Norwegian Group Research Articles

Nurses' and caregivers' definition of spirituality from the Christian perspective: a comparative study between Malta and Norway

The aim of this cross-sectional comparative exploratory study was to explore the term spirituality as defined by four groups of nurses and two groups of caregivers from Malta and Norway. Spirituality is a complex subjective concept which may or may not contain religiosity. Several factors may influence the individual's interpretation with implications to nursing care and nursing management. Data were collected from six purposive samples using focus group discussions in Malta and Norway. The Taxonomy of Spirituality guided the study. Four themes defined the term 'spirituality'. Two differences were found between Malta and Norway. Connectedness with family and nature was emphasized more by the Maltese group while the Norwegian group identified both the positive and the negative energies of spirituality. A clinical environment conducive to holistic care is needed. Inclusion of spirituality in the continuous professional development programmes may enhance understanding of spirituality and foster spiritual growth. Irrespective of differences in cultures between Malta and Norway, commonalities were found in the definition and essence of spirituality in nursing care. Trans-cultural longitudinal research is recommended to explore further the definition of spirituality.

Letter by Halle Regarding Article, “Cardiovascular Risk of High- Versus Moderate-Intensity Aerobic Exercise in Coronary Heart Disease Patients”

To the Editor: Exercise training in secondary prevention of cardiac disease is an established lifestyle strategy to improve cardiovascular risk factors and morbidity in cardiac patients. However, clinical data are surprisingly scarce. Therefore, the Norwegian group has to be congratulated for collecting a very large data set in this important clinical research field.1 In their study, Rognmo et al1 investigated 4846 patients (mean 57.8 years of age, 70% males) with cardiac disease (40% angioplasty, 35% bypass surgery, 11% valve surgery, 7% myocardial infarction, and 7% systolic heart failure) referred to cardiac rehabilitation (mean of 37 sessions, 60 minutes each, primarily bicycle ergometry) and assessed severe adverse events defined as cardiac …

Extension of NORSOK CO<SUB align="right">2 corrosion prediction model for elbow geometry

Internal corrosion of flowlines and pipelines is inevitable when transporting oil and gas that contains corrosive species. The consequences of corrosion such as material failure, loss of production, plant shutdown, and environmental pollution result in extra cost that negatively affect the project economics. Early prediction of corrosion severity is, therefore, very important to propose proper measures to avoid or eliminate corrosion. The prediction is normally carried on using a selected model for corrosion prediction. One of these models is NORSOK model, an empirical model developed by NORSOK for CO2 corrosion prediction in straight pipes. Norsk Sokkels Konkuranseposisjon or, in English, The Competitive Standing of the Norwegian Offshore Sector (NORSOK) is number of standards developed by Norwegian industry groups covering different topics that related to offshore industry. In this paper, NORSOK model has been modified to make it applicable to elbows geometries by introducing the equivalent length concept. A friendly graphical user interface computational package is developed for corrosion prediction in both straight pipes and elbows. The package is validated against measured data and acceptable accuracy is attained.

Military walking blood bank and the civilian blood service

In most countries whole blood transfusions have been replaced by component therapy. This has allowed for both better usage of the blood donations and better quality during storage. While this strategy was initially motivated by the commercial need for plasma the plasma reduction also reduced the levels of low grade proteases and sialidase, hence minimizing the cellular storage lesion/microvesiculation during prolonged storage. Plasma reduction also reduces transfusion reactions associated with plasma. During special military conditions, however, blood transfusion is urgently needed without corresponding access to blood components, in particular platelets. Accordingly, new focus on whole blood has aroused and added a new challenge to the blood transfusion services. This special issue of “what is happening” highlights the planed efforts by Swedish and Norwegian groups in the developments of military walking blood bank, which is applicable to civil blood services.

FLOX regimen (5-FU, folinic acid, oxaliplatin) and FLIRI regimen (5-FU, folinic acid, irinotecan) as first-line treatment in metastatic and locally advanced gastric cancer: A randomized phase II study.

71 Background: The Norwegian Gastrointestinal Cancer Group (NGICG) conducted a phase II randomized study comparing the efficacy and safety of FLOX and FLIRI as first line treatment in metastatic or locally advanced gastric cancer. At progression or unacceptable drug related toxicity, a crossover to the other treatment arm should be done, if second line chemotherapy was indicated. Methods: 66 patients from 6 treatment centers in Norway were randomized to FLOX (oxaliplatin 85 mg/m2 on day 1, bolus 5-FU 500 mg/m2 and FA 60 mg/m2 on day 1 and 2, or FLIRI (irinotecan 180 mg/m2 on day 1, bolus 5-FU 500 mg/m2 and FA 60 mg/m2 on day 1 and 2). Both treatments were repeated every second week. The primary endpoint was response rate (RR) and time to progression (TTP). Secondary endpoints were overall survival (OS) and safety data. Results: At the present time data from 63 patients are available for analysis. First-line treatment: FLOX (n = 32) versus (v.) FLIRI (n = 31): Complete response (CR) n = 0 in both arms, partial response (PR) n = 16 v. 9, stable disease (SD) n = 12 v. 13, progressive disease (PD) n = 3 v. 6, not assessable for evaluation n = 1 v. 3 patients. RR was 50 % in the FLOX arm v. 29 % in the FLIRI arm, p = not significant (n.s), Pearson Chi-Square test. Median TTP was 5 months (95 % CI 2.2-7.8) v. 4 months (95 % CI 2.2-5.8), p = n.s, median OS was 11 months (95 % CI 9.2-12.8 ) v. 10 months (95 % CI 5.7-14.3), p = n.s, Log Rank test. Patient characteristics were well balanced. Febrile neutropenia was present among 10 % of the patients in the FLOX arm versus 7 % in the FLIRI arm. Second line treatment: 30 patients received second line treatment with FLOX or FLIRI. Data regarding RR, TTP, OS and safety will be updated in December 2011. Conclusions: The FLOX and FLIRI regimens are well tolerated among patients with locally advanced and metastatic gastric cancer. As first line treatment the FLOX regime had a higher RR of 50% v. 29% for the FLIRI regime, longer TTP; 5 v. 4 months and longer OS 11 v. 10 months, but the difference did not reach statistical significance.

Management of Seminomatous Testicular Cancer: A Binational Prospective Population-Based Study From the Swedish Norwegian Testicular Cancer Study Group

Management of Seminomatous Testicular Cancer: A Binational Prospective Population-Based Study From the Swedish Norwegian Testicular Cancer Study Group

P2-08-09: The Impact of Preoperative Breast MRI in Newly Diagnosed Breast Cancer. A Prospective Study of Treatment Outcome in Patients Selected for Breast-Conserving Surgery in a Norwegian Multidisciplinary Breast Cancer Clinic.

Abstract Background: The aim of the study was to evaluate the impact of preoperative breast MRI on primary surgical treatment in a specialized multidisciplinary breast cancer clinic. The diagnostic tools routinely used are conventional mammography, ultrasound with core needle biopsy, and clinical examination including palpation of breast and axillary nodes. If indicated, the examination includes ultrasound examination and fine needle biopsy of axillary glands. We offer all patients selected for breast-conserving surgery preoperative breast MRI. Material and methods: We included consecutively 145 breast cancer lesions in 143 women (two had bilateral cancer) aged 35–75 in a prospective study, collecting data from January 2009 to December 2010. The patients were all selected for breast-conserving surgery based on the criteria recommended by the Norwegian Breast Cancer Group. That is, tumor ≤ 4 cm, or acceptable tumor:breast ratio, and age > 35. Multifocal lesions, defined as more than one tumor > 1 cm apart, size of tumor > 4 cm, or a large tumor:breast ratio, extensive ductal carcinoma in situ (DCIS), or known genetic disposition for breast cancer, indicates mastectomy according to these criterias. In addition, when postoperative radiation therapy is contraindicated, mastectomy is indicated. If the patients filled the criteria for breast-conserving surgery, they were offered preoperative breast MRI and included in the study. Patients who either choose mastectomy, or did not get a breast MRI for technical reasons, were excluded from the study. Two experienced breast radiologists evaluated the breast MRIs, and three experienced breast radiologists studied the mammographies and did the ultrasound examinations and biopsies. All additional MRI findings were examined by ultrasound-guided biopsy and given a histological diagnose before it influenced the surgical method. Results: We excluded 28 patients from the study; 10 patients choose mastectomy, 13 patients were excluded due to problems with the MRI technology, and 5 patients were excluded for other reasons. Among the remaining 117 patients, 96 were treated by breast-conserving surgery, and 21 by mastectomy. The change of operative method was induced by the preoperative breast MRI in 16 patients, because of multifocality in 11 patients, and because of a more extensive tumor than discovered by conventional diagnostic tools, in 5 patients. Five patients had a secondary mastectomy, due to histopathological findings in the lump. In one patient preoperative MRI revealed cancer in the contralateral breast, and in one patient the additional findings on MRI resulted in preoperative systemic chemotherapy. The multifocality diagnosed on the preoperative MRI was confirmed on histopathological examination of the breast in 10/11 patients. In one patient who received preoperative systemic chemotherapy, the removed breast was without sign of malignant cells on microscopic examination. Discussion: In this prospective study preoperative breast MRI give additional information that have impact on the primary surgical treatment in 16/117 or 13,7% of the patients selected for breast-conserving surgery. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-08-09.

Characterisation of human exposure pathways to perfluorinated compounds — Comparing exposure estimates with biomarkers of exposure

Commercially used per- and polyfluorinated compounds (PFCs) have been widely detected in humans, but the sources of human exposure are not fully characterized. The objectives of this study were to assess the relative importance of different exposure pathways of PFCs in a group of Norwegians and compare estimated intakes with internal doses obtained through biomonitoring. Individual PFC intakes from multiple exposure sources for a study group of 41 Norwegian women were estimated using measured PFC concentrations in indoor air and house dust as well as information from food frequency questionnaires and PFC concentrations in Norwegian food. Food was generally the major exposure source, representing 67–84% of the median total intake for PFOA and 88–99% for PFOS using different dust ingestion rates and biotransformation factors of ‘precursor’ compounds. However, on an individual basis, the indoor environment accounted for up to around 50% of the total intake for several women. Significant positive associations between concentrations of PFCs in house dust and the corresponding serum concentrations underline the importance of indoor environment as an exposure pathway for PFCs. For breast-fed infants, breast milk was calculated to be the single most important source to PFCs by far. The estimated intakes were confirmed by comparing serum concentrations of PFOA and PFOS calculated using PK models, with the corresponding concentrations measured in serum. Even though food in general is the major source of exposure for PFCs, the indoor environment may be an important contributor to human exposure. This study provides valuable knowledge for risk assessment of PFCs and control strategies.

Surface-modified advanced hydrogen storage alloys for hydrogen separation and purification

This paper summarises collaborative activities of South African and Norwegian groups in the development and characterisation of the advanced hydride-forming materials obtained by surface modification of AB 5-type substrate by fluorination and/or electroless deposition of single- or mixed-metal coatings on the basis of palladium. The surface modification was shown to significantly improve activation performance and poisoning tolerance of the hydride-forming materials. In particular, hydrogen absorption rate, after long-term pre-exposure to air, was shown to be increased by ∼100 times for the surface-modified materials, as compared to the unmodified alloy. It was shown that the surface modification route significantly influenced surface morphology and rate of hydrogenation. Finally, feasibility of application of the surface-modified hydride-forming materials for efficient hydrogen separation from gas mixtures containing CO 2 and CO has been demonstrated. The approach undertaken has the potential in tailoring of new classes of highly efficient and robust composite H storage materials for hydrogen separation and purification.

Reversible dyscognition in patients with a unilateral, middle fossa arachnoid cyst revealed by using a laptop based neuropsychological test battery (CANTAB)

The aim of this study was to evaluate and validate the Cambridge Neuropsychological Test Automated Battery (CANTAB) in a Norwegian group of patients undergoing surgery for middle fossa arachnoid cysts (AC). We also wanted to assess health related quality of life (HRQOL) in these patients to see if it could be improved by decompression of the AC. Adult patients (>18years) with unilateral middle fossa AC and no previous history of neurological disease, head injury, or a psychiatric disorder were eligible for inclusion. We used four tests from CANTAB to assess the level of neuropsychological performance: paired associate learning (PAL) and delayed matching to sample (DMS) assessed temporal lobe functions, while Stockings of Cambridge (SOC) and intra-extra dimensional (IED) shift focused on frontal lobe functions. Patients with postoperative cerebral complications were reported, but excluded from neuropsychological follow-up. In addition to the CANTAB data, pre- and postoperative clinical and radiological data were collected. HRQOL was assessed using Short Form 36 (SF-36) pre- and postoperatively. We found significant improvement in the two temporal tests assessing memory, but no improvement in the two frontal tests assessing executive function. HRQOL was significantly reduced preoperatively in two of eight SF-36 domains and improved significantly in four domains postoperatively. CANTAB facilitates detection of cognitive improvements after decompression of the cyst in patients with AC in the middle fossa. The improvements were detected on the tests sensitive to temporal lobe problems only, not on the tests more sensitive to frontal lobe affection. This establishes construct validity for CANTAB for the first time in this population.

Phase III study comparing vinorelbine/gemcitabine with vinorelbine/carboplatin as first-line chemotherapy of advanced NSCLC: A Norwegian Lung Cancer Study Group trial.

7597 Background: Platinum based chemotherapy is the standard first line treatment for advanced non- small cell lung cancer (NSCLC). However, side-effects are common and earlier studies have suggest...

Mitotic Activity Index Identifies Both Over- and Undertreated Lymph Node Negative Breast Cancer Patients < 55 Year According to the Norwegian Treatment Guidelines.

Abstract Background: It is a challenge to avoid under- and overtreatment of breast cancer patients in the adjuvant setting. Patients who have not received adjuvant systemic treatment and with a known outcome demonstrate the natural course of the disease after surgery. Such patients may be re-evaluated in specific guidelines like the Norwegian Breast Cancer Group (NBCG) based on the St. Gallen criteria. NBCG classify the patients in a low-risk group which should not receive systemic treatment, and a high-risk group which should be offered such therapy. New factors may be evaluated in these two strata, possibly discriminating groups of under- or overtreated patients. The aim of this study was to explore if the previous established marker of proliferation, the mitotic activity index (MAI), could give any additional information.Patients and methods: The study comprised 516 lymph node negative patients < 55 years from the Dutch prospective Multicenter Morphometric Mammary Carcinoma Project (MMMCP; 1987-1989)1. No adjuvant systemic treatment was given after surgery to these patients. The guidelines from NBCG-2005 were used to classify the patients in “NBCG low-risk” group (n=100) defined as pT1/Grade 1, all ages and pT1a-b/Grade 2-3, >35 years, all hormone receptor positive. The rest of the patients (n=416) was grouped as “NBCG high-risk”. Breast Cancer Specific Survival (BCSS) was estimated by the Kaplan-Meier method. MAI was analyzed after a standardized protocol in the invasive front of the tumor. The previous established thresholds of MAI with low (<3), intermediate (3-9) and high (≥10) proliferation were used in the calculations.Results: In the “NBCG low-risk” group 10 % of the patients had MAI ≥10. These had a 14-years BCSS of 50 % (HR=15.47, 95 % CI=3.61-66.30) and may be regarded as undertreated patients. Patients with MAI <3 and 3-9 had a BCSS of 95 % and 83 % respectively. In the “NBCG high-risk”group 24 % of the patients with MAI<3 had a 14-years BCSS of 92 % indicating overtreatment. Furthermore, patients with MAI 3-9 and ≥10 had a BCSS of 74 % and 63 % (p-trend <0.0001).Discussion: MAI represents the “converging mitotic drive” from all cellular signal pathways in the peripheral growing zone of the tumor, where also micro-environmental factors are known to influence proliferation of cancer cells. This may explain why MAI gives original information strong enough to identify subgroups breast cancer patients who would not get optimal adjuvant treatment. A disadvantage of this study is that the HER-2 status in this MMMCP material is not known. National prospective studies are needed to verify our results.1 Baak, JPA et al: Pathol Res Pract 185:664-70,1989. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3182.

Cross-informant correlations on social competence and behavioral problems in Sami and Norwegian preadolescents

In a community-based birth cohort from Arctic Norway, correlations between parents and teachers on child competence and behavioral problems were determined for Sami and Norwegian 11-12 year-olds, using as instruments the child behavior checklist (CBCL), teacher report form (TRF), and the impact supplement of the extended strength and difficulties questionnaire (SDQ). Parent-teacher correlations on child behavioral problems were generally high in the Norwegian group, but low in the Sami group. Cross-cultural differences in cross-informant correlations were highest regarding externalizing and attention problems. Parent-teacher correlations on total impact of child difficulties also differed between the ethnic groups. Once again, a lower correlation was found for the Sami children. The discrepancy between parents' and teachers' perception of problems that needed attention was highest for the Sami, and lowest for the Norwegians. The Sami parents reported fewer perceived difficulties and less impact of problems than did the Norwegian parents. In contrast, no ethnic differences emerged for teachers' ratings. The paper discusses how cultural norms might influence the reports of child problems. It demonstrates the importance of combining parent and teacher reports of child behavior problems in minority and indigenous children, who often live under different cultural norms in home and school contexts.

Explaining intention to consume a new fish product: A cross-generational and cross-cultural comparison

The general purpose of this study is to describe and explain attitudes and intention to consume a new fish product by using the general framework from the theory of planned behaviour (TPB) in a multi-group context. The field experiments were performed in Norway with 110 adolescents and young adults and 149 of their parents, and in Spain with 175 adolescents and young adults (termed “young consumers”). The product is a fish burger produced by a Norwegian firm for the Norwegian market, and was tested in-home in both countries. All constructs are analysed by multi-group analysis in LISREL for reliability, validity and invariance across groups. Results from this study indicate that the constructs within the TPB are valid and similar across cultures and generations. The parents showed a significantly higher motivation to consume and more positive attitude toward the fish burger compared with their kids. The Spanish consumers expressed a significantly more negative attitude towards the product compared with the two Norwegian groups. Perceived behavioural control is more important than attitudes and norms in explaining intention to consume the fish burger across cultures (Spain and Norway) and across generations (parents and their kids). This indicates that the TPB can be used not only in explaining intention to consume common food products, but also in the area of testing new products.

Use of traditional healing among Sami psychiatric patients in the north of Norway

OBJECTIVES: The purpose of this study was to learn more about the extent of, and factors related to, the use of traditional and complementary healing modalities among Simi psychiatric patients.STUDY DESIGN: A quantitative survey among psychiatric patients in Finnmark and Nord-Troms, Norway.RESULTS: A total of 186 Sami and Norwegian patients responded to the survey, a response rate of 48%. Of these, 43 had a strong Sami cultural affiliation. Use of traditional and complementary treatment modalities was significantly higher within the Sami group. Factors related to use differed between Sami and Norwegian groups. Sami users were found to give greater importance to religion and spirituality in dealing with illness than Sami patients who had not used these treatments. They were also found to be less satisfied with central aspects of their psychiatric treatment.CONCLUSIONS: In this study, we found several differences in factors related to the use of traditional and complementary treatments between Sami and Norwegian psychiatric patient groups. Sami users were found to give greater importance to religion and spirituality and were less satisfied with the public psychiatric services than Sami patients who had not used traditional or complementary treatments. The study implies that finding ways to include different aspects of traditional healing within the health services to the Sami community should be given consideration.

Dietary exposure to brominated flame retardants correlates with male blood levels in a selected group of Norwegians with a wide range of seafood consumption

This study investigates dietary exposure and serum levels of polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecane (HBCD) in a group of Norwegians (n = 184) with a wide range of seafood consumption (4-455 g/day). Mean dietary exposure to Sum 5 PBDEs (1.5 ng/kg body weight/day) is among the highest reported. Since concentrations in foods were similar to those found elsewhere in Europe, this may be explained by high seafood consumption among Norwegians. Oily fish was the main dietary contributor both to Sum PBDEs and to the considerably lower HBCD intake (0.3 ng/kg body weight/day). Milk products appeared to contribute most to the BDE-209 intake (1.4 ng/kg body weight/day). BDE-209 and HBCD exposures are based on few food samples and need to be confirmed. Serum levels (mean Sum 7 PBDEs = 5.2 ng/g lipid) and congener patterns (BDE-47 > BDE-153 > BDE-99) were comparable with other European reports. Correlations between individual congeners were higher for the calculated dietary exposure than for serum levels. Further, significant but weak correlations were found between dietary exposure and serum levels for Sum PBDEs, BDE-47, and BDE-28 in males. This indicates that other sources in addition to diet need to be addressed.

Consumption of fish from a contaminated lake strongly affects the concentrations of polybrominated diphenyl ethers and hexabromocyclododecane in serum

Very high concentrations of polybrominated diphenyl ethers (PBDE) have been reported in fish from Lake Mjøsa in Norway. This study was performed to examine the serum concentrations of PBDE and hexabromocyclododecane (HBCD) in consumers of fish from this lake and to investigate possible relationships between serum concentrations, self-reported fish intake and calculated total dietary PBDE exposure. Serum concentrations of the sum of the seven PBDE (BDE-28, 47, 99, 100, 153, 154 and 183) were significantly higher than those of a reference group of Norwegians eating only food with background levels of contamination (medians: 18 ng/g lipids men, 8.4 ng/g lipids women). The median dietary intake of Sum 7 PBDE was 2549 ng/day (30 ng/kg body weight/day), the highest dietary intake of PBDE reported. The contribution from fish caught from the contaminated lake comprised 98.7% of the total dietary exposure. For men, serum levels of PBDE were strongly correlated with the calculated dietary exposure, except for BDE-209. This suggests that sources other than the diet are important for human BDE-209 exposure. The median serum HBCD concentration was 4.1 and 2.6 ng/g lipids for men and women, respectively, and was also found to be associated with consumption of fish from Lake Mjøsa.

Dietary exposure to polybrominated diphenyl ethers correlate with male blood levels in a selected group of Norwegians with a wide range of seafood consumption

Dietary exposure to polybrominated diphenyl ethers correlate with male blood levels in a selected group of Norwegians with a wide range of seafood consumption

Verletzungsproblematik im Frauensport unter besonderer Berücksichtigung des Frauenhandballs

Summary This paper sets a focus on injuries in female handball and other team sports. According to the genetic basis and different effects of sex hormones, male and female athletes differ in some relevant anatomical and physiological aspects with a high impact for injuries. Different studies could demonstrate a higher risk for ACL injuries in female compared to male athletes. In handball, a fivefold higher risk for an ACL rupture could be demonstrated in female compared to male players. This is also true for younger players. Neuromuscular differences are discussed as possible mechanisms for gender-depending risks. Movement patterns while jumping and landing seem to have a high impact for the injury risk in team sports. Data on the injury risk during the menstrual cycle are conflicting. Some dependency, however, seems to exist. A possible mechanism might be a cycle-dependent reduction of the stability of the ACL. Studies on the preventive effects of oral contraceptive pills are also conflicting, not allowing any evidence-based recommendations. From a preventive point of view, some sports-specific movement patterns might be changed, like one- or two-leg landing in handball, width of feet position or ancle of knee flexion while landing, etc. Muscular dysbalances should be reduced, muscular strength in the tigh muscles increased, and proprioception and coordination optimized. A Norwegian group could demonstrate in an interventional study that a proprioceptive training program could reduce the risk for ACL injuries in female handball players dramatically.

Season of diagnosis is a predictor of cancer survival. Sun-induced vitamin D may be involved: A possible role of sun-induced Vitamin D

The calcidiol level in a group of Norwegians (14,000 individuals, age range 16–80) was found to be highest in late summer. The seasonal variation was larger for young than for old persons. The calcitriol concentration was practically constant throughout the year. Younger persons had less calcidiol and more calcitriol than older persons, indicating that the conversion of calcidiol to calcitriol is more efficient in younger persons.A seasonal variation of prognosis of cancer (colon-, breast-, prostate- cancer and Hodgkin lymphoma) was found. The survival is highest for summer and autumn diagnosis, corresponding to maximal calcidiol levels. Thus, calcidiol may act synergistically with traditional treatment modalities.In view of these calcitriol and calcidiol data, the seasonal variation of cancer survival may be related to the calcidiol gradient, indicating that this Vitamin D metabolite may be more important than believed so far.