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[Assessing the quality of medical certificates II--useful criteria or unnecessary schedule?].

https://arctichealth.org/en/permalink/ahliterature191233
Source
Tidsskr Nor Laegeforen. 2002 Jan 20;122(2):161-4
Publication Type
Article
Date
Jan-20-2002
Author
John Gunnar Maeland
Peder Rolfssøn Ringdal
Kjell Haug
Author Affiliation
Seksjon for sosialmedisin Institutt for samfunnsmedisinske fag Universitetet i Bergen Ulriksdal 8C 5009 Bergen. john.meland@isf.uib.no
Source
Tidsskr Nor Laegeforen. 2002 Jan 20;122(2):161-4
Date
Jan-20-2002
Language
Norwegian
Publication Type
Article
Keywords
Certification
Consultants
Disability Evaluation
Humans
Insurance, Disability
Norway
Physician's Role
Quality Control
Questionnaires
Rehabilitation, Vocational
Sick Leave
Abstract
In Norway, doctors must provide the National Health Insurance (NIS) with a special medical certificate if a sick-leave exceeds eight weeks. The aim of this study was to evaluate this medical information in relation to the NIS criteria for further sickness benefits and the usefulness of the certificate in assessing the need for early rehabilitative and vocational initiatives.
2,237 consecutive eight-week medical certificates submitted to 21 NIS offices in the county of Hordaland in 1994 were independently evaluated by the NIS officer and the NIS medical consultant in a questionnaire survey.
Both evaluators found sufficient medical information in the vast majority of medical certificates, though in about 12% of the cases the medical criteria for further benefits were not sufficiently documented. In less than 10% of the cases, active rehabilitative or vocational measures were called for at this point in time. However, there was a rather low degree of consensus between the NIS officer and the medical consultant about in which cases supplementary information or active measures were warranted.
We conclude that the eight-week medical certificate usually contains enough medical information but is of limited use in assessing the need for active intervention by the NIS. Supplementary information from the absentee and the employer should be collected at an early stage of the sick leave.
PubMed ID
11873570 View in PubMed
Less detail

A biobank of primary teeth within the Norwegian Mother and Child Cohort Study (MoBa): a resource for the future.

https://arctichealth.org/en/permalink/ahliterature125535
Source
Paediatr Perinat Epidemiol. 2012 May;26(3):264-71
Publication Type
Article
Date
May-2012
Author
Helene Meyer Tvinnereim
Gunvor Bentung Lygre
Kjell Haug
Patricia Schreuder
Kristin Klock
Author Affiliation
Departments of Clinical Dentistry Public Health and Primary Health Care, Faculty of Medicine and Dentistry, University of Bergen, Årstadveien 17, Bergen, Norway. helene.tvinnereim@iko.uib.no
Source
Paediatr Perinat Epidemiol. 2012 May;26(3):264-71
Date
May-2012
Language
English
Publication Type
Article
Keywords
Biological Specimen Banks - standards
Child
Cohort Studies
European Continental Ancestry Group
Female
Humans
Male
Mothers
Norway
Pregnancy
Prospective Studies
Questionnaires
Research Design
Specimen Handling - methods - standards
Tooth, Deciduous
Abstract
The Norwegian Mother and Child Cohort Study (MoBa) is a prospective population-based cohort study including >100 000 pregnancies and following the children through childhood, using questionnaires and collecting biological samples. The aim of MoBa is to test specific aetiological hypotheses by estimating the association between exposure and disease, aiming at prevention. A biobank for exfoliated primary teeth collected from the children participating in MoBa has been established (MoBaTooth Biobank). Samples of tooth tissues from the primary dentition can give information about exposure to toxic and essential elements during fetal life and early infancy. Prenatally and postnatally formed tooth tissues permanently document early exposures unlike other biomarkers, as teeth form incrementally at a known rate. Results from tooth analyses will be coupled with corresponding information in the multiple questionnaires and data from analysis of other biological samples collected by MoBa. Invitations to donate one or more teeth are sent to all mothers/children in the period 2008-2016, when the child is 6.75 years old. By August 2011, 7400 participants had been recorded into the MoBaTooth database donating altogether 9798 teeth (1.3 teeth per child). The response rate was 24%, but there is a lag of >1 year in the response. Data from the tooth biobank can supply MoBa with important additional information on the uptake of trace elements during fetal life and early infancy. This information can illuminate possible causal factors of health and disease in the future.
PubMed ID
22471685 View in PubMed
Less detail

Can 'early programming' be partly explained by smoking? Results from a prospective, population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature265056
Source
Paediatr Perinat Epidemiol. 2015 Jan;29(1):50-9
Publication Type
Article
Date
Jan-2015
Author
Liv Grimstvedt Kvalvik
Rolv Skjaerven
Kari Klungsøyr
Stein Emil Vollset
Kjell Haug
Source
Paediatr Perinat Epidemiol. 2015 Jan;29(1):50-9
Date
Jan-2015
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cause of Death
Female
Humans
Infant, Low Birth Weight
Infant, Newborn
Male
Mothers - statistics & numerical data
Norway - epidemiology
Pregnancy
Prospective Studies
Risk factors
Smoking - epidemiology
Spouses - statistics & numerical data
Young Adult
Abstract
Numerous studies have focused the association between low birthweight and later disease. Our objective was to study the association between birthweight and later adult smoking and thereby explore a possible mechanism for the association between low birthweight and later adult disease.
We studied associations between birthweight of women (n=247704) born in 1967-1995 and smoking habits at the end of their pregnancy 13-42 years later in a prospective, population-based cohort study from The Medical Birth Registry of Norway. Similarly, the association between birthweight of men (n=194393) and smoking habits of their partners were assessed. Finally, we studied the relation between smoking habits of the participating women and the cause specific death of their mothers (n=222808).
Twenty per cent of women with birthweight less than 2000 g were adult daily smokers compared with 11% with birthweight 4000-4499 g [relative risk=1.8, 95% confidence interval 1.4, 2.2]. Similarly, we found an association between men's birthweight and their partners smoking habits. Mothers of smoking women had doubled risk of dying from lung cancer and from cardiovascular disease compared with mothers of non-smoking women.
Being born with low birthweight is associated with smoking in adulthood. Associations of adult smoking with partners' birthweight and mothers' smoking-related causes of death suggest a shared smoking environment, and may account for some of the established association between birthweight and later cardiovascular disease.
PubMed ID
25417973 View in PubMed
Less detail

[Does systematic evaluation of sickness certification II lead to less use of health insurance?]

https://arctichealth.org/en/permalink/ahliterature71734
Source
Tidsskr Nor Laegeforen. 2002 Jan 20;122(2):157-60
Publication Type
Article
Date
Jan-20-2002
Author
Peder Rolfssøn Ringdal
Kjell Haug
John Gunnar Maeland
Author Affiliation
Seksjon for sosialmedisin Institutt for samfunnsmedisinske fag Universitetet i Bergen Ulriksdal 8C 5009 Bergen. peder.ringdal@isf.uib.no
Source
Tidsskr Nor Laegeforen. 2002 Jan 20;122(2):157-60
Date
Jan-20-2002
Language
Norwegian
Publication Type
Article
Keywords
Adult
Aged
Certification
Clinical Competence
Consultants
Disability Evaluation
English Abstract
Female
Humans
Insurance, Disability - economics - statistics & numerical data - trends
Male
Middle Aged
Norway
Physician's Role
Professional Competence
Sick Leave - economics - statistics & numerical data - trends
Socioeconomic Factors
Abstract
BACKGROUND: The increasing prevalence of disability pensioning in Norway has led to several attempts at strengthening the proactive role of the National Insurance System (NIS) in cases of long-term sick-listing. Since 1988, a special medical certificate is required after eight weeks of sick-leave. The aim of this study was to examine whether systematic evaluation of this medical certificate by NIS officers and NIS medical consultants could reduce future health insurance expenditure. MATERIAL AND METHODS: In 1994 a randomised study using a paired design of the NIS local offices in the county of Hordaland was undertaken. All eight-week medical certificates in the intervention group (N = 2,237) were systematically reviewed, whereas standard routines were used for the control group (N = 1,764). RESULTS: After three years, no significant differences were observed between the two groups in health insurance utilisation. INTERPRETATION: We conclude that local NIS offices are unable to use the information in the eight-week sick notes to effectively influence future utilisation of health insurance. The reason may be that NIS offices lack the skills necessary for early intervention in long-term sick-listing.
PubMed ID
11873569 View in PubMed
Less detail

Exposure to dental amalgam restorations in pregnant women.

https://arctichealth.org/en/permalink/ahliterature144092
Source
Community Dent Oral Epidemiol. 2010 Oct;38(5):460-9
Publication Type
Article
Date
Oct-2010
Author
Gunvor Bentung Lygre
Lars Björkman
Kjell Haug
Rolv Skjaerven
Vigdis Helland
Author Affiliation
Dental Biomaterials Adverse Reaction Unit, Uni Health, Bergen, Norway. Gunvor.Lygre@odont.uib.no
Source
Community Dent Oral Epidemiol. 2010 Oct;38(5):460-9
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Adult
Alcohol drinking - epidemiology
Body mass index
Cohort Studies
Confidence Intervals
Dental Amalgam - adverse effects
Dental Restoration, Permanent - adverse effects - statistics & numerical data
Educational Status
Female
Humans
Logistic Models
Norway - epidemiology
Odds Ratio
Pregnancy
Prenatal Exposure Delayed Effects - epidemiology
Smoking - epidemiology
Young Adult
Abstract
The Norwegian Mother and Child Cohort Study (MoBa) started in 1999 to identify environmental factors that could be involved in mechanisms leading to disease. Questions have been raised about potential risks to the fetus from prenatal exposure to mercury from amalgam fillings in pregnant women. The aim of the present study was to identify factors potentially associated with amalgam fillings in pregnant women participating in the Norwegian Mother and Child Cohort Study (MoBa). An additional aim was to obtain information about dental treatment in the cohort.
Total of 67,355 pregnancies from the MoBa study were included in the present study. Information regarding age, education, smoking habits, alcohol consumption, weight, and height for the women was obtained from a questionnaire that was filled in at the 17th week of pregnancy. In another questionnaire, which was sent to all participants in the 30th week of pregnancy, the women reported types of dental treatment during pregnancy, total number of teeth, and number of teeth with amalgam fillings. The self-assessed number of teeth and number of teeth with amalgam fillings were validated in an external sample of 97 women of childbearing age.
Odds ratio for having more than 12 teeth with amalgam fillings increased considerably with age. Other significant risk factors for having high exposure to amalgam were low education, high body mass index (BMI), and smoking during pregnancy. Women with the lowest levels of education had a twofold increased odds ratio of having more than 12 teeth filled with amalgam compared with women who had more than 4 years of university studies. According to the results from the validation of self-assessed number of teeth with amalgam fillings, the information obtained was reliable.
Age, education, smoking habits, and BMI were associated with amalgam exposure.
Notes
Comment In: J Evid Based Dent Pract. 2011 Sep;11(3):162-321855822
PubMed ID
20406270 View in PubMed
Less detail

Exposure to tobacco smoke in utero and subsequent plasma lipids, ApoB, and CRP among adult women in the MoBa cohort.

https://arctichealth.org/en/permalink/ahliterature122454
Source
Environ Health Perspect. 2012 Nov;120(11):1532-7
Publication Type
Article
Date
Nov-2012
Author
Lea A Cupul-Uicab
Rolv Skjaerven
Kjell Haug
Gregory S Travlos
Ralph E Wilson
Merete Eggesbø
Jane A Hoppin
Kristina W Whitworth
Matthew P Longnecker
Author Affiliation
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709, USA. cupuluicabl@niehs.nih.gov
Source
Environ Health Perspect. 2012 Nov;120(11):1532-7
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Biological Markers - blood
C-Reactive Protein - metabolism
Cohort Studies
Female
Humans
Lipids - blood
Metabolic Syndrome X - blood - chemically induced - epidemiology
Norway - epidemiology
Pregnancy
Prenatal Exposure Delayed Effects - blood - chemically induced - epidemiology
Risk factors
Smoking - adverse effects - epidemiology
Tobacco Smoke Pollution - adverse effects
Young Adult
Abstract
Recent findings suggest that maternal smoking during pregnancy may play a role in the development of metabolic alterations in offspring during childhood. However, whether such exposure increases the risk of developing similar metabolic alterations during adulthood is uncertain.
We evaluated the association of in utero exposure to maternal tobacco smoke with plasma lipids, apolipoprotein B (apoB), and C-reactive protein (CRP) in adulthood.
The study was based on a subsample of the Norwegian Mother and Child Cohort Study (MoBa) and included 479 pregnant women with plasma lipids, apoB, and CRP measurements. Information on in utero exposure to tobacco smoke, personal smoking, and other factors were obtained from the women by a self-completed questionnaire at enrollment, at approximately 17 weeks of gestation.
Women exposed to tobacco smoke in utero had higher triglycerides [10.7% higher; 95% confidence interval (CI): 3.9, 17.9] and lower high-density lipoprotein cholesterol (HDL) (-1.9 mg/dL; 95% CI: -4.3, 0.5) compared with unexposed women, after adjusting for age, physical activity, education, personal smoking, and current body mass index (BMI). Exposed women were also more likely to have triglycerides = 200 mg/dL [adjusted odds ratio (aOR) = 2.5; 95% CI: 1.3, 5.1] and HDL
Notes
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PubMed ID
22814200 View in PubMed
Less detail

In utero exposure to maternal tobacco smoke and subsequent obesity, hypertension, and gestational diabetes among women in the MoBa cohort.

https://arctichealth.org/en/permalink/ahliterature129229
Source
Environ Health Perspect. 2012 Mar;120(3):355-60
Publication Type
Article
Date
Mar-2012
Author
Lea A Cupul-Uicab
Rolv Skjaerven
Kjell Haug
Kari K Melve
Stephanie M Engel
Matthew P Longnecker
Author Affiliation
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina 27709, USA. cupuluicabl@niehs.nih.gov
Source
Environ Health Perspect. 2012 Mar;120(3):355-60
Date
Mar-2012
Language
English
Publication Type
Article
Keywords
Adult
Body mass index
Cohort Studies
Diabetes Mellitus, Type 2 - chemically induced - epidemiology
Diabetes, Gestational - chemically induced - epidemiology
Female
Humans
Hypertension - chemically induced - epidemiology
Hypertension, Pregnancy-Induced - chemically induced - epidemiology
Middle Aged
Norway - epidemiology
Obesity - chemically induced - epidemiology
Pregnancy
Prenatal Exposure Delayed Effects - chemically induced - epidemiology
Prevalence
Self Report
Tobacco Smoke Pollution
Young Adult
Abstract
Environmental factors influencing the developmental origins of health and disease need to be identified and investigated. In utero exposure to tobacco smoke has been associated with obesity and a small increase in blood pressure in children; however, whether there is a corresponding increased risk of conditions such as diabetes and hypertension during adulthood remains unclear.
Our goal was to assess the association of self-reported in utero exposure to tobacco smoke with the prevalence of obesity, hypertension, type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM) in women 14-47 years of age.
We conducted a cross-sectional analysis of the Norwegian Mother and Child Cohort Study, which enrolled pregnant women in Norway from 1999 thorough 2008. Exposure to tobacco smoke in utero (yes vs. no) was ascertained on the baseline questionnaire (obtained at ~ 17 weeks' gestation); the outcomes were ascertained from the Medical Birth Registry of Norway and the questionnaire. Our analysis included 74,023 women.
Women exposed to tobacco smoke in utero had 1.53 times the odds of obesity [95% confidence interval (CI): 1.45, 1.61] relative to those unexposed, after adjusting for age, education, and personal smoking. After further adjustment for body mass index, the odds ratio for hypertension was 1.68 (95% CI: 1.19, 2.39); for T2DM 1.14 (95% CI: 0.79, 1.65); and for GDM 1.32 (95% CI: 1.10, 1.58) among exposed compared with unexposed.
Exposure to tobacco smoke in utero was associated with obesity, hypertension, and GDM in adult women. The possibility that the associations were attributable to unmeasured confounding cannot be excluded.
Notes
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PubMed ID
22128036 View in PubMed
Less detail

In utero exposure to tobacco smoke and subsequent reduced fertility in females.

https://arctichealth.org/en/permalink/ahliterature141032
Source
Hum Reprod. 2010 Nov;25(11):2901-6
Publication Type
Article
Date
Nov-2010
Author
Xibiao Ye
Rolv Skjaerven
Olga Basso
Donna D Baird
Merete Eggesbo
Lea Aurora Cupul Uicab
Kjell Haug
Matthew P Longnecker
Author Affiliation
Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Human and Health Services, Research Triangle Park, NC 27709, USA.
Source
Hum Reprod. 2010 Nov;25(11):2901-6
Date
Nov-2010
Language
English
Publication Type
Article
Keywords
Adult
Female
Fertility - drug effects
Humans
Infertility, Female - etiology
Norway
Pregnancy
Prenatal Exposure Delayed Effects
Smoking - adverse effects
Tobacco Smoke Pollution - adverse effects
Abstract
Animal studies have shown that in utero exposure to chemicals in tobacco smoke reduces female fertility, but epidemiological findings have been inconsistent.
We examined the association between in utero exposure to tobacco smoke and female fertility among women in the Norwegian Mother and Child Cohort Study, enrolled from 1999 to 2007. Around the 17th week of pregnancy, participants reported how long they took to conceive (time to pregnancy), and whether their mother smoked while pregnant with the participant. This analysis included 48 319 planned pregnancies among women aged 15-44 years. We estimated fecundability odds ratios (FORs) using a discrete-time survival analysis, adjusting for age, education and adult tobacco smoking.
The adjusted FOR for in utero exposure to tobacco smoke among all subjects was 0.96 [95% confidence interval (CI): 0.93, 0.98], among subjects reporting no adult tobacco smoking or passive exposure it was 0.96 (95% CI: 0.93, 0.99) and among subjects reporting adult tobacco smoking or passive exposure it was 0.95 (95% CI: 0.91, 0.99). We performed a probabilistic sensitivity analysis to estimate the effect of exposure and outcome misclassification on the results, and, as expected, the association became more pronounced after taking misclassification into account.
This large cohort study supports a small-to-modest association between in utero exposure to tobacco smoke and reduced fertility.
Notes
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PubMed ID
20817739 View in PubMed
Less detail

Maternal Smoking Status in Successive Pregnancies and Risk of Having a Small for Gestational Age Infant.

https://arctichealth.org/en/permalink/ahliterature291770
Source
Paediatr Perinat Epidemiol. 2017 01; 31(1):21-28
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Date
01-2017
Author
Liv G Kvalvik
Kjell Haug
Kari Klungsøyr
Nils-Halvdan Morken
Lisa A DeRoo
Rolv Skjaerven
Author Affiliation
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Source
Paediatr Perinat Epidemiol. 2017 01; 31(1):21-28
Date
01-2017
Language
English
Publication Type
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Educational Status
Female
Fetal Growth Retardation - chemically induced - epidemiology
Health Knowledge, Attitudes, Practice
Humans
Incidence
Infant, Newborn
Infant, Small for Gestational Age
Maternal Behavior
Mothers
Norway - epidemiology
Parity
Pregnancy
Prenatal Exposure Delayed Effects - epidemiology
Recurrence
Risk factors
Smoking - adverse effects - epidemiology
Young Adult
Abstract
Smoking during pregnancy is linked to having a small for gestational age (SGA) baby. We estimated SGA risk among women who smoked persistently, quit smoking or started smoking during their first two pregnancies.
Data from the population-based Medical Birth Registry of Norway was used to evaluate self-reported smoking at the beginning and end of two successive pregnancies among 118 355 Nordic women giving birth 1999-2014. Relative risks (RR) with 95% confidence intervals (CI) of SGA in the second pregnancy were estimated using adjusted generalised linear models with non-smokers during both pregnancies serving as referent category.
Daily smokers throughout both pregnancies had almost threefold increased SGA risk in the second pregnancy (RR 2.9, 95% CI 2.7, 3.1). Daily smokers in the first pregnancy, who abstained in the second, had a 1.3-fold increased risk (95% CI 1.1, 1.5). Intermediate risks were found among persistent daily smokers who quit by the end of the second pregnancy (RR 2.0, 95% CI 1.6, 2.4) and non-smokers in first pregnancy who smoked daily throughout their second (RR 1.8, 95% CI 1.4, 2.3). Persistently smoking women without SGA in first pregnancy, had a 2.7-fold increased risk of SGA in second pregnancy (95% CI 2.5, 3.0).
Smoking throughout two successive pregnancies was associated with the greatest increased SGA risk compared with non-smokers, while cessation before or during the second pregnancy reduced this risk. Women who smoked in the first pregnancy without experiencing SGA are not protected against SGA in second pregnancy if they continue smoking.
PubMed ID
27981584 View in PubMed
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A new pathway for elective surgery to reduce cancellation rates.

https://arctichealth.org/en/permalink/ahliterature123569
Source
BMC Health Serv Res. 2012;12:154
Publication Type
Article
Date
2012
Author
Einar Hovlid
Oddbjørn Bukve
Kjell Haug
Aslak Bjarne Aslaksen
Christian von Plessen
Author Affiliation
Institute of Social Science, Sogn og Fjordane University College, Sogndal, Norway. einar.hovlid@hisf.no
Source
BMC Health Serv Res. 2012;12:154
Date
2012
Language
English
Publication Type
Article
Keywords
Appointments and Schedules
Efficiency, Organizational
Health Services Research
Hospital Information Systems
Humans
Interviews as Topic
Norway
Operating Rooms - utilization
Personnel Management - standards
Personnel, Hospital - psychology
Process Assessment (Health Care) - methods
Rural Health Services
Surgery Department, Hospital - manpower - organization & administration
Surgical Procedures, Elective - standards - statistics & numerical data - trends
Total Quality Management
Waiting Lists
Abstract
The cancellation of planned surgeries causes prolonged wait times, harm to patients, and is a waste of scarce resources. To reduce high cancellation rates in a Norwegian general hospital, the pathway for elective surgery was redesigned. The changes included earlier clinical assessment of patients, better planning and documentation systems, and increased involvement of patients in the scheduling of surgeries. This study evaluated the outcomes of this new pathway for elective surgery and explored which factors affected the outcomes.
We collected the number of planned operations, performed operations, and cancellations per month from the hospital's patient administrative system. We then used Student's t-test to analyze differences in cancellation rates (CRs) before and after interventions and a u-chart to analyze whether the improvements were sustained. We also conducted semi-structured interviews with employees of the hospital to explore the changes in the surgical pathway and the factors that facilitated these changes.
The mean CR was reduced from 8.5% to 4.9% (95% CI for mean reduction 2.6-4.5, p
Notes
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PubMed ID
22686475 View in PubMed
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