North Norway Research Articles

Interruptions: Affective futures and uncanny presences atGiemaš, Finnmark

AbstractThis paper concerns affective relations and unexpected interruptions as the planned expansion of an extractive open-pit mining site gathers momentum. The site is a mountain in Varanger, North Norway, criss-crossed by a sand-coloured meshwork of roads that are part of the current infrastructure of a quartzite quarry. Recently purchased by Chinese investors, the mining company Elkem plans a massive expansion of the operations, which will interrupt a wide range of practices and projects, including the migratory movement of reindeer, as well as their grazing patterns. Known asGiemašamongst Sámi speakers, the mountain is also alluded to as a site of other powers, manifesting as unexpected accidents. In this article, I explore how the planned expansion evokes this contested site as more than a singular mountain, and how divergent epistemic formations interrupt the making of extractive resources in multiple ways.

Religion and Health in Arctic Norway – the association of religious and spiritual factors with suicidal behaviour in a mixed Sámi and Norwegian adult population – The SAMINOR 2 Questionnaire Survey

ABSTRACT Given the higher suicide rates among the adult population in the northernmost part of Norway and some unfavourable psychosocial outcomes associated with the Laestadian revival movement in this region, it is reasonable to investigate the relationship between religiosity/spirituality and suicidal behaviour in this context. This study used cross-sectional data from the population-based SAMINOR 2 questionnaire survey (2012; n = 11,222; 66% non-Sámi; 22% Laestadian-affiliated; 27% response rate) in mixed Sámi-Norwegian areas of Mid and North Norway. We analysed the associations between religious/spiritual factors and lifetime suicidal ideation and attempts, age at the first attempt, motives, and number of attempts. Multivariable-adjusted regression models considering sociodemographics, Sámi background and self-ascription, and health-related risk factors were applied. Sámi and Laestadian affiliations were significantly associated with religious self-ascription, regular attendance, and Established Church membership. In a fully adjusted model, Laestadian family background was negatively associated with lifetime suicide attempts (OR = 0.66, 95% CI: 0.47–0.93) compared with other family circumstances, whereas regular religious participation was inversely associated with suicide ideation (OR = 0.74, 95% CI: 0.61–0.91) compared with non- or rare attendance. The findings suggest that Laestadianism and religious attendance contribute to less suicidal behaviour among adults in Sámi-Norwegian areas.

Comparing proximity for couples of close airports. Case studies on city-airports in the pre COVID-19 era

Following the existing relationships between cities and airports, well depicted in the sectorial literature ((Thierstein and Conventz, 2018), (Tira et al., 2006), (Freestone, 2009), (Percoco, 2010), (Ventura et al., 2020))), this paper aims to investigate the linkages between the touristic traffic of some airports and the related development of the cities in which they are placed. The chosen case studies regard different remote regions (ONU, 2018) of three different countries (Italy, Norway, Cyprus), considering couples of near airports (Dziedzic and Warnock-Smith, 2015). The paper focuses the analysis on four couples of near airports, two from the South of Italy (Bari and Brindisi in the Apulia Region; Palermo and Trapani in Sicily), one in the North of Norway (Bødo and Narvik in Hålogaland) and the last one in the Republic of Cyprus (Larnaca and Paphos).A GIS analytic methodology has been used to describe the differences between the different couples of airports. Managed by the GIS analytical evaluation, the purpose of this paper is to give support to the different theories about the development of couples of close airports, using geographic tools to support economic and financial planning ((Cook and Billig, 2017) (Graham, 2014), (AntonínKazdaa et al., 2017) (Young and Wells, 2011))]. There has been pointed out the results of the adopted methodology on the working Norwegian network system analysis.

Community structure of deep fjord and shelf benthic fauna receiving different detrital kelp inputs in northern Norway

Kelp forests produce large amounts of macroalgal detritus, ranging from whole plants to small particles (1 mm). The role of this kelp detritus in fueling deep-sea communities adjacent to healthy kelp forests was investigated in a region in the north of Norway by comparing the community structure and biodiversity of meio-, macro-, and megafauna in two deep (450 m) areas with different expected input of kelp detritus: a deep fjord basin surrounded by kelp forests and the adjacent continental shelf 15 km offshore from the kelp forests. The results showed that, although the fjord received a significantly higher amount of large kelp detritus (i.e. blades) than the shelf area, the amount of small kelp detritus available on the sediment was similar in both areas. There were significant differences in the multidimensional scaling analyses on the community structure for meio-, macro-, and megafauna between the fjord and the shelf. Significant differences were also found in biomass, abundance and biodiversity indices for some groups. However, no clear pattern emerged in the community structure and biodiversity between the fjord and the shelf, and the observed differences could not be linked directly to kelp detritus availability. The similar amounts of small particles of kelp detritus in the fjord and shelf area suggest that kelp detritus can provide organic matter to ecosystems further away than initially hypothesized, thus potentially shaping the structure and functioning of deep benthic communities distant from the kelp forests. Yet, the direct (trophic) links of kelp detritus and the studied benthic fauna need to be further analysed. The results are discussed in relation to current global changes in kelp forest, including regime shifts from healthy kelp reefs to turfs or barren areas, which reduce drastically the amount of macroalgal detritus produced and exported.

Evaluating the Effects of Watershed Subdivision on Hydrological Simulation by Swat Model in an Arctic Watershed

The hydrological model SWAT is a state-of-the-art tool for environmental and water resources management. Like other semi-distributed models, the whole river basin in the SWAT model is delineated into smaller sub-basins prior to conducting the simulation. Watershed delineation is an importance step since it could potentially influence the modelling results. The present study aimed to conducte an investigation of the effects of watershed delineation schemes on hydrological simulation in an Arctic watershed Målselv, north of Norway. Four delineation schemes were set up with different threshold drainage area (TDA) from fine to coarse including 100 ha, 2,000 ha, 5,000 ha and 10,000 ha. The model was run on monthly time step from 1979-2012. The results showed higher variation of average annual precipitation and runoff especially in the upstream sections of the watershed by the fine TDA schemes compared to the coarse ones. The average monthly precipitation and runoff slightly increased from the finest TDA scheme to the coarsest scheme. All TDA schemes reproduced the observed tendency of the average monthly and annual streamflow although the peak flow was over and under estimated at different hydro-gauging stations. The higher value of estimated streamflow was found at the coarsest scheme.

Seismic mapping of on-shore sediments at Andøya, Norway, deposited prior to the North Atlantic rifting

Andøya is an island in the north of Norway. On its eastern side, it contains a local downfaulted basin of Mesozoic sediments sheltered from erosion during subsequent periods of Pleistocene glaciation. The sediments were deposited before the North Atlantic rifting and partly overlie weathered basement. We have recently carried out seismic surveying to better understand the geometry and seismic responses of the basin system. Extensive civil infrastructure and wet mire made the study area challenging for seismic exploration. We shot the survey lines at wet mire with detonating cord during winter when the mire was frozen. In the summer, we conducted seismic surveying along road shoulders with a small-scale vibrator. The seismic processing was particularly challenging due to the influence of traffic noise, heterogeneous near-surface conditions, and large seismic velocity contrasts. We interpreted the seismic lines in integration with other geophysical data and well logs to obtain a consistent and best possible seismic model of the basin. Our interpretation indicates a reorganization of the regional paleostress regime that took place during the continental breakup in the Eocene. In spite of severe obstacles for seismic surveying of the area, our results honor the robustness of the seismic method for subsurface imaging.

Sex-specific temporal trends in the incidence of atrial fibrillation in a large Norwegian population-based study 1986–2014

Abstract Background Due to population aging, increasing prevalence of obesity and enhanced detection, the prevalence of atrial fibrillation (AF) worldwide is increasing steadily. Considerable sex differences in the epidemiology of AF such as lower prevalence and later onset in women compared to men have been reported. However, little is known about sex-specific temporal trends in AF incidence within the general population. Purpose To explore sex-specific age-adjusted secular trends in the incidence of AF in a general population from Norway between 1986 and 2014. Methods A total of 16,865 men and 15,413 women aged 20 years or older and without AF were enrolled in a longitudinal population study between 1986 and 2008 and followed up for incident AF to the end of 2014. Follow-up was from the date of attendance to the date of AF, emigration or death, whichever came first. All AF cases were validated by an independent endpoint committee using hospital and death records. AF incidence rates were calculated for each calendar year by dividing the number of AF cases per year by the corresponding person-time at risk. To allow for non-linear time trends, calendar year was fitted using fractional polynomials. Poisson regression was used to estimate calendar year-specific AF incidence rates adjusted for age. All analyses were stratified by sex. Results A total of 911 AF events in women and 1,139 AF events in men occurred over 324,090 person-years and 294,531 person-years of follow-up, respectively. During the study period AF incidence rates in men were at least double that in women (Figure). Age-adjusted AF incidence rates in women increased from 1986, peaked at 0.87 per 1000 person-years in 1998 and then decreased slightly towards 2014. In men AF incidence rates increased up to 2.18 per 1000 person-years in 2005 and then steeply decreased. Conclusion(s) AF incidence rates decreased in both women and men towards the end of the study period. The decrease was more profound in men compared to that in women. One possible explanation is more pronounced reduction in incidence and better treatment of myocardial infarction in men compared to women given that the aetiology of AF in men is mainly ischemic heart disease-related. However, further epidemiological analyses should be undertaken to identify explanatory factors. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): University Hospital of North Norway, Northern Norway Regional Health Authority

Metrics of structural change as indicators of chironomid community stability in high latitude lakes

Understanding the effects of climate change on ecosystem structure and stability is challenging, especially in high latitude regions that are predicted to experience the largest increases in ambient temperature. Global warming is likely to be a key driver of ecosystem change in freshwater lakes. Increased temperature can positively or negatively affect lake community composition through the loss of cold-adapted taxa and the arrival of temperate or eurytopic taxa. Here, we analyse the likely effects of temperature-induced changes in taxonomic richness and compositional turnover of environmentally-sensitive chironomids (Diptera: Chironomidae) across three regions - northern North America, Norway, and Russia - using existing datasets. Structural parameters (beta diversity, compositional disorder, and network skewness) were applied to model-simulated and empirical chironomid datasets across a large spatial temperature gradient. The analyses of empirical datasets showed changes in community structure across temperature gradients, suggesting varying states of ecosystem stability or instability. The comparison with null models enabled assessment as to whether these stresses agreed with expected patterns due to covarying summer temperature conditions or whether they deviated from expectations suggesting additional stress on the ecosystems. For all three regions, lakes in the mid-temperature range showed most evidence of relative ecosystem stability, with greater beta diversity, compositional disorder, and skewness, unanticipated by the modelled simulations. This is most likely due to more diverse habitats across the ecotone boundaries and additional factors that can influence ecosystem structures. Thus, we show that structural changes typical for ecosystem stability can be detected through changes in community structure across temperature gradients. This is important for understanding how lakes may change under current and future climate change.

Cabin temperature during prehospital patient transport \u2013 a prospective observational study

BackgroundFew studies have investigated the patient compartment temperatures during ambulance missions or its relation to admission hypothermia. Still hypothermia is a known risk factor for increased mortality and morbidity in both trauma and disease. This has special relevance to our sub-arctic region’s pre-hospital services, and we prospectively studied the environmental temperature in the patient transport compartment in both ground and air ambulances.MethodsWe recorded cabin temperature during patient transport in two ground ambulances and one ambulance helicopter in the catchment area of the University Hospital of North Norway using automatic temperature loggers. The data were collected for one month in each of the four seasons. We calculated the sum of degrees Celsius below 18 min by minute to describe the patient exposure to unfavourably low cabin temperature, and present the data as box plots. The statistical differences between transport mode and season were analysed with ANCOVA.ResultsThe recorded cabin temperatures were higher during the summer than the other three seasons. However, we also found that helicopter transports were performed at lower cabin temperatures and with significantly more exposure to unfavourably low temperatures than the ground ambulance transports. Furthermore, the helicopter cabin reached the final temperature much slower than the ground ambulance cabins did or remained at a lower than comfortable temperature.ConclusionsHelicopter cabin temperature during ambulance missions should be monitored closer, particularly for patients at risk for developing admission hypothermia.

Empirical prescribing of penicillin G/V reduces risk of readmission of hospitalized patients with community-acquired pneumonia in Norway: a retrospective observational study

BackgroundNorwegian guideline recommendations on first-line empirical antibiotic prescribing in hospitalised patients with community-acquired pneumonia (CAP) are penicillin G/V in monotherapy, or penicillin G in combination with gentamicin (or cefotaxime) in severely ill patients. The aim of this study was to explore how different empirical antibiotic treatments impact on length of hospital stay (LOS) and 30-day hospital readmission. A secondary aim was to describe median intravenous- and total treatment duration.MethodsWe included CAP patients (≥18 years age) hospitalised in North Norway during 2010 and 2012 in a retrospective study. Patients with negative chest x-ray, malignancies or immunosuppression or frequent readmissions were excluded. We collected data on patient characteristics, empirical antibiotic prescribing, treatment duration and clinical outcomes from electronic patient records and the hospital administrative system. We used directed acyclic graphs for statistical model selection, and analysed data with mulitvariable logistic and linear regression.ResultsWe included 651 patients. Median age was 77 years [IQR; 64–84] and 46.5% were female. Median LOS was 4 days [IQR; 3–6], 30-day readmission rate was 14.4% and 30-day mortality rate was 6.9%. Penicillin G/V were empirically prescribed in monotherapy in 51.5% of patients, penicillin G and gentamicin in combination in 22.9% and other antibiotics in 25.6% of patients. Prescribing other antibiotics than penicillin G/V monotherapy was associated with increased risk of readmission [OR 1.9, 95% CI; 1.08–3.42]. Empirical antibiotic prescribing was not associated with LOS. Median intravenous- and total treatment duration was 3.0 [IQR; 2–5] and 11.0 [IQR; 9.8–13] days.ConclusionsOur findings show that empirical prescribing with penicillin G/V in monotherapy in hospitalised non-severe CAP-patients, without complicating factors such as malignancy, immunosuppression and frequent readmission, is associated with lower risk of 30-day readmission compared to other antibiotic treatments. Median total treatment duration exceeds treatment recommendations.

Productivity beyond density: A critique of management models for reindeer pastoralism in Norway

The official governance of the reindeer pastoralist system in the north of Norway relies overwhelmingly on one central argument: that in order to maintain a sustainable system, maximum numbers and densities of reindeer, as well as certain herd structures, should be upheld. If these indicators are ignored, the argument goes, the consequences are resource degradation and economic collapse. Even though this argument has been challenged by both researchers and reindeer herders across Fennoscandia, it continues to dominate management policies and practice. Here we set out to investigate the validity of the premise that there is a strong relationship between density and carcass weights over the whole of Finnmark, based on official data. We find that although the relationship is present, its explanatory power is not very strong in a variety of circumstances and propose that it therefore cannot be used to frame important governance policies for the whole system. We also critically reflect on the model’s goal of high productivity per capita of reindeer (high carcass weight). We suggest that productivity per area unit can be at least as relevant as carcass weights and perhaps a better indicator for pastoralist systems in general. For the Finnmark pastoralist system, we argue, a measure of productivity in kilogrammes per square kilometer reveals a different picture: rather than being a failed system marred by suffering animals and low economic returns, reindeer herding in Western Finnmark becomes the most productive in Norway. This shift of focus is likely relevant for other pastoralist systems where governance is premised on similar arguments.

Stroke-Specific Quality of Life one-year post-stroke in two Scandinavian country-regions with different organisation of rehabilitation services: a prospective study

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

Ambassadors of the Sensible World

We may work on things, but the opposite is perhaps even more true: things work on us. Reflecting on several projects of art and research that I have been involved in over the past years, which address different aspects of the environmental mutations currently in process, this paper will aim to partly divert from a usual focus on the deliberate intentions and goals that we can set ourselves as authors, rather observing how various objects of concern can progressively grow in our conscience and in our practice, calling for new transdisciplinary and investigative tools.
 These projects include the observation of a negotiation summit re-enacted at SciencesPo Paris in 2012, during which the « specter » of climate change seemed to appear in the room as an almost physical presence; the long term artistic research project « A tale as a tool » developed with anthropologist and writer Sandrine Teixido, involving a text of fiction as an investigative object of mediation, allowing to collect testimonies by members of frontline communities from the South of Brazil to the North of Norway; and the research project « The Anthropocene Atlas of Geneva » at Geneva school of Art and Design, gathering self-reflexive interviews with numerous scientists, artists and other actors of the ecological transition.

Establishment of a multifamily therapy (MFT) service for young adults with a severe eating disorder \u2013 experience from 11 MFT groups, and from designing and implementing the model

BackgroundEating disorders are serious illnesses leading to a substantially lowered quality of life not only for the patient but also for their family. They are difficult to treat, and many patients fail to complete their treatment. At the Regional Centre for Eating Disorders (RESSP) at Nordland Hospital in Bodø, in the north of Norway, it was apparent that many young adult patients maintained an active, ongoing relationship with their family of origin, and that parents and others were often highly involved in their life and illness. It was therefore desirable to develop a treatment model involving family members; specifically a multifamily therapy (MFT) group programme.MethodsThe aim was to establish an MFT service at RESSP for young adult patients suffering from severe eating disorders. This involved, (1) work preparatory to the establishment of the new service, (2) the development and implementation of a suitable MFT model, and (3) sharing the skills and knowledge gained from our experiences to other professionals in the field, and in other settings. This work of development and change can be understood as a process of innovation and is here described within the framework of implementation theory. The work took place in a clinically naturalistic context at the centre.ResultsThe MFT model description is based on experience during its development as well as its final form. The stages of this development process and of the changes made in order to establish the new service are described, together with its core components. To date, 68 patients and 198 family members have participated. Dropout rate has been 7.4% and the majority of patients have continued in treatment after completion of the MFT groups. BMI measurements show a significant weight-gain for those with an underweight at start. 32 other professionals have been trained in the model, and a similar service started in 3 other units.ConclusionThe new model has been welcomed by patients and families alike. The MFT group programme has had a strikingly low dropout rate and a majority of patients have continued in treatment. BMI measurements show a significant weight-gain for those being underweight at start. Other therapists have been trained in the model, and similar services set up elsewhere. In order to document and increase the usefulness of the MFT treatment, a research project has been initiated to evaluate experience and outcomes both quantitatively and qualitatively.

Dreams of Prosperity – Enactments of Growth

An old tractor serves as an ethnographic entry point to shifting articulations of resources in coastal Finnmark, North Norway. Idle since the 1970s, the tractor is a relic of agricultural dreams, turned to rubble as novel layers of the Varanger landscape are conjured as resourceful. Farming in Finnmark was a geopolitical strategy to secure national borders and to expand a post-war welfare state, it was also a colonial effort to cultivate farmers in the far north. This article details the back-breaking practices required to make thin Arctic topsoil collaborate in realizing modernist dreams of agricultural growth, while state interventions sought to ensure national borders and national identity. The author highlights dialectic relations between mapping and forgetting, crucial in the making of resources and colonizing practices.

Stockfish Production, Cultural and Culinary Values

The article depicts the traditional fishing, the outdoor drying of Stockfish, and its cultural and culinary uses in a historic context and today. The fishing of the North East Arctic cod (Gadus morhua) is a sustainable coastal fishery for millennia in the North of Norway, but climate change challenges the outdoor drying of stockfish. The article follows the stockfish history during the hanseatic office in Bergen until the present trade. The early commercial production of stockfish was due to urban expansion, fasting rules and the need to provide nutritious food to the poor in Northern Europe and beyond. The article follows the traces of stockfish expansion as a staple food, first to Northern Europe, later to central Europe and the Mediterranean countries, before ending up as an important food supply to West-African countries in the nineteenth century. The article explains the early Greek and Renaissance concerns for eating fish and for stockfish in particular due to dietetic and medical beliefs. Then the cultural impact of stockfish is explained by showing some examples of both living and disappearing culinary traditions. The use of lye for soaking stockfish is not only a Scandinavian tradition but a little known shared European craft and culinary practice. Battering the stockfish with a wooden hammer, the use of lye for durability and water for softening the hard fish texture was practiced for preparing stockfish. Finally, the article touches upon rules, regulations and organisations that can help strengthening and preserve the traditional craft and culinary uses of stockfish today.

Readmissions to a cardiology department.

Patient readmissions may be an indication of inappropriate patient care pathways or quality failure. The aim of the study was to determine whether we could identify improvement areas by reviewing 50 non-planned readmissions. We reviewed 50 consecutive non-planned readmissions in the Department of Cardiology at the University Hospital of North Norway. The medical records were reviewed based on a simplified version of the '50most recent deaths' methodology. Altogether 29patients had at least one extrinsic risk factor for readmission, the most frequent of which were lack of post-discharge follow-up and failure to transfer information to the municipal health service. Insufficient registration and follow-up of abnormal blood test results, new symptoms immediately before discharge, and missing information in discharge summaries and for patients were other risk factors for readmission. Review of readmissions can serve as an instrument to identify areas for improvement of treatment quality in hospitals. Failure in communication between the hospital, municipal health service and patient was the main contributory factor for readmissions.

Bruk av videosamtale i behandling av tuberkulose-sykdom i Nord-Norge

In 2017, a total of 261patients with tuberculosis were reported in Norway, whereof 90% completed their therapy. Anti-tuberculosis drugs are administered as daily directly observed treatment (DOT) to all patients. We investigated whether this could be done by video conference. We conducted a clinical observation study at the University Hospital of North Norway in the period 2016-2019, in which patients ≥ 16 years with tuberculosis after a minimum of two weeks of daily DOT during home visits continued their treatment through video conference (video DOT). The password-protected and encrypted video conference service provided by Norwegian Healthnet was used. The home care service contacted the patient by video conference in real time and observed the intake of drugs via a tablet computer, smartphone or PC. 20 out of 30patients met the inclusion criteria, whereof 17patients (15 foreign-born) with a median age of 32 (17-74) were included. The average observed drug intake per patient was 86.1% in the period with home-based DOT and 75.9% in the period with video DOT. The median daily time spent by the home care service was 17 (2-40) minutes for home visits and 3 (1-8) minutes for video conferences. Fourteen out of 17patients and 14 out of 17 home nurses preferred video conferencing over home visits. Fifteen patients and all home care nurses would recommend video conferencing to others. Technical problems (8.9%) were the most common reason for directly observed treatment not being undertaken during the period with video conferencing. Video DOT was feasible for the selected patients. Video conferencing was time-efficient for the home care service and was preferable to home visits.

Is there a seasonal variation of survival after systemic chemotherapy for metastatic castration-resistant prostate cancer in a rural part of North Norway?

ABSTRACT The winter darkness or polar night induces endocrine and metabolic mechanisms, which might reduce the efficacy of cancer treatment and thus contribute to shorter survival. Moreover, season-and weather-related treatment delays and irregularities might also cause reduced efficacy of anti-cancer drugs. Therefore, this study evaluated the prognostic impact of timing of chemotherapy (start during winter darkness or outside of this season), in terms of overall survival, in patients with metastatic castration-resistant prostate cancer (MCRPC) who received oncology care at the Nordland hospital Bodø. The study included 111 patients treated with first-line docetaxel chemotherapy for MCRPC. Twenty patients (18%) started their treatment during winter darkness (arbitrarily defined as ±4 weeks around 21 December). In unadjusted univariate analysis, survival was shorter in this group (median 10.2 vs. 18.9 months, p = 0.055). However, not all baseline parameters were equally distributed between the two groups. In multivariable-adjusted Cox regression analysis accounting for several confounding variables, only one factor was statistically significant: pre-chemotherapy serum lactate dehydrogenase level (a surrogate marker of disease burden). Thus, the present results suggest that seasonal variation is not a major contributor to the diverging survival outcomes observed after docetaxel chemotherapy.

Opioid consumption in two surgical hospital wards.

The purpose of the study was to document the consumption of opioids in two surgical departments at the University Hospital of North Norway, Tromsø, in the period 2010-17. The consumption of opioids in the department of gastrointestinal surgery and the department of cardiovascular and thoracic surgery was obtained from Nord hospital pharmacy. All opioids were converted to oral morphine equivalents. The consumption of morphine in the department of gastrointestinal surgery was reduced from 223 835 oral morphine equivalents per year in the period 2010-13, to 147 641 in the period 2014-17. In the department of cardiovascular and thoracic surgery, the yearly consumption of morphine was reduced from 28 652 oral morphine equivalents in the period 2010-13, to 22 945 in the period 2014-17. The consumption of oxycodone in the department of gastrointestinal surgery increased from 210 643 oral morphine equivalents per year in the period 2010-13, to 376 322 in the period 2014-17. In the department of cardiovascular and thoracic surgery, the consumption of oxycodone increased from 28 922 oral morphine equivalents per year in the period 2010-13, to 123 875 in the period 2014-17. In the department of gastrointestinal surgery, the increase was most evident for oxycodone administered intravenously or subcutaneously. In the department of cardiovascular and thoracic surgery, the largest increase was for oxycodone administered orally. The consumption of opioids increased in both departments studied, and oxycodone constituted the largest part of the increase.