Patterns of co-occurrence between ADHD, Oppositional Defiant Disorder (ODD), and Conduct Disorder (CD) were examined in a sample of non-referred preschool children. ADHD subtypes and sex differences were also explored.
Children aged 3.5 years ( n = 1,048) with high scores on ADHD characteristics were recruited from the Norwegian Mother and Child Cohort Study and clinically assessed, including a semi-structured psychiatric interview.
In children with ADHD, concurrent ODD was present more often than CD (31% vs. 10%), but having ADHD gave higher increase in the odds of CD than of ODD (ODD: odds ratio [OR] = 6.7, 95% confidence interval [CI] = [4.2, 10.8]; CD: OR = 17.6, 95% CI = [5.9, 52.9]). We found a greater proportion of children having the combined ADHD subtype as well as more severe inattentiveness among children with co-occurring CD compared with ODD. Sex differences were minor.
There are important differences in co-occurring patterns of ODD and CD in preschool children with ADHD.
Cinnamon contains cumarin, which may be toxic to the liver. EU-regulations standardardize the amount of cinnamon in pastry including cinnamon rolls. The aim of the study was to investigate if cinnamon intake from pastry was associated with toxic or alcoholic hepatitis.
We registered 58 patients with toxic hepatitis, 38 (66%) women and 20 (34%) men with a median age of 51 (range: 32-80) and 53 (range: 18-78) years, respectively. A total of 22 patients had primarily cholestasis and 36 had hepatitis biochemically. The duration of toxic liver disease from admission to normalization of liver enzymes was similar in the two groups (3.5 ± 3.5 vs 3.6 ± 3.5 months). Toxic hepatitis was most often caused by drugs e.g. NSAID (n = 15; 26%), antibiotics (n = 9; 16%), alternative medicine (n = 7; 12%) and Antabuse (n = 5; 9%). We registered eight patients admitted with severe alcoholic hepatitis, five men and three women, median age of 60 (range: 34-67) years. Alcoholic hepatitis was associated with high alcohol intake. None of the patients with toxic or alcoholic hepatitis reported of excessive intake of cinnamon rolls and there was no evidence of cinnamon added to alcohol of alternative medicine products.
Intake of cinnamon from cinnamon rolls is not associated with admission for toxic or alcoholic hepatitis. However, for the diagnosis of toxic liver diseases including alcohol it is very important to have patient information regarding any new drugs, alternative medicine and alcohol intake. Further, other causes of liver diseases should be excluded.
Results of an assessment of the actual food of the population in various medicoeconomic zones of the republic (industrial, agricultural, Arctic) by method of the frequency analysis of food consumption are presented in the article. The analysis of control of compliance of quality and safety of foodstuff in the Republic of Sakha (Yakutia), according to requirements of the legislation of the Russian Federation, acts of the Customs union has been made. Decreased consumption of such foodstuff as milk, fish and meat products including products from local food staples and national dishes has been established. The data obtained are medic-biological justification for search of ways of optimization of population nutrition, creation of specialized products with a functional purpose and for the prevention of the states and diseases connected with nutrition violation. They also define innovative development of the republic in questions of biotechnologies of the production of specialized foods for various groups of the population. Results of chemical composition research of the most used wild-growing food plants of Yakutia are given. The questions connected with the nutrition and biological value of the dairy products of a functional purpose with use of wild-growing food herbs and berries of Yakutia are discussed.
This study examined the psychometric properties and diagnostic accuracy of the Swedish translations of the Spence Children's Anxiety Scale, self- and parent report versions, in a sample of 104 adolescents presenting at two general psychiatric outpatient units. Results showed high informant agreement and good internal reliability and concurrent and discriminant validity for both versions and demonstrated that this scale can distinguish between adolescents with and without an anxiety disorder in a non-anxiety-specific clinical setting. The relative clinical utility of different cutoff scores was compared by looking at the extent to which dichotomized questionnaire results altered the pretest probability of the presence of a diagnosis as defined by the Schedule for Affective Disorders and Schizophrenia for School-Age Children. Optimized for screening and diagnostic purposes in Sweden, cutoff scores obtained in the current study outperformed a previously identified cutoff score derived from an Australian community sample. The Spence Children's Anxiety Scale is a useful clinical instrument for the assessment of anxiety in adolescents.
The tradition of storytelling is an integral part of Alaska Native cultures that continues to be a way of passing on knowledge. Using a story-based approach to share cancer education is grounded in Alaska Native traditions and people's experiences and has the potential to positively impact cancer knowledge, understandings, and wellness choices. Community health workers (CHWs) in Alaska created a personal digital story as part of a 5-day, in-person cancer education course. To identify engaging elements of digital stories among Alaska Native people, one focus group was held in each of three different Alaska communities with a total of 29 adult participants. After viewing CHWs' digital stories created during CHW cancer education courses, focus group participants commented verbally and in writing about cultural relevance, engaging elements, information learned, and intent to change health behavior. Digital stories were described by Alaska focus group participants as being culturally respectful, informational, inspiring, and motivational. Viewers shared that they liked digital stories because they were short (only 2-3 min); nondirective and not preachy; emotional, told as a personal story and not just facts and figures; and relevant, using photos that showed Alaskan places and people.
Bodily conditions that are difficult to identify, explain and treat with the aid of medical knowledge and technology appear to be particularly challenging to medical encounters. Patients are often dissatisfied with the help they receive, and they often experience that their medical needs are not met. To explore factors facilitating patient satisfaction among patients with a medically unexplained condition, we ask: what is the importance of individual versus relational factors in facilitating patient satisfaction in clinical encounters between general practitioners (GPs) and women with medically unexplained long-term fatigue? We approach this question through a statistical analysis of survey data collected from a net sample of 431 women recruited through a patient organisation for people suffering from myalgic encephalomyelitis in 2013. Participants were asked about their experiences with general practitioners in the Norwegian national health system in two different phases: shortly after illness onset, and current regular general practitioner last 12?months. The questions evolved around themes concerning shared understanding and decision making, being taken seriously, being paid due respect and being treated as an equal partner. Through descriptive statistics and multivariable logistic regression analyses, we explored how their experiences were related to individual and relational factors, respectively. Free-text comments from the questionnaires were used while interpreting the results. The analysis illuminates that relational aspects in medical encounters between GPs and ME patients, especially continuity, congruence in doctor-patient views and being seen by a specialist, are important catalysts of patient satisfaction. The probability of being satisfied with the initial investigation was more than six times higher in women who were referred to specialists, compared to those who were not. We conclude that continuity of care and experiences of being in a partnership that operates on a common ground - a shared understanding of the patient's illness - foster patient satisfaction among women with medically unexplained long-term fatigue.
In the present study, the scaling up of Parent Management Training, Oregon Model (PMTO) in Norway was examined by investigating how large-scale dissemination affected the composition of the target group and the service providers by comparing child behavioral outcomes in the effectiveness and dissemination phases of implementation. Despite the larger heterogeneity of the service providers and the intake characteristics of the target group, which are contrary to the expectations that were derived from the literature, no attenuation of program effects was detected when scaling up PMTO. In Norway, a long-term-funded centralized center, combined with an active implementation strategy, seems to have affected the quality of PMTO delivered system-wide in services for children with behavior problems.
Cites: Am Psychol. 2010 Feb-Mar;65(2):73-84 PMID 20141263
While predictors of survival in older people have been examined in depth in a large number of studies, a literature search revealed no cross-national comparative prospective cohort studies on this issue. This study investigated survival and its predictors from age 75 to 85 among three local Nordic populations using survival data on national cohorts as background information.
The data were derived from national registers and from samples of 75-year old living in Denmark, Sweden, and Finland. The subjects were invited to take part in interviews and examinations focusing on different domains of health, functional capacity, and physical and social activities.
The proportion of survivors to age 75 was markedly smaller among the Finnish men and women than Danish or Swedish subjects. In the local population no marked differences in survival from age 75 to 85 were observed between the groups of men, while women survived longer than men and longer in Göteborg than in Glostrup or Jyväskylä. Univariate models revealed 12 predictors of survival. In the multivariate models, the significant predictors among men related to physical fitness, whereas among women they pertained to social activities and morbidity.
Despite great differences in the proportions of survivors to age 75, and excepting the survival advantage of women, only minor differences were present in the subjects' further survival to age 85. In the univariate analyses, many of the factors predictive of survival from age 75 to 85 were the same in the examined populations, whereas in the multivariate analyses differences between the sexes emerged.
This research aims to assess catering arrangements and dietary patterns of children at preschool educational institution and at home. The article analyses catering arrangements for pre-school children (3-7-year-old) from Ekaterinburg, Nizhny Tagil, Kamensk-Uralsky, Vladikavkaz and Krasnoyarsk. Based on menu production records provided by preschool educational institution, and family nutrition questionnaires we have examined their compliance with the nutritional physiological standards. The summarized data on menu production records from preschool educational institutions showed whether they met food basket requirements (net weight), as well as nutritional value requirements (proteins, fats, carbohydrates, calories content). The assessment was carried out in Ekaterinburg, Nizhny Tagil and Krasnoyarsk using Public catering calculations software (version 5) and a proprietary database of childreris food formulae. Childrens food basket assessment in Ekaterinburg and Kamensk-Uralsky revealed underconsumptionof vegetables (17.9-38% decrease), milk (52.7-62% decrease), curd (40.2-45.3% decrease). We have also observed decreased consumption of fruits, including dried fruit, by 31.8%, as well as cereals and legumes by 43% in Kamensk-Uralsky. Macronutrient analysis has shown underconsumption of total carbohydrates (by 19%) and animal proteins. The assessment of children nutrition at home has been carried out using NUTRITEST-IP diagnostic system in Nizhny Tagil, Kamensk-Uralsky, Vladikavkaz and Krasnoyarsk. The results showed overconsumption of most foods except vegetables. Excessive intake of fats and sugars (3.6 and 3.5 fold higher, respectively) accounted for higher than normal energy consumption by children at home. The evaluation has also revealed a significant difference in the consumption of saturated fats, mono - and disaccharides, food fibers and vitamin C by the children from the locations included in the study. The excessive intake of simple carbohydrates was typical for family diets and excessive fat intake was characteristic for child diet in preschool educational institution.
The potential non-specific effects of BCG (Bacillus Calmette-Guérin) vaccination, with reported reduction of infectious disease morbidity among vaccinated children, in addition to the protective effect against tuberculosis (TB), are highly debated. In Greenland, BCG vaccination was introduced in 1955, but temporarily discontinued from 1991 to 1996 due to nationwide policy changes. Using the transient vaccination stop, we aimed to investigate possible non-specific effects of BCG vaccination by measuring nation-wide hospitalization rates due to infectious diseases other than TB among vaccinated and unvaccinated children.
A retrospective cohort study including all children born in Greenland aged 3 months to 3 years from 1989 to 2004. A personal identification number assigned at birth allowed for follow-up through national registers. Information on hospitalization due to infectious diseases was obtained from the Greenlandic inpatient register using ICD-8 and ICD-10 codes. Participants with notified TB were censored. Incidence rate ratios (IRR) were estimated using Poisson regression.
Overall, 19 363 children, hereof 66% BCG-vaccinated, were followed for 44 065 person-years and had 2069 hospitalizations due to infectious diseases. IRRs of hospitalization in BCG-vaccinated as compared with BCG-unvaccinated children were 1.07 [95% confidence interval (CI) 0.96-1.20] for infectious diseases overall, and specifically 1.10 (95% CI 0.98-1.24) for respiratory tract infections. Among BCG-vaccinated children aged 3 to 11 months, the IRR of hospitalization due to infectious diseases was 1.00 (95% CI 0.84-1.19) as compared with BCG-unvaccinated children.
Our results do not support the hypothesis that neonatal BCG vaccination reduces morbidity in children caused by infectious diseases other than TB.
CommentIn: Int J Epidemiol. 2016 Dec 1;45(6):2131-2133 PMID 27856606
The review analyzed genetic polymorphisms contribute to the development of non-communicable diseases among the inhabitants of the Arctic. It is known that the area belongs to the arctic areas of discomfort for living and employment rights. Ecological features of the Far North have contributed to the adaptation of the indigenous population to environmental conditions, which manifested itself in particular in the power features that provide a low prevalence of obesity, metabolic syndrome, type 2 diabetes and cardiovascular disease. Active development of the Arctic zone and the associated lifestyle changes in the population, including the nature of power, caused a change in the prevalence and trends of non-communicable diseases, which has its own characteristics in comparison with the ethnic groups living in more southern latitudes. These features, as follows from the results of a number of studies to be associated, including the presence of genetic polymorphisms characteristic of the population of the Arctic zone.
Results of research of mineral composition, content of vitamin C and P, titrable acids, pectinaceous and phenol substances in fresh, fast-frozen (t=-30 °C), and also stored within 3 and 9 months (t=-18 °C) fruits of wild-growing blackberry, cornel, medlar and sea-buckthorn are presented in article. Determination of mineral composition was carried out by flame atomic absorption photometry, vitamin C and pectinaceous substances -by titirimetric methods, phenolic substances and vitamin P - by colorimetric methods. Vitamin C content was minimal in fresh fruits of cornel (6.9±0.3 mg%), amounted to 21.7-32.0 mg% in the fruits of blackberries and medlar and reached 180.1±7.2 mg% in the fruit of sea-buckthorn. Vitamin P concentration ranged from 34.9 (sea-buckthorn) to 180.0 mg% (cornel). Berries of a cornel contained also the greatest number of titrable acids (33.2±1.3 g/dm3), phenolic compounds (243.0±4.8 mg%) and pectinaceous substances (2.91±0.08%). The most significant content of potassium (521±15.6 mg%), calcium (133.2±5.2 mg%), magnesium (62.4±2.5 mg%) and iron (2.81±0.05 mg%) was revealed in medlar fruits. Consumption of 100 g of the studied fruits provides daily requirements of a human body, depending on a species of wild plants: in calcium -for 2-13.3%, potassium - for 7.0-20.8%, magnesium - for 8.1-15.6%, iron - for 5.9-19.2% and in vitamin C - from 5.8-24.6 to 145.7% in the case of sea buckthorn. The applied processing method of conservation - fast freezing (t=-30 °?) of fruits and their long storage (t=-18 °?) is the effective way ensuring high safety of nutrients in them. In the studied berries after 9-months cold storage the safety of vitamin C varied ranging from 55.7 (blackberry) to 76.1% (cornel), and vitamin P - from 81.9 (sea-buckthorn) to 92.8% (cornel). Stability of titrable acids, except for medlar fruits, varied from 84.2% (blackberry) to 94.0% (sea-buckthorn). The safety of phenolic and pectinaceous compounds by the end of 9 months of storage, has averaged 90.6 and 95.6% respectively in comparison with their initial quantity in fresh fruits. The mineral composition was the stablest. After completion of experiment the safety of mineral substances in fruits of wild plants fluctuated from 94.6 to 98.5%. Distinctions in change of biochemical complexes of berries of blackberry, cornel, medlar and sea-buckthorn at fast freezing (t=-30 °?) and storage (t=-18 °?), apparently, are caused by specific features, content of free and bound water, thickness of cellular walls, durability of a thin skin of fruits, as well as by concentration of the components that inhibit the destructive processes occurring at the cellular and molecular level.
Colorectal cancer (CRC) is one of the main causes of morbidity and mortality among all malignant tumors both in the world and in Russia. The purpose of the research was to study the association between diet and the probability of CRC in Perm Krai. The epidemiological analytical case-control study was performed. The questionnaire survey included 191 histologically proved colorectal cancer cases and 200 healthy individuals with excluded CRC by the results of colonoscopy. The surveyed groups were spread evenly by sex, age, ethnicity, place of residence and smoking (p>0.05). The odds to determine the following factors were higher in case group: diet including fried foods (OR=2.45, 95% CI: 1.58-3.80, p
aCenter for Primary Health Care Research, Department of Clinical Sciences in Malmö, Lund University, Region Skåne, Sweden bSchool of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, California, USA.
Alcohol consumption is associated with squamous cell carcinoma of the esophagus, but little is known about whether alcohol consumption is associated with adenocarcinoma of the esophagus and gastric cancer, which we attempt to clarify in this study. Individuals with alcohol use disorders were identified from the nation-wide Swedish Hospital Discharge Register and Outpatient Register, the Crime Register, and the Prescription Drug Register, and they were linked to the Swedish Cancer Registry to calculate standardized incidence ratios of esophageal and gastric cancers using those without alcohol use disorders (AUDs) as a reference. A total of 14?518 and 73?504 patients were diagnosed with esophageal and gastric cancers, separately, during the study period. The risk of esophageal cancer was significantly increased, with a standardized incidence ratio of 2.24 (95% confidence interval 2.08-2.41) among individuals with AUDs. Both squamous cell carcinoma and adenocarcinoma of the esophagus were increased (2.89 for squamous cell carcinoma and 1.20 for adenocarcinoma). The incidence of gastric cancer was significantly decreased and the decrease was even more prominant for corpus cancer compared with cardia cancer (0.57 vs. 0.82). In this retrospective cohort study, we found that AUDs were associated with an increased risk of both squamous cell carcinoma and adenocarcinoma of the esophagus, whereas individuals with AUDs had a lower risk of gastric cancer, especially for corpus cancer, which may be related to the eradication of Helicobacter pylori infection. However, the underlying mechanisms need to be explored in future studies.
Crime rates are high in substance-using populations; therefore, investigation of factors associated with crime in these populations is highly relevant. We describe crime prevalence and associations between crime, pattern of substance use and psychosocial factors, such as self-control and social network.
This is a cross-sectional study including substance users (n?=?549; mean age 34?years; 27% women) entering treatment at 21 treatment centres across Norway (December 2012 to April 2015). Data on demographics, substance use, psychosocial variables and crime in the 6?months prior to treatment were obtained through interviews. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were estimated through logistic regression.
Sixty-four percent of participants had committed crime in the 6?months prior to treatment. Of these, 93% committed income-generating crime. Several factors were associated with increased likelihood of having committed crime: use of stimulants (aOR?=?1.82, 95% CI 1.04-3.17), use of a higher number of different substances (aOR?=?1.16, 95% CI 1.04-1.31) and spending most of their time with family or friends using addictive substances (aOR?=?2.38, 95% CI 1.10-5.16 and aOR?=?2.22, 95% CI 1.32-3.73). Protective factors associated with decreased likelihood of committing crime were being older (aOR?=?0.95, 95% CI 0.92-0.97) and having higher self-control (aOR?=?0.94, 95% CI 0.91-0.97).
Stimulant use, higher number of different substances used, lower self-control, primarily a substance-using social network and being younger were associated with crime in this substance-using population. Treatment clinics should consider these risk factors for crime, and suitable interventions should be implemented and evaluated. [Skjaervø I, Skurtveit S, Clausen T, Bukten A. Substance use pattern, self-control and social network are associated with crime in a substance-using population. Drug Alcohol Rev 2017;36:245-252].
aUnit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center bDepartment of Obstetrics and Gynecology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark cDepartment of Research, The Cancer Registry of Norway, Oslo, Norway dDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden eMerck & Co. Inc., Kenilworth, New Jersey, USA.
Using a large, population-based survey, we assessed the levels and correlates of human papillomavirus (HPV) awareness among Scandinavian women after introduction of HPV vaccination. In 2011-2012, a random sample of women aged between 18 and 45 years from Denmark, Sweden and Norway received a questionnaire on lifestyle, health and HPV awareness. We included 47?895 women (response rate 60.6%) in our study. Country-specific and age-specific proportions of women who had heard of HPV in 2011-2012 (postvaccination survey) were compared with corresponding proportions in an identical survey from 2004-2005 (prevaccination survey, n=54?079, response rate 71.3%). Correlates of HPV awareness in the postvaccination survey were assessed by logistic regression. In all countries and age groups, awareness of HPV increased from the prevaccination to the postvaccination survey. In the postvaccination survey, HPV awareness was higher in Denmark (75.8%) and Sweden (74.8%) compared with Norway (62.4%), with greatest discrepancy among women aged between 18 and 19 years (Denmark: 74.9%, Sweden: 70.4%, Norway: 39.6%). Variables associated with low HPV awareness included the following: low education [=12 vs. >16 years of schooling: odds ratio (OR)=0.45, 95% confidence interval (CI): 0.42-0.48], being a virgin (vs. nonvirgins: OR=0.74, 95% CI: 0.66-0.83), never having used condoms (vs. ever: OR=0.62, 95% CI: 0.56-0.67), nonuse of contraception at first intercourse (vs. use: OR=0.83, 95% CI: 0.79-0.88) and daily smoking (vs. never: OR=0.86, 95% CI: 0.80-0.92). HPV awareness in Scandinavia has increased since the introduction of HPV vaccination. However, 24-38% of Scandinavian women still have never heard of HPV. Future information efforts should target groups with low HPV awareness.
The management of multidrug-resistant tuberculosis (MDR-TB) is strictly regulated in Norway. However, nationwide studies of the epidemic are lacking.
To describe the MDR-TB epidemic in Norway over two decades.
Retrospective analysis of data on MDR-TB cases in Norway, 1995-2014, obtained from the national registry, patient records and the reference laboratory, with genotyping and cluster analysis data. Data for non-MDR-TB cases were collected from the national registry.
Of 4427 TB cases, 89 (2.0%) had MDR-TB, 7% of whom had extensively drug-resistant TB (XDR-TB) and 24% pre-XDR-TB. Of the 89 MDR-TB cases, 96% were immigrants, mainly from the Horn of Africa or the former Soviet Union (FSU); 37% had smear-positive TB; and 4% were human immunodeficiency virus co-infected. Of the 19% infected in Norway, the majority belonged to a Delhi/Central Asian lineage cluster in a local Somali community. Among the MDR-TB cases, smear-positive TB and FSU origin were independent risk factors for XDR/pre-XDR-TB. Treatment was successful in 66%; 17% were lost to follow-up, with illicit drug use and adolescence being independent risk factors. Forty-four per cent of patients treated with linezolid discontinued treatment due to adverse effects.
MDR-TB is rare in Norway and is predominantly seen in immigrants from the Horn of Africa and FSU. Domestic transmission outside immigrant populations is minimal.