Previous studies have demonstrated the tendency to repeat gestational age and birthweight in successive pregnancies and that this tendency is associated with infant survival. Thus, newborn outcome and survival is less favourable if the gestational age and size departs from this maternal tendency. This paper aims to study diseases or conditions that might be associated with this effect. Data were provided through a linkage between three Danish health registries: the Danish Fertility Database, the National Hospital Registry, and the Registry for Preventive Medicine. Such linkage was possible due to the use of unique ID-person numbers. The study included all 8219 second-order low-birthweight (LBW) singleton Danish births, 1980-94, of whom 7811 were liveborn. It was also required that the mother's first delivery took place during that period. The analysis considered 7803 of these births; eight were excluded due to insufficient information. Of the second-order LBW children, 26% had an elder sibling who was also LBW. Early neonatal mortality of a 'non-repeat' LBW birth was 1.3 times higher than 'repeat' LBW births [53.8 vs. 41.2 per 1000; RR 1.31; 95% CI 1.03, 1.65], as was infant mortality [78.4 vs. 60.8 per 1000; RR 1.30; 95% CI 1.06, 1.56]. Also, proportionately more LBW repeat births had Apgar scores of >or=7 after 1 and 5 min. Overall, repeat second-order LBW babies weighed 68 g more than non-repeat LBW babies (P 0.05). Newborn immaturity was the most common diagnosis for hospitalisation, and infections the second most common. There were no differences between repeat and non-repeat LBW births in the proportion with each diagnosis. Apart from the differences in birthweight, we were unable to explain the improved survival for repeat compared with non-repeat LBW babies. Except for differences in Apgar scores, we observed no differences in morbidity based on registered hospitalisations during infancy.
OBJECTIVE: To compare the profiles of people visiting only a general practitioner (GP), those visiting only a practitioner of complementary and alternative medicine (CAM), and those visiting both (GP&CAM). DESIGN: A comparative total population health survey in central Norway (HUNT 2). SUBJECTS: A total of 54,448 persons 20 years of age and over who answered questions about their use of health services during the previous 12 months. VARIABLES: Sociodemographic characteristics, self-perceived health, subjective health complaints, and a variety of common diseases. RESULTS: Some 34,854 (64.0%) of those who answered the health service use question had visited only a GP, 837 (1.5%) only a CAM practitioner, and 4563 (8.4%) both during the last 12 months. The likelihood of being a CAM-only user as compared to a GP-only user was significantly increased (p
AIM: To study psychological well-being (health-related quality of life) in a population of adults 20 years and over with hearing impairment (HI) and its relation to audiological factors, consequences of the HI, sense of humour, and use of communication strategies. SUBJECTS AND METHODS: Consecutive adults (n = 343) at the outpatient Unit of Audiology of a Norwegian university hospital answered the Psychological General Well-being inventory (PGWB), Hearing Disability and Handicap Scale (HDHS), Sense of Humour Questionnaire-6 (SHQ-6), and Communication Strategies Scale (CSS) in relation to an audiological examination and medical consultation. RESULTS: Mean PGWB index for the whole sample was 81.4 (SD 14.3) and females reported a significantly lower psychological well-being. In multiple linear regression analyses well-being was negatively associated with high levels of activity limitation and participation restriction. PGWB index was positively associated with high sense of humour, but was neither explained by audiological factors nor use of communication strategies. CONCLUSIONS: Psychological well-being was associated with the outcome of a standard HI assessment of activity limitation and participation restriction, but not with degree of HI and use of communication strategies.
BACKGROUND: The aim was to explore the prevalence of visitors to CAM practitioners in a total population with reference to sex, self-rated health status and socio-demographic characteristics. METHODS: The paper reports findings from the Nord-Trøndelag Health Study (HUNT 2), a total population-based health survey of 42,277 respondents conducted in central Norway who answered questions on visits to a CAM practitioner. Variables included were age, marital status, education, receiving social welfare benefits, lifestyle (daily smoker), Hospital Anxiety and Depression Scale (HADS-T), self-rated health status, and having a limiting chronic complaint. RESULTS: Some 12.8% (95% CI 12.5-13.1) of the population had visited a CAM practitioner in the last 12 months, with females visiting almost twice as often as males. Multivariate analysis showed that consulting a CAM practitioner was significantly associated in both sexes with being middle-aged (male age 40-49 OR 1.6 (1.2-2.0), female age 30-39 OR 1.4 (1.1-1.6)); poor self-rated health status (male OR 5.1 (3.1-8.5), female 3.9 (2.2-6.8 )); and reporting a chronic complaint (male OR 1.5 (1.3-1.8), female OR 1.4 (1.2-1.6)). Daily smoking of cigarettes was associated with a decreased likelihood for visiting a CAM practitioner (male OR 0.7 (0.6-0.9), female OR 0.8 (0.7-0.9)). In females, both a higher total HADS-T score (score >20 OR 1.5 (1.2-2.0)) and middle-level education (OR 1.2 (1.1-1.4)) were associated with visiting a CAM practitioner. CONCLUSIONS: Visitors to CAM practitioners had lower self-reported health than non-users, but socio-demographic variables did not discriminate between users and non-users.
BACKGROUND: About 80% of new tuberculosis cases in Norway occur among immigrants from high incidence countries. On arrival to the country all asylum seekers are screened with Mantoux test and chest x-ray aimed to identify cases of active tuberculosis and, in the case of latent tuberculosis, to offer follow-up or prophylactic treatment.We assessed a national programme for screening, treatment and follow-up of tuberculosis infection and disease in a cohort of asylum seekers. METHODS: Asylum seekers >or= 18 years who arrived at the National Reception Centre from January 2005 to June 2006, were included as the total cohort. Those with a Mantoux test >or= 6 mm or positive x-ray findings were included in a study group for follow-up.Data were collected from public health authorities in the municipality to where the asylum seekers had moved, and from hospital based internists in case they had been referred to specialist care.Individual subjects included in the study group were matched with the Norwegian National Tuberculosis Register which receive reports of everybody diagnosed with active tuberculosis, or who had started treatment for latent tuberculosis. RESULTS: The total cohort included 4643 adult asylum seekers and 97.5% had a valid Mantoux test. At least one inclusion criterion was fulfilled by 2237 persons. By end 2007 municipal public health authorities had assessed 758 (34%) of them. Altogether 328 persons had been seen by an internist. Of 314 individuals with positive x-rays, 194 (62%) had seen an internist, while 86 of 568 with Mantoux >or= 15, but negative x-rays (16%) were also seen by an internist. By December 31st 2006, 23 patients were diagnosed with tuberculosis (prevalence 1028/100 000) and another 11 were treated for latent infection. CONCLUSION: The coverage of screening was satisfactory, but fewer subjects than could have been expected from the national guidelines were followed up in the community and referred to an internist. To improve follow-up of screening results, a simplification of organisation and guidelines, introduction of quality assurance systems, and better coordination between authorities and between different levels of health care are all required.
Sykehuset Innlandet, Divisjon Tynset og Øre-nese-halsavdelingen St. Olavs hospital og Institutt for samfunnsmedisin Norges teknisk-naturvitenskapelige universitet. anne-sofie.helvik@ntnu.no
BACKGROUND: Hearing loss is a common health problem and affects social life. We studied how adults' use of hearing aids was influenced by socio-demographic and audiological characteristics, use of coping strategies, and perceived functional disability. MATERIAL AND METHODS: 162 adult patients (82 men) who had previously used hearing aids and were referred to St. Olavs University Hospital (Trondheim, Norway) for a renewed assessment and prescription, were consecutively included in the study. Questionnaires were used to capture their experience with using hearing aids and the negative consequences of hearing loss, as well as use of specific coping strategies and the presence of tinnitus. Relations between reported use and explanatory variables were assessed by using logistic regression analyses. RESULTS: Advanced hearing loss increased the probability of using aids more frequently, while non-persistent tinnitus and a medium long experience with using hearing aids (7?-?17 years) reduced the probability. Maladaptive behaviour interferring with effective communication reduced the daily use. Use of verbal and nonverbal communication strategies, and degree of perceived functional disability did not influence the use of hearing aids. INTERPRETATION: A low degree of hearing loss, occasional tinnitus, a medium long experience in the use of hearing aids, and frequent use of dysfunctional communication strategies were associated with little use of the aids.
