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Astri Syse1, Gjøril B Aas1, Jon H Loge2,31Cancer Registry of Norway, 2Oslo University Hospital, 3University of Oslo, Oslo, NorwayBackground: Today many people are choosing to have children later in life. Additionally, the use of sophisticated diagnostic tools and screening modalities has increased over recent years. Because of these factors, cancer is being diagnosed more frequently during the child-rearing years. Sociodemographic and cancer-related information on families and minor (0–18 years) and young adult (YA) (19–25 years) children experiencing parental cancer is scarce, but this information is vital for healthcare initiatives aimed toward those potentially adversely affected. Therefore, the aim of this study was to describe features of families and minor and YA children affected by parental cancer in a nationwide population.Methods: Complete Norwegian birth cohort data were obtained from national registries. Descriptive prevalence and incidence statistics were collected for parents and minor and YA children. Logistic regression models were used to assess factors likely to influence parental death.Results: Every year around 0.3% of all families with children under the age of 18 years encounter parental cancer, and 3.1% of minors and 8.4% of YAs have a parent who has been diagnosed with cancer. This study found skin, breast, testicular, and colorectal cancers were the most common forms of cancer diagnosed. The sociodemographic features of those affected were fairly similar to those of the general population. One in five children experienced parental death from cancer; parental death was more often paternal than maternal and was most common in parents diagnosed with leukemia or brain, colorectal, and lung tumors. Deaths are uncommon among parents without cancer.Conclusion: Adequate assistance for minor and YA children affected by parental cancer requires knowledge of their number and characteristics. Parental cancer is more common than previously suggested: the annual incidence of parental cancer for children under 18 years of age is 0.3%, whereas approximately 4% of children aged 0–25 years have or have had parents diagnosed with cancer, corresponding to a population prevalence of 1.4%. Around 20% of these children experience parental death, and surveys of live respondents should account for this.Keywords: incidence, neoplasm, parental cancer, prevalence, Norway

Abstract Introduction This paper outlines the design, implementation, and usability study results of the patient empowerment process for chronic disease management, using Patient Reported Outcome Measurements and Shared Decision-Making Processes. Background The ADLIFE project aims to develop innovative, digital health solutions to support personalized, integrated care for patients with severe long-term conditions such as Chronic Obstructive Pulmonary Disease, and/or Chronic Heart Failure. Successful long-term management of patients with chronic conditions requires active patient self-management and a proactive involvement of patients in their healthcare and treatment. This calls for a patient-provider partnership within an integrated system of collaborative care, supporting self-management, shared-decision making, collection of patient reported outcome measures, education, and follow-up. Methods ADLIFE follows an outcome-based and patient-centered approach where PROMs represent an especially valuable tool to evaluate the outcomes of the care delivered. We have selected 11 standardized PROMs for evaluating the most recent patients’ clinical context, enabling the decision-making process, and personalized care planning. The ADLIFE project implements the "SHARE approach’ for enabling shared decision-making via two digital platforms for healthcare professionals and patients. We have successfully integrated PROMs and shared decision-making processes into our digital toolbox, based on an international interoperability standard, namely HL7 FHIR. A usability study was conducted with 3 clinical sites with 20 users in total to gather feedback and to subsequently prioritize updates to the ADLIFE toolbox. Results User satisfaction is measured in the QUIS7 questionnaire on a 9-point scale in the following aspects: overall reaction, screen, terminology and tool feedback, learning, multimedia, training material and system capabilities. With all the average scores above 6 in all categories, most respondents have a positive reaction to the ADLIFE PEP platform and find it easy to use. We have identified shortcomings and have prioritized updates to the platform before clinical pilot studies are initiated. Conclusions Having finalized design, implementation, and pre-deployment usability studies, and updated the tool based on further feedback, our patient empowerment mechanisms enabled via PROMs and shared decision-making processes are ready to be piloted in clinal settings. Clinical studies will be conducted based at six healthcare settings across Spain, UK, Germany, Denmark, and Israel.

Population ageing is a topic of great concern in many countries. To counteract the negative effects of ageing, increased fertility or immigration are often proposed as demographic remedies. Changed emigration is, however, rarely mentioned. We explore whether reduced emigration could mitigate ageing in a country like Norway. Using cohort-component methods, we create hypothetical future demographic scenarios with lower emigration rates, and we present (prospective) old-age dependency ratios, population growth and shares of immigrants. We also estimate howmuch fertility and immigrationwould have to change to yield the same effects. In different scenarios, emigration is reduced for the total population and for subgroups, while also taking into account that reduced emigration of natives will entail reduced return migration. Our results show that even a dramatic 50% decrease in annual emigration would mitigate ageing only slightly, by lowering the old-age dependency ratio in 2060 from 0.54 to 0.52. This corresponds to the anti-ageing effect of 15% higher fertility, or one-quarter extra child per woman.

Abstract Background Rates of all-cause and cause-specific mortality are higher among unmarried than married individuals. Cancer survival is also poorer in the unmarried population. Recently, some studies have found that the excess all-cause mortality of the unmarried has increased over time, and the same pattern has been shown for some specific causes of death. The objective of this study was to investigate whether there has been a similar change over time in marital status differences in cancer survival. Methods Discrete-time hazard regression models for cancer deaths among more than 440 000 women and men diagnosed with cancer 1970-2007 at age 30-89 were estimated, using register data encompassing the entire Norwegian population. More than 200 000 cancer deaths during over 2 million person-years of exposure were analyzed. Results The excess mortality of the never-married compared to the married has increased steadily for men, in particular the elderly. Among elderly women, the excess mortality of the never-married compared to the married has increased, and there are indications of an increasing excess mortality of the widowed. The excess mortality of divorced men and women, however, has been stable. Conclusions There is no obvious explanation for the increasing disadvantage among the never-married. It could be due to a relatively poorer general health at time of diagnosis, either because of a more protective effect of partnership in a society that may have become less cohesive or because of more positive selection into marriage. Alternatively, it could be related to increasing differentials with respect to treatment. Today's complex cancer therapy regimens may be more difficult for never-married to follow, and health care interventions directed and adapted more specifically to the broad subgroup of never-married patients might be warranted.

The introduction of artificial intelligence (AI) challenges much of our traditional understanding of military ethics. What virtues and what sort of ethics education are needed as we move into an ever more AI-driven military reality? In this article we suggest and discuss key virtues that are needed, including the virtue of prudence and the accompanying virtue of good and proper storytelling. We also reflect on the ideal of “explainable AI,” and philosophize about the role of fear in helping us understand what is actually at stake in a military infused with AI-enabled and AI-driven weapons.

We herein report on the development of a new prototype PTR-ToF-MS (proton-transfer-reaction time-of-flight mass spectrometry) instrument that combines a hollow cathode glow discharge (HCGD) ion source with a focusing ion–molecule reactor (FIMR), which consists of a resistive glass drift tube surrounded by quadrupole rods. The new instrument configuration hybridizes the two main current commercial PTR-ToF-MS instrument designs. We provide a detailed technical description of the new analyzer and its optimized operational settings for detecting volatile amines via proton transfer reactions from hydronium (H3O+) or ammonium (NH4+) ions. We show that the new prototype PTR-ToF-MS instrument is capable of monitoring rapid changes of sticky amines on the timescale of a few seconds and detects atmospheric variations of amines down to single-digit parts per trillion by volume (pptv) levels. Application examples given include the real-time monitoring of (i) methylamine emitted from a Chenopodium vulvaria L. plant, (ii) small alkylamines in ambient air on site of an agricultural research center (Senter for husdyrforsøk, Ås, Norway), and (iii) an industrial amine (2-amino-2-methylpropan-1-ol, AMP) on site and downwind of a carbon dioxide (CO2) capture test center (Technology Centre Mongstad – TCM, Mongstad, Norway).

Abstract In the Arctic, indigenous reindeer herding peoples rely on a pastoralist food and knowledge system that supplies them with protein, vitamins, and minerals. Reindeer pastoralism is a product of the interaction between animals’ physical needs, their behaviour, and the skills of the herders. The food systems of Sámi reindeer pastoralists depend on indigenous knowledge about mountain slaughtering. When the first stationary reindeer slaughterhouse opened in Guovdageaidnu (Northern Norway) in 1957, rationalisation of reindeer husbandry and methods of reindeer slaughter took place. Animal welfare and reindeer slaughter within slaughterhouses are well-documented in Norway; the historical knowledge about slaughtering reindeer in the mountains, however, is barely documented and is in danger of being lost. A qualitative study entailing interviews with five Sámi reindeer herders (50–80 years old) from Guovdageaidnu and Varanger explains indigenous, nomadic methods of killing and slaughtering reindeer. The traditional Sámi way of killing reindeer (Sámi: giehtadit) was to pierce the heart with a large knife through the chest (Sámi: mielga), particularly in the pastures close to where the herd grazed to avoid distressing the reindeer before taking their lives. This allowed reindeer herders to use the whole reindeer for food, unlike the practice in stationary slaughterhouses, which merely utilises select muscles for human consumption. Although the Supreme Court of Norway in 2008 ruled that traditional slaughter practice without stunning was illegal, this historical account provides evidence that the giehtadit method was a rational way to kill a reindeer, as bleeding (haemorrhage) in the thorax offers both high-quality blood, offal, and meat for human consumption. We conclude that the traditional Sámi method is based on systematic, complex, and holistic indigenous knowledge and determines the foods reindeer herders eat.

Aims: Studies of the association between self-rated health and persons' income and education have almost invariably shown that people with higher education and incomes report better health. Less is known of the influence of household members' socioeconomic characteristics on individuals' health. This study thus aimed to assess the extent to which the socioeconomic characteristics of partners may contribute to explaining the variation in the respondents' self-rated health (SRH). Methods: Using an observational design, we analysed cross-sectional Norwegian survey data on SRH (2015 and 2019), linked to register data on education and income for respondents (N = 7082) and their opposite-sex coresident spouse or partner. We employed logistic regression models to assess the associations between respondents' SRH and the relative income and education of their partner. Average marginal effects were calculated to enable cross-model comparisons. Results: Net of individual characteristics, having a higher-educated partner was positively associated with SRH for both male (OR = 1.56) and female (OR = 1.36) respondents. Having a partner with an above median income (by age and sex) was positively associated with SRH for female (OR = 1.29) respondents only. For education, the positive SRH associations were roughly similar for respondents and partners. For income, the associations were more pronounced for respondents than partners. Conclusions: Our findings suggest that health is affected by the resources (or lack thereof) in one's immediate networks. To reduce social inequalities in health, health personnel might customise interactions to account for household resources. Such knowledge could also be used in health-promoting activities to enhance participation and health competency. [ABSTRACT FROM AUTHOR]

Few producers of official population projections provide regular evaluations of past projection inaccuracies. This paper assesses deviations between the projected and registered total population for Norway (1996–2018), as well as deviations in the age structure, total fertility rate and number of births, period life expectancy at birth and number of deaths, and net international migration. Projected life expectancy was consistently lower than the real development. Few systematic deviations were observed for fertility up to 2009, but thereafter fertility has been consistently overprojected. However, the deviations between projected and realised trends in births and deaths have been relatively small as compared to those for net international migration. The projections produced between 1996–2005 underestimated long-term population growth due primarily to the unforeseen increase in immigration following EU expansion in 2004. More recent projections contain no consistent under- or overprojection of net migration and the deviations for the total population have been moderate.

The criterion of "reasonable likelihood of success" clearly depends on a reasonable definition of success. This article suggests three such definitions and discusses these in light of the great uncertainty that accompanies any use of this forward-looking just war criterion. The importance of thorough understanding and knowledge, both military and cultural, in order for the application of the reasonable likelihood criterion to be meaningful is also discussed. [ABSTRACT FROM AUTHOR]

In this article, our starting point is that people who are plagued by the so-called meat paradox must find ways of making meat consumption safe from the realities of meat production. They do this by way of various mechanisms of denial, which obfuscate contemporary industrial meat production. We focus on how advertisements become one notable vehicle of such denial, and select three examples for close reading. Focusing on the rhetorical techniques employed in three Norwegian ads for meat and how they mediate meat production to consumers, we argue that these ads all present an image of meat producers as progressive and caring proponents of animal welfare. This leads us to suggest that they exemplify a variant of greenwashing that we dub "welfare washing"—the main message of which is to keep calm and carry on consuming meat. [ABSTRACT FROM AUTHOR]

In a plenary address at the 2023 NCHC annual conference in Chicago, the former Vice Chair of the Norwegian Nobel Committee issued a challenge for honors students and educators to use their voices and positions of local leadership to promote peace. The call for peace advocacy extended in Chicago resonated with the large audience, as leadership development represents a high-impact practice that many honors programs embrace. As national and international conflicts produce increasing polarization and divisiveness that seep into our campuses and local communities, the urgency for honors students to hone critical thinking and practical skills needed for citizen leadership and peacemaking magnify. Nobel Peace Prize laureates are diverse and interdisciplinary exemplars that honors educators can utilize as they seek to inspire and instruct students who strive to fulfill the Chicago challenge. Drawing content from the history and laureates of the Nobel Peace Prize, we provide two tested educational modules designed to illuminate a wide lexicon of strategies and practices that leaders employ in their pursuit of peace. We share best practices gleaned from eight years of honors curricular and co-curricular program development, enriched by consultation with leaders from the Norwegian Nobel Institute, the Norwegian Nobel Committee, and the Nobel Peace Center. A link of mutual value exists between NCHC member institutions and the legacy of Alfred Nobel, which we call Partners in Peace. The models offer easy adoption logistics for NCHC institutions of any composition. We conclude with future possibilities, a few poised for adoption by NCHC's International Education Committee. [ABSTRACT FROM AUTHOR]