Health at age 17 in Norwegian adolescents: Mental and physical status in the national cohort born in 2001.

AIMS: We present self-reported data on physical and mental health at age 17 years from 82% of Norwegians born in 2001. METHODS: In Norway, the Armed Forces require that each resident who reaches the age of 17 years completes a self-administered declaration of health that is used for military selection. The declaration collects information on height and weight, various clinically diagnosed diseases, mental and behavioural disorders, and other health conditions where clinical diagnosis is not required. In 2018, there were 65,913 adolescents born in 2001 living in Norway, of whom 10,223 were exempt from completing the declaration; declarations were therefore sent to 55,690 participants. We included 54,132 participants who completed the declaration (response rate 97.2%): 27,220 male and 26,912 female respondents. RESULTS: We found that 18% of male and 28% of female respondents reported at least one clinically diagnosed disease, mental disorder or behavioural disorder. Among health condition where clinical diagnosis was not required, 19% of male and 37% of female respondents reported anxiety/depression affecting daily life and 10 versus 18% reported migraines/recurring headaches. The respondents probably represent the healthiest part of the total cohort of 17-year-old Norwegians because those who are exempt from completing the declaration are already considered unfit for military service. CONCLUSIONS: These data represent a rich resource for further research. Similar data exist for the birth cohorts in 1993-2003. We encourage further research that can help decision-makers identify areas of concern that should be targeted for interventions.

Temporal trends in the healthy soldier effect in a cohort of Royal Norwegian Navy servicemen followed for 67 years.

OBJECTIVES: To investigate temporal trends in the 'healthy soldier effect' (HSE) among 28 300 Royal Norwegian Navy servicemen who served during 1950-2004. METHODS: Standardised mortality ratios (SMRs) for all causes, diseases and external causes were calculated from national rates for the entire study period (1951-2017), and for seven successive follow-up periods after the first recorded day of Naval service, for the overall cohort and for two subgroups: land-based personnel and vessel crews. Poisson regression, expressed as rate ratios, was used to compare all-cause mortality between the subgroups. RESULTS: In the overall cohort, SMRs for all-cause mortality increased steadily during the first six 10-year follow-up periods, from 0.52 to 0.94, which was still lower than national rates. After 60 years, the lower mortality compared with national rates was no longer statistically significant (SMR=0.93). Low non-neoplastic disease mortality contributed most to the longevity of the HSE. For neoplastic diseases, there was a mortality deficit only for the first and third 10-year follow-up periods. External-cause mortality rose to national rates after 40 years. An HSE was present among vessel crews, but their total mortality rate was 24% higher than that among land-based personnel, who also showed a longer-lasting HSE. CONCLUSIONS: The HSE eroded gradually over time but was still present at 60 years of follow-up for all-cause mortality. The effect was strongest and most long-lived for non-neoplastic disease, lasted up to 40 years for external causes, and was relatively short for cancers. Land-based personnel showed stronger and longer-lasting HSE than vessel crews.

Asymptomatic COVID-19 with ambiguous test results. / Asymptomatisk covid-19 med usikre testresultater.

BACKGROUND: Testing for SARS-CoV-2 using polymerase chain reaction (PCR) and SARS-CoV-2 antibody tests is a significant part of the effort to combat the COVID-19 pandemic. Mass testing of healthy individuals raises several issues, however, and the results can be challenging to interpret. CASE PRESENTATION: A healthy 19-year-old man entered the military after two weeks of quarantine. The recruit had no respiratory symptoms or fever before, during or after his enrolment, and no history of SARS-CoV-2 exposure. At enrolment, he had a positive rapid test and a venous blood sample showed antibodies against SARS-CoV-2. PCR tests of specimens obtained from the upper respiratory tract were negative at enrolment and at week three, but were positive at week six. INTERPRETATION: The overall assessment of all the tests indicates a probable asymptomatic infection. This case report illustrates the challenge of interpreting screening results in asymptomatic individuals.

Frostbite in the Norwegian Armed Forces. / Frostskader i Forsvaret.

BAKGRUNN: Det finnes lite forskning på forekomst av frostskader, både sivilt og militært. Prognosen og tidsforløpet ved slike skader har ikke tidligere vært undersøkt i større kohorter. MATERIALE OG METODE: Deltagerne var personer registrert i Forsvarets helseregister med kulde- og frostskade i tidsrommet 1.1.2010-31.12.2014. Data om diagnostikk, forløp og behandling ble innhentet fra i alt 460 personer ved hjelp av et spørreskjema. Svarprosenten på undersøkelsen var 66. RESULTATER: 397 av 460 personer (86,3 %) som var registrert med frostskade i Forsvarets helseregister bekreftet at de hadde hatt en kulde- og frostskade. 123 av 397 personene som svarte (30,1 %) anga at de hadde hatt blemmer, noe som gir mistanke om at de hadde pådratt seg annengrads frostskade. 225 av 397 (56,7 %) anga at de hadde hatt frostskade, men ikke blemmer. De aller fleste fikk frostskaden under feltøvelse/vinterøvelse (81,1 %), og ⅔ av de som pådro seg skader var vernepliktige. Langt de fleste hadde skader på fingre/hender eller tær/føtter (96,0 %). To av tre (69,8 %) hadde fortsatt plager fra sin frostskade mer enn to år etter skadetidspunktet. FORTOLKNING: Mange i militæret pådrar seg frostskader under tjenestegjøring. En femdel anga kroniske helseplager som påvirker arbeidsevnen. Kunnskap om forekomsten av frostskader hos militært mannskap er viktig for Forsvarets videre skadeforebyggende arbeid.

External-cause mortality among 21 609 Norwegian male military peacekeepers deployed to Lebanon between 1978 and 1998.

OBJECTIVE: To investigate external-cause mortality among 21 609 Norwegian male military peacekeepers deployed to Lebanon during 1978-1998. METHODS: The cohort was followed from the 1st day of deployment through 2013, and mortality during deployment and post discharge was assessed using SMRs calculated from national rates in Norway. Poisson regression was used to see the effect of high-conflict versus low-conflict exposure. RESULTS: For the total cohort, external-cause mortality was within expected values during deployment (SMR=0.80) and post discharge (SMR=1.05). In the low-conflict exposure group, a lower mortality from all external causes (SMR=0.77), transport accidents (SMR=0.55) and accidental poisoning (SMR=0.53) was seen. The high-conflict exposure group showed an elevated mortality from all external causes (SMR=1.20), transport accidents (SMR=1.51) and suicide (SMR=1.30), but these risks were elevated only during the first 5 years after discharge. This group also showed elevated mortality from all external causes (rate ratio, RR=1.49), and for transport accidents (RR=3.30) when compared with the low-conflict exposure group. CONCLUSIONS: Overall external-cause mortality among our peacekeepers was equal to national rates during deployment and post discharge. High-conflict exposure was associated with elevated mortality from all external causes, transport accidents and suicide during the first 5 years after discharge from service.

Cause-Specific Mortality Among Norwegian Veterans Deployed to Afghanistan Between 2001 and 2019.

INTRODUCTION: Norwegian military forces participated in the military campaign Operation Enduring Freedom in Afghanistan starting in 2001. Military personnel often show a "healthy soldier effect" in terms of lowered all-cause mortality when compared to the general population. However, military service in conflict areas is associated with an increased risk of death from external causes such as transport accidents and suicide after discharge. We aimed to investigate cause-specific mortality in a cohort of 9,192 Norwegian (7.5% women) veterans deployed to Afghanistan between 2001 and 2019. MATERIALS AND METHODS: We followed cohort members from their first day of service in Afghanistan through 2019. We computed standardized mortality ratios (SMRs) with 95% CIs by comparing the observed number of deaths in our cohort with the expected number of deaths in the general population. Standardized mortality ratios were calculated for the full follow-up period among men and women separately, and among men only for two time periods: during deployment and after discharge from service in Afghanistan. RESULTS: We observed 77 deaths (3 women and 74 men), 10 of which occurred during deployment (war casualties, 1 woman and 9 men); all others occurred after discharge. All-cause mortality in women did not differ from that in the general population (SMR = 0.52, 95% CI 0.11-1.53). For men, the observed all-cause mortality was lower than the expected rate for the full follow-up period (SMR = 0.55, 95% CI 0.43-0.69), during deployment, and after discharge, while deaths because of transport accidents after discharge (13 cases) were more than twice as high as expected rates (SMR = 2.36, 95% CI 1.26-4.04). The 11 observed suicides gave a nonstatistically significant, lower suicide risk compared to the expected rates (SMR = 0.66, 95% CI 0.33-1.18). CONCLUSION: In accordance with the "healthy soldier effect," military service in Afghanistan was generally associated with a lower than expected risk of death both during deployment and after discharge. The risk of death from transport accidents was higher than expected after discharge, while the observed incidence of suicide did not differ from the expected rate in the general population.

Yersinia enterocolitica: A Follow-up of the Outbreak in the Norwegian Armed Forces in 2014.

INTRODUCTION: In the spring of 2014, there was an outbreak of Yersinia enterocolitica (YE) gastroenteritis in four Norwegian military camps-the largest outbreak ever reported in Norway. YE is usually transmitted via food, and the gastrointestinal disease caused by the bacterium is considered a public health problem in several countries. Common symptoms of YE gastroenteritis are abdominal pain, diarrhea, fever, nausea, and vomiting. Post-infectious complications can occur after YE gastroenteritis, the most common of which are erythema nodosum and reactive arthritis. Based on self-reported data, we describe the duration of illness, the duration of any absence from service, and the incidence of symptoms of post-infectious complications in two groups of servicepeople: one diagnosed with YE gastroenteritis and the other with an unspecified acute infectious gastroenteritis. MATERIALS AND METHODS: The Norwegian Armed Forces Health Register (NAFHR) is a central health register that contains data from conscripts and from military and civilian personnel in the Norwegian Armed Forces. In this study, we identified all individuals with a diagnosis of YE gastroenteritis in the NAFHR in the period from January 1 to June 30, 2014 (n = 128) as well as all those with a diagnosis of an unspecified acute infectious gastroenteritis in the same period (n = 323) to participate as controls. In October 2018, a link to an internet-based questionnaire was distributed by e-mail to all identified individuals. The questionnaires collected data on the duration of illness, the duration of absence from service, and the incidence of symptoms of post-infectious complications. RESULTS: Of all those who received the questionnaire, 72 (59%) were included in the YE group and 117 people (36%) were included in the control group. Half of those in the YE group were ill for more than 13 days, while almost all (90%) of those in the control group recovered after 1 week. There were no differences between the groups in the incidence of symptoms of post-infectious complications during the 6 weeks after recovery. There was a significantly larger proportion of officers than conscripts in the YE group who reported symptoms of post-infectious complications. None of the respondents reported symptoms of post-infectious complications in the 6 months after the termination of military service. CONCLUSION: One strength of this study is that we were able to investigate a large outbreak of YE gastroenteritis in a group of individuals with good underlying health. Weaknesses are the low response rate, especially in the control group, and the fact that we sent out the questionnaire >4 years after the acute gastroenteritis occurred. YE gastroenteritis among personnel in the Norwegian Armed Forces was associated with a significantly longer duration of illness and a longer duration of absence from service than that resulting from an unspecified acute infectious gastroenteritis. However, YE gastroenteritis was not associated with more symptoms of post-infectious complications.

Severe acute respiratory syndrome coronavirus 2 prevalence in 1170 asymptomatic Norwegian conscripts.

BACKGROUND: Accurate estimates of SARS-CoV-2 infection in different population groups are important for the health authorities. In Norway, public infection control measures have successfully curbed the pandemic. However, military training and service are incompatible with these measures; therefore extended infection control measures were implemented in the Norwegian Armed Forces. We aimed to describe these measures, discuss their value, and investigate the polymerase chain reaction (PCR) prevalence and seroprevalence of SARS-CoV-2, as well as changes in antibody titer levels over the 6-week military training period in a young, asymptomatic population of conscripts. METHODS: In April 2020, 1170 healthy conscripts (median age 20 years) enrolled in military training. Extended infection control measures included a pre-enrollment telephone interview, self-imposed quarantine, questionnaires, and serial SARS-CoV-2 testing. At enrollment, questionnaires were used to collect information on symptoms, and SARS-CoV-2 rapid antibody testing was conducted. Serial SARS-CoV-2 PCR and serology testing were used to estimate the prevalence of confirmed SARS-CoV-2 and monitor titer levels at enrollment, and 3 and 6 weeks thereafter. RESULTS: At enrollment, only 0.2% of conscripts were SARS-CoV-2 PCR-positive, and seroprevalence was 0.6%. Serological titer levels increased nearly 5-fold over the 6-week observation period. Eighteen conscripts reported mild respiratory symptoms during the 2 weeks prior to enrollment (all were PCR-negative; one was serology-positive), whereas 17 conscripts reported respiratory symptoms and nine had fever at enrollment (all were PCR- and serology-negative). CONCLUSIONS: The prevalence of SARS-CoV-2 was less than 1% in our sample of healthy Norwegian conscripts. Testing of asymptomatic conscripts seems of no value in times of low COVID-19 prevalence. SARS-CoV-2 antibody titer levels increased substantially over time in conscripts with mild symptoms.

A 5-Year Continued Follow-up of Cancer Risk and All-Cause Mortality Among Norwegian Military Peacekeepers Deployed to Kosovo During 1999-2016.

INTRODUCTION: In 2012, Norwegian news media reported on cases of brain cancer among Norwegian peacekeeping troops who served in Kosovo, allegedly caused by exposure to depleted uranium fired during airstrikes before the peacekeepers arrived in 1999. A first study followed 6076 military men and women with peacekeeping service in Kosovo during 1999-2011 for cancers and deaths throughout 2011. The study did not support to the idea that peacekeeping service in Kosovo could lead to increased risk of brain cancer or other cancers. However, the average time of follow-up (10.6 years) was rather short for cancer development; therefore the aim of the present study was to evaluate cancer risk and general mortality in an updated cohort after 5 years of additional follow-up. MATERIALS AND METHODS: The updated cohort consisted of 6,159 peacekeepers (5,884 men and 275 women) who served in Kosovo during 1999-2016 and were followed for cancer incidence and mortality from all causes combined throughout 2016. We calculated standardized incidence ratios (SIR) for cancer and standardized mortality ratios (SMR) from national population rates. Poisson regression was used to assess the effect of length of service (<1 year vs. ≥1 year) on cancer risk. RESULTS: We observed 149 cancer cases and 75 deaths in the updated cohort. Observed cancer incidence did not exceed national rates. In men, the SIR for brain cancer was 0.73 (95% confidence interval (CI) 0.32-1.44), based on eight cases, while the risk of colon cancer was lowered (SIR = 0.14, 95% CI 0.00-0.79). The Poisson regression showed no effect of service duration on all-site cancer incidence. Mortality from all causes combined was lower than expected (SMR = 0.62, 95% CI 0.49-0.78) and in accordance with a "healthy soldier effect". CONCLUSION: The extended follow-up did not give support to the suggestion that peacekeeping service in Kosovo could lead to increased risk of cancer.

Cancer incidence and all-cause mortality among civilian men and women employed by the Royal Norwegian Navy between 1950 and 2005.

OBJECTIVE: We aimed to investigate cancer incidence and all-cause mortality in a cohort of 8358 civilians (5134 men and 3224 women) employed by the Royal Norwegian Navy at any time between 1950 and 2005. METHODS: The cohort was followed for cancer incidence and all-cause mortality from 1960 through 2015. Standardised incidence ratios (SIR) and mortality ratios (SMR) were calculated from national rates. Separate SIRs were calculated for a subgroup of male workshop workers and another of female cleaners. RESULTS: Overall cancer incidence among men was similar to the reference rate; male breast cancer was more frequent (SIR = 3.23). Male workshop workers showed a SIR of 1.77 for stomach cancer, while their incidence of lympho-haematopoietic cancers was half that of the reference rates. Women had increased risks of overall cancer (SIR = 1.11), lung cancer (SIR = 1.35), and ovarian cancer (SIR = 1.39). Female cleaners showed a SIR of 2.33 for bladder cancer and a lowered incidence of brain cancer (SIR = 0.18). In the overall cohort, all-cause mortality was lower than expected for men (SMR = 0.92) and closer to the reference rate for women (SMR = 0.95). CONCLUSION: In men, we observed a lowered all-cause mortality and an excess of stomach cancer in workshop workers. In women, increased risks of overall cancer, lung cancer and ovarian cancer was seen. An increased risk of bladder cancer and a lowered incidence of brain cancer was observed among female cleaners.

Presence of minor and major mental health impairment in adolescence and death from suicide and unintentional injuries/accidents in men: a national longitudinal cohort study.

OBJECTIVE: To examine the association between minor and major mental health impairment in late adolescence and death from suicide and unintentional injuries/accidents in men. METHODS: In Norway, all men attend a compulsory military medical and psychological examination. We included 558 949 men aged 17-19 years at the time of military examination in 1980-1999 and followed them up for death from suicide and unintentional injuries/accidents until the end of 2013. We used Cox proportional hazard models to examine the association between the presence of minor and major mental health impairments at examination and death from suicide and unintentional injuries/accidents. RESULTS: Compared to men with no mental health impairment, those with minor mental health impairment was associated with an increased risk of death from suicide (adjusted HR (HRadj)=1.63, 95% CI 1.39 to 1.92), transport accidents (HRadj=1.33, 95% CI 1.09 to 1.63), accidental poisoning (HRadj=2.27, 95% CI 1.79 to 2.88) and other unintentional injuries/accidents (HRadj=1.54, 95% CI 1.17 to 2.02). In men with major mental health impairment, the risk of death from suicide and accidental poisoning was elevated two times (HRadj=2.29, 95% CI 1.85 to 2.85) and three times (HRadj=3.53, 95% CI 2.61 to 4.79), respectively. CONCLUSIONS: We found an increased risk of death from suicide and unintentional injuries/accidents in men who had minor and major mental health impairment at age 17-19 years.

Introduction of a new instrument to measure motivation for gaming: the electronic gaming motives questionnaire.

AIMS: To adapt the four-dimensional Gambling Motives Questionnaire-Revised (GMQ-R) to measure the motivation for engaging in electronic gaming, and to validate the internal structure and investigate the criterion validity of the new Electronic Gaming Motives Questionnaire (EGMQ). DESIGN AND SETTING: The GMQ-R was adapted to measure motivation for playing video games and the new instrument was tested on a sample of Norwegian conscripts selected randomly from the pool of conscripts who started their military service between 2013 and 2015. PARTICIPANTS: The questionnaire was administered to all those who had played video games during the last 6 months and consisted of 853 gamers (86.8% men, mean age = 19.4 years). MEASUREMENTS: All participants completed the EGMQ, as well as other measures of gaming behaviour, gaming problems, boredom, loneliness and depression. FINDINGS: The confirmatory factor analyses showed that the proposed EGMQ (measuring enhancement, coping, social and self-gratification motives) displayed satisfactory fit and internal consistency. Hierarchical regression analyses showed that gender emerged as a significant predictor (P < 0.001) of all the dependent variables (variety, hours weekly gaming, loss of control and gaming problems) and the first step explained between 1 and 6.1% of the variance in the gaming behaviours. In the second step the four motivational dimensions explained an additional 5.8-38.8% of the variance. Coping and self-gratification predicted gaming problems (P < 0.001) and coping alone predicted loss of control (P < 0.001). The four motivational dimensions were also predicted differentially by indicators of psychosocial wellbeing, indicating divergent validity of the four motives. CONCLUSIONS: The four-dimensional Electronic Gaming Motives Questionnaire is a valid instrument for measuring motives for gaming.

Disease-related mortality among 21,609 Norwegian male military peacekeepers deployed to Lebanon between 1978 and 1998.

PURPOSE: Our study assessed disease-related mortality among Norwegian male military peacekeepers deployed to Lebanon during 1978-1998. METHODS: A total of 21,609 peacekeepers were followed from start of deployment through 2013. Standardized mortality ratios (SMRs) were calculated based on national rates for the overall cohort, by length of time since first deployment to Lebanon, and for service during high- and low-conflict periods. Poisson regression was used to determine the effect of conflict exposure. RESULTS: In the overall cohort, a decreased risk was seen for all-cause mortality (1213 deaths, SMR = 0.85), mortality from neoplasms (SMR = 0.89), and from non-neoplastic diseases (SMR = 0.68). Disease-related mortality was lower during the first 5 years of follow-up, while mortality from external causes was elevated. After 5 years, mortality from neoplasms and external causes were similar to national rates, but mortality from non-neoplastic diseases remained lower. The high-conflict exposure group had a two-fold increased risk of mortality from non-neoplastic diseases (rate ratio = 2.33), including ischemic heart disease (rate ratio = 2.25) compared to the low-conflict exposure group. CONCLUSIONS: We found a "healthy soldier effect" for all-cause mortality and disease-related mortality, but for neoplasms, this effect disappeared after 5 years. Conflict exposure was positively correlated with increased risk of mortality from non-neoplastic diseases.

Cancer incidence and all-cause mortality in a cohort of 21,582 Norwegian military peacekeepers deployed to Lebanon during 1978-1998.

OBJECTIVE: We investigated cancer incidence and all-cause mortality among 21,582 Norwegian male military peacekeepers deployed to Lebanon during 1978-1998. We also looked at cancer risk according to duration of service in Lebanon, in the occupational groups of cooks and mechanics, and the risk of alcohol- and smoking-related cancers among those who served during high- or low-conflict periods. METHODS: The cohort was followed for cancer incidence and all-cause mortality from 1978 through 2012. Standardised incidence ratios (SIR) for cancer and mortality ratios (SMR) were calculated from national rates for the total cohort. SIRs were calculated according to duration of service; among cooks and mechanics; and according to high- and low-conflict exposure. Poisson regression, expressed as rate ratio (RR), was used to see the effect of duration of service, and of conflict exposure. RESULTS: A decreased risk was found for cancer incidence overall (1050 cases, SIR=0.90, 95% confidence interval [CI] 0.84-0.95) and for cancers of the prostate (SIR=0.78) and skin (other than melanoma) (SIR=0.58). The incidence of rectal cancer was 73% higher in those who served for 1 year or more than in those with shorter-term service (RR=1.73, 95% CI 1.00-3.02). The cancer risk in cooks and mechanics was within expected values. The risk of lung cancer was higher in the high-conflict exposure group than in the low-conflict exposure group (RR=1.79; 95% CI 1.00-3.18). In the total cohort, all-cause mortality was lower than expected (SMR=0.83; 95% CI 0.78-0.88). CONCLUSION: We found a "healthy soldier effect" for overall cancer incidence and all-cause mortality. Service during high-conflict periods was associated with a higher risk of lung cancer than service during low-conflict periods, but this risk was in line with that of the reference population.

Cancer risk and all-cause mortality among Norwegian military United Nations peacekeepers deployed to Kosovo between 1999 and 2011.

OBJECTIVE: Media reports of leukaemia and other cancers among European United Nations (UN) peacekeepers who served in the Balkans, and a scientific finding of excess Hodgkin lymphoma among Italian UN peacekeepers who served in Bosnia, suggested a link between cancer incidence and depleted uranium (DU) exposure. This spurred several studies on cancer risk among UN peacekeepers who served in the Balkans. Although these studies turned out to be negative, the debate about possible cancers and other health risks caused by DU exposure continues. The aim of the present study was to investigate cancer incidence and all-cause mortality in a cohort of 6076 (4.4% women) Norwegian military UN peacekeepers deployed to Kosovo between 1999 and 2011. METHODS: The cohort was followed for cancer incidence and mortality from 1999 to 2011. Standardised incidence ratios for cancer (SIR) and mortality ratios (SMR) were calculated from national rates. RESULTS: Sixty-nine cancer cases and 38 deaths were observed during follow-up. Cancer incidence in the cohort was similar to that in the general Norwegian population. No cancers in the overall cohort significantly exceeded incidence rates in the general Norwegian population, but there was an elevated SIR for melanoma of skin in men of 1.90 (95% confidence interval [CI] 0.95-3.40). A fivefold increased incidence of bladder cancer was observed among men who served in Kosovo for ≥ 1 year, based on 2 excess cases (SIR=5.27; 95% CI 1.09-15.4). All-cause mortality was half the expected rate (SMR=0.49; 95% CI 0.35-0.67). CONCLUSION: Our study did not support the suggestion that UN peacekeeping service in Kosovo is associated with increased cancer risk.

Perioperative acupuncture and postoperative acupressure can prevent postoperative vomiting following paediatric tonsillectomy or adenoidectomy: a pragmatic randomised controlled trial.

OBJECTIVE: To investigate the effectiveness of acupuncture and acupressure as supplements to standard treatment for postoperative vomiting in children undergoing tonsillectomy and/or adenoidectomy. METHODS: A pragmatic, open, block-randomised controlled trial. The results were analysed according to the intention-to-treat principle. The study was conducted without extra resources in a normal setting at the day-surgery department of Lovisenberg Diakonale Hospital in Oslo. 154 children with an American Society of Anesthesiologists grade 1-2, weighing at least 10 kg, were included. Children with concomitant gastrointestinal diseases, emesis or antiemetic treatment <24 h preoperatively, rash or local infection over the actual acupuncture points were excluded together with patients whose parents' informed consent could not be obtained. The intervention group received acupuncture at pericardium 6 bilaterally, at a depth of approximately 0.7 cm with a median of 21 min during anaesthesia, followed by acupressure wristbands for 24 h and standard treatment. The control group received standard treatment. The primary end point was the occurrence of vomiting or retching during 24 h postoperatively. RESULTS: Children in the acustimulation group experienced less retching and vomiting than the control group-46.8% versus 66.2% (p=0.015). The effect of acustimulation was specifically pronounced in girls and children aged 1-3 years. CONCLUSION: This trial indicates the effectiveness of acustimulation as an adjunct to standard treatment. The results should encourage and promote the implementation of acustimulation for postoperative vomiting in children undergoing adenoidectomy or tonsillectomy.

The Acupuncture on Hot Flashes Among Menopausal Women study: observational follow-up results at 6 and 12 months.

OBJECTIVE: The previously published Acupuncture on Hot Flashes Among Menopausal Women study compared the effectiveness of individualized acupuncture treatment plus self-care versus self-care alone on hot flashes and health-related quality of life in postmenopausal women. This article reports on the observational follow-up results at 6 and 12 months. METHODS: The Acupuncture on Hot Flashes Among Menopausal Women study was a pragmatic, multicenter randomized controlled trial with two parallel arms, conducted in 2006 to 2007. The 267 participants were postmenopausal women experiencing, on average, 12.6 hot flashes per 24 h. The acupuncture group received 10 individualized acupuncture treatments during 12 weeks and advice on self-care, whereas the control group received only advice on self-care. Hot flash frequency and intensity (0-10 scale) and hours of sleep per night were registered in a diary. Health-related quality of life was assessed by the Women's Health Questionnaire. RESULTS: From baseline to 6 months, the mean reduction in hot flash frequency per 24 hours was 5.3 in the acupuncture group and 5.0 in the control group, a nonsignificant difference of 0.3. At 12 months, the mean reduction in hot flash frequency was 6.0 in the acupuncture group and 5.8 in the control group, a nonsignificant difference of 0.2. Differences in quality-of-life scores were not statistically significant at 6 and 12 months. CONCLUSION: The statistically significant differences between the study groups found at 12 weeks were no longer present at 6 and 12 months. Acupuncture can contribute to a more rapid reduction in vasomotor symptoms and increase in health-related quality of life in postmenopausal women but probably has no long-term effects.

The acupuncture treatment for postmenopausal hot flushes (Acuflash) study: traditional Chinese medicine diagnoses and acupuncture points used, and their relation to the treatment response.

INTRODUCTION: the multicentre, pragmatic, randomised controlled Acuflash study evaluated the effect of traditional Chinese medicine (TCM) acupuncture on postmenopausal vasomotor symptoms and health-related quality of life. It concluded that use of acupuncture in addition to self-care can contribute to a clinically relevant reduction of hot flushes and increased health-related quality of life. This article reports on the TCM syndrome diagnoses and acupuncture points used and their relation to the treatment response, and on treatment reactions and adverse events. METHODS: the acupuncture group (n = 134) received 10 acupuncture treatment sessions and advice on self-care; the control group (n = 133) received advice on self-care only. The study acupuncturists met the current membership criteria of the Norwegian Acupuncture Society, and had at least 3 years' experience of practising TCM acupuncture. They were free to diagnose and select acupuncture points for each participant, after initial discussion. RESULTS: fifty per cent of the participants in the acupuncture group were diagnosed with Kidney Yin Xu as their primary TCM syndrome diagnosis. No statistically significant differences were demonstrated between the syndrome groups regarding the distribution of responders and non-responders, nor regarding the change in health-related quality of life scores. A core of common acupuncture points (SP6, HT6, KI7, KI6, CV4, LU7, LI4, and LR3) were used in all the syndromes, and in addition multiple idiosyncratic points. Core point selection and frequency of use did not differ between responders and non-responders. No serious adverse events were reported. CONCLUSION: factors other than the TCM syndrome diagnoses and the point selection may be of importance regarding the outcome of the treatment.