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This paper reports results from two meta-analyses of the potential individual-level outcomes of exposure to workplace bullying. After introducing a theoretical framework for the possible relationships between bullying and outcomes, Study 1 summarizes 137 cross-sectional effect sizes from 66 independent samples (N=77,721). The findings show that exposure to bullying is associated with both job-related and health- and well-being-related outcomes, such as mental and physical health problems, symptoms of post-traumatic stress, burnout, increased intentions to leave, and reduced job satisfaction and organizational commitment. Non-significant or weak associations were established for absenteeism, performance, self-perceptions, and sleep. Study 2 examines longitudinal relationships between bullying and mental health and absenteeism, respectively. Based on prospective associations from 13 samples (N=62,916), workplace bullying influenced mental health problems over time, while baseline mental health problems were associated with a similar increased risk of subsequent reports of exposure to bullying. The long-term effect of exposure to bullying on absenteeism was rather weak. To summarize, the two meta-analyses provide robust evidence for the detrimental effects of workplace bullying that are in line with the theoretical framework presented. The findings have implications for the development of strategies against bullying. Directions for future research are discussed. [ABSTRACT FROM AUTHOR]

This paper describes the participation of informal caregivers in the discharge process when patients aged 80 and over who were admitted from home to different hospitals in Norway were discharged to long-term community care. Data for this cross-sectional survey were collected through telephone interviews with a consecutive sample of 262 caregivers recruited between October 2007 and May 2009. The Discharge of Elderly Questionnaire was developed by the research team and was designed to elicit data concerning informal caregivers' self-reported perceptions on participation in the discharge process. A descriptive and comparative analysis of Thompson's levels of participation reported by the older generation (spouses and siblings) and the younger generation (adult children and children-in-law, nieces and grandchildren) was undertaken using bivariate cross-tabulations and chi-square tests for association and trend. Analyses showed that the younger generation of caregivers received and provided information to hospital staff to a greater degree than the older generation. Overall, 52% of the informal caregivers reported co-operating with the staff to a high or to some degree. A multivariate logistic regression analysis was used to analyse factors predicting the likelihood of informal caregivers reporting co-operation with hospital staff. The odds of younger generation caregivers reporting co-operation were more than twice as high ( OR = 2.121, P = 0.045) as the odds of the older generation. Caregivers of patients with a hearing impairment had higher odds of reporting co-operation ( OR = 1.722, P = 0.049) than caregivers of patients with no such impairment. The length of hospital stay, the caregiver's and patient's gender and education level were not significantly associated with caregiver's co-operation. The informal caregivers' experiences with information practices and user participation in hospitals highlight important challenges that must be taken seriously to ensure co-operation between families and hospitals when elderly patients are discharged back to the community. [ABSTRACT FROM AUTHOR]

This paper examines the prevalence of multiple symptoms and the relationships between future expectations and multiple symptoms in a cross-sectional study of 100 patients with chronic obstructive pulmonary disease. A questionnaire was used to examine the patients' symptoms of breathlessness, anxiety, depression, sleeplessness, fatigue, and pain, and their outlook for the future. All patients reported breathlessness, 64% anxiety, 69% depression, 28% sleeplessness, 72% fatigue, and 45% pain. Those with anxiety reported significant depression ( P < 0.001), and those with fatigue reported significant depression ( P = 0.004). Patients who reported pain also reported significant sleeplessness ( P = 0.022). A negative outlook for the future was reported by 42% of patients who also reported significantly more anxiety, depression, sleeplessness, fatigue, and pain ( P ≤ 0.049). Multiple symptoms are common in chronic obstructive pulmonary disease, and patients with a pessimistic view of the future reported more symptoms. Those with multiple symptoms and a negative outlook toward the future may benefit from interventions to help them achieve a more positive outlook for the future, which may relieve symptom burden. [ABSTRACT FROM AUTHOR]

The aim of this paper was to investigate whether psychosocial functioning in adulthood (e.g., friends support, cohabitation, community connectedness and work satisfaction) could be predicted by mental health, subjective well-being, social relations and behavior problems in adolescence, and whether gender was a moderator in these associations. Data were obtained from a major population-based Norwegian study, the Nord-Trøndelag Health Study ( HUNT), in which 517 men and 819 women completed an extensive self-report questionnaires at baseline (mean age 14.4 years) and at follow-up (mean age 26.9 years). Community connectedness as well as work satisfaction were predicted by subjective well-being. Cohabitation was predicted by male gender and frequency of meeting friends in adolescence, and friends support was predicted by frequency of meeting friends. Gender had a minor effect as a moderator. Frequency of meeting friends and subjective well-being seemed to be the strongest adolescent predictors of psychosocial functioning in young adulthood. These findings may have implications both for prevention and intervention in adolescence, as well as for future research. [ABSTRACT FROM AUTHOR]

Jøsendal, O. & Aarø, L. E. (2012). Adolescent smoking behavior and outcome expectancies. Scandinavian Journal of Psychology 53, 129-135. Adolescent smoking behavior is assumed to be associated with smoking outcome expectancies. Results in this paper are based on data from the control group of two data collections among Norwegian secondary school students taken approximately 30 months apart (T1 and T2). The dimensionality of smoking outcome expectancies was the same at both time points, revealing three components ('Addicted', 'Not harmful' and 'Social'). After correction for attenuation, the Pearson's correlation between T1 and T2 was 0.41 for the total sumscore, indicating low to moderate relative stability. When examining smoking expectancy sumscore means by smoking habits at T1 and T2, never smokers were different from smokers on both occasions. Never smokers scored low on 'Social' and 'Not harmful', and high on 'Addictive'. All associations were statistically significant ( p < 0.001). The 'Social' dimension was the strongest predictor of smoking behavior at T1 and T2. One of the outcome expectancy sumscores ('Addictive') at T1 predicted smoking habits at T2 after controlling for smoking habits at T1 ( p < 0.01). This predictor was significant also after entering outcome expectancy sumscores at T2 into the model ( p < 0.05). These results indicate that outcome expectations other than the health-related ones should be paid attention to when planning new prevention programs. [ABSTRACT FROM AUTHOR]

It has been hypothesized that Laestadianism has contributed to the less drinking observed among indigenous Sami. This paper further investigates the bivariate protective influence of Sami ethnicity on youth drinking behavior using logistic regressions. We simultaneously controlled for the influence of religious revival movements (Laestadianism or evangelic) and religious importance (being personally Christian), in addition to socio-demographics and parental factors. Cross-sectional data from the 1994/95 North Norwegian Youth Study including 2,950 (675 Sami) 15-19 year-old high school students (RR: 85%) was used. Sami ethnicity was statistically significant for two out of six alcohol outcome measures, after adjustment for religiosity and other covariates, indicating less current drinking and party drinking. Religiousness was associated with higher youth and parental abstinence across ethnicities. Generally, stronger protective influences on drinking behavior were found for religious importance (being personally Christian) than religious affiliation (Laestadianism). The non-significance between Sami and non-Sami drinking may partly be explained by ethnic differences in religiosity, but also socio-demographics (e.g., residing in the Sami Highland) and parental factors (e.g., abstinence) contributed to such a result. Laestadianism`s profound impact on Sami culture, and its strong anti-alcohol norms may have contributed to a religious-socio-cultural context of abstinence. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of a study of the impact of finger rings, wrist watches, nail polish, length of fingernails, hand lotion, gender and occupation on hand microbiology of healthcare workers. Background. The impact of the above mentioned variables on hand microbiology of healthcare workers is not well defined. Large scale studies suitable for multivariate analysis are needed to elucidate their role. Methods. Both hands of 465 Norwegian healthcare workers were sampled by the glove juice method during two study periods (2004 and 2007), and examined for total number of bacteria and presence of Staphylococcus aureus, Enterobacteriacea and non-fermentative Gram-negative rods. Multiple regression analysis was performed. Results. The use of a wrist watch was associated with an enhanced total bacterial count on hands compared to hands without a watch [(B) 3.25 (95% CI: 1.73-6.07), P < 0.001], while the use of one plain finger ring increased the carriage rate of Enterobacteriaceae [odds ratio 2.71 (95% CI: 1.42-5.20), P = 0.003]. The carriage rate of Staphylococcus aureus was enhanced with fingernails longer than 2 mm [odds ratio 2.17 (95% CI: 1.29-3.66), P = 0.004] and after recent use of hand lotion [odds ratio 22.52 (95% CI: 4.05-125.30), P < 0.001]. No effect of nail polish was observed. We found an association between occupation and carriage rate of S. aureus and Enterobacteriaceae. Conclusions. Health care workers should remove finger rings and watches at work. Fingernails should be shorter than 2 mm, nail polish may be used. [ABSTRACT FROM AUTHOR]

Background: Reliable information on headache characteristics, including frequency and intensity, headache-associated impairment, and use of analgesic medications, may depend on the assessment method used. This study analyzed the correlations between headache characteristics determined in structured interviews and those determined in prospective diary recordings kept by adolescents in the general population. Methods: In this cross-sectional school-based study, a representative sample of 488 adolescents aged 12-18 years were interviewed about headaches experienced during the previous year. Headache diaries for a three-week period were kept by 393 participants: 244 girls (62 %) and 149 (38 %) boys. Results: Most adolescents (88 %) who reported headaches during their interview also recorded headaches in their diary. In contrast, 51 % of those who reported being headache-free during the last year recorded headaches in their diary. In the interviews, frequent headaches (at least 50 % of days during the last year) were reported by 2.9 % of participants, while 25.5 % reported this headache frequency in their diary. Overall, the ratings of headache frequency were significantly higher in diaries than in interviews ( p < 0.001). Significant but low correlations were observed between intensity levels reported retrospectively and prospectively (rho = 0.28; p < 0.001) and between average scores of headache-related impairment reported retrospectively and prospectively (rho = 0.35; p < 0.001). The use of medications by those who reported one or more current headache disorder during their interview was significantly lower in prospective recordings than in the retrospective interview estimates ( p < 0.001). Conclusions: There is inconsistency in the estimates of headache characteristics between retrospective reports and diary recordings. A comprehensive picture of headache complaints among adolescents may be better obtained through a combination of prospective diary recordings and interviews by school health and clinical services. [ABSTRACT FROM AUTHOR]

Background: Previous studies, all of <20 years of followup, have suggested an association between lung function and the risk of fatal stroke. This study investigates the stability of this association in a cohort followed for 4 decades. Methods: The Bergen Clinical Blood Pressure Survey was conducted in Norway in 1964--1971. The risk of fatal stroke associated with forced expiratory volume after one second (FEV1) was estimated with Cox proportional hazards regression, making progressive adjustment for potential confounders. Results: Of 5617 (84%) participants with recorded baseline FEV1, 462 died from stroke over 152 786 subsequent person-years of follow-up according to mortality statistics of 2005; mean (SD) follow-up was 27 (12) years. An association between baseline FEV1 (L) and fatal stroke was observed; HR=1.38 (95% CI 1.11 to 1.71) and HR=1.62 (95% CI 1.22 to 2.15) for men and women, respectively (adjusted for age and height). The findings were not explained by smoking, hypertension, diabetes, atherosclerosis, socioeconomic status, obstructive lung disease, physical inactivity, cholesterol or body mass index and persisted in subgroups of never-smokers, subgroups without respiratory symptoms and survivors of the first 20 years of follow-up. For male survivors with a valid FEV1 at follow-up (1988--1990) (n=953), baseline FEV1 (L) indicated a possible strong and independent association to the risk of fatal stroke after adjustments for individual changes in FEV1 (ml/year) (HR 1.95 (95% CI 0.98 to 3.86)). Conclusion: There is a consistent, independent and long-lasting association between lung function and fatal stroke, probably irrespective of changes during adult life. [ABSTRACT FROM AUTHOR]

Introduction: Objective sales data have indicated that the Norwegian indoor smoke-free regime implemented in June 2004 did not affect the hospitality business negatively. This paper investigates whether self-reports on the economic impact of the smoking ban from employees in the hospitality sector gave similar results, and whether post-ban self-reports on the economic impact of the ban were influenced by pre-ban attitudes towards smoke-free policies. Methods: A random sample of 516 employees in bars and restaurants stated their attitudes towards smoke-free policies shortly before the ban became effective. One year later, the same respondents gave their perceptions of changes in patronage for their workplace. Data were collected using self-administered questionnaires and telephone interviews. Results: 56.4% of the hospitality workers stated that the ban on smoking had led to a large reduction (28.2%) or some reduction (28.2%) in the number of patrons, a result inconsistent with analysis of sales data. After adjusting for demographic and smoking-related variables, a negative pre-ban attitude significantly increased the odds for reporting a negative economic impact post ban (odds ratio 2.48, confidence interval 1.48—4.14). Conclusions: Subjective reports of the economic impact from an indoor ban on smoking are influenced by attitudes towards smoke-free policies and should not be considered as a valid measure of the economic effect. [ABSTRACT FROM PUBLISHER]

BACKGROUND: Findings from studies on the association between smoking and socioeconomic status are mixed. While adolescent smoking is reduced in many countries, use of smokeless tobacco seems to increase. Associations between socioeducational status and smoking as well as use of snus (smokeless tobacco), and to what extent these associations had changed significantly from 2004 to 2007 (a period of relatively abrupt changes in tobacco use in Norway), were examined. METHODS: Data from two national representative cross-sectional studies of Norwegian 16–20 year olds, where participants were asked questions allowing us to construct indicators of socioeducational status, was used. Information was also collected about the adolescents' smoking and use of snus, as well as their intentions with regard to future use of these products. RESULTS: Adolescents with a lower socioeducational status had much higher odds for smoking compared to those with higher socioeducational status (ORs ranged from 2.9 to 3.8). There was no similar association between socioeducational status and snus use (ORs ranged from 0.6 to 1.2). No support was found for a change in the socioeducational status–smoking/snus use association from 2004 to 2007. CONCLUSIONS: Adolescents' socioeducational status was associated with smoking for boys and girls, while there was no similar association with snus use. This may indicate that snus truly deviates from how smoking is distributed across social strata or that snus is at a much earlier stage in the social diffusion process. [ABSTRACT FROM AUTHOR]

Objective: Identify predictive variables related to the development and continuation of high dental anxiety among young people over 2 years and assess differences between youth experiencing increased, decreased or unchanged dental anxiety scores over time. Methods: An observational panel study of 15‐ to 21‐year‐old people in Tromsø and Balsfjord region followed students from their first to their last year of upper secondary school (2010/11‐2012/13). Logistic regression was used to estimate odds ratios and their 95% confidence intervals (CI) of possible predictive variables assessed at baseline when using dental anxiety score from the second wave as a dichotomous dependent variable. Variables measured at baseline: Sex, Dental Caries Experiences (DMFS index), Dental Anxiety (Corah's Dental Anxiety Scale/DAS), Psychological Distress (Hopkins Symptom Checklist/HSCL‐10), Avoidance of dental treatment, Pain Estimation at the dentist and motivational questions related to tooth brushing and caries (Self and Social Motivation). Wilcoxon signed‐rank tests and Kruskal‐Wallis tests were used to test whether changes in DAS score between waves were associated with changes in Pain Estimation between waves and HSCL‐10 scores at baseline. Results: Hopkins Symptom Checklist, DMFS and DAS scores at baseline predicted high dental anxiety scores after 2 years. Sex, motivation related to oral hygiene and avoidance due to fear at baseline did not contribute significantly to our model. DMFS and HSCL‐10 were higher among young people who reported a substantial change in DAS score (2.0 > Interquartile range/IQR), irrespective of the direction of change. Pain Estimation changed consistently with a change in DAS score. Conclusion: Mental health symptoms, pre‐existing dental anxiety and dental health status are important contributors to the development of dental anxiety in youth. Estimations of pain at the dentist are central when it comes to changes in dental anxiety over time in this study. [ABSTRACT FROM AUTHOR]

Aims: Vitamin D and polyunsaturated fatty acids (PUFAs) are derived from partially overlapping sources. Vitamin D is produced in the skin after sun exposure, but is also derived from fatty fish and fish oils. Dietary PUFAs are mainly derived from plant oils that are rich in n-6 PUFAs, but fatty fish provides high amounts of the marine n-3 PUFAs. The Western diet provides an excess of n-6 PUFAs compared to n-3 PUFAs, and the ratios of these may influence human health. Here, we investigated the potential associations of plasma concentrations of vitamin D, marine PUFAs and PUFA ratios.Methods: Plasma concentrations of vitamin D (25(OH)D), marine PUFAs, and PUFA ratios were measured in 372 women from the Norwegian Women and Cancer (NOWAC) Post-Genome Cohort. Covariability was examined in 310 non-users of cod liver oil, using Spearman’s rank correlation and linear regression. Results: In non-users of cod liver oil, the average concentration of vitamin D was 40.3 nmol/L, and marine PUFA concentration was 0.2 mg/g. PUFA ratios were dominated by the n-6 fatty acids. Vitamin D levels were significantly associated with marine fatty acids and weakly associated with PUFA ratios. Conclusions: Concentrations of vitamin D and marine PUFAs were below recommended levels. The correlation analyses indicated that health-related effects of vitamin D and marine PUFAs respectively may be hard to separate in epidemiological studies. However, measured health effects of PUFA ratios and vitamin D are likely to derive from the influence of the two factors separately. The presented results are the first to show these associations in a nationally representative cohort. [ABSTRACT FROM PUBLISHER]

Background Knowledge is scarce on what contributes to whether children with early language delay (LD) show persistent, recovering or sometimes late-onset LD without a prior history of early LD in subsequent preschool years. Aims To explore whether an integrative model of vital risk factors, including poor early communication skills, family history of language-related difficulties and male gender, predicts the development of persistent, recovering or late-onset LD trajectories from 3 to 5 years quantitatively and qualitatively differently. Methods & Procedures LD was assessed by maternal reports on the Ages and Stages Questionnaire at 3 and 5 years for 10 587 children in The Norwegian Mother and Child Cohort Study. Children were classified across time as having no, late onset, transient or persistent LD. Multinomial logistic regression analyses included the integrative model of vital risk factors and covariates. Outcome & Results Across time, 3%, 5% and 6.5% of the children displayed persistent, transient and late-onset LD, respectively. The odds for persistent LD were doubled for boys and children with low language comprehension at 1.5 years; and tripled by late-talking familial risk. These same odds decreased for transient LD, and even further for late-onset LD. Familial risk for writing and reading difficulties especially increased the odds for late-onset and persistent LD, while familial risk of unintelligible speech increased the odds for transient LD. Although girls had on average far better language comprehension than boys, low language comprehension was a stronger risk factor for persistent LD in girls. Conclusions & Implications Preschool LD trajectories were uniquely predicted from the integrative risk model of poor early communicative skills, family history and male gender. This might benefit identification of different LD trajectories by supporting broader severe vulnerability for persistent LD, milder vulnerability for transient LD, and possibly a specific risk for reading and learning difficulties for children with late-onset LD. [ABSTRACT FROM AUTHOR]

A combination of high folate with low vitamin B12 plasma status has been associated with cognitive impairment in a population exposed to mandatory folic acid fortification. The objective of the present study was to examine the interactions between plasma concentrations of folate and vitamin B12 markers in relation to cognitive performance in Norwegian elderly who were unexposed to mandatory or voluntary folic acid fortification. Cognitive performance was assessed by six cognitive tests in 2203 individuals aged 72–74 years. A combined score was calculated using principal component analysis. The associations of folate concentrations, vitamin B12 markers (total vitamin B12, holotranscobalamin (holoTC) and methylmalonic acid (MMA)) and their interactions in relation to cognitive performance were evaluated by quantile regression and least-squares regression, adjusted for sex, education, apo-ɛ4 genotype, history of CVD/hypertension and creatinine. Cross-sectional analyses revealed an interaction (P= 0·009) between plasma concentrations of folate and vitamin B12 in relation to cognitive performance. Plasma vitamin B12 concentrations in the lowest quartile ( < 274 pmol/l) combined with plasma folate concentrations in the highest quartile (>18·5 nmol/l) were associated with a reduced risk of cognitive impairment compared with plasma concentrations in the middle quartiles of both vitamins (OR 0·22, 95 % CI 0·05, 0·92). The interaction between folate and holoTC or MMA in relation to cognitive performance was not significant. In conclusion, this large study population unexposed to mandatory folic acid fortification showed that plasma folate, but not plasma vitamin B12, was associated with cognitive performance. Among the elderly participants with vitamin B12 concentrations in the lower range, the association between plasma folate and cognitive performance was strongest. [ABSTRACT FROM PUBLISHER]

Aims To examine characteristics of 15- to 16-year-old adolescents who used over-the-counter analgesics daily to weekly (high-frequency users) as compared to those who used less or no analgesics (low-frequency users). Further to analyse the differences in pain experience, lifestyle, self-esteem, school attendance and educational ambition. Methods An anonymous cross-sectional questionnaire-based study. The questionnaire covered the use of over-the-counter analgesics, pain experience, sociodemographics, lifestyle factors, self-esteem, school absence and future educational plans. The study took place in the 10th grade in six junior high schools in a medium-sized town in Norway. The local sales data for analgesics and antipyretics were close to the national average. We invited 626 adolescents to participate. Of the 367 adolescents (59%) who responded, 51% were girls. Associations between the frequency of use of over-the-counter analgesic and the mentioned variables were analysed using multiple logistic regression. Results In total, 26% (42 boys and 48 girls) used over-the-counter analgesics daily to weekly. These high-frequency users experienced more widespread pain, slept less, had more paid spare-time work, drank more caffeinated drinks, participated more often in binge drinking, had lower self-esteem, less ambitious educational plans and more frequent school absence than did the low-frequency users. These associations remained significant when controlling for gender, cultural background and self-evaluated economic status. Conclusion Adolescent, who are high-frequency users of over-the-counter analgesics, suffer more pain and have identifiable characteristics indicative of complex problems. Their ability to handle stress appears to be discordant with the kind of situations to which they are exposed. The wear and tear associated with allostatic mechanisms counteracting stress may heighten their pain experience. [ABSTRACT FROM AUTHOR]

Background: Perceived health is a subjective measure of an individual’s health based on self-reported, and self-knowledge about one’s health status. It is related to one’s functional status, morbidity, and mortality and serves as an important indicator in determining an individual’s health status and health-related quality of life. The main purpose of this study is to explore (i) how a sample of adult inmates perceived their health and (ii) identify factors that may be associated with their perceived health. Methods: This was a cross-sectional study, where data collection involved the use of a structured questionnaire. The study sites were six prisons. A total of 144 inmates, 13 women (14%) and 131 men (91%) took part in the study. Results: The odds of having perceived good health were reduced by increasing age of the inmate (OR = 0.94, 95% CI = 0.90–0.98) and increased by high level of education (OR = 4.11, 95% CI = 1.09–15.50) and long time spent in prison (OR = 3.56, 95% CI = 1.09–15.50), adjusting for ethnicity and a previous history of murder/manslaughter (p > .02). In the same adjusted analysis, the odds of perceived good health were decreased with medium high and high depressive score (OR = 0.06, 95% CI = 0.02–0.17 and OR = 0.06, 95% CI = 0.00–0.48, respectively). Conclusions: Psychological distress, time spent in prison, level of education and age were independent predictors of perceived health. High levels of psychological distress predict poor perceived health. Low level of education predict poor perceived health, while time spent in prison and age predict good perceived health. [ABSTRACT FROM PUBLISHER]

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]

In line with the 'Work environment hypothesis,' role stressors have been proposed as important antecedents of bullying in the workplace. Only a few longitudinal studies on the relationship between role stressors and bullying exist, however, and earlier studies have largely been cross-sectional. The aim of the present prospective study was to determine whether role stressors at baseline predict new cases of workplace bullying at follow-up. A total of 2,835 Norwegian employees participated at both baseline and follow-up, with an interval of two years between the measurements. The study supports the hypotheses that role ambiguity and role conflict, independently, contribute to subsequent new reports of workplace bullying. However, there was a weak reverse effect: reporting being bullied at work at baseline predicted reporting increased levels of role ambiguity and role conflict at follow-up. Even though the results may indicate a circular relationship between the variables at hand, the weak reverse relationship seems to have little practical impact compared to the stronger relationship from role stressors to bullying. Hence, the results mainly support the hypotheses stating that role ambiguity and role conflict, independently, predict subsequent exposure to workplace bullying. [ABSTRACT FROM AUTHOR]

The article discusses a study that examined two health risk behaviours namely drug abuse and attempted suicide which constitutes central health problems in prison populations including women prisoners. It reports cross-sectional data from a structured interview by the author and a research assistant with women prisoners in Norway. Findings indicate an association between the accumulation of childhood adversity to increased odds of a history of drug abuse and suicide attempts.

Background: Religious belief can be used as a pain coping strategy. Our purpose was to evaluate the relationship between headache and religious activity using prospective data from a large population-based study. Methods: This longitudinal cohort study used data from two consecutive surveys in the Nord-Trøndelag Health Survey (HUNT 2 and 3) performed in 1995-1997; and 2006-2008. Among the 51,383 participants aged ≥ 20 years who answered headache questions at baseline, 41,766 were eligible approximately 11 years later. Of these, 25,177 (60%) completed the question in HUNT 3 regarding religious activity. Frequent religious attendees (fRA) (used as a marker of stronger religious belief than average) were defined as those who had been to church/prayer house at least once monthly during the last six months. Results: In the multivariate analyses, adjusting for known potential confounders, individuals with headache 1-14 days/month in HUNT 2 were more likely to be fRA 11 years later than headache-free individuals. Migraine at baseline predisposed more strongly to fRA at follow-up (OR = 1.25; 95% CI 1.19-1.40) than did non-migrainous headache (OR = 1.13; 95% 1.04-1.23). The odds of being fRA was 48% increased (OR 1.48; 95% 1.19-1.83) among those with migraine 7-14 days/month at baseline compared to subjects without headache. In contrast, headache status at baseline did not influence the odds of being frequent visitors of concerts, cinema and/or theatre at follow-up 11 years later. Conclusions: In this prospective study, headache, in particular migraine, at baseline slightly increased the odds of being fRA 11 years later. [ABSTRACT FROM AUTHOR]

Background Studies have shown the negative impact sexual violence has on pregnancy outcome, yet the impact on antenatal hospitalization has been poorly examined. The aim of this study was to investigate if a history of sexual violence was associated with hospitalization during pregnancy. Methods A population-based national cohort study conducted by the Institute of Public Health, The Norwegian Mother and Child Cohort study. Women filled out questionnaires at 17 and 30 weeks' gestation. History of sexual violence was reported at three levels: pressured to sexual acts (mild), forced with violence (moderate), and raped (severe). The comparison group did not report sexual violence. Differences were assessed using Pearson's X2 tests and logistic regression analyses. Results Of 78,660 women, 12.0% were pressured to sexual acts, 2.8% forced with violence, and 3.6% reported rape. A history of sexual violence was associated with significantly more hospitalizations during pregnancy, 6.6 percent for mild, 8.7 percent for moderate and 12.5 percent for severe, compared to 5.8 percent for no sexual violence. Women were significantly more often admitted for hyperemesis, bleeding, threatening preterm birth, other reasons and admitted without giving any reason. Reporting severe sexual violence had an AOR for being hospitalized with hyperemesis or threatening preterm birth of 1.9 (95% CI 1.4-2.5), and 1.9 (1.3-2.7) respectively. Similarly, severe sexual violence was associated with being admitted more than once during pregnancy AOR 1.9 (1.3-2.7). Conclusion Women with a history of sexual violence reported significantly more antenatal hospitalizations during pregnancy than women without such a history. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate socio-economic inequalities in health care utilization from the 1980s and through the last 3 decades in a Norwegian county population. Methods: Altogether, 166 758 observations of 97 251 individuals during surveys in 1984–86 (83% eligible responses), 1995–97 (51% eligible responses) and 2006–08 (50% eligible responses) of the total population of adults (≥20 years) from Nord-Trøndelag county in Norway were included. Health care utilization was measured as at least one visit to general practitioner (GP), hospital outpatient services and inpatient care in the past year. Socio-economy was measured by both education and income and rescaled to measure relative indexes of inequality (RII). Relative and absolute inequalities were estimated from multilevel logistic regression. Estimates were adjusted for age, sex, municipality size and self-reported health. Results: GP utilization was higher among individuals with higher education in 1984–86. Among men the RII was 0.54 (CI: 0.48–0.62), and among women RII was 0.67 (CI: 0.58–0.77). In 2006–08, the corresponding RII was 1.31 (CI: 1.13–1.52) for men and 1.00 (CI: 0.85–1.18) for women, indicating higher or equal GP utilization among those with lower education, respectively. The corresponding RIIs for outpatient consultations were 0.58 (CI: 0.49–0.68) for men and 0.40 (CI: 0.34–0.46) for women in 1984–86, and 0.53 (CI: 0.46–0.62) for men and 0.47 (CI: 0.41–0.53) for women in 2006–08. Conclusion: Through the last 3 decades, the previous socio-economic differences in GP utilization have diminished. Despite this, highly educated people were more prone to utilize hospital outpatient consultations throughout the period 1984–2008. [ABSTRACT FROM AUTHOR]

Objectives. The primary objective of this study was to explore whether general practitioners (GPs) in Norway, Sweden, and Denmark make similar or different decisions regarding sick leave for patients with severe subjective health complaints (SHC). The secondary objective was to investigate if patient diagnoses, the reasons attributed for patient complaints, and GP demographics could explain variations in sick leave decisions. Design. A cross-sectional study. Method. Video vignettes of GP consultations with nine different patients. Subjects. 126 GPs in Norway, Sweden, and Denmark. Setting. Primary care in Norway, Sweden, and Denmark. Main outcome measure. Sick leave decisions made by GPs. Results. 'Psychological' diagnoses in Sweden were related to lower odds ratio (OR) of granting sick leave than in Norway (OR = 0.07; 95% CI = 0.01-0.83) Assessments of patient health, the risk of deterioration, and their ability to work predicted sick leave decisions. Specialists in general medicine grant significantly fewer sick leaves than non-specialists. Conclusion. Sick-leave decisions made by GPs in the three countries were relatively similar. However, Swedish GPs were more reluctant to grant sick leave for patients with 'psychological' diagnoses. Assessments regarding health-related factors were more important than diagnoses in sick-leave decisions. Specialist training may be of importance for sick-leave decisions. [ABSTRACT FROM AUTHOR]

Background The use of moist snuff (snus) in young Norwegians is increasing, while smoking rates are declining. It is not clear whether snus facilitates smoking. Objective To assess whether 16-year-old men who were never-smokers, but snus users in 2001, had an increased risk of smoking 3 years later. Methods In a prospective school-based cohort study, 1440 men, who responded to questionnaires in 2001 and 2004, were included in the analyses. The participation rate was 89% in 2001 and 50% in 2004. Multinomial logistic regression models were used to assess the OR of snus users, smokers and dual users of cigarettes and snus, compared with non-tobacco users at baseline, to be smokers at follow-up. Results Snus use at baseline was associated with increased odds of dual use at follow-up when the outcome was (1) current dual use versus no tobacco (OR 3.49, 95% CI 1.8 to 6.8) and when the outcome was (2) current dual use versus no smoking but including snus-only use (OR 1.88, 95% CI 1.1 to 3.3). Baseline snus users who were dual users at follow-up seemed to prefer using snus daily and cigarettes occasionally. Use of snus only at baseline was not associated with increased odds of smoking only at follow-up, after adjusting for known risk factors. Conclusions Young men who only used snus at baseline had an increased risk of being dual users at follow-up. Snus use may therefore facilitate smoking. [ABSTRACT FROM AUTHOR]

The article focuses on a study on the improvement of antibiotic prescription in acute respiratory tract infections by general practitioners. It states that in the study, the intervention comprises of a prescription peer academic detailer (Rx-PAD) which focuses on the national guidelines for antibiotic prescribing and research evidence. It mentions that the study reports treatment of acute respiratory tract infection with antibiotics.

Characteristics of female and male visitors to practitioners of acupuncture were investigated in a large cross-sectional adult population in Central Norway. A total population health survey, HUNT3, conducted in 2008 with 50,827 respondents provided the data. Demographic variables, lifestyle, health, and use of conventional medicine were analyzed using multivariable logistic regression models. The one year prevalence of visiting a practitioner of acupuncture was 5.7% for females and 2.2% for males. Visitors of both genders were five times more likely to have had somatic complaints in the preceding year and were 2-3 times more likely to report poor global health than female or male non-visitors. Also, visitors of both genders were more likely to do hard physical activities every week, and they were less likely to live alone or be daily smokers. Further, female visitors were characterized by having higher education and were more likely to have a paid job than other females. Corresponding differences were not seen among males. Age showed limited associations with being a visitor, and for females only. Valid for both genders, our findings draw a picture of visitors to acupuncture treatment as persons who actively contribute to promoting their health through lifestyle choices of physical activity and non-smoking while simultaneously having worse global health and higher burdens of somatic complaints than other adults. In contrast to males, it is suggested that females may be more dependent on personal income, as indicated by higher education and being in a paid job, in choosing acupuncture treatment in addition to conventional medicine. [ABSTRACT FROM AUTHOR]

The aim of the present study was to describe awareness and attitudes related to dental erosive wear among 18-yr-old adolescents in Oslo and to explore attitudinal differences between participants with and without the condition. All 18-yr-old subjects scheduled for their routine examination at the Public Dental Service clinics during 2008 ( n = 3,206) were invited, and 1,456 agreed to participate (a response rate of 45%). The data were collected using structured questionnaires and by clinical examination of the participants. Dental erosive wear was assessed using a pictorial manual - the Visual Erosion Dental Examination scoring system - as a guide. Overall, 88% of participants had heard about dental erosive wear; however, of participants with erosive lesions only 56% were aware of, and only 47% could recall their dentist mentioning, the condition. Participants with erosive wear were more likely to have low or moderate positive attitudes towards acidic drink consumption and to be reluctant to change. In multivariate analyses controlling for gender and behavioural variables, weak or moderate positive awareness of acidic drinks remained significantly associated with higher erosion risk. This study emphasizes the importance of assessment and understanding of awareness and attitudinal aspects in relation to dental erosive wear. [ABSTRACT FROM AUTHOR]

In contrast to the body of research focusing on female sexual desire, there has been very little research into patterns of male sexual desire. This study addresses this deficiency in the literature by providing empirical answers to the following three questions: (1) is there a pattern of responsive sexual desire – defined as being predominantly receptive to a partner's initiation of sexual activity without initially desiring it – among men? (2) Is this pattern associated with lower levels of sexual health than a more spontaneous pattern of male desire? (3) Are existing clinical observations regarding possible causes of reduced interest in partnered sex useful for understanding the more responsive men's sexual desire? A large online survey about men's sexual interest was conducted in 2011 among 2215 Norwegian and Portuguese men aged 18–75 years (the average age in the sample was 36.5 years). Sociodemographic, health-related, sociosexual and relationship-related information was collected. Three distinct patterns of male sexual desire were observed: decreased (23.6%), responsive (2.5%) and spontaneous (73.9%) desire patterns. Men in the more responsive and spontaneous desire groups significantly differed from participants in the decreased desire group, as they reported significantly higher levels of sexual interest, sexual satisfaction and frequency of sexual intercourse and were less likely to have experienced sexual health difficulties in the past 12 months. Interestingly, participants with more responsive and spontaneous desire patterns were indistinguishable in terms of a number of sociodemographic, health-related, sociosexual and relationship-related variables. The sole predictor of the responsive sexual desire pattern was proneness to relationship-related sexual boredom. Clinical observations about the roles of negative emotions, relationship strain and specific sexual arousal patterns (homoerotic, autoerotic and/or paraphilic) in the etiology of hypoactive sexual desire did not seem relevant for men with responsive desire. [ABSTRACT FROM PUBLISHER]

Objective: The aim of the study was to analyse non-warfarin-associated bleeding adverse drug events reported to the Norwegian spontaneous reporting system, with characterisation of the bleeding locations, outcome and drug interactions. In addition, concordance in assessments between reporters and evaluators, trend shifts in reporting, and detection of potentially new adverse drug interaction signals were studied. Methods: Data on bleeding events reported between 1 January 2003 and 31 December 2005 were retrieved from the Norwegian spontaneous reporting system database. Results: Of 327 case reports of non-warfarin-associated bleeding events, 270 reports (82.6 %) were characterised as serious and 69 (21.1 %) had a fatal outcome. One hundred and eighty-seven bleeds (57.5 %) were gastrointestinal, 57 (17.4 %) were cerebral, and 81 (24.8 %) were from other bleeding sites. The bleeding sites differed with respect to the patient's age, drug use, diagnoses and outcomes. Of drugs associated with bleeding, nonsteroidal anti-inflammatory drugs (NSAIDs)/COX-2 inhibitors (145 reports) and acetylsalicylic acid (128 reports) were most frequently used. Only fibrinolytics were associated with increased mortality. There was a 67.4 % correlation between reporters and evaluators in assessment of drugs associated with bleeding ( P < 0.001), with considerable variation in concordance between drug groups. Conclusion: Non-warfarin-associated bleeding events are associated with substantial mortality. Old age, cerebral bleeds, number of drugs used, and use of fibrinolytics are all independently associated with increased mortality. The recognition of the bleeding risk of commonly used drugs such as acetylsalicylic acid and heparins may be insufficient among prescribers. [ABSTRACT FROM AUTHOR]

Background Parent-offspring studies have shown that cardiovascular risk factors cluster within families. However, most studies have assessed the offspring cardiovascular risk factor level at a young age, and whether an association persists into the offspring’s adult life is less clear. This study linked information between parents and their adult offspring to investigate the intergenerational association of anthropometric measures, blood pressure, blood lipid levels and physical activity. Methods The study population consisted of parent and adult offspring pairs (11 931 fathers–sons, 12 563 fathers–daughters, 15 626 mothers–sons and 16 449 mothers–daughters) who participated in the second and third cross-sectional waves of the Nord-Trøndelag Health Study (HUNT 2, 1995–1997 and HUNT 3, 2006–2008). A general linear model and logistic regression were used to estimate the association between the parent and offspring risk factor levels. Results All continuously measured cardiovascular risk factors under study showed a statistically significant positive association between parents and offspring, except the waist-hip ratio. Adjusted coefficients from linear regression ranged from 0.09 (95% CI 0.07 to 0.11) for waist circumference to 0.29 (95% CI 0.27 to 0.32) for body weight. Moreover, offspring were two to three times more likely to be obese, have a high cholesterol level, or hypertension when comparing extreme categories of the corresponding parental risk factor level. Physically active parents had a lower risk of having physically inactive offspring. Conclusions The results suggested that cardiovascular risk factors track across generations and persist into the offspring’s adult life. [ABSTRACT FROM AUTHOR]

The aim of this study is to examine whether and how laissez-faire, transformational, and authentic leadership styles are related to the occurrence of bullying in work groups. It is hypothesized that the investigated leadership styles have direct associations, as well as indirect associations through group cohesion and safety perceptions, with indicators of bullying among subordinates. Using a cross-sectional survey design, the variables were assessed in a randomly selected sample comprising 594 seafarers from two Norwegian shipping companies. Laissez-faire leadership was associated with an increased risk of exposure to bullying behavior, self-labeled victimization from bullying, and perpetrated bullying. Transformational leadership and authentic leadership were related to decreased risk of exposure to bullying behavior. Authentic leadership contributed to the variance in bullying beyond laissez-faire and transformational leadership. Analyses of indirect effects showed that the association between transformational leadership and bullying was fully mediated through safety perceptions, whereas a partial indirect association through safety perceptions was found for authentic leadership. This study makes a significant contribution to the literature by providing evidence for how leadership styles predict workplace bullying. The findings highlight the importance of recruiting, developing, and training leaders who promote both positive psychological capacities and positive perceptions among their subordinates. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this study is to assess the relationships between trips in nature, gathering of wild plants, fishing and hunting and weight status. Methods: Data from a cross-sectional questionnaire survey of 996 parents of sixth- and seventh-graders from 38 randomly chosen schools in two Norwegian counties. All data are self-reported: Weight and height (participants were considered as overweight if BMI were 25 or higher), family trips in nature (dichotomized into ≥once a week vs. less than once a week), gathering of wild plants/mushrooms, fishing and hunting (all dichotomized into ≥sometimes vs. never), sex, family education level and general physical activity level. Multivariate logistic regression analyses were performed with overweight as the dependent variable Results: Adjusting for all outdoor activities; those engaging in nature trips (OR = 0.52; 95% CI = 0.37–0.75) and those engaging in gathering (OR = 0.73; 95% CI = 0.55–0.98) were less frequently overweight, while those fishing (OR = 1.83; 95% CI = 1.35–2.47) were more frequently overweight. After also adjusting for sex, family education level and general physical activity level, nature trips (OR = 0.52; 95% CI = 0.36–0.75) and fishing (OR = 1.53; 95% CI = 1.12–2.10) were still significant, gathering was not. No association between hunting and weight status was observed. Conclusion: Frequent family trips in nature might be an important behaviour in order to reverse the obesity epidemic. [ABSTRACT FROM PUBLISHER]

Summary: Compared to pH ≥7.0 in Norwegian municipal drinking water, pH <7.0 increased the risk of forearm fractures in the population-based Cohort of Norway (CONOR; n = 127,272). The association was attenuated ( p > 0.05) after adjustments for indicators of bacteria and organic matter, which may signify an association between poor drinking water and bone health. Introduction: The Norwegian population has the highest rate of fractures ever reported. A large variation in fracture rate both between and within countries indicates that an environmental factor, such as the quality of drinking water, could be one of the causes of the disparities. Our aim was to investigate a possible association between pH (an important parameter for water quality) and self-reported forearm fracture and to examine whether other water quality factors could account for this association. Methods: Using Geographic Information Systems, information on the quality of drinking water was linked to CONOR ( n = 127,272; mean age, 50.2 ± 15.8 years), a database comprising ten regional epidemiological health surveys from across the country in the time period 1994-2003. Results: The highest risk of forearm fracture was found at a pH of around 6.75, with a decreasing risk toward both higher and lower pH values. The increased adjusted odds of forearm fracture in men consuming municipal drinking water with pH <7.0 compared to water with pH ≥7.0 was odds ratio (OR) = 1.19 (95 % CI, 1.14, 1.25), and the corresponding increased odds in women was OR = 1.14 (95 % CI, 1.08, 1.19). This association was attenuated ( p > 0.05) after further adjustments for other water quality factors (color grade, intestinal enterococci, and Clostridium perfringens). Conclusions: Our findings indicate a higher risk of fracture when consuming water of an acidic pH; however, the risk does not only seem to be due to the acidity level per se, but also to other aspects of water quality associated with pH. [ABSTRACT FROM AUTHOR]

Street-level bureaucrats have been given an increasing role in the implementation of policies aimed at the poor. The article analyses: (1) how social workers in the Nordic countries explain the causes of poverty and whether there are variations between countries in social workers’ perceptions; and (2) the nature of the impact, if any, of various individual- and municipal-level factors on social workers’ perceptions of the causes of poverty. Survey data gathered from social workers in four countries are analysed and combined with data from the municipalities in which the respondents work. The results illustrate that social workers display a surprisingly large variation in perceptions: there are differences between countries and also differences related to individual-level factors, while municipality-level factors do not appear to influence the perceptions of social workers in an obvious way. [ABSTRACT FROM PUBLISHER]

The aim of this study is to explore the association between motivational 'stage' and intake of selected foods, and risk factors for diabetes; and what degree of attendance in an intervention that was necessary to show movements across the motivational 'stages of change'. Participants (n = 198, aged 25-62 years) were randomly assigned into intervention and control. Data collection: Interviews with a structured questionnaire, anthropometric and biochemical assessments. Intake of several food items and blood parameters at baseline differed according to motivational stage. Those who participated in at least four group sessions in the intervention were more likely to show a positive move through the 'stages of change'. Those in low motivational stages at baseline had benefitted just as much from the intervention as those in higher stages. Intake of several food items corresponded to the motivational 'stage'. High attendance in the intervention was necessary for a positive move through 'stages of change'. [ABSTRACT FROM AUTHOR]

Background Prevention programs often aim at preventing early onset of drinking ( EOD) on the grounds that this may curb heavy drinking in adulthood. While many studies have shown an association between EOD and adult alcohol use disorders, these findings could be inflated by retrospective reports or insufficient control for confounders. This study examined the association between EOD behavior assessed in early adolescence and heavy drinking in adulthood, controlling for deviant behavior and parental heavy drinking. Methods Data were collected prospectively over a 13-year period from 1,311 Norwegian school students. At t1 (ages 13 to 14 years), onset of drinking behavior (any drinking and heavy episodic drinking), conduct problems ( CP), other problem behaviors, and parental heavy drinking were assessed. At t2 (ages 26 to 27 years), heavy drinking behavior was assessed in terms of heavy episodic drinking frequency and AUDIT score. Results EOD behavior was associated with CP, other problem behaviors, and parental heavy drinking in early adolescence. A higher risk of heavy drinking in adulthood was found among those with EOD behavior, yet after control for CP, this association became small and statistically nonsignificant. Among low-risk individuals (i.e., those with no CP at t1), there was no association between EOD behavior and heavy drinking in adulthood, while there was a significant association among those with CP. Conclusions EOD behavior appears not per se responsible for heavy drinking in adulthood unless being part of a broader array of problem behaviors. [ABSTRACT FROM AUTHOR]

Background. Lung cancer and mesothelioma are malignant tumors with generally dismal prognosis and therefore palliative pain treatment constitutes a challenge for the clinician. Objectives. The aim of this study was to compare the outcomes of pain treatment with opioids among mesothelioma and lung cancer patients treated for palliation and assess factors which confound to optimal treatment. Patients and methods. A sub-cohort of 373 lung cancer and 22 mesothelioma patients was identified in multi-center European Pharmacogenetic Opioid Study (EPOS) cohort. A nested case-control (1:4) setting was designed to estimate the pain and other covariates distinguishing 22 mesothelioma- (= cases) and 88 lung cancer patients (controls), analyzed using univariate- and multivariate conditional (fixed-effects) logistic regression models. Results. The mean total daily dose of opioids varied from 30.0 to 960.0 mg (mean 275, median 160 mg, SD 293) in mesothelioma, and from 10 to 5072 mg (mean 414, median 175, SD 788) in lung cancer patients (p = 0.420). In both groups, pain was mostly experienced as moderate and severe and it was frequently accompanied by depression, poor sleep, anxiety and fatigue. Four mesothelioma patients (18%) and seven lung cancer patients (10%) experienced complete pain relief with opioids by self-assessment. Assessments of pain severity by the patients and their physicians deviated significantly in mesothelioma (p = 0.039 McNemar test), as well as in lung cancer (p = 0.0001). In conditional logistic regression, no significant differences were found in distribution of pain covariates between lung cancer and mesothelioma patients. Conclusion. Pain perception by the patients was associated frequently with other symptoms and complete pain control with opioids was achieved only with minority of patients both with mesothelioma and advanced lung cancer. Adequate pain control requires continuous monitoring and tailoring the dose to patient's individual needs and tolerance, recognition of accompanying symptoms such as depression and poor sleep, and their management. [ABSTRACT FROM AUTHOR]

Background: Health reforms in many countries affect the scope and nature of primary care. General Practitioners (GPs) are expected to spend more time developing public health, preventive health care, coordination of care and teamwork. We aimed to explore which professional activities GPs consider to be meaningful and how they would like to prioritise tasks. Methods: In a cross sectional online survey 3,270 GPs were invited to consider twenty different activities in general practice. They were asked to rate each of them on a Likert scale anchored from 1 (not meaningful) to 5 (very meaningful). They then selected three activities from the item list on which they would like to spend more time and three activities on which they would like to spend less time. We used multinomial logistic regression to explore associations between the GPs' preferences for time spent on preventive health care activities and age, gender and practice characteristics. Results: Approximately 40% (n=1,308) responded. The most meaningful activities were handling common symptoms and complaints (94% scored 4 or 5), chronic somatic diseases (93%), terminal care (80%), chronic psychiatric diseases (77%), risk conditions (76%) and on call emergency services (70%). In terms of priority the same items prevailed except that GPs would like to spend less time on emergency services. Items with low priority were health certificates, practice administration, meetings with local health authorities, medically unexplained symptoms, addiction medicine, follow up of people certified unfit for work, psychosocial problems, preventive health clinics for children and school health services. In multivariate regression models physician and practice characteristics explained no more than 10% of the variability in the GPs' preferences for time spent on preventive health care services. Conclusions: The GPs found diagnosis and treatment of diseases most meaningful. Their priorities were partly at odds with those of the health authorities and policy makers. [ABSTRACT FROM AUTHOR]

Background: There is a need for more longitudinal studies investigating the associations between screen-based sedentary behaviors (SB), dietary behaviors and leisure-time physical activity (PA). Methods: In the HEIA cohort study, 908 children were followed from age 11 to age 13 (September 2007 - May 2009). The children self-reported their intake of fruits, vegetables, soft drinks with sugar and snacks. TV/DVD use, computer/game use and leisure-time PA were also self-reported. Multilevel generalized linear mixed model analysis was used to assess longitudinal associations between the screen-based SB and each of the two other behaviors. Results: Twenty-month changes in TV/DVD use and computer/game use were positively associated with changes in the consumption of soft drinks with sugar and unhealthy snacks in the same period; and inversely associated with change in vegetable consumption. Change in computer/game use was also inversely related to change in fruit consumption. An inverse but non-substantive association was found between change in TV/DVD use and change in leisure-time PA. Change in computer/game use was not significantly associated with change in leisure-time PA. Conclusions: Changes in screen-based SB were associated with multiple unfavorable changes in dietary habits, although the associations were weak. These associations need to be further investigated in intervention/ experimental studies, to assess whether changing screen-based SB will result in clinically relevant changes in dietary behaviors. However, the findings of this study suggest that screen-based SB and leisure-time PA are largely independent behaviors which should be addressed separately in health promotion activities. [ABSTRACT FROM AUTHOR]

The aim was to investigate risk indicators associated with dental erosive wear among 18-yr-old subjects in Oslo, Norway. Of 3,206 adolescents invited to participate in a screening examination for erosive wear, 1,456 were examined (giving a response rate of 45%). As part of the examination all participants completed a self-administered questionnaire. Associations between the presence of erosive lesions and the possible risk indicators were assessed by logistic regression analyses, taking into account the hierarchical relationships between the independent variables. Of all 18-yr-old subjects examined, 38% had at least one tooth with erosive lesions. Multivariate analyses showed significant associations between the presence of erosive wear and being male, brushing teeth once per day or less, episodes of vomiting, daily/weekly episodes of gastro-oesophageal reflux, consumption of fruit juice and sugary soft drinks several times per day, as well as consumption of sugary soft drinks daily to once per week. In conclusion, in addition to gender, dietary habits such as frequent consumption of fruit juice and sugary soft drinks, and the occurrence of reflux and vomiting, appear to be risk indicators for erosive wear. When counselling adolescents at risk, the gender-specific risk indicators should be taken into account. [ABSTRACT FROM AUTHOR]

Objective. In Norway the default payment option for general practice is a patient list system based on private practice, but other options exist. This study aimed to explore whether general practitioners (GPs) prefer private practice or salaried positions. Design. Cross-sectional online survey (QuestBack). Setting. General practice in Norway. Intervention. Participants were asked whether their current practice was based on (1) private practice in which the GP holds office space, equipment, and employs the staff, (2) private practice in which the GPs hire office space, equipment, or staff from the municipality, (3) salary with bonus arrangements, or (4) salary without bonus arrangement. Furthermore, they were asked which of these options they would prefer if they could choose. Subjects. GPs in Norway (n = 3270). Main outcome measures. Proportion of GPs who preferred private practice. Results. Responses were obtained from 1304 GPs (40%). Among these, 75% were currently in private practice, 18% in private practice with some services provided by the municipality, 4% had a fixed salary plus a proportion of service fees, whereas 3% had salary only. Corresponding figures for the preferred option were 52%, 26%, 16%, and 6%, respectively. In multivariate logistic regression analysis, size of municipality, specialty attainment, and number of patients listed were associated with preference for private practice. Conclusion. The majority of Norwegian GPs had and preferred private practice, but a significant minority would prefer a salaried position. The current private practice based system in Norway seems best suited to the preferences of experienced GPs in urban communities. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the relationship between personality and depression in a general population in relation to gender and age. The Nord-Trøndelag Health Study (2006-2008), a large cross-sectional survey, was used. The sample consists of 35,832 men (16,104) and women (19,728) aged 20-89 years, living in the Nord-Trøndelag County of Norway, with valid ratings on the depression subscale of the Hospital Anxiety and Depression Scale (HADS) and Eysenck Personality Questionnaire (EPQ). This study demonstrates a relationship between depression and both neuroticism and extraversion in a general population. Older people score low more often on Extraversion (E) than younger people. Interactions were observed between neuroticism and age, gender, and extraversion with depression. The interaction term indicates a high score on Neuroticism (N) enhanced by introversion, older age, and being a male with depression. The findings suggest that health professionals may need to put extra effort into the care of patients with low extraversion and high neuroticism, in order to help those patients avoid depression. [ABSTRACT FROM AUTHOR]

Purpose – This study aims to examine the predictive validity of an adherence measure to Brief Parent Training (BPT) delivered in real-world settings. BPT promotes effective parenting practices in families with children who either are at an early stage of problem behaviour development or have developed conduct problems. Design/methodology/approach – In a sample of 108 families who received BPT, whether adherence predicted parenting practices and child conduct problems after intervention completion was examined. Findings – The results showed that high ratings of adherence predicted low levels of inconsistent discipline and high levels of appropriate discipline and positive parenting. The combined effect of inconsistent discipline and positive parenting mediated the relationship between adherence and child conduct problems. When the indirect effects were separated, inconsistent discipline functioned as a mediator, whereas positive parenting did not. Originality/value – Findings indicate that it is possible to develop a sound and feasible parent-reported measure of adherence to BPT. [ABSTRACT FROM AUTHOR]

We followed 74 children with autistic disorder (AD) and 39 children with pervasive developmental disorder not otherwise specified (PDD NOS) for 17-38 years in a record linkage study. Rates of disability pension award, marital status, criminality and mortality were compared between groups. Disability pension award was the only outcome measure that differed significantly between the AD and PDD NOS groups (89% vs. 72%, p < 0.05). The lower rate of disability pension award in the PDD NOS group was predicted by better psychosocial functioning. The lack of substantial differences in prognosis between the groups supports a dimensional description of autism spectrum disorder, in line with proposed DSM-V revision. [ABSTRACT FROM AUTHOR]

Objective. To investigate the use of laboratory tests and which factors influence the use in Norwegian out-of-hours (OOH) services. Design. Cross-sectional observational study. Setting. Out-of-hours services in Norway. Subjects. All electronic reimbursement claims from doctors at OOH services in Norway in 2007. Main outcome measures. Number of contacts and laboratory tests in relation to patients' and doctors' characteristics. Results. 1 323 281 consultations and home visits were reported. Laboratory tests were used in 31% of the contacts. C-reactive protein (CRP) was the most common test (27% of all contacts), especially in respiratory illness (55%) and infants (44%). Electrocardiogram and rapid strep A test were used in 4% of the contacts. Young doctors, female doctors, and doctors in central areas used laboratory tests more often. Conclusion. CRP is extensively used in OOH services, especially by young and inexperienced doctors, and in central areas. Further investigations are required to see if this extensive use of CRP is of importance for correct diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Vie, T. L., Glasø, L. & Einarsen, S. (2012). How does it feel? Workplace bullying, emotions and musculoskeletal complaints. Scandinavian Journal of Psychology 53, 165-173. The present study examines experienced emotions among self-labelled victims of ongoing workplace bullying and tests whether emotions mediate the relationship between exposure to bullying and health in the form of musculoskeletal complaints. A total of 1,024 employees from a Norwegian public transport company participated in the study, in which 116 self-labelled victims were identified. Ten positive and 10 negative emotions were measured (PANAS). The results showed significant differences in emotional experiences between victims and non-victims regarding all 10 negative emotions and one out of 10 positive emotions. Victims felt less 'interested' and more 'afraid,''upset,''angry,''guilty,''nervous,''hostile,''frustrated,''ashamed,''scared' and 'stressed' than did non-victims. Further, the results pointed to both positive and negative emotions as mediators of the relationship between exposure to bullying and musculoskeletal complaints. In particular the negative emotion 'stress' acted as a significant mediator regarding this relationship. Hence, emotions seem to be central to understanding the detrimental effects of bullying on the victims' health. [ABSTRACT FROM AUTHOR]

Immigrants from low-income countries are more likely than ethnic Norwegians to receive disability pensions. In a previous study in Oslo, we showed that occupational position probably accounted for all of this difference. The present article presents a study of the total population, with data on education and age at receipt of pension. Census and social security data for all persons living in Norway from 1992 to 2003 were used to identify new disability pensions to those aged 30-55 years and eligible in 1992, comprising 15.9% females and 11.4% males. Age-adjusted relative risk was 2.03 (95% CI 1.97-2.08) for non-Western males and 1.30 (1.26-1.36) for non-Western females compared with Westerners, and more than three times higher for males from North Africa/the Middle East. Education did not explain any of the risk differences, but when adjusting for age at pension receipt the differences disappeared completely. This is probably due to their being in predominantly unskilled occupations where there is also a low pension age among ethnic Norwegians. [ABSTRACT FROM AUTHOR]