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Henriksen L, Kisa S, Lukasse M, Flaathen EM, Mortensen B, Karlsen E, Garnweidner-Holme L. Cultural Sensitivity in Interventions Aiming to Reduce or Prevent Intimate Partner Violence During Pregnancy: A Scoping Review. Trauma Violence Abuse 2023; 24:97-109. [PMID: 34109872 PMCID: PMC9660282 DOI: 10.1177/15248380211021788] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Intimate partner violence (IPV) around the time of pregnancy is a recognized global health problem. Ethnic minorities and immigrant pregnant women experiencing IPV require culturally responsive health services. The aim of this scoping review was to identify aspects of cultural sensitivity in interventions to prevent or reduce IPV among ethnic minorities and immigrant pregnant women in high-income countries. Eight databases were searched in November 2019. Any type of scientific research, quantitative, qualitative, or mixed methods studies regarding interventions against IPV among pregnant women were considered for inclusion. Resnicow et al.'s definition of cultural sensitivity was used to identify aspects of cultural sensitivity. Ten papers relating to nine interventions/studies met our inclusion criteria. These studies, which included randomized controlled trials, a mixed methods study, a program evaluation, and a longitudinal study, were conducted in Australia, Belgium, Norway, and the United States. Aspects of surface cultural sensitivity, including the translation of intervention content into the language of the target group(s) and the involvement of bilingual staff to recruit participants, were identified in eight studies. Deep structure aspects of cultural sensitivity were identified in one study, where the intervention content was pretested among the target group(s). Results that could be related to the culture-sensitive adaptions included successful recruitment of the target population. Three studies were planning to investigate women's experiences of interventions, but no publications were yet available. This scoping review provides evidence that culturally sensitive interventions to reduce or prevent IPV among immigrant pregnant women are limited in number and detail.
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Affiliation(s)
- Lena Henriksen
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
- Division of General Gynaecology and Obstetrics, Oslo University
Hospital, Norway
| | - Sezer Kisa
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
- Department of Nursing and Health Sciences, University of
South-Eastern Norway, Kongsberg, Norway
| | - Eva Marie Flaathen
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
| | - Berit Mortensen
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
| | - Elisabeth Karlsen
- Department of Nursing and Health Promotion, Oslo Metropolitan
University, Norway
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Lund Håheim L, Thelle DS, Rønningen KS, Olsen I, Schwarze PE. Low level of antibodies to the oral bacterium Tannerella forsythia predicts bladder cancers and Treponema denticola predicts colon and bladder cancers: A prospective cohort study. PLoS One 2022; 17:e0272148. [PMID: 35994451 PMCID: PMC9394794 DOI: 10.1371/journal.pone.0272148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/13/2022] [Indexed: 11/18/2022] Open
Abstract
This study explores the risk for cancer by level of antibodies to the anaerobe oral bacteria of periodontitis Tannerella forsythia (TF), Porphyromonas gingivalis (PG), and Treponema denticola (TD) all three collectively termed the red complex, and the facultative anaerobe bacterium Aggregatibacter actinomycetemcomitans (AA). The prospective cohort, the Oslo II-study from 2000, the second screening of the Oslo study of 1972/73, has been followed for 17 ½ years with regard to cancer incidence and mortality. A random sample of 697 elderly men comprised the study cohort. The antibody results measured by enzyme linked immunosorbent assay (ELISA) were used in the Cox proportional hazards analyses, and quartile risk on cancer incidence in a 17 ½ years follow-up. Among the 621 participants with no prior cancer diagnoses, 221 men developed cancer. The incidence trend was inverse, and the results are shown as 1st quartile of highest value and 4th as lowest of antibody levels. The results of the Cox proportional regression analyses showed that TF inversely predicts bladder cancer (n = 22) by Hazard Ratio (HR) = 1.71 (95% CI: 1.12, 2.61). TD inversely predicts colon cancer (n = 26) by HR = 1.52 (95% CI: 1.06, 2.19) and bladder cancer (n = 22) by HR = 1.60 (95% CI: 1.05, 2.43). Antibodies to two oral bacteria, TF and TD, showed an inverse risk relationship with incidence of specific cancers: TF bladder cancer, TD bladder and colon cancer. Lowered immunological response to the oral infection, periodontitis, is shown to be a risk factor in terms of cancer aetiology.
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Affiliation(s)
- Lise Lund Håheim
- Department of Oral Biology, University of Oslo, Oslo, Norway
- * E-mail:
| | - Dag S. Thelle
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Community Medicine and Public Health, University of Gothenburg, Gothenburg, Sweden
| | | | - Ingar Olsen
- Department of Oral Biology, University of Oslo, Oslo, Norway
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Mangset M, Kitzmüller G, Evju AS, Angel S, Aadal L, Martinsen R, Bronken BA, Kvigne KJ, Bragstad LK, Hjelle EG, Sveen U, Kirkevold M. Perceived study-induced influence on the control group in a randomized controlled trial evaluating a complex intervention to promote psychosocial well-being after stroke: a process evaluation. Trials 2021; 22:850. [PMID: 34838094 PMCID: PMC8627040 DOI: 10.1186/s13063-021-05765-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A commonly applied control condition in trials evaluating complex interventions in rehabilitation research is "usual care." The main challenge is to ensure that the control group receives genuine usual care as delivered in everyday clinical practice. The assessment interviews and dialogues with the data collectors may influence the control group participants' reflections on their condition and adjustments. This represents a threat to the internal validity of the trial. Thus, the aim of this study was to explore the perceived study-induced influence of assessment interviews on the adjustment of the members of a control group in a randomized clinical trial. The aim of the trial was to test a dialogue-based psychosocial intervention aiming at promoting the psychosocial well-being and adjustment of stroke survivors. METHODS Fifteen participants in the control group of a multicenter stroke rehabilitation trial participated in narrative semi-structured interviews. Ricoeur's interpretation theory guided the analysis. RESULTS The perceived study-induced influence of the assessment interviews on the adjustment process of members of the control group varied considerably. The results demonstrated that the assessment interviews facilitated some participants' feelings of control and their ability to cope. Other participants' statements indicate that they relied on their existing personal capacity to cope and adjust and that the assessment interviews did not make any difference either on their coping ability or on their process of adjustment. Five themes were identified that described the perceived study-induced influence of the assessment interviews in the control group. The themes illustrated that the assessments served as a safety net, enhanced awareness and understanding, encouraged seeking support, allowed the opportunity to vent disappointment, or did not make any difference either way. CONCLUSIONS RCT assessment interviews may influence the adjustment process and represent a serious problem in measuring interventions over time in trials of complex interventions in rehabilitation research. To uphold rigor and stringency, the usual care control conditions should be thoroughly assessed and described. Informing participants only about the treatment they were allocated to receive might counteract the potential to dilute the difference between the two arms of the trial. TRIAL REGISTRATION ClinicalTrials.gov NCT02338869. Registered on October 4, 2014.
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Affiliation(s)
- Margrete Mangset
- Department of Geriatric Medicine, Oslo University Hospital, Ullevaal, P.O. Box 4956, 0424 Oslo, Nydalen Norway
| | - Gabriele Kitzmüller
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, P.O. Box 385, 8505 Narvik, Norway
| | - Anne S. Evju
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, P.O. Box 385, 8505 Narvik, Norway
| | - Sanne Angel
- Department of Public Health – Research Unit for Nursing and Healthcare, Department of Science in Nursing, Aarhus University, 8000 Aarhus, Denmark
- Faculty of Health Sciences and Social Care, Molde University College, P.O. Box 2110, NO-6402 Molde, Norway
| | - Lena Aadal
- Faculty of Health Sciences and Social Care, Molde University College, P.O. Box 2110, NO-6402 Molde, Norway
- Hammel Neurorehabilitation Centre and University Research Clinic, 8450 Hammel, Denmark
- Department of Clinical Medicine, Aarhus University, C, 8000 Aarhus, Denmark
| | - Randi Martinsen
- Inland Norway University of Applied Sciences, P.B. 400, 2418 Elverum, Norway
| | | | - Kari J. Kvigne
- Inland Norway University of Applied Sciences, P.B. 400, 2418 Elverum, Norway
- The Faculty of Nursing and Health Sciences, Nord University, P.B. 1490, 8049 Bodø, Norway
| | - Line K. Bragstad
- Department of Geriatric Medicine, Oslo University Hospital, Ullevaal, P.O. Box 4956, 0424 Oslo, Nydalen Norway
- University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
- Institute of Health and Society and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
| | - Ellen Gabrielsen Hjelle
- University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
- Institute of Health and Society and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
| | - Unni Sveen
- Department of Geriatric Medicine, Oslo University Hospital, Ullevaal, P.O. Box 4956, 0424 Oslo, Nydalen Norway
- Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, 0130 Oslo, Norway
| | - Marit Kirkevold
- University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
- Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, 0130 Oslo, Norway
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Sandin K, Anyan F, Osnes K, Gunnarsdatter Hole Gjengedal R, Risberg Leversen JS, Endresen Reme S, Hjemdal O. Sick leave and return to work for patients with anxiety and depression: a longitudinal study of trajectories before, during and after work-focused treatment. BMJ Open 2021; 11:e046336. [PMID: 34588236 PMCID: PMC8483037 DOI: 10.1136/bmjopen-2020-046336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Sick leave due to anxiety and depression is a heterogeneous process constituting a pressing public health issue. This longitudinal study aimed to identify sick leave trajectories among patients before, during and after work-focused treatment, in all 29.5 months. We then aimed to determine the background and clinical characteristics of these trajectory groups. METHODS Background and clinical data were collected by patient self-report (N=619) in an observational study in a specialised mental healthcare clinic. Sick leave was recorded from national registry data. A latent growth mixture model identified trajectories. Multinomial logistic regression determined differences in background characteristics while a one-way analysis of variance (ANOVA) identified clinical differences. RESULTS We identified three trajectories: The 'Resilient' group (47.7%) had low sick leave throughout the period. The two other groups ('Recovery', 31.8% and 'High risk', 20.5%) had similar pretreatment trajectories: lower sick leave one year prior which increased to high sick leave at the start of treatment. After treatment, the 'Recovery' group made an almost full return to work while the 'High risk' group remained at high sick leave. The two groups with high sick leave had more women and higher age compared with the 'Resilient' group. All groups had similar clinical scores at the start of treatment, but the 'High risk' groups had residual depressive symptoms at the end of treatment. Effect sizes for anxiety and depression were moderate or large for all groups, (Cohen's d=0.74-1.81), and 87.2% of the total sample were fully working one year after treatment. CONCLUSION We found three subgroups with distinctly different trajectories. Female gender and higher age were associated with high sick leave at the start of treatment, while residual depressive symptoms at the end of treatment predicted continued sick leave. The study points to the possibility of improving patient outcomes in the future by stratifying and tailoring treatment to patient characteristics.
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Affiliation(s)
- Kenneth Sandin
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kåre Osnes
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
| | - Ragne Gunnarsdatter Hole Gjengedal
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | - Odin Hjemdal
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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Følling IS, Oldervoll LM, Hilmarsen C, Ersfjord EMI. Exploring use of activity monitors for patients with obesity during weight-loss treatment - a qualitative study. BMC Sports Sci Med Rehabil 2021; 13:25. [PMID: 33731190 PMCID: PMC7968213 DOI: 10.1186/s13102-021-00253-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 03/04/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Obesity is a major health concern in western countries. In Norway, patients with obesity can attend weight-loss programmes, which focus on changes in dietary and physical activity habits. Use of self-monitoring is advocated when changing dietary and physical activity habits for adults with obesity. This study aimed to explore the experiences of patients with obesity who used activity monitors while attending a weight-loss programme. METHODS Patients with body mass index (BMI) > 35 kg/m2 with weight related comorbidities or a BMI > 40 kg/m2 referred to an intermittent weight-loss programme were recruited into this study. They were introduced to one of three different activity monitors, Fitbit Zip™, Mio Fuse™, or Mio Slice™. Semi-structured interviews were performed with patients six months into the weight-loss programme. Thematic analysis was applied when analysing the data. RESULTS Of the 29 informants (aged 21 to 66 years) interviewed, 59% were female. Their experience with activity monitors was related to their adherence to the weight-loss programme. Two main themes emerged from the informants stories: 1. "Activity monitors visualize proof of effort or failure to change health habits". 2. "Activity monitors act as a positive or negative enforcer when incorporating change". CONCLUSIONS Using activity monitors either strengthens or undermines patients' attempts to change health habits when attending a weight-loss program. Our findings suggest a need for more individualized weight-loss programmes for patients with obesity.
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Affiliation(s)
- Ingrid S Følling
- Centre for Obesity Research, Department of Surgery, Forsyningssenteret, St. Olavs Hospital, Trondheim, 7006, Norway.
| | - Line M Oldervoll
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, 7491, Norway
- Centre for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, 5020, Norway
| | - Christina Hilmarsen
- Department of Circulation and Medical Imaging Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, 7491, Norway
| | - Ellen M I Ersfjord
- Centre for Obesity Research, Department of Surgery, Forsyningssenteret, St. Olavs Hospital, Trondheim, 7006, Norway
- Centre for eHealth, University of Agder, Campus Grimstad, 4879, Norway
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Sørensen K, Skirbekk H, Kvarstein G, Wøien H. I don't want to think about it: a qualitative study of children (6-18 years) with rheumatic diseases and parents' experiences with regular needle injections at home. Pediatr Rheumatol Online J 2021; 19:8. [PMID: 33482852 PMCID: PMC7821489 DOI: 10.1186/s12969-021-00495-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 01/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overall outcomes of pediatric rheumatic diseases (RD) have improved due to treatment with biologic agents and methotrexate. For many children, this treatment often entails regular needle injections. Pain and fear of needle injections are common in childhood, but how children and parents handle long-term needle injections at home has not been fully explored. This study aimed to explore how regular needle injections affect children with RD and their parents in their daily living. METHODS This explorative qualitative study used individual interviews and focus groups to ensure a comprehensive investigation of the topic. Children aged 6 to 16 years (n = 7) and their parents (n = 8) were interviewed individually 4 to 6 months after the onset of needle injection treatment. The focus groups included children aged 11 to 17 years (n = 9) and parents (n = 8) with a minimum of 6 months of experience with injection treatment. Data were analyzed using thematic analysis. RESULTS The main themes; "challenges," "motivational factors," and "routines" captured experiences and strategies that influenced the continuation of needle injections at home. Many children feared the moment immediately before the needle stick, although they had become accustomed to the pain. Most parents felt insecure about handling needle injections and lacked follow-up from healthcare providers. The children's experience of treatment effects and self-confidence were essential to maintain motivation for further injections. A number of coping strategies helped children focus away from injection related discomfort, often discovered by chance. Facilitating firm routines and shared responsibility within families helped children develop self-confidence during the procedure. Children and parents struggled to find suitable information on the Internet. CONCLUSIONS Children and parents experienced long-term needle injections challenging. They used their own limited resources and cooperated within the families to create routines and to introduce coping strategies necessary to manage and keep up with the procedure. Although the injection itself was not experienced very painful, the discomfort, worries and impact on daily life represented far more than a little needle stick, and thus needs more attention from healthcare providers.
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Affiliation(s)
- Kari Sørensen
- Department of Nursing Science, University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Department of Undergraduate Studies Lovisenberg Diaconal University College, Oslo, Norway
| | - Helge Skirbekk
- Department of Undergraduate Studies Lovisenberg Diaconal University College, Oslo, Norway
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Gunnvald Kvarstein
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
- Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Hilde Wøien
- Department of Nursing Science, University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Bjørnarå HB, Westergren T, Fegran L, te Velde SJ, Fyhri A, Deforche B, Andersen LB, Berntsen S, Bere E. Cumbersome but desirable-Breaking the code of everyday cycling. PLoS One 2020; 15:e0239127. [PMID: 32925959 PMCID: PMC7489513 DOI: 10.1371/journal.pone.0239127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 08/31/2020] [Indexed: 01/10/2023] Open
Abstract
Introduction Cycling for transport could integrate physical activity (PA) into daily routines and potentially increase total PA levels. However, for parents with young children, most factors affecting transport mode choice tend to facilitate car use. Greater insight is necessary into reasons for (not) using sustainable transport modes in parents with young children. Therefore, the objective of this study was to explore the experiences, including motives, perceptions, attitudes, and norms, of parents of young children by using an e-bike, a longtail bike, and a traditional bike for everyday travel to the workplace, kindergarten, and the grocery store during the autumn, winter, and spring, in nine months. Methods Semistructured focus group interviews were conducted with 18 parents of young children residing in southern Norway. Parents were recruited through Facebook announcements and direct contact with kindergartens, selected organisations, and companies in the Kristiansand municipality. Data were analysed by systematic text condensation by using NVivo V.11. Results Participants’ experiences were summarised by three main themes: ‘cycling is cumbersome’, ‘cycling reflects the desirable me’, and ‘breaking the cycling code’. Time use, planning, logistics, wet and cold weather, long distances, and no cycling habit were frequently mentioned barriers, and the most notable facilitator was the children’s attitude towards cycling. In general, children loved to cycle and preferred cycling to driving. Additionally, the freedom and independence of cycling were emphasised and valued. Conclusion In challenging weather conditions, parents of young children may experience cycling as cumbersome but desirable, and bike access could increase the feasibility of daily cycling.
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Affiliation(s)
- Helga Birgit Bjørnarå
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- * E-mail:
| | - Thomas Westergren
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Liv Fegran
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Saskia J. te Velde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Aslak Fyhri
- Department of Safety and the Environment, Institute of Transport Economics, Oslo, Norway
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lars Bo Andersen
- Western Norwegian University of Applied Sciences, Faculty of Education, Arts and Sport, Sogndal, Norway
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Elling Bere
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Health and Inequalities & Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
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Lofterød T, Frydenberg H, Flote V, Eggen AE, McTiernan A, Mortensen ES, Akslen LA, Reitan JB, Wilsgaard T, Thune I. Exploring the effects of lifestyle on breast cancer risk, age at diagnosis, and survival: the EBBA-Life study. Breast Cancer Res Treat 2020; 182:215-227. [PMID: 32436147 PMCID: PMC7275030 DOI: 10.1007/s10549-020-05679-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/09/2020] [Indexed: 12/13/2022]
Abstract
Purpose Whether an unfavorable lifestyle not only affects breast cancer risk, but also influences age at onset of breast cancer and survival, is under debate. Methods In a population-based cohort, the Energy Balance and Breast Cancer Aspects throughout life (EBBA-Life) study, a total of 17,145 women were included. During follow-up, 574 women developed invasive breast cancer. Breast cancer cases were followed for an additional 9.1 years. Detailed medical records were obtained. Cox’s proportional hazard regression models were used to study the association between pre-diagnostic lifestyle factors (weight, physical activity, alcohol use, smoking, and hypertension), breast cancer risk, age at diagnosis, and survival. Results At study entry, 34.3% of the participating women were overweight and 30.7% were physically inactive. Mean age at breast cancer diagnosis was 58.0 years, and 78.9% of the tumors were estrogen receptor positive. Among menopausal women who did not use hormone therapy and had an unfavorable lifestyle (3–5 unfavorable factors), compared with women who had a favorable lifestyle, we observed a twofold higher risk for postmenopausal breast cancer (hazard ratio [HR] 2.13, 95% confidence interval [CI] 1.23–3.69), and they were 3.4 years younger at diagnosis (64.8 versus 68.2 years, P = 0.032). Breast cancer patients with an unfavorable lifestyle, compared with patients with a favorable lifestyle, had almost a two times higher overall mortality risk (HR 1.96, 95% CI 1.01–3.80). Conclusions Our study supports a healthy lifestyle improving breast cancer prevention, postponing onset of disease, and extending life expectancy among breast cancer patients. Electronic supplementary material The online version of this article (10.1007/s10549-020-05679-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Trygve Lofterød
- Department of Oncology, Oslo University Hospital, Oslo, Norway.
| | | | - Vidar Flote
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Anne Elise Eggen
- Faculty of Health Services, Institute of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Anne McTiernan
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, USA
| | - Elin S Mortensen
- Department of Pathology, University Hospital of North Norway, Tromsø, Norway
| | - Lars A Akslen
- Department of Clinical Medicine, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway
- Department of Pathology, Haukeland University Hospital, Bergen, Norway
| | - Jon B Reitan
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Tom Wilsgaard
- Faculty of Health Services, Institute of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Inger Thune
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- Faculty of Health Services, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway
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Maugesten Ø, Mathiessen A, Hammer HB, Hestetun SV, Kvien TK, Uhlig T, Ohrndorf S, Haugen IK. Validity and diagnostic performance of fluorescence optical imaging measuring synovitis in hand osteoarthritis: baseline results from the Nor-Hand cohort. Arthritis Res Ther 2020; 22:98. [PMID: 32357904 PMCID: PMC7193370 DOI: 10.1186/s13075-020-02185-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/13/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Fluorescence optical imaging (FOI) demonstrates enhanced microcirculation in finger joints as a sign of inflammation. We wanted to assess the validity and diagnostic performance of FOI measuring synovitis in persons with hand OA, comparing it with magnetic resonance imaging (MRI)- and ultrasound-detected synovitis. METHODS Two hundred and twenty-one participants with hand OA underwent FOI and ultrasound (gray-scale synovitis and power Doppler activity) of the bilateral hands and contrast-enhanced MRI examination of the dominant hand. Fifteen joints in each hand were scored on semi-quantitative scales (grade 0-3) for all modalities. Four FOI images were evaluated: one composite image (Prima Vista Mode (PVM)) and three images representing phases of fluorescent dye distribution. Spearman's correlation coefficients were calculated between sum scores of FOI, MRI, and ultrasound. Sensitivity, specificity, and area under the curve (AUC) were calculated for FOI using MRI or ultrasound as reference. RESULTS FOI did not demonstrate enhancement in the thumb base, and the joint was excluded from further analyses. FOI sum scores showed poor to fair correlations with MRI (rho 0.01-0.24) and GS synovitis sum scores (rho 0.12-0.25). None of the FOI images demonstrated both good sensitivity and specificity, and the AUC ranged from 0.50-0.61 and 0.51-0.63 with MRI and GS synovitis as reference, respectively. FOI demonstrated similar diagnostic performance with PD activity and GS synovitis as reference. CONCLUSION FOI enhancement correlated poorly with synovitis assessed by more established imaging modalities, questioning the value of FOI for the evaluation of synovitis in hand OA.
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Affiliation(s)
- Øystein Maugesten
- Department of Rheumatology, Diakonhjemmet Hospital, Diakonveien 12, 0370, Oslo, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Alexander Mathiessen
- Department of Rheumatology, Diakonhjemmet Hospital, Diakonveien 12, 0370, Oslo, Norway
| | - Hilde Berner Hammer
- Department of Rheumatology, Diakonhjemmet Hospital, Diakonveien 12, 0370, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sigrid Valen Hestetun
- Department of Rheumatology, Diakonhjemmet Hospital, Diakonveien 12, 0370, Oslo, Norway
| | - Tore Kristian Kvien
- Department of Rheumatology, Diakonhjemmet Hospital, Diakonveien 12, 0370, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Till Uhlig
- Department of Rheumatology, Diakonhjemmet Hospital, Diakonveien 12, 0370, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Sarah Ohrndorf
- Department of Rheumatology and Clinical Immunology, Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Ida Kristin Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Diakonveien 12, 0370, Oslo, Norway
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Danielsen SO, Moons P, Leegaard M, Solheim S, Tønnessen T, Lie I. Facilitators of and barriers to reducing thirty-day readmissions and improving patient-reported outcomes after surgical aortic valve replacement: a process evaluation of the AVRre trial. BMC Health Serv Res 2020; 20:256. [PMID: 32220252 PMCID: PMC7102432 DOI: 10.1186/s12913-020-05125-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/18/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The Aortic Valve Replacement Readmission (AVRre) randomized control trial tested whether a telephone intervention would reduce hospital readmissions following surgical aortic valve replacement (SAVR). The telephone support provided 30 days of continuous phone-support (hotline) and two scheduled phone-calls from the hospital after discharge. The intervention had no effect on reducing 30-day all-cause readmission rate (30-DACR) but did reduce participants' anxiety compared to a control group receiving usual care. Depression and participant-reported health state were unaffected by the intervention. To better understand these outcomes, we conducted a process evaluation of the AVRre trial to gain insight into the (1) the dose and fidelity of the intervention, (2) mechanism of impacts, and (3) contextual factors that may have influenced the outcomes. METHODS The process evaluation was informed by the Medical Research Council framework, a widely used set of guidelines for evaluating complex interventions. A mix of quantitative (questionnaire and journal records) and qualitative data (field notes, memos, registration forms, questionnaire) was prospectively collected, and retrospective interviews were conducted. We performed descriptive analyses of the quantitative data. Content analyses, assisted by NVivo, were performed to evaluate qualitative data. RESULTS The nurses who were serving the 24/7 hotline intervention desired to receive more preparation before intervention implementation. SAVR patient participants were highly satisfied with the telephone intervention (58%), felt safe (86%), and trusted having the option of calling in for support (91%). The support for the telephone hotline staff was perceived as a facilitator of the intervention implementation. Content analyses revealed themes: "gap in the care continuum," "need for individualized care," and "need for easy access to health information" after SAVR. Differences in local hospital discharge management practices influenced the 30-DACR incidence. CONCLUSIONS The prospective follow-up of the hotline service during the trial facilitated implementation of the intervention, contributing to high participant satisfaction and likely reduced their anxiety after SAVR. Perceived less-than-optimal preparations for the hotline could be a barrier to AVRre trial implementation. Integrating user experiences into a mixed-methods evaluation of clinical trials is important for broadening understanding of trial outcomes, the mechanism of impact, and contextual factors that influence clinical trials. TRIAL REGISTRATION ClinicalTrials.gov, NCT02522663. Registered on 11 August 2015.
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Affiliation(s)
- Stein Ove Danielsen
- Center for Patient-centered Heart and Lung Research, Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Building 63, Ullevål, PO Box 4956, Nydalen, 0424 Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- KU Leuven Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Philip Moons
- KU Leuven Department of Public Health and Primary Care, KU Leuven-University of Leuven, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - Marit Leegaard
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Svein Solheim
- Center for Clinical Heart Research, Department of Cardiology, Division of Medicine, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Theis Tønnessen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Irene Lie
- Center for Patient-centered Heart and Lung Research, Department of Cardiothoracic Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Building 63, Ullevål, PO Box 4956, Nydalen, 0424 Oslo, Norway
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Nilsen SA, Breivik K, Wold B, Askeland KG, Sivertsen B, Hysing M, Bøe T. Divorce and adolescent academic achievement: Heterogeneity in the associations by parental education. PLoS One 2020; 15:e0229183. [PMID: 32130231 PMCID: PMC7055798 DOI: 10.1371/journal.pone.0229183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 02/02/2020] [Indexed: 11/18/2022] Open
Abstract
Background The link between parental divorce and adolescents’ academic achievement may depend on parental educational levels. However, findings have been inconsistent regarding whether the negative associations between parental divorce and adolescents’ academic outcomes are greater or smaller in highly educated families. The present study aimed to investigate the possible heterogeneity in the associations between divorce and adolescents’ academic achievement by parental educational levels, within the context of the elaborate Norwegian welfare state. Methods The population-based cross-sectional youth@hordaland study of adolescents aged 16–19 years conducted in Norway in 2012, provided information about parental divorce and was linked to national administrative registries (N = 9,166) to obtain high-quality, objective data on the adolescents’ grade point average (GPA), and their parents’ educational qualifications and income. Results The negative association between parental divorce and GPA was stronger among adolescents with educated or highly educated parents compared to adolescents with less educated parents. This heterogeneity was driven by maternal educational qualifications, whereby divorce was more strongly and negatively associated with GPA among adolescents with educated mothers compared to those with less educated mothers, independent of paternal educational levels and income measures. Conclusions Among adolescents whose parents have low educational qualifications, parental divorce is not associated with their academic achievement. Educated divorced mothers appear less likely to transfer their educational advantages onto their children than nondivorced equally educated mothers, perhaps due to a “double-burden” regarding work pressure and child-rearing responsibilities. There is a need for future studies to detail the mechanisms underlying this finding.
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Affiliation(s)
- Sondre Aasen Nilsen
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
- * E-mail:
| | - Kyrre Breivik
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Bente Wold
- Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Kristin Gärtner Askeland
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
- Department of Research & Innovation, Helse Fonna HF, Haugesund, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mari Hysing
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - Tormod Bøe
- Regional Centre for Child and Youth Mental Health and Child Welfare, NORCE Norwegian Research Centre, Bergen, Norway
- Department of Psychosocial Science, Faculty of Psychology, University of Bergen, Bergen, Norway
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Sørensen K, Skirbekk H, Kvarstein G, Wøien H. Children's fear of needle injections: a qualitative study of training sessions for children with rheumatic diseases before home administration. Pediatr Rheumatol Online J 2020; 18:13. [PMID: 32033566 PMCID: PMC7007654 DOI: 10.1186/s12969-020-0406-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/09/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Treatment of rheumatic diseases in children often includes long-term needle injections, which represent a risk for refusing medication based on potential needle-fear. How nurses manage children's fear and pain during the initial educational training session of subcutaneous injections, may affect the management of the subsequent injections in the home settings. The aim of this study was to explore how children expressed fear and pain during these training sessions, and how adults' communication affected children's expressed emotions. METHODS This qualitative explorative study used video observations and short interviews during training sessions in a rheumatic hospital ward. Participants were children between five and fifteen years (n = 8), their parents (n = 11) and nurses (n = 7) in nine training sessions in total. The analysis followed descriptions of thematic analysis and interaction analysis. RESULTS The children expressed fears indirectly as cues and nonverbal signs more often than direct statements. Three children stated explicit being afraid or wanting to stop. The children worried about needle-pain, but experienced the stinging pain after the injection more bothersome. The technical instructions were detailed and comprehensive and each nurse shaped the structure of the sessions. Both nurses and parents frequently offered coping strategies unclearly without sufficient time for children to understand. We identified three main adult communication approaches (acknowledging, ambiguous and disregarding) that influenced children's expressed emotions during the training session. CONCLUSIONS Children's expression of fear was likely to be indirectly, and pain was mostly related to the injection rather than the needle stick. When adults used an acknowledging communication and offered sufficient coping strategies, children seemed to become involved in the procedure and acted with confidence. The initial educational training session may have a great impact on long-term repeated injections in a home setting by providing children with confidence at the onset.
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Affiliation(s)
- Kari Sørensen
- Department of Nursing Science, University of Oslo, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Department of Undergraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
| | - Helge Skirbekk
- Department of Undergraduate Studies, Lovisenberg Diaconal University College, Oslo, Norway
- Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Gunnvald Kvarstein
- Department of Pain Management and Research, Oslo University Hospital, Oslo, Norway
- Department of Clinical Medicine, the Arctic University of Norway, Tromsø, Norway
| | - Hilde Wøien
- Department of Nursing Science, University of Oslo, Oslo, Norway
- Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
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Sunde T, Hummelen B, Himle JA, Walseth LT, Vogel PA, Launes G, Haaland VØ, Haaland ÅT. Early maladaptive schemas impact on long-term outcome in patients treated with group behavioral therapy for obsessive-compulsive disorder. BMC Psychiatry 2019; 19:318. [PMID: 31655556 PMCID: PMC6815412 DOI: 10.1186/s12888-019-2285-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/11/2019] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Some studies have previously found that certain elevated early maladaptive schemas (EMSs) are negative predictors for outcome for patients with obsessive-compulsive disorder (OCD) treated with Cognitive-Behavioral Therapy (CBT) or Exposure and Response Prevention (ERP). The current study explores whether EMS were related to reductions in OCD symptom severity at long-term follow-up (Mean = 8 years) after group ERP for patients with OCD. The central hypothesis was that patients with no response to treatment or patients who relapsed during the follow-up period were more likely to have elevated pre-treatment EMSs compared to those who responded to initial treatment and maintained gains over time. We also investigated whether there were any differences in change over time of overall EMS between patients who were recovered versus patients who were not recovered at extended follow-up. METHODS Young Schema Questionnaire -Short Form (YSQ-SF), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI) were measured in 40 OCD patients in a general outpatient clinic before and after group ERP, after 12-months and at extended follow-up. To analyze the predictors, a multiple regression analyses was conducted. Changes in overall EMS was analyzed by mixed models procedures. RESULTS The major finding is that patients with high pre-treatment YSQ-SF total scores were less likely to respond to initial treatment or were more likely to relapse between post-treatment and the extended follow-up. The YSQ-SF total score at pre-treatment explained 10.5% of the variance of extended long-term follow-up outcome. The entire sample experienced a significant reduction in overall EMS over time with largest reduction from pre- to post-test. There were no statistically significant differences in total EMS change trajectories between the patients who were recovered at the extended follow-up compared to those who were not. CONCLUSION The results from the present study suggest that patients with higher pre-treatment EMSs score are less likely to recover in the long-term after receiving group ERP for OCD. A combined treatment that also targets early maladaptive schemas may be a more effective approach for OCD patients with elevated EMS who don't respond to standard ERP.
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Affiliation(s)
- Tor Sunde
- DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
| | - Benjamin Hummelen
- Clinic of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Joseph A. Himle
- School of Social Work and School of Medicine-Psychiatry, University of Michigan, Ann Arbor, USA
| | - Liv Tveit Walseth
- DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
| | - Patrick A. Vogel
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunvor Launes
- DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
| | - Vegard Øksendal Haaland
- DPS Solvang, Sørlandet Hospital, SSHF, Seviceboks 416, 4604 Kristiansand, Norway
- Clinical Neuroscience Research Group, Department of Psychology, University of Oslo, Oslo, Norway
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Bjørnarå HB, Berntsen S, J te Velde S, Fyhri A, Deforche B, Andersen LB, Bere E. From cars to bikes - The effect of an intervention providing access to different bike types: A randomized controlled trial. PLoS One 2019; 14:e0219304. [PMID: 31291314 PMCID: PMC6619759 DOI: 10.1371/journal.pone.0219304] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/20/2019] [Indexed: 12/29/2022] Open
Abstract
Introduction We aimed to investigate whether providing parents with children in kindergarten with access to different bicycle types could influence (i) travel behavior and cycling amount, and (ii) intrinsic motivation for cycling and psychological constructs related to car use. Methods A randomized, controlled trial was conducted in Southern Norway from September 2017 to June 2018. In total 36 parents were recruited and randomly drawn into an intervention (n = 18) or control group (n = 18). The intervention group was in random order equipped with an e-bike with trailer (n = 6), a cargo (longtail) bike (n = 6) and a traditional bike with trailer (n = 6). Results At follow-up, more participants from the intervention group (vs. the control group) were classified as cyclists to the workplace (n = 7 (38.9%) vs. n = 1 (5.9%), p = 0.04), but not to the kindergarten (n = 6 (33.3%) vs. n = 2 (11.8%), p = 0.23) or to the grocery store (n = 2 (11.1%) vs. n = 0 (0%), p = 0.49). A significant (p = ≤0.05) increase in cycling frequency (0.1 to 2.0 days/week) from baseline to follow-up was found in the intervention group for all destinations and seasons, except to the grocery store during winter (p = 0.16). A decrease in frequency of car driving (-0.2 to -1.7 days/week) was found to be apparent in terms of travelling to the workplace and the kindergarten for all seasons, yet not to the grocery store for any season (p = 0.15–0.49). The intervention group (vs. the control group) reported significantly higher “intrinsic regulation” for cycling (p = 0.01) at follow-up. Conclusion Access to different bike types for parents with children attending kindergarten resulted in overall increased cycling, decreased car use and higher intrinsic motivation for cycling. E-bikes obtained the greatest cycling amount in total, with the smallest sample variability. Hence, providing parents with children in kindergarten with access to e-bikes might result in increased and sustained cycling, also during the winter season.
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Affiliation(s)
- Helga Birgit Bjørnarå
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- * E-mail:
| | - Sveinung Berntsen
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Saskia J te Velde
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Aslak Fyhri
- Department of Safety and the Environment, Institute of Transport Economics, Oslo, Norway
| | - Benedicte Deforche
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lars Bo Andersen
- Western Norwegian University of Applied Sciences, Faculty Education, Arts and Sports, Sogndal Campus, Sogndal, Norway
| | - Elling Bere
- Department of Public Health, Sport and Nutrition, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Health and Inequalities, & Centre for Evaluation of Public Health Measures Norwegian Institute of Public Health, Oslo, Norway
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Heier M, Espeland CN, Brunborg C, Seljeflot I, Margeirsdottir HD, Hanssen KF, Fugelseth D, Dahl-Jørgensen K. Preserved endothelial function in young adults with type 1 diabetes. PLoS One 2018; 13:e0206523. [PMID: 30359432 PMCID: PMC6201945 DOI: 10.1371/journal.pone.0206523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/15/2018] [Indexed: 01/02/2023] Open
Abstract
Background and aim Endothelial dysfunction is involved in the pathogenesis of atherosclerosis and is typically present in older adults with type 1 diabetes (T1D). In young adults, we aimed to assess the impact of T1D on endothelial function as detected by digital peripheral arterial tonometry (PAT) and its relationship with cardiovascular risk factors and long term glycemic control. Materials and methods Reactive hyperemia index (RHI) as a measure of endothelial function was assessed by PAT in 46 T1D patients and 32 healthy controls. All were participants in the "Atherosclerosis and Childhood Diabetes" study, with baseline values registered five years previously. Annual measurements of HbA1c for assessment of glycemic burden were provided by the Norwegian Childhood Diabetes Registry. Results The diabetes patients had a mean age of 20.8 years, a median duration of diabetes of 10.0 years and a mean HbA1c of 8.7%. RHI was not significantly decreased in the diabetes group, mean 2.00 (SD = 0.59) vs. 2.21 (SD = 0.56), p = .116. There was no gender difference or any associations with traditional risk factors. Furthermore, there was no significant association between RHI and either HbA1c or long term glycemic burden. Conclusions RHI as a measure of endothelial function was preserved in young adults with T1D compared with healthy controls.
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Affiliation(s)
- Martin Heier
- Pediatric Department, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Oslo Diabetes Research Centre, Oslo, Norway
- * E-mail:
| | | | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Ingebjørg Seljeflot
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Center for Clinical Heart Research and Department of Cardiology, Oslo University Hospital, Oslo, Norway
| | - Hanna Dis Margeirsdottir
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Oslo Diabetes Research Centre, Oslo, Norway
- Pediatric Department, Akershus University Hospital, Lørenskog, Norway
| | - Kristian F. Hanssen
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Oslo Diabetes Research Centre, Oslo, Norway
- Department of Endocrinology, Oslo University Hospital, Oslo, Norway
| | - Drude Fugelseth
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Neonatal Intensive Care, Oslo University Hospital, Oslo, Norway
| | - Knut Dahl-Jørgensen
- Pediatric Department, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Oslo Diabetes Research Centre, Oslo, Norway
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Mork R, Falkenberg HK, Fostervold KI, Thorud HMS. Visual and psychological stress during computer work in healthy, young females-physiological responses. Int Arch Occup Environ Health 2018; 91:811-830. [PMID: 29850947 PMCID: PMC6132651 DOI: 10.1007/s00420-018-1324-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 05/22/2018] [Indexed: 11/26/2022]
Abstract
Purpose Among computer workers, visual complaints, and neck pain are highly prevalent. This study explores how occupational simulated stressors during computer work, like glare and psychosocial stress, affect physiological responses in young females with normal vision. Methods The study was a within-subject laboratory experiment with a counterbalanced, repeated design. Forty-three females performed four 10-min computer-work sessions with different stress exposures: (1) minimal stress; (2) visual stress (direct glare); (3) psychological stress; and (4) combined visual and psychological stress. Muscle activity and muscle blood flow in trapezius, muscle blood flow in orbicularis oculi, heart rate, blood pressure, blink rate and postural angles were continuously recorded. Immediately after each computer-work session, fixation disparity was measured and a questionnaire regarding perceived workstation lighting and stress was completed. Results Exposure to direct glare resulted in increased trapezius muscle blood flow, increased blink rate, and forward bending of the head. Psychological stress induced a transient increase in trapezius muscle activity and a more forward-bent posture. Bending forward towards the computer screen was correlated with higher productivity (reading speed), indicating a concentration or stress response. Forward bent posture was also associated with changes in fixation disparity. Furthermore, during computer work per se, trapezius muscle activity and blood flow, orbicularis oculi muscle blood flow, and heart rate were increased compared to rest. Conclusions Exposure to glare and psychological stress during computer work were shown to influence the trapezius muscle, posture, and blink rate in young, healthy females with normal binocular vision, but in different ways. Accordingly, both visual and psychological factors must be taken into account when optimizing computer workstations to reduce physiological responses that may cause excessive eyestrain and musculoskeletal load.
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Affiliation(s)
- Randi Mork
- Department of Public Health Science, Norwegian University of Life Sciences, Ås, Norway.
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, National Centre for Optics, Vision and Eye Care, P.O. Box 235, 3603, Kongsberg, Norway.
| | - Helle K Falkenberg
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, National Centre for Optics, Vision and Eye Care, P.O. Box 235, 3603, Kongsberg, Norway
| | | | - Hanne Mari S Thorud
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, National Centre for Optics, Vision and Eye Care, P.O. Box 235, 3603, Kongsberg, Norway
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Rabanal KS, Meyer HE, Tell GS, Igland J, Pylypchuk R, Mehta S, Kumar B, Jenum AK, Selmer RM, Jackson R. Can traditional risk factors explain the higher risk of cardiovascular disease in South Asians compared to Europeans in Norway and New Zealand? Two cohort studies. BMJ Open 2017; 7:e016819. [PMID: 29217719 PMCID: PMC5728264 DOI: 10.1136/bmjopen-2017-016819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The objective was to prospectively examine potential differences in the risk of first cardiovascular disease (CVD) events between South Asians and Europeans living in Norway and New Zealand, and to investigate whether traditional risk factors could explain any differences. METHODS We included participants (30-74 years) without prior CVD in a Norwegian (n=16 606) and a New Zealand (n=129 449) cohort. Ethnicity and cardiovascular risk factor information was linked with hospital registry data and cause of death registries to identify subsequent CVD events. We used Cox proportional hazards regression to investigate the relationship between risk factors and subsequent CVD for South Asians and Europeans, and to calculate age-adjusted HRs for CVD in South Asians versus Europeans in the two cohorts separately. We sequentially added the major CVD risk factors (blood pressure, lipids, diabetes and smoking) to study their explanatory role in observed ethnic CVD risk differences. RESULTS South Asians had higher total cholesterol (TC)/high-density lipoprotein (HDL) ratio and more diabetes at baseline than Europeans, but lower blood pressure and smoking levels. South Asians had increased age-adjusted risk of CVD compared with Europeans (87%-92% higher in the Norwegian cohort and 42%-75% higher in the New Zealand cohort) and remained with significantly increased risk after adjusting for all major CVD risk factors. Adjusted HRs for South Asians versus Europeans in the Norwegian cohort were 1.57 (95% CI 1.19 to 2.07) in men and 1.76 (95% CI 1.09 to 2.82) in women. Corresponding figures for the New Zealand cohort were 1.64 (95% CI 1.43 to 1.88) in men and 1.39 (95% CI 1.11 to 1.73) in women. CONCLUSION Differences in TC/HDL ratio and diabetes appear to explain some of the excess risk of CVD in South Asians compared with Europeans. Preventing dyslipidaemia and diabetes in South Asians may therefore help reduce their excess risk of CVD.
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Affiliation(s)
- Kjersti S Rabanal
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Haakon E Meyer
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Grethe S Tell
- Division for Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Romana Pylypchuk
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Suneela Mehta
- School of Population Health, University of Auckland, Auckland, New Zealand
| | | | - Anne Karen Jenum
- Faculty of Health and Society, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Randi M Selmer
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Rod Jackson
- School of Population Health, University of Auckland, Auckland, New Zealand
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