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Purpose:The aim of the present paper was to study preferences for web based self-administered questionnaires (web SAQs) vs. paper-based self-administered questionnaires (paper SAQs) and to evaluate the feasibility of using web SAQs in patients referred to cardiac, lung, occupational and cancer rehabilitation programs. Methods:The patients were approached by mail and given the choice to answer the compulsory SAQs either on paper or on a web-based platform. Results:Hundred and twenty seven out of 183 eligible patients (69.3%) were willing to participate and 126 completed the study. Web SAQs were preferred by 77.7%, and these patients were significantly younger, more often cohabiting and tended to have higher level of education than paper SAQ users. Mean number of data missing per patient was less among the web SAQ users than the paper SAQ users (0.55 vs. 2.15,p < 0.001). Costs related to human resources were estimated to be 60% lower with web SAQs compared to paper SAQs. Conclusions:Web SAQs were well accepted among the patients scheduled for rehabilitation, led to less missing data and considerable cost savings related to human resources. Patients referred to rehabilitation should be offered the choice to complete self-administered questionnaires on internet platforms when internet access is common and available.Implications for RehabilitationThe high acceptability of web-based self-administered questionnaires among rehabilitation patients suggests that internet platforms are suitable tools to collect patient information for rehabilitation units.Web-based modes of patient data collection demonstrate low number of missing data and can therefore improve the quality of data collection from rehabilitation patients.Use of web-based questionnaires considerably reduces administrative costs of data collection in rehabilitation settings compared to traditional pen and paper methods. [ABSTRACT FROM PUBLISHER]

To explore alcohol consumption among older Norwegian adults with symptoms of cognitive decline, assess the agreement between the reports of older adults and their next of kin regarding a person's alcohol consumption, and explore clinical and sociodemographic variables associated with agreement. Alcohol consumption was measured among 3608 older adults consulting specialist health care for symptoms of cognitive decline. Agreement between the participant and their next of kin regarding the participant's alcohol consumption was assessed with a weighted kappa (κ). A logistic regression analysis for hierarchical data was used to explore variables associated with agreement. Both the participants and their next of kin reported that more than 20% of the participants consumed alcohol 1–3 times a week, and that approximately 10% consumed alcohol four or more times a week. The agreement between the participant's and their next of kin's report regarding the participant's alcohol consumption was high (κ =.852), and variables associated with agreement were no cognitive decline, not drinking alcohol during the last year or ever as reported by the participant, and low agitation scores on a psychiatric assessment. This paper found alcohol consumption among older adults with symptoms of cognitive decline that was above the national average in Norway. This is also the first paper to demonstrate that a next of kin can be a reliable source of information regarding older adults' alcohol consumption. Health personnel should consider these findings when performing medical assessments or developing interventions for older adults. [ABSTRACT FROM AUTHOR]

Purpose: Access to adaptive equipment is a crucial factor that can determine if a child or youth with disabilities is going to participate in physical activities, sports and play in different local settings. A prerequisite for success is awareness of and specific knowledge concerning the equipment and its use among relevant actors. The aim of this paper is to explore how important groups of actors working with young people with disabilities perceive their level of knowledge concerning adaptive equipment and discuss these actors' role in children and youths' opportunities to obtain relevant equipment to participate in activities. Methods: An online, population-based national survey was distributed to: (1) occupational therapists and physiotherapists, (2) teachers, and (3) leaders and coaches in sports clubs in Norway. Results: The findings generally indicate that overall knowledge concerning adaptive equipment among the three groups is limited. However, significant statistical difference is found, indicating that occupational therapists and physiotherapists have higher levels of general knowledge, about the accessibility of equipment, regulations and legislation and that they are more familiar with adaptive equipment than teachers, leaders and coaches. Conclusions: A practical implication of the results is that the actors' varying knowledge and experiences need to be brought together to form a coherent picture of how the equipment will be used and by whom. This can contribute to an increased understanding concerning adaptive equipment and its importance among different actors, which could help more young people with disabilities to participate. Important actors must utilize the knowledge and experience possessed by young people with disabilities concerning adaptive equipment. Improved access to knowledge concerning adaptive equipment among important actors is required. Increased collaboration between different actors relating to adaptive equipment and participation is needed. [ABSTRACT FROM AUTHOR]

Background: Advance care planning (ACP) allows patients to define their goals and preferences. Spending more time at home and less time in the hospital, along with avoiding death in the hospital, are often considered desirable outcomes of palliative care (PC). In 2015, 36% of cancer patients died in the hospital and 13% died at home in Norway. Method: From 2015 to 2022, this prospective controlled non-randomized intervention trial observed 144 cancer patients with or without an organized ACP conversation in primary health care and a summarizing palliative plan (ClinicalTrials.gov Identifier: NCT02170168, 23 June 2014). The patients were identified through contact with the local cancer outpatient clinic or hospital-based PC team. Results: A total of 128 patients died during the observation period. Of these, 67 patients had an organized ACP conversation and summarizing palliative plan (intervention (I) group) and 61 had not (control (C) group). Dying in the hospital was significantly less common for patients in the I group compared to the C group (17.9% vs. 34.4%; X2 (1, n = 128) = 4.55, p = 0.033). There were no differences between the groups in terms of where they spent their time in the last 90 days of life (home, nursing home, or hospital). Most patients (62%) preferred to die at home. The observed differences between the groups regarding preferred and actual places of death did not reach statistical significance. Conclusion: With organized ACP conversations in primary health care and a summarizing palliative plan, cancer patients died less often in the hospital in our observational study. A structured ACP approach integrating palliative care for cancer patients into primary health care can support patients´ preferences at the end of life. [ABSTRACT FROM AUTHOR]

Background.There is currently not much in-depth understanding of employee perspectives on the adoption of arts-based organisational interventions. This paper focuses on how one intervention consisting of choral singing in a workplace affected the employees’ sense of well-being and their perceptions of their work environment.Methods.Ten employees were interviewed about their personal experiences after the completion of a choral singing intervention in their organisation. Template analysis was adopted, and the study drew on the findings of a quantitative study of the same intervention.Results.Four themes were identified: (1) barriers for participation in the project; (2) positive experiences and effects; (3) negative experiences and effects; and (4) a sense of emptiness after the project had ended.Conclusions.It was evident that participation in the intervention was experienced positively, but also that a divide emerged between participants and non-participants, something which had negative consequences for both parties. [ABSTRACT FROM AUTHOR]

Much research has now documented the substantial influence of safety climate on a range of important outcomes in safety critical organizations, but there has been scant attention to the question of what factors might be responsible for positive or negative safety climate. The present paper draws from positive organizational behavior theory to test workplace and individual factors that may affect safety climate. Specifically, we explore the potential influence of authentic leadership style and psychological capital on safety climate and risk outcomes. Across two samples of offshore oil-workers and seafarers working on oil platform supply ships, structural equation modeling yielded results that support a model in which authentic leadership exerts a direct effect on safety climate, as well as an indirect effect via psychological capital. This study shows the importance of leadership qualities as well as psychological factors in shaping a positive work safety climate and lowering the risk of accidents. [ABSTRACT FROM AUTHOR]

The purpose of the present paper is to explore the extent to which different groups of Norwegian psychologists address sexual topics during therapy and clinical work. What is the relationship between the frequency of discussing various aspects of sexuality with clients and the therapists’ social background, training in sexology and beliefs and attitudes about handling sexual issues in therapy? A random sample of 2352 clinical psychologists was invited by email to participate in an online survey. The response rate was 47%. The psychologists reported that, in therapy, they most frequently discussed topics related to negative sexual experiences, sexual problems, sexual function and sexual orientation with their clients. Psychologists who did not believe that sexuality should be communicated on the initiative of the patient did not feel uncertainty about sexuality as a topic, and those who had talked about sexuality during supervision were more likely to communicate with their clients about any sexual topic. Psychologists who are self-confident and who have received supervision regarding sexuality deal with sexual topics more often during therapy. [ABSTRACT FROM PUBLISHER]

This study describes interventions provided by community occupational therapists for persons with cognitive impairments. Using an online questionnaire, a cross-sectional study was conducted, collecting data from 497 of the 1367 occupational therapists in Norwegian community-based services. The most common interventions provided were environmental modifications (87%), implementation of assistive devices (85%), and training of activities of daily life (ADL) (77%). Two main reasons to carry out these interventions were identified as the initial assessment of clients (89%) and expectations of others. The most preferred interventions were ADL training (77%), cognitive training (63%), and environmental modifications (56%). Chi-squared tests identified a significant difference (p < 0.001) between interventions provided and preferred interventions on all interventions except environmental modifications. The findings provide an insight into interventions provided for persons with cognitive impairments in community services. [ABSTRACT FROM AUTHOR]

To counteract a decreasing number of physician-scientists, a national intercalated Medical Student Research Programme (MSRP) was launched in Norway in 2002. We aimed to assess whether the students' favourable perceptions and satisfaction with the program had prevailed since the inception in 2002 and until 2015, and to identify factors associated with pursuing a PhD. The study was an incorporation of data from two previous national evaluations of the MSRP performed in 2007 and 2015. We used electronic questionnaires to explore demographic characteristics, area and type of research, student satisfaction, and future scientific goals. In 2007, questionnaires were sent to all 208 students, and 183 (88%) replied. In 2015, the corresponding numbers were 279, and 240 (86%). Categorical data were analysed using either Kruskal-Wallis or Pearson's chi square test. Differences between sample means were assessed with Student's t-test while logistic regression was used to test associations between selected covariates and the students' ambitions to pursue a PhD degree. Overall, the student satisfaction was 79%. However, more students in 2015 received less regular and less supervision time and expressed a need for more of it. Seventy-seven per cent expressed an ambition to pursue a PhD. Students were more likely to have a PhD ambition if they were satisfied with the program, had a supervisor with high expectations for them, or had already published some of their results. At both time points, students (86% vs. 89%) responded that the MSRP had a positive impact on their regular curriculum achievements. The high degree of satisfaction with the national MSRP among undergraduate students has prevailed since the inception in 2002. By far, the program has also met its goal to increase the number of aspiring physician-scientists. However, to maintain that goal over time, adequate and personal supervision is a prerequisite. [ABSTRACT FROM AUTHOR]

Objective: This study investigates how men who have sex exclusively with women (MSEW) differ from men who have sex exclusively with men (MSEM), and men who have sex with men and women (MSMW) on selected variables. Methods: A probability-based web sample of 2,181 men was recruited. Results: Most MSEM considered their sexual identity as gay, and most MSMW as heterosexual. The MSEM were the most frequent condom users, while MSMW were the least frequent users and had the highest number of sexual partners. The MSEM and MSMW had a lower likelihood of premature ejaculation than MSEW. Conclusions: MSMW should be targeted in health campaigns. [ABSTRACT FROM AUTHOR]

To study patient experiences with physical activity among persons with Loeys-Dietz- or vascular Ehlers-Danlos syndrome. A postal questionnaire survey in 2018. Seventy adults with molecularly verified Loeys-Dietz syndrome types 1-4, or vascular Ehlers-Danlos syndrome recruited through a National Resource Centre for Rare Disorders in Norway. The response rate was 74%, (Loeys-Dietz n = 34, vascular Ehlers-Danlos n = 18), aged 18 to 68 years, 58% women. In total, 88.5% reported they had received advice regarding physical activity and most (77%) had modified their habits. Fifty percent had an appropriate- and 40% a low mean physical activity sum score. Another 10% had too high physical activity levels due to high intensity scores. Lower scores with the Fatigue Severity Scale (p = 0.033) and the anxiety subscale of the Hospital Anxiety and Depression Scale (p = 0.021), were associated with high physical activity levels. About a third reported unmet rehabilitation needs. Many adults with Loeys-Dietz- or vascular Ehlers-Danlos syndrome may have a potential to reach more favorable physical activity levels by increasing the frequency and duration of activities. Future directions should include evaluation of effects of professional-led practical and safe physical activity sessions as well as customized multidisciplinary rehabilitation programs for these patient groups. [ABSTRACT FROM AUTHOR]

Productive approaches to studying (deep and strategic learning) are associated with a variety of favourable academic outcomes, and may be of particular importance for students in multifaceted and complex disciplines such as occupational therapy. To explore associations between student characteristics and their dominant approaches to studying in two samples of occupational therapy students: a national sample of Norwegian first-year students, and an international sample of students in different year cohorts (Australia, Hong Kong, Singapore and Norway). A total of 180 (national sample) and 665 (international sample) students were included in the study. Approaches to studying were measured with the Approaches to Study Skills Inventory for Students (ASSIST). Data were analyzed with adjusted multinomial regression analyses. Age, gender and prior higher education were not associated with the dominant study approach. More time spent on independent study (international sample: OR = 1.07/1.08, p < 0.01/<0.001) and having current study program as the top priority line of education at enrolment (national sample: OR = 2.89, p < 0.05) predicted productive study approaches. Factors such as age, gender and prior higher education seem to be of limited importance for understanding students' dominant approaches to studying. [ABSTRACT FROM AUTHOR]

To compare stroke-specific health related quality of life in two country-regions with organisational differences in subacute rehabilitation services, and to reveal whether organisational factors or individual factors impact outcome. A prospective multicentre study with one-year follow-up of 369 first-ever stroke survivors with ischaemic or haemorrhagic stroke, recruited from stroke units in North Norway (n = 208) and Central Denmark (n = 161). The 12-domain Stroke-Specific Quality of Life scale was the primary outcome-measure. The Norwegian participants were older than the Danish (Mage= 69.8 vs. 66.7 years, respectively), had higher initial stroke severity, and longer stroke unit stays. Both cohorts reported more problems with cognitive, social, and emotional functioning compared to physical functioning. Two scale components were revealed. Between-country differences in the cognitive-social-mental component showed slightly better function in the Norwegian participants. Depression, anxiety, pre-stroke dependency, initial stroke severity, and older age were substantially associated to scale scores. Successful improvements in one-year functioning in both country-regions may result from optimising long-term rehabilitation services to address cognitive, emotional, and social functioning. Stroke-Specific Quality of Life one-year post-stroke could be explained by individual factors, such as pre-stroke dependency and mental health, rather than differences in the organisation of subacute rehabilitation services. The stroke-specific health related quality of life (SS-QOL) assessment tool captures multidimensional effects of a stroke from the perspective of the patient, which is clinically important information for the rehabilitation services. The cognitive-social-mental component and the physical health component, indicate specific functional problems which may vary across and within countries and regions with different organisation of rehabilitation services. For persons with mild to moderate stroke, longer-term functional improvements may be better optimised if the rehabilitation services particularly address cognitive, emotional, and social functioning. [ABSTRACT FROM AUTHOR]

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The aim of this study was to investigate the association between self-reported seasonality, i.e., seasonal variations in mood and related behavior, and chronotype, and between self-reported seasonality and home address' latitude. Data were collected from an online questionnaire with 45,338 participants. Seasonality and chronotype were measured with the Global Seasonality Score (GSS) and the Composite Scale of Morningness, respectively. The participants were categorized into extreme morning types, moderate morning types, intermediate types, moderate evening types, and extreme evening types. Furthermore, participants were categorized depending on home address' latitude. Data were analyzed with chi-square tests and logistic regression analyses adjusting for sex, age, marital status, level of education, and children living at home. Results showed that high seasonality (GSS 11+) was found in 20.9%. The prevalence dose-dependency ranged from 12.2% in extreme morning types to 42.6% in extreme evening types (adjusted OR = 4.21, CI = 3.27–5.41). The prevalence was higher in participants living in North-Norway (latitude from 65 to 71⁰N) versus South-Norway (latitude from 58 to 65⁰N) (23.8% versus 20.7%; adjusted OR = 1.18, CI = 1.08–1.28). When comparing the northernmost (69–71⁰N) to the southernmost (58–59⁰N) counties of Norway, the association was stronger (24.9% versus 18.7%; adjusted OR = 1.37, CI = 1.20–1.56). Among the adjusting variables, high seasonality was associated with female sex, younger age, being unmarried, low level of education, and not having children living at home. In conclusion, about one in five Norwegians reported high seasonality. High seasonality was strongly associated with late chronotype (being an evening type) and weakly associated with living in the north (high latitude). [ABSTRACT FROM AUTHOR]

Introduction: Nursing home residents may have difficulty maintaining occupational balance. The study aimed to explore occupational balance in nursing home residents, and examine the association between occupational balance and quality of life in this group. Methods: Forty-six nursing home residents (age range 69-101 years) in Norway were recruited to participate. The data were analyzed descriptively and with independent t-tests and Spearman's correlation coefficient rho (rs). Results: The participants' occupational balance (M = 20.7) was in the higher end of the scale. In the total sample, occupational balance and quality of life were not significantly associated (rs = 0.18, p = 0.23). However, splitting the sample by gender revealed a positive association for men (rs = 0.61, p = 0.01), while it was absent for women (rs = −0.00, p = 0.99). Conclusion: When assessing occupational balance and its correlates in elderly nursing home residents, gender appears important to consider. [ABSTRACT FROM AUTHOR]

Purpose: This article analyses the psychometric properties of the Social Provisions Scale 10-items version. Methods: The Social Provisions Scale was analysed by means of the polytomous Rasch model, applied to data on 93 young adults (16–30 years) out of school or work, participating in different nature-based services, due to mental or drug-related problems. Results: The psychometric analysis concludes that the original scale has difficulties related to targeting and construct validity. In order to improve the psychometric properties, the scale was modified to include eight items measuring functional support. The modification was based on theoretical and statistical considerations. Conclusion: After modifications the scale showed not only satisfying psychometric properties, but it also clarified uncertainties regarding construct validity of the measure. However, further analysis on larger samples are required. Social support is important for a variety of rehabilitation outcomes and for different patient groups in the rehabilitation context, including people with mental health or drug-related problems. Social Provisions Scale may be used as a screening tool to assess social support of participants in rehabilitation, and the scale may also be an important instrument in rehabilitation research. There might be issues measuring structural support using a 10-items version of the Social Provisions Scale but it seemed to work well as an 8-item scale measuring functional support. [ABSTRACT FROM AUTHOR]

The stigma associated with a diagnosis of mental illness is well known yet has not reduced significantly in recent years. Health professionals, including nurses, have been found to share similar negative attitudes towards people with labelled with mental illness as the general public. The low uptake of mental health nursing as a career option reflects these stigmatised views and is generally regarded as one of the least popular areas of in which to establish a nursing career. The aim of the current project was to examine nursing students' attitudes towards the concept of mental illness and mental health nursing across four European countries (Ireland, Finland, Norway and the Netherlands), and Australia, using the Opening Minds Scale and the Mental Health Nurse Education survey. The surveys were distributed to students prior to the commencement of the mental health theory component. Attitudes towards mental health nursing were generally favourable. Differences in opinion were evident in attitudes towards mental illness as a construct; with students from Australia and Ireland tending to have more positive attitudes than students from Finland, Norway and the Netherlands. The future quality of mental health services is dependent on attracting sufficient nurses with the desire, knowledge and attitudes to work in mental health settings. Understanding attitudes towards mental illness and mental health nursing is essential to achieving this aim. [ABSTRACT FROM AUTHOR]

Aim: To describe aspects of hand function in a population-based sample of young children with clinical signs of unilateral or bilateral cerebral palsy (CP).Method: A cross-sectional study with data from national CP registers in Norway. Manual ability was classified with the Manual Ability Classification System (MACS) or Mini-MACS. Hand use in bimanual activities was measured with the Assisting Hand Assessment (AHA) for unilateral CP or the newly developed Both Hands Assessment (BoHA) for bilateral CP.Results: From 202 children, 128 (57 females) were included (Mini-MACS/MACS levels I–V, mean age 30.4 months; SD = 12.1). Manual abilities were distributed across levels I–III in unilateral CP and levels I–V in bilateral CP. Variations in AHA and BoHA units were large. One-way ANOVA revealed associations between higher AHA or BoHA units and Mini-MACS/MACS levels of higher ability (p< 0.01) and higher age (p< 0.04).Conclusions: Compared with young children with unilateral CP, children with bilateral CP showed greater variation in Mini-MACS/MACS levels, and both sub-groups showed large variations in AHA or BoHA units. The classifications and assessments used in this study are useful to differentiate young children's ability levels. Such information is important to tailor upper limb interventions to the specific needs of children with CP. [ABSTRACT FROM PUBLISHER]

The novel assessment tool Cross-Linguistic Lexical Tasks (LITMUS-CLT) aims for comparable cross-linguistic assessment of multilingual children’s lexical skills by basing each language version on two language-specific variables: age of acquisition (AoA) and complexity index (CI), a novel measure related to phonology, morphology, exposure and etymology. This article investigates the validity of this methodology, asking whether the underlying properties are robust predictors of children’s performance. The Polish and Norwegian CLTs were used to assess 32 bilingual Polish–Norwegian, 34 monolingual Norwegian and 36 monolingual Polish children. The effects of AoA and CI were contrasted with frequency in child directed speech (CDS) and imageability, two known predictors of lexical development. AoA was a reliable predictor of performance within all parts of CLT, in contrast to CI. Apart from AoA, only exposure and CDS frequency had a significant effect within both monolinguals and bilinguals. These results indicate that CLT assesses lexical skills in a cross-linguistically comparable manner, but suggest a revision of the CI measure. [ABSTRACT FROM PUBLISHER]

Purpose:The aim of the current study was to examine whether patient perceptions of autonomy support from the treatment team in a vocational rehabilitation program will be associated with change (increase) in need satisfaction, autonomous motivation, perceived competence, well-being, physical activity, and return to work (RTW), and whether the self-determination theory (SDT) Model of Health Behavior will provide adequate fit to the data. Method:A total of 90 participants were enrolled in a longitudinal study and completed measures at four time points over 15 months. Results:Participants reported increases in all variables, and in general these changes were maintained at six weeks post-rehabilitation and at 15 months post-baseline. As well, the SDT Model of Health Behavior provided adequate fit to the data. Conclusions:These results underscore the importance of health care practitioners’ providing support for their patients’ autonomy, competence, and relatedness to improve well-being, physical activity, and RTW in the context of vocational rehabilitation.Implications for RehabilitationVocational rehabilitation that emphasizes physical activity is associated with increases in patients’ well-being, physical activity, and return to work (RTW).It is important for health care practitioners to provide support for their patients’ autonomy, competence, and relatedness in the context of vocational rehabilitation, as doing so is associated with increases in patients’ autonomous motivation, perceived competence, and psychosocial outcomes. [ABSTRACT FROM AUTHOR]

Purpose:The aim of this study was to test the validity and reliability of the translated Norwegian version of the Chronic Pain Acceptance Questionnaire (CPAQ-20) and the shorter version CPAQ-8 based on the same data. Method:The sample consisted of 120 women with chronic widespread musculoskeletal pain (CWP). The respondents completed CPAQ-20 and visual analogue scales (pain, fatigue, sleep problems and depression), General Health Questionnaire-12, The Pain Catastrophizing Scale, Fibromyalgia Impact Questionnaire and SF-8. Confirmatory factor analyses were performed on a one-factor baseline model, the previous validated CPAQ-20 and CPAQ-8 models, as well as an exploratory generated model based on the current sample. Results:The two-factor model of CPAQ-20 and a two-factor model of CPAQ-8 obtained adequate model fit and outperformed the baseline model. The exploratory factor, analysis-generated two-factor model obtained only a marginally better fit, supporting the two-dimensional model of CPAQ-20. CPAQ-20 and CPAQ-8 had Cronbach’s alphas between 0.75 (Pain Willingness subscales both versions) and 0.85. Both scales correlated significantly in the hypothesised direction with all the other scales. Conclusion:The Norwegian versions of CPAQ-20 and CPAQ-8 are reliable assessment tools with good construct validity for measurement of acceptance. Future studies should validate the scales in other Norwegian samples.Implication for RehabilitationCPAQ-20 and CPAQ-8 are valid Norwegian instruments for measuring acceptance of pain.Acceptance of pain is an important process in the rehabilitation of persons with chronic widespread pain.Treatment models supporting acceptance can now be developed and measured further in Norway. [ABSTRACT FROM PUBLISHER]

Background:The Intentional Relationship Model is specifically focused on the relational aspect of therapy. The model describes six therapeutic modes; these represent different types of interaction for the therapist. However, preferences for therapeutic mode use are under researched. Aims:This study aims to describe preferences for therapeutic modes in undergraduate occupational therapy students, as well as to explore factors associated to each of the therapeutic modes. Methods:A sample of 96 occupational therapy students, based at two different Norwegian universities, participated in the study. They completed the Norwegian Self-Assessment of Modes Questionnaire along with sociodemographic information. Descriptive analysis, bivariate correlation and linear regression analysis were employed. Results:The problem-solving mode was most frequently endorsed. There were generally weak associations between the variables, but female sex and being a student in the education program in Trondheim were associated with higher preference for collaboration. Conclusion:There is diversity in students’ preferences for the modes, but the problem-solving mode was the most preferred. Students need to be aware of the mode they feel more comfortable with and make sure they use modes that fit with the specific client. Significance:The occupational therapy education programs need to incorporate raising awareness about therapeutic modes. [ABSTRACT FROM PUBLISHER]

Objective:To explore reasons for attending a general emergency outpatient clinic versus a regular general practitioner (RGP). Design:Cross-sectional study using a multilingual anonymous questionnaire. Setting:Native and immigrant walk-in patients attending a general emergency outpatient clinic in Oslo (Monday–Friday, 08:00–23:00) during 2 weeks in September 2009. Subjects:We included 1022 walk-in patients: 565 native Norwegians (55%) and 457 immigrants (45%). Main outcome measures:Patients’ reasons for attending an emergency outpatient clinic versus their RGP. Results:Among patients reporting an RGP affiliation, 49% tried to contact their RGP before this emergency encounter: 44% of native Norwegian and 58% of immigrant respondents. Immigrants from Africa [odds ratio (OR) = 2.55 (95% confidence interval [CI]: 1.46–4.46)] and Asia [OR = 2.32 (95% CI: 1.42–3.78)] were more likely to contact their RGP before attending the general emergency outpatient clinic compared with native Norwegians. The most frequent reason for attending the emergency clinic was difficulty making an immediate appointment with their RGP. A frequent reason for not contacting an RGP was lack of access: 21% of the native Norwegians versus 4% of the immigrants claimed their RGP was in another district/municipality, and 31% of the immigrants reported a lack of affiliation with the RGP scheme. Conclusions and implications:Access to primary care provided by an RGP affects patients’ use of emergency health care services. To facilitate continuity of health care, policymakers should emphasize initiatives to improve access to primary health care services.KEY POINTSAccess to immediate primary health care provided by a regular general practitioner (RGP) can reduce patients’ use of emergency health care services.The main reason for attending a general emergency outpatient clinic was difficulty obtaining an immediate appointment with an RGP.A frequent reason for native Norwegians attending a general emergency outpatient clinic during the daytime is having an RGP outside Oslo.Lack of affiliation with the RGP scheme is a frequent reason for attending a general emergency outpatient clinic among immigrants. [ABSTRACT FROM PUBLISHER]

Background: Promoting adaptation, improving well-being and maintaining an optimal quality of life (QOL) is an important aspect in dementia care. The purpose of this study was to identify determinants of QOL in young onset dementia, and to assess differences in QoL domains between people with Alzheimer's disease (AD) and frontotemporal dementia (FTD). Methods: In total 135 persons with AD and 58 persons with FTD were included from two prospective cohort studies. QOL was assessed with the proxy reported quality of life in Alzheimer's disease questionnaire (QoL-AD). Possible determinants were explored using multiple linear regression and included sociodemographic variables, diagnosis, dementia severity, disease awareness, neuropsychiatric symptoms, met and unmet needs and hours of personal and instrumental care. Differences between QOL domains in people with AD and FTD were calculated using Mann-Whitney U tests. Results: Lower QOL was associated with more depressive symptoms, lower disease awareness, and a higher amount of needs, both met and unmet. People with AD scored lower on the memory and higher on the friends' subscale. No differences were found for the other items. Conclusion: This study demonstrates a unique set of determinants of QOL in AD and FTD. Interventions directed towards these specific factors may improve QOL. [ABSTRACT FROM AUTHOR]

Objective: This study compared cortical and sub-cortical volumes between patients with complicated (i.e. presence of intracranial abnormality on the day-of-injury CT) and uncomplicated (i.e. absence of intracranial abnormality) mild traumatic brain injury (MTBI) 4 weeks post-injury. The study hypothesized regionally decreased brain volumes and reduced cortical thickness in patients with complicated MTBIs compared with uncomplicated MTBI. Methods: This study was part of a larger 2 years cohort study on MTBI. Baseline clinical and magnetic resonance imaging (MRI) data were compared for those with complicated and uncomplicated MTBI. It identified 168 patients with MTBI (90 uncomplicated and 78 complicated), aged 16–65 years. 3T MRI-system (Signa HDxt, GE Medical Systems, Milwaukee, WI) and cortical reconstruction and volumetric segmentation by FreeSurfer software have been used. Results: No significant differences between uncomplicated and complicated MTBIs were found in neuroanatomic volumes and cortical thickness after controlling for age, gender and education. The complicated MTBI group showed larger ventricles compared with the uncomplicated group, but this effect diluted when adjusting for potential confounders. Conclusion: The study findings suggest that the classification of complicated and uncomplicated MTBI may be too broad to differentiate volumetric and morphometric effects of injury in the early post-injury phase. [ABSTRACT FROM PUBLISHER]

The Care Process Self-Evaluation Tool (CPSET) assesses key characteristics of well-organised care processes in hospitals from an interprofessional team perspective. The present study investigated the psychometric properties of the CPSET in terms of factor structure, convergent and discriminant validity, and reliability in Norwegian language and context. After a pilot test, the Norwegian version of the questionnaire was administered as a web form to 501 health professionals in public general hospitals and mental health specialist services; 301 completed forms (response rate 60%) were returned, and 268 (54%) forms representing 27 care processes (19 from somatic care and 8 from mental healthcare) were included in the valid sample. A confirmatory factor analysis (CFA) confirmed the original five-factor structure. All model fit indices, including the standardised root mean square residual (SRMR), which is independent of the χ2-test, met the criteria for an acceptable model fit. Internal consistencies within sub-scales as measured by Cronbach’s alpha were high (range 0.83–0.94). As expected, some redundancy between factors existed (in particular among the PO (Patient-focused organisation), COR (Coordination of the care process), COM (Communication with patient and family), and PO (Follow-up of the care process) factors). In conclusion, the Norwegian CPSET scale showed acceptable psychometric properties in terms of convergent validity and reliability, and fit indices from the CFA confirmed the original factor structure. Based on these findings, we recommend the Norwegian version of the CPSET for use in the assessment of interprofessional teamwork in care processes in specialist healthcare. [ABSTRACT FROM AUTHOR]

Objectives: Our aims were to explore prevalence of anxiety among patients admitted to departments of geriatric psychiatry for treatment of various diagnoses and to examine how often anxiety was registered as a previous or ongoing diagnosis. Method: In all, 473 patients admitted to one of five departments of geriatric psychiatry were included in a quality register and examined according to a standardized protocol. The Geriatric Anxiety Inventory (GAI) was used to measure anxiety during the first week after admission. Diagnoses were made at discharge. Results: Using a cutoff on the GAI of 8/9, the prevalence of anxiety for the following diagnostic groups was depression 65.3%, psychosis 28%, dementia 38.8% and mania 33.3%. Of 24 patients with a primary diagnosis of anxiety, 66.7% scored above 8 on the GAI. Of 236 patients with a GAI score above 8, only 22 (9.3%) were reported to have a comorbid anxiety disorder by the treating psychiatrist. In a multiple regression analysis, we found that the severity of depression (beta 0.585, p < 0.001), being female (beta 0.096, p 0.028) and the use of antipsychotic drugs (beta 0.129, p 0.006) and anxiolytic drugs (beta 0.129, p 0.005) were associated with a higher GAI score. Conclusion: Anxiety is common in geriatric psychiatric patients, regardless of the primary diagnosis. Our findings suggest that anxiety is often a hidden comorbidity in various psychiatric disorders. A high score on the GAI was associated with the severity of depression, female gender and the use of antipsychotic and anxiolytic drugs. [ABSTRACT FROM AUTHOR]

Objective:To chart follow-up of patients after acute poisoning by substances of abuse, register whether patients referred to specialist health services attended, and whether patients contacted a general practitioner (GP) after the poisoning episode. Design:Observational cohort study. Setting:A primary care emergency outpatient clinic in Oslo, Norway. Subjects:Patients ≥12 years treated for acute poisoning by substances of abuse were included consecutively from October 2011 to September 2012. Main outcome measures:Follow-up initiated at discharge, proportion of cases in which referred patients attended within three months, and proportion of cases in which the patient consulted a GP the first month following discharge. Results:There were 2343 episodes of acute poisoning by substances of abuse. In 391 (17%) cases the patient was hospitalised, including 49 (2%) in psychiatric wards. In 235 (10%) cases the patient was referred to specialist health services, in 91 (4%) advised to see their GP, in 82 (3%) to contact social services, in 74 (3%) allotted place in a homeless shelter, and in 93 (4%) other follow-up was initiated. In 1096 (47%) cases, the patient was discharged without follow-up, and in a further 324 (14%), the patient self-discharged. When referred to specialist health services, in 200/235 (85%) cases the patient attended within three months. Among all discharges, in 527/1952 (27%) cases the patient consulted a GP within one month. When advised to see their GP, in 45/91 (49%) cases the patient did. Conclusion:Attendance was high for follow-up initiated after acute poisoning by substances of abuse.KEY POINTSDespite poor long-term prognosis, patients treated for acute poisoning by substances of abuse are frequently not referred to follow-up.Nearly all patients referred to specialist health services attended, indicating the acute poisoning as an opportune moment for intervention.Advising patients to contact their GP was significantly associated with patients consulting the GP, but few patients were so advised.One out of three patients was discharged without follow-up, and there seems to be an unused potential for GP involvement. [ABSTRACT FROM PUBLISHER]

Objective:To investigate how cancer patients in Norway use primary care out-of-hours (OOH) services and describe different contact types and procedures. Design:A retrospective cross-sectional registry study using a billing registry data source. Setting:Norwegian primary care OOH services in 2014. Subjects:All patients’ contacts in OOH services in 2014. Cancer patients were identified by ICPC-2 diagnosis. Main outcome measures:Frequency of cancer patients’ contacts with OOH services, contact types, diagnoses, procedures, and socio-demographic characteristics. Results:In total, 5752 cancer patients had 20,220 contacts (1% of all) in OOH services. Half of the contacts were cancer related. Cancer in the digestive (22.9%) and respiratory (18.0%) systems were most frequent; and infection/fever (21.8%) and pain (13.6%) most frequent additional diagnoses. A total of 4170 patients had at least one cancer-related direct contact; of these, 64.5% had only one contact during the year. Cancer patients had more home visits and more physicians’ contact with municipal nursing services than other patients, but fewer consultations (p < 0.001). Patients in the least central municipalities had significantly more contacts than more central municipalities (p < 0.001). Conclusion:There was no indication of overuse of OOH services by cancer patients in Norway, which could indicate good quality of cancer care in general.KEY POINTS  Many are concerned about unnecessary use of emergency medical services for non-urgent conditions.• There was no indication of overuse of out-of-hours services by cancer patients in Norway.• Cancer patients had relatively more home visits, physician’s contact with the municipal nursing service, and weekend contacts than other patients.• Cancer patients in the least central municipalities had relatively more contacts with out-of-hours services than those in more central municipalities. [ABSTRACT FROM PUBLISHER]

Objectives: To compare locus of control and coping strategies in older persons with and without depression. Method: This cross-sectional study included 144 depressed in-patients from seven psychogeriatric hospital units, and 106 community-dwelling older persons without depression. All participants were 60 years and older. Locus of control was assessed by a 17-items self-report questionnaire with six response categories. Coping strategies were assessed by a 26- items self-report questionnaire with five response categories. For analytical purposes, age (<75 years vs. ⩾75 years), level of education (<10 years vs. ⩾10 years) and general medical health (poor vs. not poor) were categorized. Results: In linear regression analysis, controlling for demographics, health, and social variables, the depressed in-patients showed a higher external locus of control orientation and a less frequent use of problem-focused coping strategies compared with the non-depressed group. No differences in use of emotion-focused strategies were found between the two groups. Conclusion: Compared with the non-depressed old persons, the depressed hospitalized older persons were characterized by perceptions of less personal control, and less use of problem-focused strategies, what also might have brought positive alterations into their situation. [ABSTRACT FROM AUTHOR]

Objectives. This study is designed to provide an empirical conceptualization of daily hassles among unaccompanied refugees, and whether they might affect mental health of young refugees after resettlement. First, we examined the underlying structure of daily hassles conceptualized as measuring general and acculturation-specific hassles. Second, we examined whether these two distinct categories of daily hassles significantly contribute to depression above and beyond the impact of premigration trauma. Design. The study was based on self-report questionnaire data collected from 895 unaccompanied refugees who had been granted residence in Norway. Results. Using structural equation modeling, the results confirmed the grouping of hassles in two general categories, which explained 43% of the variance in depression. Conclusion. The findings underscore the importance of current life conditions for unaccompanied refugees' mental health. [ABSTRACT FROM PUBLISHER]

The aim of this study was to assess whether demographic and social network variables, independently of each other, are associated with quality of life (QoL), self-rated health or physical function. The sample consisted of 307 women aged ≥ 75 years. Social networks were assessed by Fillenbaum’s five questions and a question on ability to participate in organizations. Variables of demographic composition, QoL, health and physical function were registered. We found significant associations between social networks, QoL, health and physical functioning. Seeing friends and relatives as often as wanted, getting help when sick or disabled and having no problems participating in organizations were associated with higher QoL. Higher educational level, the ability to see friends and relatives as often as wanted and having no problems participating in organizations were associated with better health. Living alone, getting help when sick or disabled and having no problems participating in organizations indicated better mobility. Being younger, having higher education and no problems in participating in organizations were associated with better balance. Higher scores on muscle strength were associated with being younger, not living alone and having no problems in participating in organizations. Our results highlight the importance of social networks for maintaining good QoL, health and physical functioning. [ABSTRACT FROM AUTHOR]

The aim was to investigate relatives of inpatients with severe depression - their perceptions of encountering psychiatric specialist health services and their degree of burden. Sixty-eight relatives recruited via hospital wards and community specialist health centers responded to a questionnaire, with questions from the Quality from the Patients Perspective modified to relatives and the Burden Assessment Scale. Relatives recruited via community specialist health centers perceived less received information and support than those recruited via hospital wards. Higher burden was reported among relatives receiving less information and support than they needed from the psychiatric specialist health services. Healthcare professionals are recommended to give relatives the information and support according to their needs. [ABSTRACT FROM PUBLISHER]

Researchers in Norway explore treatment options in primary care for immigrant women with mental health problems compared with nonimmigrant women. Three national registers were linked together for 2008. Immigrant women from Sweden, Poland, the Philippines, Thailand, Pakistan, and Russia were selected for analysis and compared with Norwegian women. Using logistic regression, we investigated whether treatment type varied by country of origin. Rates of sickness leave and psychiatric referrals were similar across all groups. Conversational therapy and use of antidepressants and anxiolytics were lower among Filipina, Thai, Pakistani, and Russian women than among Norwegians. Using the broad term “immigrants” masks important differences in treatment and health service use. By closely examining mental health treatment differences by country of origin, gaps in service provision and treatment uptake may be identified and addressed with more success. [ABSTRACT FROM PUBLISHER]

Objectives: To study the relationship between obesity and heart rate (HR) in women and men.Design: We studied 241 overweight and obese subjects without known heart disease. All subjects underwent ergospirometry during maximal exercise testing on treadmill and recording of body composition, electrocardiogram and clinic and ambulatory blood pressure.Results: Women (n = 132) were slightly older and had higher fat mass, but lower weight, blood pressure and prevalence of metabolic syndrome (MetS) than men (n = 109) (all p < 0.05), while prevalences of obesity and hypertension did not differ. A significant interaction between sex and HR was demonstrated (p < 0.05). In multivariate analysis, female sex (β = 0.99, p < 0.01) predicted higher resting HR independent of confounders. Higher resting HR was particularly associated with presence of MetS, hypertension, higher insulin resistance and lower relative muscle mass in men (all p < 0.05). Female sex also predicted higher peak exercise HR (β = 0.48, p < 0.01) independent of confounders. Higher peak exercise HR was particularly associated with higher exercise capacity and lower age and self-reported physical activity in men, while lower HbA1c and absence of obesity were the main covariates in women in multivariate analyses (all p < 0.05).Conclusions: In our study population, obesity and obesity-associated metabolic changes influenced both resting and peak exercise HR. [ABSTRACT FROM AUTHOR]

More knowledge is needed about how different rehabilitation models in the municipality influence stroke survivors' ability in activities of daily living (ADL). Objectives: To compare three models of outpatient rehabilitation; early supported discharge (ESD) in a day unit, ESD at home and traditional treatment in the municipality (control group), regarding change in ADL ability during the first three months after stroke. Methods: A group comparison study was designed within a randomized controlled trial. Included participants were tested with the Assessment of Motor and Process Skills (AMPS) at baseline and discharged directly home. Primary and secondary outcomes were the AMPS and the modified Rankin Scale (mRS). Results and conclusions: Included were 154 participants (57% men, median age 73 years), and 103 participants completed the study. There were no significant group differences in pre-post changed ADL ability measured by the AMPS. To find the best rehabilitation model to improve the quality of stroke survivors' motor and process skills needs further research. Patients participating in the ESD rehabilitation models were, compared with traditional treatment, significantly associated with improved ADL ability measured by the mRS when controlling for confounding factors, indicating that patients with social needs and physical impairment after stroke may benefit from ESD rehabilitation models. [ABSTRACT FROM AUTHOR]

Background: Treatment studies for anomia in primary progressive aphasia (PPA) have rarely compared multiple treatments in the same individual, and few anomia treatment studies have included participants with the logopenic variant of PPA (lvPPA). Aims: The goals of this study were to evaluate two types of treatment for anomia in a bilingual participant (ND) with lvPPA, and to examine possible cross-language transfer of treatment effects. Methods & Procedures: ND is a Norwegian-English bilingual woman with lvPPA who began this study at the age of 69. In the phonological treatment, ND listened to a word while viewing a corresponding picture, and she repeated the word. In the orthographic treatment, ND read a word out loud while viewing the corresponding picture, and she then copied the word. Both treatments were conducted in English, and accuracy for three tasks (oral naming, written naming, and naming to definition) was assessed in English and Norwegian. The treatment occurred over a one-year period, with eight sessions at the laboratory during the first month, followed by monthly laboratory sessions and thrice-weekly home practice sessions during the subsequent 11 months. Post-treatment assessments were conducted at 1 week, 8 months, 1 year, 20 months, and 3 years. Outcomes & Results: Compared to untrained items, the orthographic treatment resulted in greater English written naming accuracy. This treatment also resulted in cross-language transfer: greater Norwegian oral naming and naming to definition accuracy. The phonological treatment resulted in marginally greater English oral naming accuracy, but it did not have a significant effect on naming accuracy in Norwegian. Conclusions: These findings suggest that the orthographic treatment was effective in strengthening the orthographic representations of the treated items, which facilitated ND’s written naming performance. The pattern of cross-language transfer suggests that the orthographic treatment also strengthened the language-independent semantic representations of the treated items, thereby facilitating access to their Norwegian phonological representations. [ABSTRACT FROM AUTHOR]

Previous studies investigating human values and alcohol consumption have focused on adolescents, so the current study examined associations between human values and alcohol consumption in a cohort of Norwegians in the second half of life (40 years and above). Human values were studied within Schwartz’ theory.1A survey was conducted in 2002/2003 among Norwegians aged 40 to 79 years (n= 4 149). The respondents completed measures of human values, drinking frequency and typical drinking quantity. Females (9%) were more likely to report abstinence than males (3%). Males also reported a higher consumption level. Individuals with high education had lower levels of abstinence (4%) than those with basic education (7%), and high education was also related to more consumption. People aged 40–60 years were less likely to abstain from alcohol (3%) than individuals aged 61 years and above (10%). Unmarried individuals were more likely to report abstinence, but also reported somewhat higher consumption than married individuals. Multivariate analyses adjusting for demographics as well as somatic and mental health showed that hedonistic values were related to lower probability of abstaining, while Conformity and Universalism values were associated with a higher probability of abstaining. Achivement and Hedonism values were associated with more alcohol consumption, whereas Universialism, Tradition, and Conformity were related to lower alcohol consumption. [ABSTRACT FROM PUBLISHER]

In this study, the relationship between shame proneness, guilt proneness, behavioral self-handicapping, and skill level was examined in elite youth soccer players (N= 589,Mage= 16.8,SD= 1.8). Mediation analyses showed that shame proneness had a positive direct relationship with self-handicapping and a weak negative indirect relationship with skill level. Guilt proneness was shown to have a negative direct relationship to self-handicapping and a positive weak indirect relationship to skill level. Shame proneness may, thus, stimulate behavioral self-handicapping, whereas guilt proneness may discourage behavioral self-handicapping in soccer players. [ABSTRACT FROM AUTHOR]

Objective. To examine drug treatment in nursing home patients at the end of life, and identify predictors of palliative drug therapy. Design. A historical cohort study. Setting. Three urban nursing homes in Norway. Subjects. All patients admitted from January 2008 and deceased before February 2013. Main outcome measures. Drug prescriptions, diagnoses, and demographic data were collected from electronic patient records. Palliative end-of-life drug treatment was defined on the basis of indication, drug, and formulation. Results. 524 patients were included, median (range) age at death 86 (19-104) years, 59% women. On the day of death, 99.4% of the study population had active prescriptions; 74.2% had palliative drugs either alone (26.9%) or concomitantly with curative/preventive drugs (47.3%). Palliative drugs were associated with nursing home, length of stay > 16 months (AOR 2.10, 95% CI 1.12-3.94), age (1.03, 1.005-1.05), and a diagnosis of cancer (2.12, 1.19-3.76). Most initiations of palliative drugs and withdrawals of curative/preventive drugs took place on the day of death. Conclusion. Palliative drug therapy and drug therapy changes are common for nursing home patients on the last day of life. Improvements in end-of-life care in nursing homes imply addressing prognostication and earlier response to palliative needs. [ABSTRACT FROM AUTHOR]

Primary objective: To evaluate longitudinal trajectories of emotional distress symptoms after traumatic brain injury (TBI). Research design: Longitudinal study. Methods and procedures: Patients with mild-to-severe TBI, 118 patients participated at 3 months, 109 attended at 1-year and 89 attended the 5-year follow-up. Emotional distress was measured with the Impact of Event Scale-Revised. Patients were also assessed for coping style, anxiety, depression, substance abuse and trauma severity. Main outcomes and results: Based on growth mixture modelling, four trajectories of emotional distress symptoms were identified: 73.5% of patients were characterized by a pattern of resilience, 6.8% by a pattern of delayed distress, 14.6% by recovery and 5.1% by chronic distress. Relative to the resilience trajectory, avoidant-coping style and psychiatric problems were related to recovery and chronic trajectories. The delayed trajectory was similar to the resilience trajectory, except for elevated depressive and anxiety symptoms at 1- and 5-years. Demographics and injury-related variables were not significantly associated with emotional distress trajectories. Conclusions: Resilience was the most common trajectory following TBI. Patients characterized by recovery and chronic trajectories required attention and long-term clinical monitoring of their symptoms. Future research would benefit from longitudinal studies to analyse emotional distress symptoms and the strength of resilience over time. [ABSTRACT FROM AUTHOR]

Somatic symptom burden, or the experience of physical symptomatology without a medical explanation, is related to functional disability and poor quality of life. The consequences of somatic symptom burden extend beyond the individual and affect society, as manifested in higher medical utilization and lower job productivity. Using self-determination theory, we posited that employees' perceptions of managerial support for basic psychological needs may be associated with lower levels of somatic symptom burden among employees, in part because such contexts promote autonomous self-regulation (a type of motivation) at work. Also, we posited that somatic symptom burden among employees would explain some of the relations of managerial need support and autonomous self-regulation at work to indices of work-related functioning, namely emotional exhaustion, turnover intention and absenteeism. Results from 287 Norwegian employees confirmed these hypotheses. These findings not only identify a theoretical mechanism that may explain (in part) the origin of somatic symptoms, but also offer a model by which social-contextual and motivational factors affect important work-related outcomes. These findings also bespeak the importance of developing workplace interventions that provide support for satisfaction of the basic psychological needs. [ABSTRACT FROM PUBLISHER]

Within a stressor-strain framework, the aim of this study is to examine the influence of perceived laissez-faire leadership – a type of leadership characterized by the superiors' avoidance and inaction when subordinates are experiencing a situational need for leadership – on stress in the form of experiences of role ambiguity. This was tested within a prospective 3-wave research design with time lags of 2 and 3 years respectively. A combination of 2 constructive types of leadership, initiating structure and showing consideration, was included as a control. In a sample of 1771 employees drawn from the Norwegian working population, structural equation modelling supported the hypothesis that perceived laissez-faire leadership would be positively related to experiencing role ambiguity at 3 consecutive measurement points. The findings did not support a potential reciprocal relationship between the two across time. Initiation of structure and Consideration were not related to role ambiguity, providing strong evidence of the importance of laissez-faire leadership within a stressor-strain framework. Demonstrating that laissez-faire leadership is a root source of subordinate role ambiguity underlines the importance of superiors perceiving situations and circumstances where subordinates experience a need for leadership and, accordingly, approaching this need instead of avoiding it. [ABSTRACT FROM PUBLISHER]

Objective: This study sought to identify potential differing clinical characteristics between patients with a mild traumatic brain injury (MTBI) who attended a planned follow-up session and not. This study investigated whether clinical characteristics and attendance for a planned follow-up service 2-months after injury could be related to return-to-work (RTW) 1-year later. Method: Prospective cohort study of 343 patients with MTBI admitted consecutively to the Department of Neurosurgery in 2009-2011. Demographic and clinical data were obtained from the hospital files and data about sick leave from The Norwegian Labour and Welfare Service. Patients were categorized into two groups according to their attendance. Results: One hundred and sixty-one (67%) patients attended (AG) and 80 (33%) did not (NAG) attend their follow-up appointments. The AG had significantly more frequently intracranial pathology on CT scan, had consumed less alcohol and were older. Logistic regression showed that follow-up attendance (OR = 16.89) and sick leave before injury (OR = 9.70) are unfavourably related to RTW at 12-months. Skull fracture and cause of injury had no influence of the outcome. Conclusion: Not attending the follow-up has a favourable outcome after MBTI, indicating that these patients have a reduced need for medical and rehabilitation support for their brain injury. [ABSTRACT FROM AUTHOR]

Objectives:Assessing subjective age perception (SAP) and changes in SAP as well as exploring which variables of socio-demographic, health and personal mastery independently predicted SAP.Methods:The panel data are from two waves of the Norwegian Study on the Life Course, Ageing and Generations (NorLAG). Our sample consists of 2471 people aged 40–79 years at baseline who were surveyed in 2002/2003 (T1) and 2007/2008 (T2). Univariate and multiple regressions were performed; multivariate analyses assessing the relative importance of the independent variables (at T1) for the SAP at T2.Results:Older chronological age, good physical health, good mental health, a high level of personal mastery and having lower education significantly predicted a youthful SAP. For the whole sample, older age and a high level of personal mastery were the most important predictors. For those aged 40–49 being a man, having lower education, good physical health and high personal mastery predicted a younger SAP, whereas in the group aged 50–59 years being married/cohabiting and having a high level of education were predictors of an older SAP. For those aged 60–69, high personal mastery was the only independent predictor of a younger SAP. For those aged 70–79 years, only health – good mental and physical health – independently predicted a younger SAP.Conclusions:Most respondents feel younger than their chronological age, the more the older they are. Self-rated physical and mental health and personal mastery are associated with SAP and vary in different age groups. [ABSTRACT FROM PUBLISHER]

Aims: The aim of this study was to investigate functioning and self-rated health (SRH) among the oldest old community-dwelling women. Methods: The numbers of community-dwelling women who took part in this four-year study with three study waves were 113 (T1), 79 (T2), and 41 (T3), respectively. The participants mean baseline (T1) age was 88 years. Functioning measurements were: Activities of Daily Living (ADL), Timed Up and Go (TUG) and Mini-Mental State Examination (MMSE-12). Results: A statistically significant increase in the prevalence of disability (need for personal assistance in at least one basic ADL item) was revealed from T1 through to T3. The TUG, MMSE-12 and SRH declined significantly from T1 to T2; however, the decline attenuated from T2 to T3. Better baseline TUG and MMSE-12 were independently associated with remaining nondisabled at T3. Conclusions: Our results indicate the importance of enhancing mobility aiming at reducing the period of disability. [ABSTRACT FROM AUTHOR]

Objective:Persons with substance use disorders often have comorbid psychiatric problems, and treating all problem domains is important for treatment success and recovery. This study examined reported interventions provided to patients as well as patients’ reports of domains of help received, perceived areas of greatest benefit, and satisfaction with substance use disorder treatment. We also compared patients with co-occurring disorders and patients with only substance use disorders to see whether there were significant differences across groups on these measures.Methods:Patients receiving inpatient substance use treatment at clinics in Norway were recruited for the study; 85 completed a cross-sectional survey prior to discharge. Treatment personnel also completed a separate survey and gathered information from patient charts.Results:The most frequently provided treatment interventions involved improving relationships with family and important others, applied relaxation, psychodynamic therapy, cognitive behavior therapy, and motivational interviewing. Patients reported receiving the most help in domains of relapse prevention, physical health, daily functioning, relationships with people, psychological health, and self-esteem. They benefited most from physical activities, support from co-patients, group therapy, counseling, and assessment/treatment of psychological health. Patients with co-occurring disorders were given more exposure therapy, motivational interviewing, and cognitive behavior therapy interventions than those without comorbidity. Patients with co-occurring disorders self-reported receiving more help with self-esteem and coping with psychiatric symptoms and benefiting more from interventions involving psychological health, acute help, and social situations.Conclusions:Patients perceived psychological and physical health as important areas for improvement. There were differences between patients with co-occurring disorders and those with substance use disorders only in several measures. It is important to acknowledge that patients with substance use disorders and co-occurring mental problems are heterogeneous groups with unique but overlapping needs. [ABSTRACT FROM AUTHOR]

Aim: From 2005 to 2009, increased support for restrictive alcohol policy measures was observed in the Norwegian population. This article addresses whether this increase was mediated by changes in belief about the effectiveness of restrictive measures and belief about the harm caused by drinking. Method: The data were derived from five surveys conducted during the period 2005-2009 ( N = 7244). In each survey, we used identical measures of attitudes towards regulation of price and availability, belief in the effectiveness of such measures and belief in the association between overall consumption and harm. Results: During the period, there was an increase in support for restrictive policy measures; in belief in the effectiveness of these measures and in belief in the harm caused by drinking. Increased support for restrictive measures was partly mediated by changes in beliefs in terms of statistically significant indirect effects from both belief in the effectiveness of such measures and belief in the harm caused by drinking. Half of the increased support for restrictive measures could be attributed to changes in beliefs. Conclusion: Strengthening people's belief in the effectiveness of restrictive measures and in the harm caused by drinking may increase public support for restrictive alcohol policy measures. [ABSTRACT FROM AUTHOR]

Objectives:The purpose of the study was to explore whether and how loneliness in adults was influenced by life events and experiences in early and later stages in life. Applying a life-course and gender perspective, the current study investigates statuses and transitions that influence self-reported loneliness among men and women in middle age (age 40–59) and when older (age 60–80). Method:The panel data are from two waves of the Norwegian study of the life course, ageing and generations. Our sample consists of 3750 people aged 40–80 at baseline who were surveyed in 2002–2003 (T1) and 2007–2008 (T2). Multivariate analyses were used to investigate personal characteristics and life events associated with loneliness at baseline and life events predicting the incidence of loneliness during the five-year period. Results:Adverse childhood events were associated with loneliness by both men and women. In the older group, men's loneliness was related to having been bullied, and conflicts between parents. Women's loneliness was related to economic problems in their childhood family. Regarding the incidence of loneliness – becoming lonely between T1 and T2 – among those aged 40–59, divorce predicted women becoming lonely, but not men. Among those aged 60–80, the partner's death was a stronger predictor of the incidence of loneliness among men than among women. Conclusion:The results demonstrate that loneliness is influenced by events and experiences from early childhood to later life, and that some events and experiences influence loneliness in men and women differently. [ABSTRACT FROM PUBLISHER]