on type of sport and competition level. The association between team sports and use of snus suggests that sport subcultures play a role.

We used marine phytoplankton from mesocosms seeded with different zooplankton densities to study the impact of mesozooplankton on phytoplankton nutrient limitation. After 7 d of grazing (copepod mesocosms) or 9 d (appendicularian mesocosms) phytoplankton nutrient limitation was studied by enrichment bioassays. After removal of mesozooplankton, bioassay bottles received either no nutrients, phosphorus or nitrogen alone, or a combination of nitrogen and phosphorus and were incubated for 2 d. Phytoplankton reproductive rates in the bottles without nutrient addition were calculated after correction for grazing by ciliates and indicated increasing nitrogen limitation with increasing copepod abundance. No nutrient limitation was found in the appendicularian mesocosms. The increase of nutrient limitation with increasing copepod density seems to be mainly the result of a trophic cascade effect: Copepods released nanoplankton from ciliate grazing pressure, and thereby enhanced nitrogen exhaustion by nanophytoplankton and reduced nitrogen excretion by ciliates. Nitrogen sequestration in copepod biomass, the mechanism predicted by the ecological stoichiometry theory, seems to have been a weaker effect because there was only little copepod growth during the experiment.

It is difficult to put research findings into clinical practice by either guidelines or prescription feedback. To study the effect on the quality of prescribing by a combined intervention of providing individual feedback and deriving quality criteria using guideline recommendations in peer review groups. 199 general practitioners in 32 groups were randomised to participate in peer review meetings related to either asthma or urinary tract infections. The dispensing by the participating doctors of antiasthmatic drugs and antibiotics during the year before the intervention period provided the basis for prescription feedback. The intervention feedback was designed to describe the treatment given in relation to recommendations in the national guidelines. In each group the doctors agreed on quality criteria for their own treatment of the corresponding diseases based on these recommendations. Comparison of their prescription feedback with their own quality criteria gave each doctor the pro...

Aim: The aim of this paper is to explore Norwegian health workers' experiences from cross-cultural patient encounters, and how they understand and enact their role when meeting patients with Pakistani background to whom they give dietary advice related to type 2 diabetes. Methods: Qualitative in-depth interviews have been performed with six hospital dietitians and six general practitioners in Oslo. Results: The health workers consider themselves to be patient-centred and stress the importance of the two dimensions, empathy and equality. However, they often experience that patients want them to be more authoritarian, a way of acting that would be totally in disagreement with their convictions, although some occasionally do adopt an authoritarian style. More striking is that some health workers' moral engagement to involve and empower patients actually leads them to be authoritarian. For others, a fear of insulting the patient results in their advice being too diffuse. Conclusions: A possible explanation for such ways of responding to the patient may be that the health workers, in their articulation of patient-centredness, draw on a repertoire of social conduct that involves an effort to level out, or tacitly deny, hierarchic structures, and that this becomes more pronounced in cross-cultural encounters. Patient-centredness and empowerment are results of long ongoing processes in Western countries, based on ideals of equality and individual freedom. The results from this study indicate that these approaches may pose intricate dilemmas for the health workers in their cross-cultural encounters, and need further attention.

An inverse association between allergic conditions and glioma risk has been reported previously. In this large population-based case-control study, the authors identified cases diagnosed with glioma or meningioma in Denmark, Norway, Finland, Sweden, and southeast England between 2000 and. Detailed information on self-reported physician-diagnosed allergic conditions was collected from 1,527 glioma cases, 1,210 meningioma cases, and 3,309 randomly selected controls. Logistic regression showed an odds ratio of 0.70 (95% confidence interval: 0.61, 0.80) for glioma associated with a diagnosis of any of asthma, hay fever, eczema, or other type of allergy. The risk estimates for glioma were around 0.65 for each allergic condition (asthma, eczema, hay fever, and food allergy), and the 95% confidence intervals were equally consistent, at around 0.55, 0.80. The reduced risks of glioma related to eczema, hay fever, and allergy overall, but not asthma, were confined to current rather than past conditions. Meningioma risk was not associated with allergic conditions, except for eczema (odds ratio ¼ 0.74, 95% confidence interval: 0.60, 0.91). Our results show a reduced risk for glioma associated primarily with current allergic conditions. If this is etiologic, it has implications for the understanding of how allergic conditions might reduce the tumor risk.

To document the oral health status, to study oral health determinants and oral health-related quality of life among 12-year-olds from the Barents Euro-Arctic Region. The study was conducted in Severodvinsk (North-West Russia) and Tromsø (Northern Norway). Two schools representing each region were selected and all 12-year-old pupils having obtained their parents&#39; written consent were included (Severodvinsk n=48, Tromsø n=36). Background factors were collected by questionnaires. Oral health conditions, i.e. caries (DMFT/S), oral hygiene (OHI-S) and satisfaction with their own dental appearance were recorded under field conditions and possible associations between background factors and the children&#39;s oral health status were studied. Oral health was better among Norwegian than Russian participants. The most important factors explaining variation in oral health were country of origin and treatment (filling/no filling) received at the last dental visit. Among parental factors, ed...

The source characteristics of biosonar signals from sympatric killer whales and long-finned pilot whales in a Norwegian fjord were compared. A total of 137 pilot whale and more than 2000 killer whale echolocation clicks were recorded using a linear four-hydrophone array. Of these, 20 pilot whale clicks and 28 killer whale clicks were categorized as being recorded on-axis. The clicks of pilot whales had a mean apparent source level of 196 dB re 1 lPa pp and those of killer whales 203 dB re 1 lPa pp. The duration of pilot whale clicks was significantly shorter (23 ls, S.E. ¼ 1.3) and the centroid frequency significantly higher (55 kHz, S.E. ¼ 2.1) than killer whale clicks (duration: 41 ls, S.E. ¼ 2.6; centroid frequency: 32 kHz, S.E. ¼ 1.5). The rate of increase in the accumulated energy as a function of time also differed between clicks from the two species. The differences in duration, frequency, and energy distribution may have a potential to allow for the distinction between pilot and killer whale clicks when using automated detection routines for acoustic monitoring.

Several studies have illustrated the importance of social support and social networks for persons with mental health problems. Social networks may mean a reduced need for professional services, but also help to facilitate access to professional help. The interplay between social networks and professional services is complicated and invites further investigation. Compare aspects of clients' experiences with social networks to experiences with professional services and learn about the relationship between network resources and help from the public health service system. Quantitative analyses of a sample of 850 informants. Supportive networks exist for a majority of the informants and can also be a substitute for public/professional services in many respects. Regarding help to recover, social networks may offer qualities equal to those of professional services. Furthermore, there is a positive relationship between trust in a social network and trust in public professional services. Trust in a social network also increases the probability of achieving positive experiences with professional services. Our findings imply that more network qualities should be included in professional services, and also that professionals should assist vulnerable groups in building networks.

Sustainable management of contaminated sediments requires careful prioritization of available resources and focuses on efforts to optimize decisions that consider environmental, economic, and societal aspects simultaneously. This may be achieved by combining different analytical approaches such as risk analysis (RA), life cycle analysis (LCA), multicriteria decision analysis (MCDA), and economic valuation methods. We propose the use of stochastic MCDA based on outranking algorithms to implement integrative sustainability strategies for sediment management. In this paper we use the method to select the best sediment management alternatives for the dibenzo-pdioxin and -furan (PCDD/F) contaminated Grenland fjord in Norway. In the analysis, the benefits of health risk reductions and socio-economic benefits from removing seafood health advisories are evaluated against the detriments of remedial costs and life cycle environmental impacts. A value-plural based weighing of criteria is compared to criteria weights mimicking traditional cost−effectiveness (CEA) and cost−benefit (CBA) analyses. Capping highly contaminated areas in the inner or outer fjord is identified as the most preferable remediation alternative under all criteria schemes and the results are confirmed by a probabilistic sensitivity analysis. The proposed methodology can serve as a flexible framework for future decision support and can be a step toward more sustainable decision making for contaminated sediment management. It may be applicable to the broader field of ecosystem restoration for trade-off analysis between ecosystem services and restoration costs.