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Medical school predictors of later perceived mastery of clinical work among Norwegian doctors: a cohort study with 10-year and 20-year follow-up.

https://arctichealth.org/en/permalink/ahliterature292099
Source
BMJ Open. 2017 Sep 24; 7(9):e014462
Publication Type
Journal Article
Date
Sep-24-2017
Author
Anna Belfrage
Kjersti Støen Grotmol
Lars Lien
Torbjørn Moum
Ragna Veslemøy Wiese
Reidar Tyssen
Author Affiliation
Department of Behavioural Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
Source
BMJ Open. 2017 Sep 24; 7(9):e014462
Date
Sep-24-2017
Language
English
Publication Type
Journal Article
Keywords
Adaptation, Psychological
Adult
Alcohol drinking - epidemiology
Clinical Competence
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Norway - epidemiology
Personality Inventory
Physician's Role - psychology
Physicians - psychology
Schools, Medical
Self Concept
Stress, Psychological - epidemiology
Students, Medical - psychology
Surveys and Questionnaires
Time Factors
Young Adult
Abstract
Doctors' self-perceived mastery of clinical work might have an impact on their career and patient care, in addition to their own health and well-being. The aim of this study is to identify predictors at medical school of perceived mastery later in doctors' careers.
A cohort of medical students (n=631) was surveyed in the final year of medical school in 1993/1994 (T1), and 10 (T2) and 20 (T3) years later.
Nationwide healthcare institutions.
Medical students from all universities in Norway.
Perceived mastery of clinical work was measured at T2 and T3. The studied predictors measured at T1 included personality traits, medical school stress, perceived medical recording skills, identification with the role of doctor, hazardous drinking and drinking to cope, in addition to age and gender. Effects were studied using multiple linear regression models.
Response rates: T1, 522/631 (83%); T2, 390/522 (75%); and T3, 303/522 (58%). Mean scores at T2 and T3 were 22.3 (SD=4.2) and 24.5 (3.0) (t=8.2, p
Notes
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PubMed ID
28947437 View in PubMed
Less detail

Recall intervals and time used for examination and prevention by dentists in child dental care in Denmark, Iceland, Norway and Sweden in 1996 and 2014.

https://arctichealth.org/en/permalink/ahliterature292193
Source
Community Dent Health. 2018 Mar 01; 35(1):52-57
Publication Type
Journal Article
Date
Mar-01-2018
Author
N J Wang
P E Petersen
E G Sveinsdóttir
I B Arnadóttir
C Källestål
Author Affiliation
Institute of Clinical Dentistry, Faculty of Dentistry, University of Oslo, Norway.
Source
Community Dent Health. 2018 Mar 01; 35(1):52-57
Date
Mar-01-2018
Language
English
Publication Type
Journal Article
Keywords
Adult
Appointments and Schedules
Child
Denmark
Dental Care for Children - trends
Dentists
Female
Humans
Iceland
Male
Middle Aged
Norway
Practice Patterns, Dentists'
Self Report
Sweden
Time Factors
Abstract
The purpose of the present study was to explore intervals between regular dental examination and the time dentists spent for examination and preventive dental care of children in 1996 and 2014.
In Denmark, Norway and Sweden, random samples of dentists working with children were included, while in Iceland all dentists were mailed questionnaires. Complete information was provided by 1082 of 1834 dentists (64%) in 1996 and 1366 of 2334 dentists (59%) in 2014. Results were assessed using chi-square and analysis of variance with post-hoc tests.
Some trends were consistent in all countries, but considerable differences in routines between the countries persisted during the period. The most used and maximum planned recall intervals were on average 14.8 (sd 4.8) and 18.5 (sd 4.6) months in 2014, respectively 3.1 and 3.5 months longer than in 1996 (p?0.05). In 2014 dentists used ample time delivering preventive care to children. Dentists reported spending significantly more time providing preventive care for caries risk children than for other children both in 1996 and 2014. Concurrent with extended intervals, dentists reported spending longer performing routine examinations in three of the four countries in 2014 than in 1996.
This study of trends in dental care delivered by dentists during recent decades showed moves towards extended recall intervals and preventive care individualized according to caries risk. In addition, extending intervals could necessitate more time for a routine dental examination.
PubMed ID
29369547 View in PubMed
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Telephone counselling by nurses in Norwegian primary care out-of-hours services: a cross-sectional study.

https://arctichealth.org/en/permalink/ahliterature292236
Source
BMC Fam Pract. 2017 Sep 06; 18(1):84
Publication Type
Journal Article
Date
Sep-06-2017
Author
Vivian Midtbø
Guttorm Raknes
Steinar Hunskaar
Author Affiliation
National Centre for Emergency Primary Health Care, Uni Research Health, Box 7810, NO 5020, Bergen, Norway. vivian.midtbo@uni.no.
Source
BMC Fam Pract. 2017 Sep 06; 18(1):84
Date
Sep-06-2017
Language
English
Publication Type
Journal Article
Keywords
Abdominal Pain
Adolescent
Adult
After-Hours Care
Age Factors
Aged
Aged, 80 and over
Child
Child, Preschool
Cough
Counseling
Cross-Sectional Studies
Earache
Female
Fever
Humans
Infant
Infant, Newborn
Male
Middle Aged
Norway
Nurses
Primary Health Care
Telephone
Time Factors
Young Adult
Abstract
The primary care out-of-hours (OOH) services in Norway are characterized by high contact rates by telephone. The telephone contacts are handled by local emergency medical communication centres (LEMCs), mainly staffed by registered nurses. When assessment by a medical doctor is not required, the nurse often handles the contact solely by nurse telephone counselling. Little is known about this group of contacts. Thus, the aim of this study was to investigate characteristics of encounters with the OOH services that are handled solely by nurse telephone counselling.
Nurses recorded ICPC-2 reason for encounter (RFE) codes and patient characteristics of all patients who contacted six primary care OOH services in Norway during 2014. Descriptive statistics and frequency analyses were applied.
Of all telephone contacts (n = 61,441), 23% were handled solely by nurse counselling. Fever was the RFE most frequently handled (7.3% of all nurse advice), followed by abdominal pain, cough, ear pain and general symptoms. Among the youngest patients, 32% of the total telephone contacts were resolved by nurse advice compared with 17% in the oldest age group. At night, 31% of the total telephone contacts were resolved solely by nurse advice compared with 21% during the day shift and 23% in the evening. The share of nurse advice was higher on weekdays compared to weekends (mean share 25% versus 20% respectively).
This study shows that nurses make a significant contribution to patient management in the Norwegian OOH services. The findings indicate which conditions nurses should be able to handle by telephone, which has implications for training and routines in the LEMCs. There is the potential for more nurse involvement in several of the RFEs with a currently low share of nurse counselling.
Notes
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PubMed ID
28874124 View in PubMed
Less detail

Does Moderate Drinking Increase the Risk of Atrial Fibrillation? The Norwegian HUNT (Nord-Tr√łndelag Health) Study.

https://arctichealth.org/en/permalink/ahliterature292345
Source
J Am Heart Assoc. 2017 Oct 20; 6(10):
Publication Type
Journal Article
Date
Oct-20-2017
Author
Katalin Gémes
Vegard Malmo
Lars Erik Laugsand
Jan Pål Loennechen
Hanne Ellekjaer
Krisztina D László
Staffan Ahnve
Lars J Vatten
Kenneth J Mukamal
Imre Janszky
Author Affiliation
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden katalin.gemes@ki.se imre.janszky@ntnu.no.
Source
J Am Heart Assoc. 2017 Oct 20; 6(10):
Date
Oct-20-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Aged
Alcohol Drinking - adverse effects - epidemiology
Atrial Fibrillation - diagnosis - epidemiology
Chi-Square Distribution
Female
Health Surveys
Humans
Life Style
Male
Middle Aged
Multivariate Analysis
Nonlinear Dynamics
Norway - epidemiology
Proportional Hazards Models
Risk assessment
Risk factors
Time Factors
Abstract
Compelling evidence suggests that excessive alcohol consumption increases the risk of atrial fibrillation (AF), but the effect of light-moderate alcohol consumption is less certain. We investigated the association between alcohol consumption within recommended limits and AF risk in a light-drinking population.
Among 47 002 participants with information on alcohol consumption in a population-based cohort study in Norway, conducted from October 2006 to June 2008, 1697 validated AF diagnoses were registered during the 8 years of follow-up. We used Cox proportional hazard models with fractional polynomials to analyze the association between alcohol intake and AF. Population attributable risk for drinking within the recommended limit (ie, at most 1 drink per day for women and 2 drinks per day for men without risky drinking) compared with nondrinking was also calculated. The average alcohol intake was 3.8±4.8 g/d. The adjusted hazard ratio for AF was 1.38 (95% confidence interval, 1.06-1.80) when we compared participants consuming >7 drinks per week with abstainers. When we modeled the quantity of alcohol intake as a continuous variable, the risk increased in a curvilinear manner. It was higher with heavier alcohol intake, but there was virtually no association at
Notes
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PubMed ID
29054845 View in PubMed
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Use of mechanical and pharmacological restraint over an eight-year period and its relation to clinical factors.

https://arctichealth.org/en/permalink/ahliterature292366
Source
Nord J Psychiatry. 2018 Jan; 72(1):24-30
Publication Type
Journal Article
Date
Jan-2018
Author
Solveig Klæbo Reitan
Anne-Sofie Helvik
Valentina Iversen
Author Affiliation
a Department of Mental Health , St. Olav University Hospital HF , Trondheim , Norway.
Source
Nord J Psychiatry. 2018 Jan; 72(1):24-30
Date
Jan-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Antipsychotic Agents - therapeutic use
Female
Hospitalization - trends
Hospitals, Psychiatric - trends
Humans
Inpatients - psychology
Male
Mental Disorders - drug therapy - epidemiology - psychology
Middle Aged
Norway - epidemiology
Psychiatric Department, Hospital - trends
Restraint, Physical - psychology - utilization
Retrospective Studies
Time Factors
Young Adult
Abstract
Use of restraint and finding the balance between security and ethics is a continuous dilemma in clinical psychiatry. In daily clinic and in planning health-care service, knowledge on the characteristics of restraint situations is necessary to optimize its use and avoid abuse.
We describe characteristics in the use of pharmacological and mechanical restraint in psychiatric acute wards in a hospital in Middle Norway over an eight-year period. Data on all cases of mechanical and pharmacological restraint from 2004 to 2011 were retrospectively collected from hand-written protocols. Complementary information on the patients was obtained from the hospital patient administrative system.
Restraint in acute wards was used on 13 persons per 100,000 inhabitants annually. The percentage of admitted patients exposed to restraint was 1.7%, with a mean of 4.5 cases per exposed patient. Frequency per 100 admitted patients varied from 3.7 (in 2007) to 10 (in 2009). The majority of restraint cases concerned male patients under 50 years and with substance-abuse, psychotic, or affective disorders. Significantly more coercive means were used during daytime compared to night and morning. There was a significant increase in pharmacological coercion during spring and mechanical coercion during summer.
Restraint was used on 1.7% of admitted patients, representing 13 per 100,000 inhabitants per year. Use of restraint was higher during certain periods of the day and was associated with the patient's diagnosis, age, gender, and legal status of hospitalization. There was a marked variation over the years.
PubMed ID
28875773 View in PubMed
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Association between height and osteoarthritis of the knee and hip: The Northern Finland Birth Cohort 1966 Study.

https://arctichealth.org/en/permalink/ahliterature292398
Source
Int J Rheum Dis. 2017 Sep; 20(9):1095-1104
Publication Type
Journal Article
Date
Sep-2017
Author
Maiju Welling
Juha Auvinen
Petri Lehenkari
Minna Männikkö
Jaro Karppinen
Pasi J Eskola
Author Affiliation
Center for Life Course Health Research, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Source
Int J Rheum Dis. 2017 Sep; 20(9):1095-1104
Date
Sep-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Age Factors
Body Height
Body Weight
Case-Control Studies
Female
Finland - epidemiology
Humans
Incidence
Kaplan-Meier Estimate
Male
Middle Aged
Osteoarthritis, Hip - diagnosis - epidemiology - physiopathology
Osteoarthritis, Knee - diagnosis - epidemiology - physiopathology
Proportional Hazards Models
Prospective Studies
Risk factors
Sex Factors
Time Factors
Abstract
To investigate whether height at the age of 31 is associated with the incidence of knee and hip osteoarthritis (OA) in the following 15 years.
Participants in The Northern Finland Birth Cohort 1966 (NFBC1966) diagnosed with knee or hip OA between the ages of 31 and 46 were used as OA cases. Study subjects without knee and hip OA were used as the controls. Height and weight were measured in a clinical examination at the age of 31 (baseline). Mean heights for the OA cases and the controls were compared by an independent samples t-test. Cox regression analysis was performed to calculate the risk for OA for different height quartiles. The results were adjusted for body mass index/weight, education, smoking and leisure-time physical activity at baseline. Additionally, a Kaplan-Meier analysis was performed.
Men with knee OA were 2.6 cm taller (P
PubMed ID
28296269 View in PubMed
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Connecting remote populations to public health: the case for a digital immunisation information system in Nunavut.

https://arctichealth.org/en/permalink/ahliterature292491
Source
Int J Circumpolar Health. 2017; 76(1):1358566
Publication Type
Journal Article
Date
2017
Author
Lindsay A Wilson
Barry Pakes
Malia S Q Murphy
Katherine M Atkinson
Cameron Bell
Kumanan Wilson
Author Affiliation
a Clinical Epidemiology Program , Ottawa Hospital Research Institute , Ottawa , Canada.
Source
Int J Circumpolar Health. 2017; 76(1):1358566
Date
2017
Language
English
Publication Type
Journal Article
Keywords
Arctic Regions
Canada
Computer Security
Confidentiality
Cultural Competency
Humans
Information Systems - organization & administration - standards
Mobile Applications
Nunavut
Public Health Surveillance - methods
Time Factors
Vaccination Coverage
Abstract
Despite the best efforts of local healthcare workers and health officials, Nunavut, a large geographical region in Northern Canada, has struggled with outbreaks of vaccine-preventable diseases (VPD). We contend that the implementation of an immunisation information system (IIS) could strengthen prevention and response efforts to this and future outbreaks of vaccine-preventable diseases. Developing an IIS in Nunavut that builds on the existing CANImmunize infrastructure would reduce the cost and complexity of developing a new IIS, and allow Nunavut to benefit from the ongoing efforts to secure data on the CANImmunize platform. Such a system would enable the identification of individuals and subpopulations at highest risk of infection based on vaccine series completion and permit the exploration of the underlying causes of outbreaks in the territory through consideration of demographic and temporal factors. Confirmed high rates of vaccination in the context of an outbreak would indicate potential issues with vaccine efficacy while low rates of vaccination would suggest that efforts should be devoted to increasing vaccine coverage. This approach could also lay the foundation for infrastructure expansion to other remote and/or Indigenous communities where geographical and accessibility issues complicate health care utilisation and monitoring, both in Canada and internationally.
Notes
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Cites: CMAJ Open. 2016 Oct 18;4(4):E623-E633 PMID 28443266
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PubMed ID
28782441 View in PubMed
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Sauna Bathing and Incident Hypertension: A Prospective Cohort Study.

https://arctichealth.org/en/permalink/ahliterature292503
Source
Am J Hypertens. 2017 Nov 01; 30(11):1120-1125
Publication Type
Journal Article
Date
Nov-01-2017
Author
Francesco Zaccardi
Tanjaniina Laukkanen
Peter Willeit
Setor K Kunutsor
Jussi Kauhanen
Jari A Laukkanen
Author Affiliation
Diabetes Research Centre, University of Leicester, Leicester, UK.
Source
Am J Hypertens. 2017 Nov 01; 30(11):1120-1125
Date
Nov-01-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
Blood pressure
Chi-Square Distribution
Finland - epidemiology
Humans
Hypertension - diagnosis - epidemiology - physiopathology - prevention & control
Incidence
Male
Middle Aged
Multivariate Analysis
Proportional Hazards Models
Protective factors
Risk factors
Steam Bath - adverse effects
Time Factors
Abstract
Sauna bathing is associated with reduced cardiovascular risk, but the mechanisms underlying this beneficial effect are not entirely understood. We aimed to assess the relationship between sauna bathing and risk of incident hypertension.
Frequency of sauna bathing was ascertained using questionnaires in the Kuopio Ischemic Heart Disease Study, a prospective cohort study conducted in Eastern Finland that comprised a population-based sample of 1,621 men aged 42 to 60 years without hypertension at baseline. The incidence of hypertension was defined as a physician diagnosis of hypertension, systolic blood pressure (SBP) >140 mm Hg, diastolic blood pressure >90 mm Hg, or use of antihypertensive medication.
During a median follow-up of 24.7 years, 251 incident cases (15.5%) were recorded. In Cox regression analysis adjusted for baseline age, smoking, body mass index, and SBP; compared to participants reporting 1 sauna session per week, the hazard ratio for incident hypertension in participants reporting 2 to 3 sessions and 4 to 7 sessions was 0.76 (95% confidence interval: 0.57-1.02) and 0.54 (0.32-0.91), respectively. The corresponding hazard ratios were similar after further adjustment for glucose, creatinine, alcohol consumption, heart rate, family history of hypertension, socioeconomic status, and cardiorespiratory fitness: 0.83 (95% confidence interval: 0.59-1.18) and 0.53 (0.28-0.98), respectively.
Regular sauna bathing is associated with reduced risk of hypertension, which may be a mechanism underlying the decreased cardiovascular risk associated with sauna use. Further epidemiological and experimental studies could help elucidate the effects of sauna bathing on cardiovascular function.
PubMed ID
28633297 View in PubMed
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Gamma-Glutamyltransferase and Future Risk of Pneumonia: A Long-Term Prospective Cohort Study.

https://arctichealth.org/en/permalink/ahliterature292691
Source
Lung. 2017 Dec; 195(6):799-803
Publication Type
Journal Article
Date
Dec-2017
Author
Setor K Kunutsor
Jari A Laukkanen
Author Affiliation
Translational Health Sciences, Bristol Medical School, Southmead Hospital, University of Bristol, Learning & Research Building (Level 1), Southmead Road, Bristol, BS10 5NB, UK. skk31@cantab.net.
Source
Lung. 2017 Dec; 195(6):799-803
Date
Dec-2017
Language
English
Publication Type
Journal Article
Keywords
Adult
C-Reactive Protein - metabolism
Finland - epidemiology
Follow-Up Studies
Humans
Male
Middle Aged
Pneumonia - enzymology - epidemiology
Prospective Studies
Risk factors
Time Factors
gamma-Glutamyltransferase - blood
Abstract
Serum gamma-glutamyltransferase (GGT) has been linked with the risk of adverse health outcomes. We aimed to assess the prospective association of GGT activity with pneumonia risk. Serum GGT was measured at baseline in 2400 middle-aged men. Within-person variability in GGT values was corrected for using data from repeat measurements. During a median follow-up of 25.3 years, 409 pneumonia cases were recorded. The age-adjusted regression dilution ratio of GGT was 0.68 (95% CI 0.63-0.73). Gamma-glutamyltransferase was approximately log-linearly associated with pneumonia risk. In analysis adjusted for several major pneumonia risk factors, the hazard ratio (95% CI) for pneumonia per 1 standard deviation increase in GGT was 1.14 (1.02-1.28). The association was however attenuated on additional adjustment for high-sensitivity C-reactive protein (hsCRP) 1.08 (0.96-1.22). There is an approximately log-linear positive association between GGT activity and future risk of pneumonia in a middle-aged male population, which is partly dependent on hsCRP.
Notes
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PubMed ID
28993933 View in PubMed
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Sudden parental death from external causes and risk of suicide in the bereaved offspring: A national study.

https://arctichealth.org/en/permalink/ahliterature292692
Source
J Psychiatr Res. 2018 Jan; 96:49-56
Publication Type
Journal Article
Date
Jan-2018
Author
Lisa Victoria Burrell
Lars Mehlum
Ping Qin
Author Affiliation
National Centre for Suicide Research and Prevention, University of Oslo, Sognsvannsveien 21, N-0372 Oslo, Norway. Electronic address: l.v.burrell@medisin.uio.no.
Source
J Psychiatr Res. 2018 Jan; 96:49-56
Date
Jan-2018
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Age Factors
Bereavement
Case-Control Studies
Child
Death, Sudden - epidemiology
Female
Humans
Longitudinal Studies
Male
Middle Aged
Norway - epidemiology
Parents
Registries
Risk factors
Sex Factors
Suicide
Time Factors
Young Adult
Abstract
Previous research has revealed an association between parental bereavement from external causes and risk of suicide in offspring. Few studies have however provided insights into specific influences of cause of death, gender of the deceased and bereaved, age at bereavement and suicide, and time since bereavement. The present nested case-control study was based on data from three longitudinal registers. Subjects comprised 19 015 persons who died from suicide at an age of 11-64 years during 1969-2012 (cases), and 332 046 live comparison individuals matched for gender and date of birth. Information about deceased parents' cause and date of death, and sociodemographic data was retrieved and merged. Data were analysed with conditional logistic regression. Losing a parent to suicide, transport accidents and other external causes of death was associated with an increased suicide risk in offspring. Parental suicide was associated with a substantially higher suicide risk than transport accidents and other external causes. These effects were equally strong for daughters and sons, and for the loss of a mother, father or both parents. Suicide risk was highest in younger bereaved offspring, and bereavement had both short and long-term impacts on suicide risk. In conclusion, all offspring exposed to parental death by external causes have an increased suicide risk, independent of factors related to the exposure. The consequences are long lasting, and offspring should be offered follow-up in primary healthcare. Younger offspring bereaved by parental suicide have the highest risk and may be targeted for prevention and intervention programs in specialist healthcare.
PubMed ID
28965005 View in PubMed
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