Euthanasia of animals - association with veterinarians' suicidal thoughts and attitudes towards assisted dying in humans: a nationwide cross-sectional survey (the NORVET study).

BACKGROUND: Veterinarians are an occupational group with an increased suicide risk. Euthanasing animals may influence both veterinarians' views on assisted dying in humans and their suicide risk. We investigated (I) attitudes towards assisted dying, (II) whether the field of work and the frequency of euthanasing animals were associated with positive attitudes towards human euthanasia, and (III) whether frequently euthanasing animals was associated with serious suicidal thoughts. METHODS: We conducted a nationwide cross-sectional study among veterinarians in Norway (response rate: 75%). Logistic regression models were used to calculate the odds ratios for both positive attitudes towards human euthanasia and serious suicidal thoughts. The analyses were adjusted for socio-demographic and work-related factors. RESULTS: Fifty-five percent of the veterinarians agreed that euthanasia should be permitted for humans with a fatal disease and short life expectancy. Working with companion animals was independently associated with positive attitudes towards human euthanasia (OR = 1.66 (95% CI: 1.23-2.23)), while veterinarians' frequency of euthanasing animals was not. Frequency of euthanasing animals was independently associated with serious suicidal thoughts, OR = 2.56 (95% CI: 1.35-4.87). CONCLUSIONS: Veterinarians' attitudes towards assisted dying in humans did not differ from those of the general population. Veterinarians' frequency of euthanasing animals was not associated with positive attitudes towards euthanasia in humans. However, veterinarians working in companion animal practices were more likely to have positive attitudes towards euthanasia in humans. Moreover, euthanising animals five times or more a week was associated with serious suicidal thoughts. We need more research to infer about causality in these findings.

Burnout among intensive care nurses, physicians and leaders during the COVID-19 pandemic: A national longitudinal study.

BACKGROUND: Burnout is frequent among intensive care unit (ICU) healthcare professionals and may result in medical errors and absenteeism. The COVID-19 pandemic caused additional strain during working hours and also affected off-duty life. The aims of this study were to survey burnout levels among ICU healthcare professionals during the first year of COVID-19, describe those who reported burnout, and analyse demographic and work-related factors associated with burnout. METHODS: This was a national prospective longitudinal cohort study of 484 nurses, physicians and leaders working in intensive care units with COVID-19 patients in Norway. Burnout was measured at 6- and 12-month follow-up, after a registration of baseline data during the first months of the COVID epidemic. The Copenhagen Burnout Inventory (CBI), was used (range 0-100), burnout caseness defined as CBI ≥50. Bi- and multivariable logistic regression analyses were performed to examine baseline demographic variables and work-related factors associated with burnout caseness at 12 months. RESULTS: At 6 months, the median CBI score was 17, increasing to 21 at 12 months (p = .037), with nurses accounting for most of the increase. Thirty-two per cent had an increase in score of more than 5, whereas 25% had a decrease of more than 5. Ten per cent reported caseness of burnout at 6 months and 14% at 12 months (n.s.). The participants with burnout caseness were of significantly lower age, had fewer years of experience, reported more previous anxiety and/or depression, more moral distress, less perceived hospital recognition, and more fear of infection in the bivariate analyses. Burnout was the single standing most reported type of psychological distress, and 24 out of 41 (59%) with burnout caseness also reported caseness of anxiety, depression and/or post-traumatic stress disorder (PTSD) symptoms. Multivariate analysis showed statistically significant associations of burnout caseness with fewer years of professional experience (p = .041) and borderline significance of perceived support by leader (p = .049). CONCLUSION: In Norway, a minority of ICU nurses, physicians and leaders reported burnout 1 year into the pandemic. A majority of those with burnout reported anxiety, depression and/or PTSD symptoms combined. Burnout was associated with less years of professional experience.

Professional help-seeking behaviour for mental health problems among veterinarians in Norway: a nationwide, cross-sectional study (The NORVET study).

BACKGROUND: Veterinarians have a relatively high prevalence of mental health problems; however, research on professional help-seeking is limited. The main purpose of the present study was to investigate the prevalence of mental health problems and professional help-seeking behaviour for such problems, and the independent factors associated with help-seeking behaviour among veterinarians in Norway. METHOD: This cross-sectional study included all veterinarians in Norway (response rate 75%, 70% women). Logistic regression was used to calculate odds ratios (OR) for professional help-seeking for mental health problems. Analyses were controlled for socio-demographic, individual (personality trait reality weakness, SCL-5, attitudes toward mental illness), and work-related factors (work field, job stress). RESULTS: The prevalence of self-reported mental health problems in need of treatment was 30% (746/2494), significantly higher among women than men (36% vs. 15%). Fifty-four percent had sought professional help, women significantly more often (56%) than men (41%). Among veterinarians with serious suicidal thoughts, 50% (69/139) had sought help. Veterinarians most frequently related mental health problems to work problems (47%), women significantly more often (49%) than men (34%). Factors significantly associated with help-seeking were being female, OR = 2.11 (95% CI: 1.24-3.60), working with production animals, OR = 0.35 (0.13-0.98), public administration, OR = 2.27 (1.15-4.45), academia/research, OR = 4.78 (1.99-11.47) or 'other' fields, OR = 2.79 (1.23-6.32), and attitudes toward mental illness, OR = 1.32 (1.03-1.68). CONCLUSIONS: Thirty percent of veterinarians in Norway reported mental health problems in need of treatment, and only half of them had sought professional help. A low degree of help-seeking was also seen among those with serious suicidal thoughts. Being female, positive attitudes toward treatment of mental illness, working in public administration, academia/research and 'other' field were associated with more help-seeking, while working in production animal practice was associated with less help-seeking. Interventions to increase help-seeking behaviour for mental health problems among veterinarians are warranted.

Psychoactive substances in natural and unnatural deaths in Norway and Sweden - a study on victims of suicide and accidents compared with natural deaths in psychiatric patients.

BACKGROUND: The extent of post-mortem detection of specific psychoactive drugs may differ between countries, and may greatly influence the national death register's classification of manner and cause of death. The main objective of the present study was to analyse the magnitude and pattern of post-mortem detection of various psychoactive substances by the manner of death (suicide, accidental, undetermined and natural death with a psychiatric diagnosis) in Norway and Sweden. METHODS: The Cause of Death Registers in Norway and Sweden provided data on 600 deaths in 2008 from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of death and 200 as natural deaths in individuals with a diagnosis of mental disorder as the underlying cause of death. We examined death certificates and forensic reports including toxicological analyses. RESULTS: The detection of psychoactive substances was commonly reported in suicides (66 and 74% in Norway and Sweden respectively), accidents (85 and 66%), undetermined manner of deaths (80% in the Swedish dataset) and in natural deaths with a psychiatric diagnosis (50 and 53%). Ethanol was the most commonly reported substance in the three manners of death, except from opioids being more common in accidental deaths in the Norwegian dataset. In cases of suicide by poisoning, benzodiazepines and z-drugs were the most common substances in both countries. Heroin or morphine was the most commonly reported substance in cases of accidental death by poisoning in the Norwegian dataset, while other opioids dominated the Swedish dataset. Anti-depressants were found in 22% of the suicide cases in the Norwegian dataset and in 29% of suicide cases in the Swedish dataset. CONCLUSIONS: Psychoactive substances were detected in 66 and 74% of suicides and in 85 and 66% of accidental deaths in the Norwegian and Swedish datasets, respectively. Apart from a higher detection rate of heroin in deaths by accident in Norway than in Sweden, the pattern of detected psychoactive substances was similar in the two countries. Assessment of a suicidal motive may be hampered by the common use of psychoactive substances in suicide victims.

Ragnhild Vogt Hauge - psychiatrist, pioneer and member of the Norwegian Nazi party. / Ragnhild Vogt Hauge ­ psykiater, pioner og NS-medlem.

BACKGROUND: Ragnhild Vogt Hauge (1890-1987) was Norway's first woman psychiatrist, but has today been almost forgotten. In this article we present her biography, medical background and work as a doctor. MATERIAL AND METHOD: We have searched through the Retriever media archive, the digital archives of the National Library and the Aftenposten daily, as well as in the following files in the National Archives of Norway: the legal purge of World War II collaborators and the files of the State Police, the Norwegian Medical Association and the Directorate of Health. RESULTS: After her mother's early death in 1908, Ragnhild Vogt cared for her younger siblings and took her mother's place. These family responsibilities caused her education to be delayed, and she did not graduate from her medical studies in Oslo until the age of 35, in 1925. In 1931, she became the first woman in Norway to be authorised as a psychiatrist. She later worked also as a forensic psychiatrist. In 1934 she married and settled in Arendal, where she continued practising until the end of her career. In the years 1941-45 she was a member of Nasjonal Samling, the Norwegian Nazi party, and was convicted of treason after the war. INTERPRETATION: There can be many reasons why the name of Ragnhild Vogt Hauge has been almost forgotten. She worked on the periphery and combined her practice as a psychiatrist with that of a GP. Most likely, her membership in Nasjonal Samling during the war has also played a role. The sources testify to a kind-hearted Christian doctor.

Roar Strøm - the Norwegian surgeon who was three years ahead of Zollinger and Ellison. / Roar Strøm ­ kirurgen som kom Zollinger og Ellison i forkjøpet.

BACKGROUND: In 1952, Norwegian surgeon Roar Strøm (1903-58) published the medical history of a 32-year-old man with recurrent peptic ulcer disease and a pancreatic tumour. Three years later, two American surgeons described a similar condition and, only the following year, the condition was named after them: Zollinger-Ellison syndrome. Strøm's contribution has gone remarkably unrecognised. This article aims to highlight his professional achievements. MATERIAL AND METHOD: We searched archives and reference databases for information on Roar Strøm. RESULTS: Roar Strøm grew up in Oslo, where he graduated with a medical degree in 1926, at just 23 years of age. Strøm pursued a focused career in surgery: specialist in surgery in 1935, medical doctorate in 1942, and senior consultant in surgery at Rogaland Hospital in Stavanger over the period 1945-1956. While in Stavanger, he published the extensive case history in Acta Chirurgica Scandinavica. The patient had a multi-year medical history of peptic ulcers, for which he had undergone surgery twice previously before being operated on by Strøm in the spring of 1951. The man died two years after the last operation. INTERPRETATION: Neither Strøm nor Zollinger and Ellison were the first to identify this clinical condition as a new disease entity. But Strøm's article was an important contribution to the early literature on the syndrome.

Augusta Rasmussen - psychiatrist, pioneer and the scientific truths of the time. / Augusta Rasmussen ­ psykiater, pioner og tidens vitenskapelige sannheter.

In 1934, senior registrar Augusta Rasmussen (1895­1979) published a study of 77 cases involving sexual offences. She found that the women involved had suffered no mental injury from the abuse. In 1947, she published a study of the intelligence level of 310 Norwegian women who had formed relationships with German soldiers during the occupation. She found that nearly all of them were more or less retarded. Her conclusions, however, were not scientifically valid. Here we present Rasmussen's biography, academic background and scientific activity.

Always stay cheerful - health information in the 1920s. / Vær alltid i godt humør ­ helseopplysning i 1920-årene.

BACKGROUND: The interwar period was a time of comprehensive preventive health programmes in Norway. Physical exercise, nutritious diets, strict sleep regimens and better hygiene were at the centre of these efforts. A massive mobilisation of volunteers and professionals took place. The publication of House Maxims for Mothers and Children was part of this large-scale mobilisation, and consisted of ten posters with pithy health advice for hanging on the wall. Mothers were an important target group for health promotion. MATERIAL AND METHOD: The posters have previously received little attention in medical literature, but they can elucidate some features of life and the health propaganda of their time. We have used databases that provide access to newspapers, books and medical literature: Retriever, bokhylla.no, Oria, PubMed and Web of Science. RESULTS: It is hard to quantify the effect of this popular movement when compared to political measures to improve living conditions. In any case, mortality rates fell, life expectancy increased and the dreaded communicable diseases were largely defeated. Special efforts were targeted at children, also with good results. Infant mortality fell and schoolchildren became healthier, stronger, taller and cleaner. INTERPRETATION: The line between social hygiene and general disciplining is blurred, for example the boundary between a healthy diet and bourgeois norms. The education of mothers and children also included a normative aspect that concerned good manners and control.

The fair-haired giant. / Den blonde kjempe.

The much-loved fictional character of Jonas Fjeld is a heroic surgeon. But who was he modelled on? It may have been Dr. Tandberg at Lillehammer.

Accidents and undetermined deaths: re-evaluation of nationwide samples from the Scandinavian countries.

BACKGROUND: National mortality statistics should be comparable between countries that use the World Health Organization's International Classification of Diseases. Distinguishing between manners of death, especially suicides and accidents, is a challenge. Knowledge about accidents is important in prevention of both accidents and suicides. The aim of the present study was to assess the reliability of classifying deaths as accidents and undetermined manner of deaths in the three Scandinavian countries and to compare cross-national differences. METHODS: The cause of death registers in Norway, Sweden and Denmark provided data from 2008 for samples of 600 deaths from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of deaths and 200 as natural deaths. The information given to the eight experts was identical to the information used by the Cause of Death Register. This included death certificates, and if available external post-mortem examinations, forensic autopsy reports and police reports. RESULTS: In total, 69 % (Sweden and Norway) and 78 % (Denmark) of deaths registered in the official mortality statistics as accidents were confirmed by the experts. In the majority of the cases where disagreement was seen, the experts reclassified accidents to undetermined manner of death, in 26, 25 and 19 % of cases, respectively. Few cases were reclassified as suicides or natural deaths. Among the extracted accidents, the experts agreed least with the official mortality statistics concerning drowning and poisoning accidents. They also reported most uncertainty in these categories of accidents. In a second re-evaluation, where more information was made available, the Norwegian psychiatrist and forensic pathologist increased their agreement with the official mortality statistics from 76 to 87 %, and from 85 to 88 %, respectively, regarding the Norwegian and Swedish datasets. Among the extracted undetermined deaths in the Swedish dataset, the two experts reclassified 22 and 51 %, respectively, to accidents. CONCLUSION: There was moderate agreement in reclassification of accidents between the official mortality statistics and the experts. In the majority of cases where there was disagreement, accidents were reclassified as undetermined manner of death, and only a small proportion as suicides.

Effect of acute exercise and hypoxia on markers of systemic and mucosal immunity.

PURPOSE: To determine how immune markers are affected by acute hypoxic exercise at the same relative intensity. METHODS: Twelve endurance-trained males (age: 28 ± 4 years, [Formula: see text]O2max: 63.7 ± 5.3 mL/kg/min) cycled for 75 min at 70 % of altitude-specific [Formula: see text]O2max, once in normoxia (N) and once in hypobaric hypoxia equivalent to 2000 m above sea-level (H). Blood and saliva samples were collected pre-, post- and 2 h post-exercise. RESULTS: Participants cycled at 10.5 % lower power output in H vs. N, with no significant differences in heart rate (P = 0.10) or rating of perceived exertion (P = 0.21). Post-exercise plasma cortisol was higher in H vs. N [683 (95 % CI 576-810) nmol/l vs. 549 (469-643) nmol/l, P = 0.017]. The exercise-induced decrease in CD4:CD8 ratio was greater in H vs. N (-0.5 ± 0.2 vs. -0.3 ± 0.2, P = 0.019). There were no significant between-trial differences for adrenocorticotropic hormone, plasma cytokines, antigen-stimulated cytokine production, salivary immunoglobulin-A or lactoferrin. However, there was a main trial effect for concentration [F(11) = 5.99, P < 0.032] and secretion [F(11) = 5.01, P < 0.047] of salivary lysozyme, with this being higher in N at every time-point. CONCLUSION: Whether the observed differences between H and N are of sufficient magnitude to clinically impair host defence is questionable, particularly as they are transient in nature and since other immune markers are unaffected. As such, acute hypoxic exercise likely does not pose a meaningful additional threat to immune function compared to exercise at sea level, provided that absolute workload is reduced in hypoxia so that relative exercise intensity is the same.

Finn Bøe--war, medicine, music.

In January 1944 the Norwegian Resistance Movement placed a radio transmitter in the attic of the Department of Obstetrics and Gynaecology, the National Hospital (Rikshospitalet), Oslo. Knut Haugland (1917-2009) used this to send messages to the Norwegian government-in-exile in London. The transmitter was discovered by the Gestapo, and German troops surrounded the building on 1 April 1944. Haugland survived a dramatic escape. While the transmitter was in operation, Haugland lived with senior registrar Finn Bøe (1906-70) and his family in a hospital apartment. Bøe risked his own life and that of his family to assist during a dramatic phase of the resistance struggle. Bøe had completed a focused and purposeful clinical and academic training when he was appointed senior registrar at the Department of Obstetrics and Gynaecology, the National Hospital, in 1943. He was professionally ambitious. His thesis from 1938 was disqualified, but four years later he submitted a new, experimental thesis which he successfully defended in 1945. In 1955, Bøe became the first senior consultant at the Department of Obstetrics and Gynaecology at Aker hospital. Under his leadership, it became the largest in the Oslo area, and one of the most active in Norway with regard to science. Several of Bøe's own academic works on placental morphology and blood circulation have become classics. Outside of medicine, his great interest was music, and not only as a piano player. He also wrote a book about his fellow townsman Edvard Grieg.

Not quite so fast: effect of training at 90% sprint speed on maximal and repeated-sprint ability in soccer players.

Abstract The aim of the present study was to investigate the effect of training at an intensity eliciting 90% of maximal sprinting speed on maximal and repeated-sprint performance in soccer. It was hypothesised that sprint training at 90% of maximal velocity would improve soccer-related sprinting. Twenty-two junior club-level male and female soccer players (age 17 ± 1 year, body mass 64 ± 8 kg, body height 174 ± 8 cm) completed an intervention study where the training group (TG) replaced one of their weekly soccer training sessions with a repeated-sprint training session performed at 90% of maximal sprint speed, while the control group (CG) completed regular soccer training according to their teams' original training plans. Countermovement jump, 12 × 20-m repeated-sprint, VO2max and the Yo-Yo Intermittent Recovery Level 1 test were performed prior to and after a 9-week intervention period. No significant between-group differences were observed for any of the performance indices and effect magnitudes were trivial or small. Before rejecting the hypothesis, we recommend that future studies should perform intervention programmes with either stronger stimulus or at other times during the season where total training load is reduced.