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1.
BMC Public Health ; 24(1): 1750, 2024 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-38951781

RESUMO

BACKGROUND: Public health and working life are closely related. Even though Norway is one of the world's most equality-oriented countries, working life is still divided by gender. Women have a lower rate of participation in working life than men, they work more part-time and they have a higher sickness absence. Research has mostly focused on structural and cultural reasons for gender differences, rather than on the fact that women and men have different biology and face different health challenges. The aim of this project was to explore experienced associations between women's health and female participation in working life. METHODS: Qualitative methods were chosen for investigating women's experiences. We carried out in-depth interviews with 11 female high school teachers and supplemented the material with a focus group with five managers from the same organisation. The interviews were recorded and transcribed verbatim. We used the six steps of reflexive thematic analysis for consistency in the analysis process. RESULTS: The teachers shared a variety of experienced health issues within the field of women's health and perceived barriers in the work environment. Four main themes were identified: (1) invisibility of women's health at work, (2) complexity and lack of recognition of women's health at work, (3) women's health in work environment and (4) women's health and role conflicts. There were few contradictions between the two informant groups. We found that health, work and total life intertwine and that complexity, lack of recognition and invisibility of women's health appear at different levels in a mutual influence: for the women themselves, in the organisation and in society. CONCLUSION: Lack of recognition and invisibility of women's health in the work environment is suggested to influence women's work participation. The complexity of female health is not captured by gender-neutral structures in the work environment meant to protect and promote employees' occupational health. Recognition of women's health in the work context can therefore contribute to a gender-equal, health-promoting and sustainable working life.


Assuntos
Pesquisa Qualitativa , Professores Escolares , Saúde da Mulher , Humanos , Feminino , Noruega , Adulto , Professores Escolares/psicologia , Professores Escolares/estatística & dados numéricos , Pessoa de Meia-Idade , Grupos Focais , Entrevistas como Assunto , Saúde Ocupacional , Instituições Acadêmicas , Local de Trabalho/psicologia
2.
BMC Psychiatry ; 24(1): 481, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956493

RESUMO

BACKGROUND: Patients' online record access (ORA) enables patients to read and use their health data through online digital solutions. One such solution, patient-accessible electronic health records (PAEHRs) have been implemented in Estonia, Finland, Norway, and Sweden. While accumulated research has pointed to many potential benefits of ORA, its application in mental healthcare (MHC) continues to be contested. The present study aimed to describe MHC users' overall experiences with national PAEHR services. METHODS: The study analysed the MHC-part of the NORDeHEALTH 2022 Patient Survey, a large-scale multi-country survey. The survey consisted of 45 questions, including demographic variables and questions related to users' experiences with ORA. We focused on the questions concerning positive experiences (benefits), negative experiences (errors, omissions, offence), and breaches of security and privacy. Participants were included in this analysis if they reported receiving mental healthcare within the past two years. Descriptive statistics were used to summarise data, and percentages were calculated on available data. RESULTS: 6,157 respondents were included. In line with previous research, almost half (45%) reported very positive experiences with ORA. A majority in each country also reported improved trust (at least 69%) and communication (at least 71%) with healthcare providers. One-third (29.5%) reported very negative experiences with ORA. In total, half of the respondents (47.9%) found errors and a third (35.5%) found omissions in their medical documentation. One-third (34.8%) of all respondents also reported being offended by the content. When errors or omissions were identified, about half (46.5%) reported that they took no action. There seems to be differences in how patients experience errors, omissions, and missing information between the countries. A small proportion reported instances where family or others demanded access to their records (3.1%), and about one in ten (10.7%) noted that unauthorised individuals had seen their health information. CONCLUSIONS: Overall, MHC patients reported more positive experiences than negative, but a large portion of respondents reported problems with the content of the PAEHR. Further research on best practice in implementation of ORA in MHC is therefore needed, to ensure that all patients may reap the benefits while limiting potential negative consequences.


Assuntos
Registros Eletrônicos de Saúde , Serviços de Saúde Mental , Humanos , Registros Eletrônicos de Saúde/estatística & dados numéricos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Estônia , Noruega , Finlândia , Serviços de Saúde Mental/estatística & dados numéricos , Suécia , Inquéritos e Questionários , Adulto Jovem , Idoso , Acesso dos Pacientes aos Registros , Adolescente
3.
Arch Osteoporos ; 19(1): 58, 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38960953

RESUMO

In a Norwegian youth cohort followed from adolescence to young adulthood, bone mineral density (BMD) levels declined at the femoral neck and total hip from 16 to 27 years but continued to increase at the total body indicating a site-specific attainment of peak bone mass. PURPOSE: To examine longitudinal trends in bone mineral density (BMD) levels in Norwegian adolescents into young adulthood. METHOD: In a prospective cohort design, we followed 980 adolescents (473 (48%) females) aged 16-19 years into adulthood (age of 26-29) on three occasions: 2010-2011 (Fit Futures 1 (FF1)), 2012-2013 (FF2), and 2021-2022 (FF3), measuring BMD (g/cm2) at the femoral neck, total hip, and total body with dual x-ray absorptiometry (DXA). We used linear mixed models to examine longitudinal BMD changes from FF1 to FF3. RESULTS: From the median age of 16 years (FF1), femoral neck BMD (mean g/cm2 (95% CI)) slightly increased in females from 1.070 (1.059-1.082) to 1.076 (1.065-1.088, p = 0.015) at the median age of 18 years (FF2) but declined to 1.041 (1.029-1.053, p < 0.001) at the median age of 27 years (FF3). Similar patterns were observed in males: 16 years, 1.104 (1.091-1.116); 27 years, 1.063 (1.050-1.077, p < 0.001); and for the total hip in both sexes (both p < 0.001). Total body BMD increased from age 16 to 27 years in both sexes (females: 16 years, 1.141 (1.133-1.148); 27 years, 1.204 (1.196-1.212), p < 0.001; males: 16 years, 1.179 (1.170-1.188); 27 years, 1.310 (1.296-1.315), p < 0.001). CONCLUSION: BMD levels increased from 16 to 18 years at the femoral and total hip sites in young Norwegian females and males, and a small decline was observed at the femoral sites when the participants were followed up to 27 years. Total body BMD continued to increase from adolescence to young adulthood.


Assuntos
Absorciometria de Fóton , Densidade Óssea , Colo do Fêmur , Humanos , Adolescente , Feminino , Masculino , Noruega/epidemiologia , Adulto Jovem , Adulto , Estudos Longitudinais , Colo do Fêmur/diagnóstico por imagem , Estudos Prospectivos , Estudos de Coortes
4.
Int J Behav Nutr Phys Act ; 21(1): 69, 2024 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-38961489

RESUMO

BACKGROUND: Fundamental motor skills (FMS) and physical fitness (FIT) play important roles in child development and provide a foundation for lifelong participation in physical activity (PA). Unfortunately, many children have suboptimal levels of PA, FMS, and FIT. The Active Learning Norwegian Preschool(er)s (ACTNOW) study investigated the effects of a staff-led PA intervention on FMS, FIT, and PA in 3-5-year-old children. METHODS: Preschools in Western Norway having ≥ six 3-4-year-old children were invited (n = 56). Of these, 46 agreed to participate and were cluster-randomized into an intervention (n = 23 preschools [381 children, 3.8 yrs., 55% boys]) or a control group (n = 23 [438, 3.7 yrs., 52% boys]). Intervention preschools participated in an 18-month PA intervention involving a 7-month staff professional development between 2019 and 2022, amounting to 50 h, including face-to-face seminars, webinars, and digital lectures. Primary outcomes in ACTNOW were cognition variables, whereas this study investigated effects on secondary outcomes. FMS was measured through 9 items covering locomotor, object control, and balance skills. FIT was assessed as motor fitness (4 × 10 shuttle-run test) and upper and lower muscular strength (handgrip and standing long jump). PA was measured with accelerometers (ActiGraph GT3X +). All measures took place at baseline, 7-, and 18-month follow-up. Effects were analysed using a repeated measures linear mixed model with child and preschool as random effects and with adjustment for baseline scores. RESULTS: Participants in the intervention preschools showed positive, significant effects for object control skills at 7 months (standardized effect size (ES) = 0.17) and locomotor skills at 18 months (ES = 0.21) relative to controls. A negative effect was found for handgrip strength (ES = -0.16) at 7 months. No effects were found for balance skills, standing long jump, or motor fitness. During preschool hours, sedentary time decreased (ES = -0.18), and light (ES = 0.14) and moderate-to-vigorous PA (ES = 0.16) increased at 7 months, whereas light PA decreased at 18 months (ES = -0.15), for intervention vs control. No effects were found for other intensities or full day PA. CONCLUSIONS: The ACTNOW intervention improved some FMS outcomes and increased PA short-term. Further research is needed to investigate how to improve effectiveness of staff-led PA interventions and achieve sustainable improvements in children's PA, FMS, and FIT. TRIAL REGISTRATION: Clinicaltrials.gov, identifier NCT04048967 , registered August 7, 2019. FUNDING: ACTNOW was supported by the Research Council of Norway (grant number 287903), the County Governor of Sogn og Fjordane, the Sparebanken Sogn og Fjordane Foundation, and the Western Norway University of Applied Sciences.


Assuntos
Exercício Físico , Destreza Motora , Aptidão Física , Humanos , Masculino , Feminino , Noruega , Pré-Escolar , Promoção da Saúde/métodos , Desenvolvimento Infantil , Desenvolvimento de Pessoal/métodos , Força da Mão
5.
BMC Ecol Evol ; 24(1): 91, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38965473

RESUMO

BACKGROUND: Thyasirid bivalves are often recorded as a dominant component of macrobenthic infaunal communities in depositional environments such as fjord basins. Fjord basins comprise patchy soft-bottom habitats bounded by steep walls and sills; however, little is known how this semi-isolated nature of fjords affects benthic populations. Accordingly, data on the composition and population connectivity of thyasirids can provide valuable information on the ecology of these ecosystems. RESULTS: The species composition of thyasirid bivalves has been studied in the basins of three sub-Arctic fjords (Nordland, Northern Norway). Overall, six thyasirid species were recorded: Parathyasira equalis, Parathyasira dunbari, Mendicula ferruginosa, Genaxinus eumyarius, Thyasira sarsii, and Thyasira obsoleta. The species composition remained stable within the basins during the sampling period (2013-2020) and suggested the importance of local reproduction over advection of individuals for population dynamics. Only one species, Parathyasira equalis, was common in all fjords. We have further investigated the population genetics of this species by combining two types of genetic markers: a 579 bp fragment of the cytochrome c oxidase subunit I (COI) gene and 4043 single-nucleotide polymorphisms (SNPs) generated by genotyping-by-sequencing. The latter provided a more in-depth resolution on the population genetics of this species and revealed a weak but significant differentiation of populations within fjords, further indicating limited connectivity between basins. CONCLUSION: Based on our findings, we conclude that limited dispersal between the basin communities results in weakly connected populations and might be an important structuring factor for macrobenthic communities.


Assuntos
Bivalves , Animais , Bivalves/genética , Bivalves/classificação , Noruega , Ecossistema , Regiões Árticas , Filogenia , Biodiversidade , Complexo IV da Cadeia de Transporte de Elétrons/genética
6.
BMC Emerg Med ; 24(1): 108, 2024 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-38956498

RESUMO

BACKGROUND: Teamwork in the context of ambulance services exhibits unique characteristics, as this environment involves a small core team that must adapt to a dynamic team structure that involves health care professionals and emergency services. It is essential to acquire a deeper understanding of how ambulance teams operate. Therefore, this study aimed to explore the experiences of ambulance professionals with teamwork and how they were influenced by the implementation of a team training programme. METHODS: A qualitative descriptive study was conducted involving ambulance professionals who took part in focus group interviews carried out both before and after the implementation of a team training program across seven ambulance stations within a Norwegian hospital trust. The data were analysed using reflexive thematic analysis based on a deductive-inductive approach. RESULTS: Our analysis revealed 15 subthemes that characterised ambulance professionals' experiences with teamwork and a team training programme, which were organised according to the five main themes of team structure, communication, leadership, situation monitoring, and mutual support. Ambulance professionals' experiences ranged from the significance of team composition and interpersonal and professional relationships to their preferences regarding different communication styles and the necessity of team leaders within the ambulance service. The team training programme raised awareness of teamwork, while the adoption of teamwork tools was influenced by both individual and contextual factors. The Introduction/Identity, Situation, Background, Assessment and Recommendation (ISBAR) communication tool was identified as the most beneficial aspect of the programme due to its ease of use, which led to improvements in the structure and quality of consultations and information handover. CONCLUSIONS: This study documented the diverse characteristics and preferences associated with teamwork among ambulance professionals, emphasising the particular importance of proficient partnerships in this context. Participation in a team training programme was perceived as a valuable reminder of the significance of teamwork, thus providing a foundation for the enhancement of communication skills. TRIAL REGISTRATION: ClinicalTrials.gov-ID: NCT05244928.


Assuntos
Ambulâncias , Grupos Focais , Equipe de Assistência ao Paciente , Pesquisa Qualitativa , Humanos , Equipe de Assistência ao Paciente/organização & administração , Noruega , Feminino , Masculino , Liderança , Comunicação , Adulto , Relações Interprofissionais , Pessoa de Meia-Idade , Atitude do Pessoal de Saúde , Comportamento Cooperativo , Capacitação em Serviço , Auxiliares de Emergência/educação
8.
Acta Vet Scand ; 66(1): 28, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38965632

RESUMO

BACKGROUND: Visna-maedi is a notifiable disease in Norway, and eliminating the disease is a national goal. The import of sheep into Norway is very limited, and strict regulations apply to the movement of small ruminants between flocks and within defined geographical regions. Several outbreaks have occurred in the last 50 years, and the most recent before 2019 occurred in Trøndelag county in Central Norway in 2002. A national surveillance programme for small ruminant lentivirus infection exists since 2003. RESULTS: In 2019, the national surveillance programme detected seropositive animals for small ruminant lentivirus in a sheep flock in Trøndelag. Based on the result of polymerase chain reaction analysis and histopathological findings, the Norwegian Food Safety Authority concluded the diagnosis of maedi. Further investigations detected maedi in eight additional sheep flocks in the same county. The flocks were placed under restrictions, and the authorities also imposed restrictions on 82 contact flocks. Sequencing of partial gag genes indicated that the virus in the current outbreak was related to the small ruminant lentivirus detected in the same area between 2002 and 2005. CONCLUSIONS: The outbreak investigation shows the need for sensitive and specific diagnostic methods, and an improved and more targeted surveillance strategy. It also demonstrates the risk of disease spreading between flocks through animal movements, and highlights the importance of biosecurity and structured livestock trade. In addition to allowing livestock trade only from flocks documented free from maedi, it may be necessary to monitor sheep flocks over many years, when aiming to eliminate maedi from the Norwegian sheep population.


Assuntos
Surtos de Doenças , Vírus Visna-Maedi , Animais , Noruega/epidemiologia , Ovinos , Surtos de Doenças/veterinária , Vírus Visna-Maedi/isolamento & purificação , Pneumonia Intersticial Progressiva dos Ovinos/epidemiologia , Pneumonia Intersticial Progressiva dos Ovinos/virologia , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/virologia
9.
PLoS One ; 19(7): e0301427, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38968179

RESUMO

This study investigates effects of subtle methodological choices on the estimation and biological interpretation of age, growth and reproductive parameters for harbour porpoises. The core analyses are based on a focal Norwegian data set built on samples from 134 harbour porpoises caught incidentally in gillnet fisheries along the Norwegian coast during autumn 2016 and spring 2017. Two contrasting practices for interpretation of seasonal and ontogenetic characteristics of tooth growth layer formation resulted in significant age differences among spring samples of young porpoises and for older animals across seasons. In turn, these differences affected estimates of age at maturity and asymptotic lengths, respectively. We also found significant differences in male age at maturity between two well-documented maturity criteria and between mathematical estimators of age at maturity for both sexes. Two different criteria for corpus albicans classification furthermore resulted in different patterns of ovarian corpora accumulation, which may affect some estimates of fecundity rates and contaminant loads. Both corpora accumulation patterns were also found in reanalysed data from German and Greenlandic porpoises. Based on tabulated overviews of methodological choices made in previous harbour porpoise studies, we argue that several of the issues mentioned above have wider relevance and may affect the validity of meta-analyses as a tool for estimating harbour porpoise sensitivity to extrinsic pressures. Differences in cause of death (COD) composition between data sets can have a similar effect. We demonstrate this in a meta-analysis of published harbour porpoise pregnancy rates, showing significantly higher values for trauma-killed samples compared to samples comprising mixed COD categories. COD also affected the estimated impacts of three previously analysed extrinsic predictors as well as an added predictor for vessel noise levels. We discuss the potential contributions of methodological, biological and anthropogenic factors in shaping observed regional differences in estimates of harbour porpoise life history parameters.


Assuntos
Phocoena , Animais , Phocoena/fisiologia , Noruega , Feminino , Masculino , Estações do Ano , Reprodução/fisiologia , Maturidade Sexual/fisiologia , Fertilidade
10.
BMC Microbiol ; 24(1): 248, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38971718

RESUMO

BACKGROUND: The usage of fluoroquinolones in Norwegian livestock production is very low, including in broiler production. Historically, quinolone-resistant Escherichia coli (QREC) isolated from Norwegian production animals rarely occur. However, with the introduction of a selective screening method for QREC in the Norwegian monitoring programme for antimicrobial resistance in the veterinary sector in 2014; 89.5% of broiler caecal samples and 70.7% of broiler meat samples were positive. This triggered the concern if there could be possible links between broiler and human reservoirs of QREC. We are addressing this by characterizing genomes of QREC from humans (healthy carriers and patients) and broiler isolates (meat and caecum). RESULTS: The most frequent mechanism for quinolone resistance in both broiler and human E. coli isolates were mutations in the chromosomally located gyrA and parC genes, although plasmid mediated quinolone resistance (PMQR) was also identified. There was some relatedness of the isolates within human and broiler groups, but little between these two groups. Further, some overlap was seen for isolates with the same sequence type isolated from broiler and humans, but overall, the SNP distance was high. CONCLUSION: Based on data from this study, QREC from broiler makes a limited contribution to the incidence of QREC in humans in Norway.


Assuntos
Antibacterianos , Galinhas , Farmacorresistência Bacteriana , Infecções por Escherichia coli , Escherichia coli , Quinolonas , Animais , Galinhas/microbiologia , Escherichia coli/genética , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Humanos , Noruega , Infecções por Escherichia coli/veterinária , Infecções por Escherichia coli/microbiologia , Farmacorresistência Bacteriana/genética , Quinolonas/farmacologia , Antibacterianos/farmacologia , Genômica , Plasmídeos/genética , Doenças das Aves Domésticas/microbiologia , Testes de Sensibilidade Microbiana , Genoma Bacteriano/genética , DNA Girase/genética , DNA Topoisomerase IV/genética , Carne/microbiologia , Mutação , Proteínas de Escherichia coli/genética , Ceco/microbiologia
11.
BMC Public Health ; 24(1): 1801, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38971760

RESUMO

BACKGROUND: This study aims to explore the varied experiences of patients with drug-resistant tuberculosis in Norway. The study emphasizes challenges and implications of being diagnosed with drug-resistant tuberculosis, including the impact on psychosocial health during the diagnosis, disease, treatment, isolation and recovery phases. Norway is a low endemic country of tuberculosis. Most patients are immigrants, and some of them have recently arrived in the country. Patients undergoing treatment for drug-resistant tuberculosis endure prolonged and demanding treatment that could affect their psychosocial health. METHODS: This qualitative study conducted 16 in-depth interviews with individuals aged 18 years and above who were diagnosed with drug-resistant tuberculosis. All participants completed the treatment between 2008 and 2020. Fourteen participants were immigrants, and eight of them had resided in Norway for less than four years before diagnosis. Data analysis followed the six-phase reflexive thematic analysis framework, focusing on identifying patterns in participants' experiences, thoughts, expectations and attitudes. RESULTS: The narratives of the participants highlighted the complexities of navigating the diagnosis of drug-resistant tuberculosis, treatment, side effects and life after treatment. Immigrants encountered additional challenges, including language barriers and adapting to new social environments. All participants reported experiencing physical health issues that additionally affected their mental health and social activity. Several participants had a delayed or prolonged diagnosis that complicated their disease trajectory. Participants with suspected or confirmed contagious pulmonary tuberculosis underwent hospital isolation for periods ranging from weeks to six months. The participants reported mental health issues, social isolation and stigma, however few were offered follow-up by a psychologist. Many participants had persistent problems at the time of the interviews. Three main themes emerged from the analysis: Delayed and prolonged diagnosis; Psychosocial impact of isolation during treatment; The life after tuberculosis. CONCLUSION: This study highlights the enduring impact of drug-resistant tuberculosis on patients and the significance of timely diagnosis, psychosocial support and post-treatment follow-up. The participants universally faced serious implications of the disease, including stigma and isolation. Participants who experienced delayed diagnosis, reflected on missed early intervention opportunities. We recommend further research in low endemic countries to evaluate the international and local recommendations on psychosocial support.


Assuntos
Pesquisa Qualitativa , Tuberculose Resistente a Múltiplos Medicamentos , Humanos , Noruega/epidemiologia , Masculino , Feminino , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Resistente a Múltiplos Medicamentos/psicologia , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Adulto , Pessoa de Meia-Idade , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Adulto Jovem , Entrevistas como Assunto , Antituberculosos/uso terapêutico
12.
Sci Rep ; 14(1): 15618, 2024 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-38971860

RESUMO

To compare two screening strategies for diabetic retinopathy (DR), and to determine the health-economic impact of including optical coherence tomography (OCT) in a regular DR screening. This cross-sectional study included a cohort of patients (≥ 18 years) with type 1 or 2 diabetes mellitus (T1D or T2D) from a pilot DR screening program at Oslo University Hospital, Norway. A combined screening strategy where OCT was performed in addition to fundus photography for all patients, was conducted on this cohort and compared to our existing sequential screening strategy. In the sequential screening strategy, OCT was performed on a separate day only if fundus photography indicated diabetic macular edema (DME). The presence of diabetic maculopathy on fundus photography and DME on OCT was determined by two medical retina specialists. Based on the prevalence rate of diabetic maculopathy and DME from the pilot, we determined the health-economic impact of the two screening strategies. The study included 180 eyes of 90 patients. Twenty-seven eyes of 18 patients had diabetic maculopathy, and of these, 7 eyes of 6 patients revealed DME on OCT. When diabetic maculopathy was absent on fundus photographs, OCT could not reveal DME. Accordingly, 18 patients (20%) with diabetic maculopathy would have needed an additional examination with OCT in the sequential screening strategy, 6 (33%) of whom would have had DME on OCT. In an extended healthcare perspective analysis, the cost of the sequential screening strategy was higher than the cost of the combined screening strategy. There was a weak association between diabetic maculopathy on fundus photography and DME on OCT. The health economic analysis suggests that including OCT as a standard test in DR screening could potentially be cost-saving.


Assuntos
Retinopatia Diabética , Programas de Rastreamento , Tomografia de Coerência Óptica , Humanos , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/economia , Retinopatia Diabética/diagnóstico por imagem , Masculino , Feminino , Projetos Piloto , Pessoa de Meia-Idade , Tomografia de Coerência Óptica/economia , Tomografia de Coerência Óptica/métodos , Estudos Transversais , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Idoso , Edema Macular/diagnóstico , Edema Macular/economia , Edema Macular/diagnóstico por imagem , Noruega/epidemiologia , Adulto , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/economia , Análise Custo-Benefício
13.
Water Sci Technol ; 90(1): 168-189, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39007313

RESUMO

Co-located infrastructure networks such as road, water, and sewer in theory offer the possibility for integrated multi-infrastructure interventions. However, how closely these networks are aligned in space and time determines the practical extent to which such coordinated interventions can be realized. This study quantifies the spatial alignment of the aforementioned infrastructure networks and demonstrates its application for integrated interventions and potential cost savings. It proposes two metrics, namely 1) shared surface area and, 2) shared trench volume, to quantify the spatial relationship (i.e., degree of co-location) of infrastructures. Furthermore, the study demonstrates how the degree of co-location can be used as a proxy for cost-saving potential of integrated interventions compared to silo-based, single-infrastructure, interventions. Through six case studies conducted in Norwegian municipalities, the research reveals that implementing integrated interventions across road, water, and sewer networks can result in potential average cost savings of 24% in urban areas and 11% in rural areas. Utility-specific savings under different cost-sharing scenarios were also analysed. To identify the yearly potential of integrated multi-infrastructure interventions, future work should add the temporal alignment of rehabilitation of infrastructures (i.e., time of intervention need for the infrastructures).


Assuntos
Cidades , Abastecimento de Água , Noruega
14.
Front Endocrinol (Lausanne) ; 15: 1417656, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39006361

RESUMO

Introduction: Maternal nutritional and vitamin status during pregnancy may have long-term effects on offspring health and disease. The aim of this study was to examine the associations between maternal vitamin A and D status in pregnancy and offspring bone mineral content (BMC) at nine years of age. Methods: This is a post-hoc study of a randomized control trial including 855 pregnant women from two Norwegian cities; Trondheim and Stavanger. The women were randomized into an exercise intervention or standard antenatal care. Mother and child pairs for the present study were recruited from those still living in Trondheim after 8-10 years. Serum vitamin A (retinol) and vitamin D (25(OH)D) were measured in the 2nd and 3rd trimesters of pregnancy, and active vitamin D (1,25(OH)2D) in serum was measured in a subgroup. Spine BMC and trabecular bone score were measured in the children at nine years of age. Associations were analyzed with linear regression models. Results: A total of 119 mother and child pairs were included in the analyses. Vitamin A insufficiency (retinol< 1.05 µmol/L) and vitamin D deficiency (25(OH)D< 50 mmol/L) increased from ~7% to ~43% and from ~28% to ~33%, respectively, from the 2nd to the 3rd trimester. An increase in serum 1,25(OH)2D from the 2nd to the 3rd trimester was observed in the subgroup. There was a negative association between serum retinol in the 2nd trimester and spine BMC in the boys, but not in the girls, when adjusted for maternal and child confounders. No other associations between maternal serum vitamin A or D and BMC in the children were found. Conclusion: We observed a high prevalence of vitamin A insufficiency and vitamin D deficiency during pregnancy. A negative association between mid-pregnancy vitamin A status and spine BMC was observed in boys, but not girls, while no associations were found between maternal vitamin D status and child BMC. The implications of optimal vitamin A and D status in pregnancy for offspring bone health, remains a subject for further investigations.


Assuntos
Densidade Óssea , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Vitamina A , Vitamina D , Humanos , Feminino , Gravidez , Vitamina A/sangue , Vitamina D/sangue , Terceiro Trimestre da Gravidez/sangue , Masculino , Criança , Adulto , Segundo Trimestre da Gravidez/sangue , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/sangue , Deficiência de Vitamina A/sangue , Deficiência de Vitamina A/epidemiologia , Noruega/epidemiologia , Fenômenos Fisiológicos da Nutrição Materna , Efeitos Tardios da Exposição Pré-Natal/sangue , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
15.
Front Immunol ; 15: 1414830, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39007131

RESUMO

Introduction: Cytomegalovirus (CMV) infection remains a challenge following kidney transplantation (KTx). Currently, CMV-IgG serostatus at transplantation is used to individualize CMV preventive strategies. We assessed the clinical utility of CMV-IGRA for predicting CMV infection following KTx. Methods: We performed a nationwide prospective cohort study from August 2016 until December 2022. Data from all adult KTx recipients in Norway, n=1,546 (R+; n=1,157, D+/R-; n=260, D-/R-; 129), were included with a total of 3,556 CMV-IGRA analyses (1,375 at KTx, 1,188 at eight weeks, 993 one-year after KTx) and 35,782 CMV DNAemia analyses. Results: In R+ recipients CMV-IGRA status, measured at any of the time-points, could not identify any differential risk of later CMV infection. D+/R- recipients remaining CMV-IGRA negative 1-year after transplantation (regardless of positive CMV DNAemia and/or CMV IgG status at that time) had increased risk of developing later CMV infection compared to D+/R- recipients who had become CMV-IGRA positive (14% vs. 2%, p=0.01). Conclusion: Knowledge of pre-transplant CMV-IGRA status did not provide additional information to CMV-IgG serostatus that could improve current post-transplant CMV treatment algorithms. However, D+/R- recipients with a persisting negative CMV-IGRA one-year after transplantation remained at increased risk of experiencing later CMV infection. Therefore we advocate post-transplant CMV-IGRA monitoring in these patients.


Assuntos
Infecções por Citomegalovirus , Citomegalovirus , Imunidade Celular , Transplante de Rim , Humanos , Transplante de Rim/efeitos adversos , Infecções por Citomegalovirus/imunologia , Citomegalovirus/imunologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Estudos Prospectivos , Anticorpos Antivirais/sangue , Idoso , Noruega/epidemiologia , Fatores de Risco , Imunoglobulina G/sangue
16.
Anesth Analg ; 139(2): 313-322, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39008976

RESUMO

BACKGROUND: An elevated cardiac troponin concentration is a prognostic factor for perioperative cardiac morbidity and mortality. In elderly patients undergoing emergency abdominal surgery, frailty is a recognized risk factor, but little is known about the prognostic value of cardiac troponin in these vulnerable patients. Therefore, we investigated the prognostic significance of elevated high-sensitivity cardiac troponin T (hs-cTnT) concentration and frailty in a cohort of elderly patients undergoing emergency abdominal surgery. METHODS: We included consecutive patients ≥75 years of age who presented for emergency abdominal surgery, defined as abdominal pathology requiring surgery within 72 hours, in a university hospital in Norway. Patients who underwent vascular procedures or palliative surgery for inoperable malignancies were excluded. Preoperatively, frailty was assessed using the Clinical Frailty Scale (CFS), and blood samples were measured for hs-cTnT. We evaluated the predictive power of CFS and hs-cTnT concentrations using receiver operating characteristic (ROC) curves and Cox proportional hazard regression with 30-day mortality as the primary outcome. Secondary outcomes included (1) a composite of 30-day all-cause mortality and major adverse cardiac event (MACE), defined as myocardial infarction, nonfatal cardiac arrest, or coronary revascularization; and (2) 90-day mortality. RESULTS: Of the 210 screened and 156 eligible patients, blood samples were available in 146, who were included. Troponin concentration exceeded the 99th percentile upper reference limit (URL) in 83% and 89% of the patients pre- and postoperatively. Of the participants, 53% were classified as vulnerable or frail (CFS ≥4). The 30-day mortality rate was 12% (18 of 146). Preoperatively, a threshold of hs-cTnT ≥34 ng/L independently predicted 30-day mortality (hazard ratio [HR] 3.14, 95% confidence interval [CI], 1.13-9.45), and the composite outcome of 30-day mortality and MACE (HR 2.58, 95% CI, 1.07-6.49). In this model, frailty (continuous CFS score) also independently predicted 30-day mortality (HR 1.42, 95% CI, 1.01-2.00) and 30-day mortality or MACE (HR 1.37, 95% CI, 1.02-1.84). The combination of troponin and frailty, 0.14 × hs-cTnT +4.0 × CFS, yielded apparent superior predictive power (area under the receiver operating characteristics curve [AUC] 0.79, 95% CI, 0.68-0.88), compared to troponin concentration (AUC 0.69, 95% CI, 0.55-0.83) or frailty (AUC 0.69, 95% CI, 0.57-0.82) alone. CONCLUSIONS: After emergency abdominal surgery in elderly patients, increased preoperative troponin concentration and frailty were independent predictors of 30-day mortality. The combination of increased troponin concentration and frailty seemed to provide better prognostic information than troponin or frailty alone. These results must be validated in an independent sample.


Assuntos
Abdome , Biomarcadores , Fragilidade , Valor Preditivo dos Testes , Troponina T , Humanos , Troponina T/sangue , Idoso , Masculino , Feminino , Estudos Prospectivos , Idoso de 80 Anos ou mais , Fragilidade/sangue , Fragilidade/mortalidade , Fragilidade/diagnóstico , Biomarcadores/sangue , Abdome/cirurgia , Fatores de Risco , Idoso Fragilizado , Medição de Risco , Fatores de Tempo , Noruega/epidemiologia , Resultado do Tratamento
17.
Harmful Algae ; 137: 102681, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39003025

RESUMO

In May-June 2019, the microalga Chrysochromulina leadbeateri caused a massive fish-killing event in several fjords in Northern Norway, resulting in the largest direct impact ever on aquaculture in northern Europe due to toxic algae. Motivated by the fact that no algal toxins have previously been described from C. leadbeateri, we set out to investigate the chemical nature and toxicity of secondary metabolites in extracts of two strains (UIO 393, UIO 394) isolated from the 2019 bloom, as well as one older strain (UIO 035) isolated during a bloom in Northern Norway in 1991. Initial LC-DAD-MS/MS-based molecular networking analysis of the crude MeOH extracts of the cultivated strains showed that their profiles of small organic molecules, including a large number of known lipids, were very similar, suggesting that the same class of toxin(s) were likely the causative agents of the two harmful algal bloom (HAB) events. Next, bioassay-guided fractionation using the RTgill-W1 cell line and metabolomics analysis pointed to a major compound affording [M + H]+ ions at m/z 1399.8333 as a possible toxin, corresponding to a compound with the formula C67H127ClO27. Moreover, our study unveiled a series of minor analogues exhibiting distinct patterns of chlorination and sulfation, together defining a new family of compounds, which we propose to name leadbeaterins. Remarkably, these suspected toxins were detected in situ in samples collected during the 2019 bloom close to Tromsø, thereby consistent with a role in fish kills. The elemental compositions of the putative C. leadbeateri ichthyotoxins strongly indicate them to be long linear polyhydroxylated polyketides, structurally similar to sterolysins reported from a number of dinoflagellates.


Assuntos
Proliferação Nociva de Algas , Toxinas Marinhas , Noruega , Toxinas Marinhas/toxicidade , Toxinas Marinhas/química , Toxinas Marinhas/análise , Estuários , Animais , Espectrometria de Massas em Tandem , Haptófitas/química
18.
PLoS One ; 19(7): e0305164, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38991043

RESUMO

AIMS: Maintaining continuity of care between doctors and patients is considered a fundamental aspect of quality in primary healthcare. In this study, we aim to examine continuity in Norway over time by computing two commonly used indicators of continuity: the St Leonard's Index of Continuity of Care (SLICC) and the Usual Provider of Care Index (UPC). METHOD: We employ individual-level data, which covers all primary care consultations. This data includes the identities of each patient and physician, and we can identify each patient's regular general practitioner (GP). The SLICC is calculated as the share of consultations conducted by the patient's regular GP annually from 2006 to 2021. Additionally, we identify each patient's most visited physician and compute the UPC as the share of total consultations conducted by the most visited physician during the same period. Our analysis is conducted at the national level and stratified according to the level of centrality, differentiating between areas of high, moderate, and low centrality. RESULTS: Our findings reveal that, at the national level, SLICC and UPC exhibit remarkable stability, reaching 64 and 71 percent, respectively, in 2021. However, there is significant geographical variation, with the least central areas experiencing less continuous healthcare (SLICC at 49 percent in 2021) than patients residing in more central areas (SLICC at 68 in 2021). CONCLUSION: Our results demonstrate a high degree of continuity that has been stable over time. However, large geographical variations suggest that policymakers should strive to reduce geographical disparities in healthcare quality.


Assuntos
Continuidade da Assistência ao Paciente , Medicina Geral , Noruega , Humanos , Continuidade da Assistência ao Paciente/estatística & dados numéricos , Medicina Geral/estatística & dados numéricos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Atenção Primária à Saúde/estatística & dados numéricos , Idoso , Clínicos Gerais/estatística & dados numéricos , Qualidade da Assistência à Saúde
19.
BMC Public Health ; 24(1): 1861, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38992631

RESUMO

BACKGROUND: Due to changes in testing policy and increased use of rapid tests, other indicators for SARS-CoV-2 infections are needed to monitor vaccine effectiveness (VE). We aimed to estimate VE against COVID-19 sick leave (> 3 days, certified by a medical professional) among employed individuals (25-64-years-old) in Norway. METHODS: We performed a nationwide cohort study by collating data from the Emergency preparedness register for COVID-19. We used adjusted Cox proportional hazard models with vaccine status as a time-varying covariate and presented results as adjusted hazard ratios (aHRs) with corresponding 95% confidence intervals. Separate models were run against sick leave and against SARS-CoV-2 infections during the Delta period (June-December 2021), and against sick leave during the Omicron period (January-December 2022) when SARS-CoV-2 PCR-testing was replaced by rapid self-tests and infections were underreported. RESULTS: We included 2,236,419 individuals during the Delta period, of whom 73,776 (3.3%) had a reported infection and 54,334 (2.4%) were registered with sick leave. Of the 2,206,952 included individuals in the Omicron period, 300,140 (13.6%) were registered with sick leave. During the Delta period, 55% (26,611) of individuals who had registered sick leave also had a positive test, compared to 32% (96,445) during the Omicron period. The VE against sick leave during the Delta period followed a similar waning pattern to that against SARS-CoV-2 infections. After the second and third dose, the lowest aHRs were estimated for 2-7 days after vaccination for both sick leave (0.25; 95%CI 0.24-0.26 and 0.26; 95% CI 0.24-0.29) and infection ( 0.16; 95% CI 0.15-0.17 and 0.18; 95% CI 0.16-0.19) respectively. During the Omicron period, aHRs for sick leave were higher than during the Delta period, but the lowest aHRs were still found in 2-7 weeks after receiving the second (0.61; 95% CI 0.59-0.64) or third dose (0.63; 95% CI 0.62-0.64). CONCLUSION: Our results showed that sick leave could be a relevant indicator for VE in the surveillance of COVID-19 and a finding that may be important in the surveillance of other respiratory infection.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Licença Médica , Eficácia de Vacinas , Humanos , Licença Médica/estatística & dados numéricos , COVID-19/prevenção & controle , COVID-19/epidemiologia , Noruega/epidemiologia , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Estudos de Coortes , Vacinas contra COVID-19/administração & dosagem , Eficácia de Vacinas/estatística & dados numéricos , SARS-CoV-2/imunologia
20.
BMC Health Serv Res ; 24(1): 799, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38992652

RESUMO

BACKGROUND: The Norwegian colorectal cancer (CRC) screening program started in May 2022. Inequalities in CRC screening participation are a challenge, and we expect that certain groups, such as immigrants, are at risk of non-participation. Prior to the start of the national screening program, a pilot study showed lower participation rates in CRC screening among immigrants from Pakistan. These immigrants are a populous group with a long history in Norway and yet have a relatively low participation rate also in other cancer screening programs. The purpose of this study was to identify and explore perspectives and factors influencing CRC screening participation among immigrants from Pakistan in Norway. MATERIALS AND METHODS: In this study we used a qualitative study design and conducted 12 individual interviews with Pakistani immigrants aged between 50 and 65 years. The participants varied in terms of gender, age, education, work, residence time in Norway and familiarity with the Norwegian language and culture. We performed thematic analysis with health literacy as a theoretical framework to understand Pakistani immigrants' perspectives on CRC screening. RESULTS: We identified four main themes: Health-related knowledge, the health care system, screening, and social factors. Within these themes we identified several factors that affect Pakistani immigrants' accessibility to CRC screening. These factors included knowledge of the causes and development of cancer, sources of health-related information, the general practitioner's role, understanding of screening and the intention behind it, language skills and religious beliefs. CONCLUSION: There are many factors influencing Pakistani immigrants' decision of participation in CRC screening. The roles of the general practitioner and adult children are particularly important. Key elements to improve accessibility to CRC screening and enable informed participation for Pakistani immigrants are measures that improve personal and organizational health literacy.


Assuntos
Neoplasias Colorretais , Detecção Precoce de Câncer , Emigrantes e Imigrantes , Acessibilidade aos Serviços de Saúde , Pesquisa Qualitativa , Humanos , Noruega , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/etnologia , Paquistão/etnologia , Emigrantes e Imigrantes/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Masculino , Feminino , Pessoa de Meia-Idade , Detecção Precoce de Câncer/estatística & dados numéricos , Detecção Precoce de Câncer/psicologia , Idoso , Conhecimentos, Atitudes e Prática em Saúde , Entrevistas como Assunto
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