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PubMed1991

International collaborative effort (ICE) on birth weight, plurality, perinatal, and infant mortality. IV. Differences in obstetrical delivery practice: Norway, Scotland and the United States.

We have carried out a comparative study on differences in operative obstetrical practice during the 1970s and 1980s, in Norway, Scotland and the United States of America. It was based on information from official sources in each country. We compared rates of cesarean section (CS) and operative vaginal delivery according to maternal age, parity and gestational age at delivery, birthweight, fetal presentation, and other characteristics of the child, indications for operative delivery, and hospital size and teaching status. While all three countries had rising CS rates, the Scottish rates, which lay between those of the U.S.A. and Norway, rose more slowly than in the latter. In 1985, the rates were 22.8% in the U.S.A., 13.5% in Scotland and 12.0% in Norway. Use of forceps and vacuum extractor declined in the U.S.A. and Scotland, but increased in Norway. CS rates in mothers aged 35 and over were uniformly high in 1970 and rose relatively little. Specific CS rates for very low birthweight children, breech presentation and twins rose to 30-50% in all three countries with some national trend differences. Rate ratios of operative delivery between large and small hospitals fell from about 2-3 in the 1970s to approximately 1.5 in 1985, least markedly in Scotland. The impact of previous CS as an indication for CS cannot be resolved because of notification and recording differences.

Adult↗
PubMed1990

Streptococcal serogroup A epidemic in Norway 1987-1988.

A nationwide outbreak of Lancefield group A streptococcal (GAS) infections in Norway during the season 1987-88 is described. Data were collected from the Norwegian infectious disease notification system and supplemented by active search for cases of bacteraemia and other serious infections in addition to serotyping of selected clinical bacterial isolates. The number of reported cases of non-invasive GAS infections from week 29/1987 to week 28/1988 was 60% higher than expected. Between 1 Jan. and 30 June 1988, 84 cases of bacteraemia were notified, several with fulminant septicaemia and shock. The case fatality rate was 25%. Six cases of neonatal GAS septicaemia were seen. There was a nearly 3-fold total increase in occurrence of GAS bacteraemia compared with previous years, and the increase was marked particularly in cases among older children and adults 30-50 years old. Additional culture-confirmed diagnoses included unusual cases compared to recent decades such as pneumonia with empyema, necrotising fasciitis and primary peritonitis. Serotyping of strains collected consecutively from localized infections revealed a marked predominance of T-type 1, opacity factor negative strains (T-1 OF-), ranging from 41% in North Norway to 87% in Mid-Norway. M-typing confirmed that these strains were M-1, as were 87% of the preserved bacteraemia strains from the period described. Although most of the M-1 strains were distinctly mucoid only one case of acute rheumatic fever was reported during the first half of 1988. We conclude that an epidemic of GAS infections caused by M-1 strains has occurred in Norway resulting in an increase in both incidence and seriousness of disease.

Adult↗
PubMed1998

Serosurvey for orthopoxviruses in rodents and shrews from Norway.

Two hundred and twenty one blood samples representing eight different rodent species and the common shrew (Sorex araneus), collected in Norway between 1993 and 1995, were examined for anti-orthopoxvirus antibodies by a competition enzyme linked imunnosorbent assay (ELISA) and, when possible, an indirect immunofluorescence assay. The serological results indicated that the bank vole (Clethrionomys glareolus), woodmouse (Apodemus sylvaticus) and Norway lemming (Lemmus lemmus) may be reservoir species for orthopoxviruses in Norway, with antibody prevalences of 17 (12/69), 30 (24/81) and 56% (19/34), respectively. Orthopoxvirus infection in lemmings has not been reported previously. On some other small rodent species such as field voles (Microtus agrestis), common rats (Rattus norvegicus), and common shrews, seropositive individuals were detected. However, the total number of tested animals was low, and the role of these species in the epidemiology of orthopoxvirus infections remains unclear. Attempts to isolate orthopoxviruses from these small mammals failed, although orthopoxvirus specific DNA sequences were detected previously in the same animals by the polymerase chain reaction (PCR). The serological results were compared with and discussed in the context of the occurrence of orthopoxvirus-specific DNA sequences, and it is concluded that orthopoxviruses are widely distributed among wildlife in Norway.

Animals↗
PubMed1999

[Antibodies against Herpes simplex virus type 2 among pregnant women in Norway].

The prevalence of antibodies against herpes simplex virus type 2 (anti-HSV-2) among pregnant women in Norway is not known. To study the prevalence of anti-HSV-2, a random sample of 961 women was drawn from a study population of 35,940 pregnant women in Norway during 1992-94. 27% (256/961) had anti-HSV-2. The prevalence increased with age. 17% of the 20-24-year-olds and 34% of the 35 year-old or older had anti-HSV-2. The presence of antibodies also varied geographically, from 18% in the south to 39% in the north of Norway. Among women with repeated anti-HSV-2 tests during pregnancy, 2.6% of the seronegative women seroconverted (16/623). HSV-2 infection is common among pregnant women in Norway. The public health implications of this infection need to be clarified.

Adult↗
PubMed1999

[Kidney transplantation in Norway--a historical perspective].

Until the late 1950s, few treatment modalities for patients with chronic renal failure were available. The first successful renal transplantation was performed in Boston, USA in 1954 when a young man with renal failure received a kidney from his monozygotic twin brother. Tissue typing was not available, there were few options for immunosuppressive treatment, and dialysis could be offered for short-term treatment only. At the Surgical Department A of the National Hospital, Oslo, Norway, treatment of acute renal failure by hemodialysis was started in 1956 and the first renal transplantation in Scandinavia performed the same year. In 1963, the first renal transplantation at Ullevål Hospital, Oslo was performed, the first in Norway with a long-term function transplant. Since 1983, all renal transplantations in Norway have been performed at the National Hospital. In 1969, Scandiatransplant was established as an organisation for organ exchange between the Scandinavian countries, and a national program for renal transplantation in Norway was launched. The Norwegian renal transplant program is based on co-operation between regional and central hospitals and the transplant centre at the National Hospital. In recent years, the number of renal transplantations per year has been 180-200, i.e. 40-45 per million population. Approximately 40% of the transplanted kidneys come from living related or spouse donors. The results in terms of renal graft survival are good.

History, 20th Century↗
PubMed1999

[HIV infection, gonorrhea and syphilis from Thailand to Norway].

Thailand, a popular tourist destination for Norwegians, is experiencing an increasing epidemic of HIV infection. We used the Norwegian surveillance system for communicable diseases to assess the connections between the Norwegian and Thai epidemics. Before 1999, 1,869 cases of HIV-infection had been reported in Norway. From 1993 to 1998, 1,334 cases of gonorrhoea and 62 cases of syphilis were reported. We studied cases with a Thai patient or source partner and cases acquired in Thailand. 56 (3%) of HIV-infection cases, 64 (5%) of gonorrhoea cases and two (3%) of syphilis cases were connected to Thailand. All the Norwegians who acquired HIV in Thailand were males, with a median age of 39. Eight of them were diagnosed in 1998 as compared to 16 during the previous ten-year period. 21 Thai women and seven males were diagnosed with HIV infection in Norway, eight in 1998 and 20 in the previous ten-year period. The Norwegian HIV epidemic is influenced by the Thai epidemic. Norwegian men are infected in Thailand during holidays. Thai women come with their Norwegian partner to Norway and later discover their HIV status. We recommend raising the awareness of the Thai epidemic among Norwegian tourists. Immigrants to Norway from highly endemic countries should be offered HIV counselling and testing.

Communicable Disease Control↗
PubMed2001

[Geographic variation in body mass index measured among men born in Norway between 1967-80].

BACKGROUND: Conscripts born in 1980 were only 0.2 cm higher but weighed on average 3.3 kg more than those born in 1967. This weight gain corresponds to an average increase of body mass index (BMI) of 0.92 kg/m2. A description of geographical differences in changes of BMI is given. MATERIAL AND METHODS: All men born in Norway 1967-80, with Norwegian citizenship and known county of residence at the age of 18 are included, a total of 399,512 men. BMI was calculated for each birth cohort on the basis of data from the medical examinations for military service obtained from the Central Service Administration. RESULTS: Significant geographical differences in changes of BMI were found. Conscripts from Northern Norway had the largest increase of BMI, 2.0 kg/m2. The percentage of conscripts from Northern Norway with a BMI > or = 30 kg/m2 (obesity) increased from 1.5 for those born in 1967 to 6.5 for those born 13 years later. The smallest weight gain was observed among conscripts from the central counties of southeastern Norway; their average BMI increased only 0.5 kg/m2. The geographical differences became evident in the 1973-76 birth cohorts and are present also among the more recent birth cohorts. INTERPRETATION: To disclose the causes of these differences would be important in the prevention of overweight in young men.

Adult↗
PubMed1992

[Who is long-term sick-listed in Norway? From the project Evaluation of the follow-up of long-term sick-listed].

The aim of the study was to analyse the characteristics of persons with long-term sickness certification at the end of 1990 in Norway. The study was based on data registered by the National Insurance Administration: Age, sex, place of residence, diagnoses, and prognosis as registered on Sickness certificate II. At the end of 1990 a total of 57,567 persons had been incapacitated for work for longer than eight weeks and up to 52 weeks. The prevalence was 27.9 per 1,000 employed persons, with a significantly higher prevalence among women than among men. 25% of the women certified as sick were 40-49 years old. The highest prevalence of long-term certification of sickness was found in the counties Finnmark and Troms in Northern Norway, and Hedmark in central Norway. In cases of long-term sickness certification, the most common diagnoses were musculoskeletal/connective tissue diseases and mental disorders, with a prevalence of 9.3 and 3.1 per 1,000 employed persons respectively. The study indicates the possibility of using data from existing administrative population registers to provide information on the epidemiology of long-term sickness certification in Norway. It is necessary to further improve the validity of the data.

Adult↗
PubMed2004

[Medical education in Tromsø--does it secure recruitment of physicians to the northern parts of Norway?].

BACKGROUND: Medical education was established in the University of Tromsø in order to recruit doctors to the northern parts of Norway. Earlier publications have shown that this goal has been reached. We wanted to see whether this has remained unchanged during the last few years (1996-2001). METHOD: Our material is based on information about 318 doctors educated in Tromsø and 851 doctors educated in Oslo between 1996 and 2001. The medical faculties in Tromsø and Oslo provided us with doctors' names and dates of birth. The Norwegian Medical Association assisted with information about each doctor' practice and place of work. RESULTS: Among doctors educated in Tromsø, the numbers going into general practice are decreasing; the majority of graduates prefer hospital work. A decreasing number take up academic work. Most of the students coming from the northern parts of Norway stay in that region upon graduation (75.4%), but the proportion is lower than earlier. Only 7.5% of doctors educated in Oslo choose to work in the northern parts of Norway. INTERPRETATION: The University of Tromsø is still important in recruiting doctors to the northern regions of Norway, primarily because this university educates students who come from these regions.

Arctic Regions↗
PubMed2005

[Breast-conserving surgery and sentinel node procedure in Norway, 1993-2001].

BACKGROUND: The aim of the present study is to describe the development in the use of breast-conserving surgery and sentinel node procedures in Norway from 1993 to 2001, with special emphasis on geographical variations and possible relationships with the mammography screening programme. MATERIAL AND METHODS: The Cancer Registry of Norway registers diagnosis and treatment of all cases of cancer in Norway. All women diagnosed with breast cancer in the period 1993-2001 who received surgical treatment were included in the study except those with distant metastases at diagnosis. RESULTS: During the period, there were 18,564 surgically treated female breast cancer patients without evidence of distant metastases. Breast-conserving surgery was applied in 4203 (22%) out of 19,408 cases. The proportion increased from 14% in 1993 to 36% in 2001. In most counties with mammography screening, the proportion of breast-conserving surgery in women aged 50-69 rose to 40% or more in 2001. Utilisation of sentinel node biopsy in breast-conserving surgery increased from 2% in 1998 to 55% in 2001. INTERPRETATION: Over the 1993-2001 period, there was a strong increase in the extent of utilisation of breast-conserving surgery and sentinel node biopsy in breast cancer in Norway.

Adult↗
PubMed2005

Disseminated and chronic Lyme borreliosis in Norway, 1995 - 2004.

Lyme borreliosis is the most common tickborne infection in Norway. All clinical manifestations of Lyme borreliosis other than erythema migrans are notifiable to Folkehelseinstituttet, the Norwegian Institute of Public Health. During the period 1995-2004 a total of 1506 cases of disseminated and chronic Lyme borreliosis were reported. Serological tests were the basis for laboratory diagnosis in almost all cases. The annual numbers of cases showed no clear trend over the period, but varied each year between 120 and 253 cases, with the highest number of cases reported in 2004. Seventy five per cent of cases with information on time of onset were in patients who fell ill during the months of June to October. There was marked geographical variation in reported incidence rates, with the highest rates reported from coastal counties in southern and central Norway. Fifty six per cent of the cases were in males and 44% in females. The highest incidence rate was found in children aged between 5 and 9 years. Neuroborreliosis was the most common clinical manifestation (71%), followed by arthritis/arthralgia (22%) and acrodermatitis chronica atrophicans (5%). Forty six per cent of patients were admitted to hospital. Prevention of borreliosis in Norway relies on measures to prevent tick bites, such as use of protective clothing and insect repellents, and early detection and removal of ticks. Antibiotics are generally not recommended for prophylaxis after tick bites in Norway.

Adolescent↗
PubMed2005

[Visions contra democratic majority decisions. Invitation of ten Jewish specialists to Norway and Sweden in 1939].

The attempt to save Jewish physicians from Germany by issuing invitations to neutral countries was first initiated in 1939 in Danzig, then under the protection of the League of Nations. Dr. Karl Evang in Norway and Dr. J. Axel Höjer in Sweden, then heads of their respective country's Health Departments, went to considerable lengths in their efforts to obtain work permits in Norway or Sweden. In Sweden, both student unions and the medical profession were firmly opposed to allowing their foreign colleagues to enter the country, whereas Norway accepted to admit ten of the altogether 222 applying physicians, on certain conditions. Owing to the German occupation of Norway, the majority of those finally admitted had to find refuge elsewhere.

Democracy↗
PubMed1976

Cord blood cholesterol, triglyceride, and lipoprotein pattern from two districts in Norway.

Lipid levels of cord blood from two districts in Norway were studied. Although the mean levels of cholesterol and triglycerides in the two populations were similar, high cord blood lipid levels were more frequently found in a population in Finnmark in northern Norway than in Bergen in western Norway. In Bergen the 95-percentile value for both cholesterol and triglycerides was 90 mg/100 ml. In Finnmark the corresponding values were 100 and 115 mg/100 ml. The lipid levels in cord blood from children of Norwegian, Finnish, and Lappish origin were nearly identical. The frequency of lipoprotein subfractions as distinct bands between beta and pre-beta fractions in polyacrylamide gel electrophoresis was the same in the two populations. Thus no genetic difference was found in lipoprotein patterns of cord blood in the populations of western and northern Norway.

Cholesterol↗
PubMed1989

[Measles in Norway. The first 6 months of 1988].

The incidence rate of measles in Norway in the first six months of 1988 was 2.6 per 100,000. This is the lowest half-yearly incidence rate registered in Norway, but because of a change in the method of reporting the figures are not directly comparable. There was an epidemic in Norway's northernmost county (Finnmark) and an outbreak in an army camp in the county of Troms (also in the north). On a national basis 48% of the cases were preventable, but there were considerable local variations. In Finnmark 77% of cases were preventable. No serious complications (death or encephalitis) were registered but the rate of other complications was higher than expected. There was an even distribution of cases in the different age-groups up to 15 years, but there were considerable local variations. Despite the low incidence rate there is much that suggests that immunization coverage is still low in some areas. If the goal of eliminating indigenous measles by 1990 is to be achieved then urgent action is required to improve immunization coverage. Intensification of preventive measures around individual cases is also necessary. Suggestions for measures to further reduce the incidence rate of measles in Norway are included in the conclusions to the article.

Adolescent↗
PubMedDate not supplied

Training for general practice: a look to Norway.

In the 1960s general practitioners were a dying race in Norway. Today general practice is a highly approved specialty among doctors as well as patients. Better education is one of the revitalizing factors. General practice is currently taught as a mandatory subject at all four universities in Norway. The practice apprenticeship is the essential element in our undergraduate curricula. In their fifth year, the students spend three to eight weeks in a structured training program supervised by general practice faculty. Approximately 500 general practitioners take part in this decentralized training network. In 1985 general practice was recognized as a specialty in Norway. The obligatory requirements in the five-year educational program are: -courses, 400 hours -hospital training, one year -general practice training, four years -group-based training program, two years The last element is based on a decentralized concept where a group of two to 10 trainees meet for three hours every two weeks during a two-year period. The group is headed by an appointed and qualified trainer. Besides being in accordance with the geography and demography of Norway, this model gives substance to the slogan "general practice can only be learnt in general practice."

Curriculum↗
PubMed1980

Epidemiological patterns of meningococcal disease in Norway 1975-1979.

Using official notification figures for 1975-79, the recent meningococcal (MC) epidemic in Norway is described and related briefly to historical and international trends. This is the fourth major MC epidemic in Norway. Such epidemics have occurred at intervals of about 30 years. Apparent morbidity and mortality are presented in relation to time, region, serogroup, age and sex. Main characteristics of this epidemic are long duration, higher attack rates in North Norway and Mid-Norway, and in the winter/spring months, and a relatively high case fatality. The start of the epidemic coincided with a development of serogroup B predominance, following a shift from sulphonamide sensitivity to sulphonamide resistance in the majority of causative strains isolated shortly before. Morbidity peaks are observed in the second half of the first year of life (the highest rate) and among the age-group 14-17 years, with more male cases than female cases in the first three years of life. Case fatality appears to be high in the first five years of life, and even higher in the age-group 20 years and above. In the youngest age-groups and among adults, the case fatality is higher for males. The features of the epidemic are discussed in the light of coverage in official statistics of true occurrence of morbidity and mortality.

Adolescent↗
PubMed1993

The effects of tobacco sales promotion on initiation of smoking--experiences from Finland and Norway.

Norway and Finland were among the first countries to adopt a total ban on tobacco sales promotion. Such legislation came into force in Norway and Finland in 1975 and 1978 respectively. These two countries are sometimes referred to as illustrations that such legislation has been successfully used as a means to reduce tobacco consumption. Tobacco industry spokesmen seem to interpret available evidence in the opposite way and maintain that the prohibition has not contributed to reducing the use of tobacco. Among the publications referred to and misused by tobacco industry spokesmen are publications from the authors of the present report. The effects of a ban on advertising can only be properly examined after describing a reasonable conceptual model. Such a model has to take into account (i) other social and cultural predictors of smoking, (ii) tobacco sales promotion in the contexts of all other mass communication, (iii) control measures other than a ban, and (iv) the degree of success in implementing the ban on advertising. Like any other kind of mass communication tobacco advertising influences the individual in a rather complex way. Behaviour change may be regarded as the outcome of an interpersonal and intrapersonal process. Social science research on tobacco advertising and the effects of banning such advertising has a short history, most studies having been carried out in the late 1980s. After examining available evidence related to the effects of tobacco advertising on the smoking habits of adolescents we conclude as follows: the few scientifically valid reports available today give both theoretical and empirical evidence for a causal relationship. Tobacco sales promotion seems both to promote and to reinforce smoking among young people. The dynamic tobacco market represented by children and adolescents is probably the main target of tobacco sales promotion. In Finland, there have been few studies explicitly addressing the causal links between tobacco sales promotion and the smoking habits of adolescents. In Norway, no such studies have been carried out. If we examine the changes in the use of tobacco over time, the data available do not lend support to the conclusions drawn by the tobacco industry spokesmen. In Norway the prevalence of daily smokers was higher in 1975, when the ban on tobacco advertising came into force than either before or after. The strongest decrease in the prevalence of daily smokers took place during the first five-year period after the ban was introduced.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1993

Comparison of the use of a dry chemistry analyser in primary care in Norway and the United Kingdom.

The results of a quality assessment survey of the most commonly used dry chemistry instrument in primary care in Norway and the United Kingdom, the Reflotron (Boehringer), are reported including an evaluation of some of the operational characteristics of the Reflotron users. The primary care users in Norway taking part in the study comprised 95 occupational health care departments and 89 general practices. In the UK, primary care users taking part were 95 occupational health care departments and 37 general practices. In terms of both accuracy and precision evaluation of concentrations of bilirubin, cholesterol, gamma-glutamyl transferase, glucose, triglycerides, urea and uric acid by primary care users was similar in the two countries, and to that of 60 Norwegian laboratories. Examination of operational characteristics revealed a lack of effective quality control measures in both countries, and some differences in the pattern of usage between primary care users in Norway and the UK, especially in general practice. The result of Reflotron tests were ready before the patient left in a considerably higher proportion of general practices in the UK than in Norway. It is concluded that the Reflotron is suitable for primary care use, but good, routine quality of analysis must be ensured through collaboration between primary care users and clinical chemists.

Blood Chemical Analysis↗