Wheat challenge in self-reported gluten sensitivity: a comparison of scoring methods

<p><b>Background:</b> The condition non-coeliac gluten sensitivity (NCGS) is clinically similar to coeliac disease, but lack objective diagnostic criteria. Symptom relief on gluten-free diet followed by gluten containing food challenge may confirm the condition in clinical settings.</p> <p><b>Aim:</b> To describe the results of an open bread challenge in patients with suspected NCGS, and to compare the results with recently suggested cut-offs for symptom change.</p> <p><b>Material and methods:</b> Fifty-six patients (12 males) self-instituted on gluten-free diet with negative coeliac disease diagnostics were examined for NCGS by an open bread challenge. Symptoms were reported by Gastrointestinal Symptom Rating Scale, IBS-version (GSRS-IBS) and visual analogue scale (VAS). Results were retrospectively compared to the Salerno and Monash cut-offs for symptom change.</p> <p><b>Results:</b> Forty-seven patients were diagnosed with NCGS. Total GSRS-IBS score and overall symptoms by VAS increased significantly in NCGS (<i>p</i> < .001), but not in non-NCGS patients (<i>p</i> < .12 and <i>p</i> = .08, respectively). Total GSRS-IBS challenge score and overall symptoms by VAS were significantly higher in NCGS than in non-NCGS patients (53 vs. 37, <i>p</i> = .004 and 76 vs. 39 mm, <i>p</i> = .02, respectively). Applying the Salerno and Monash cut-offs, 63 and 75% would be classified with NCGS, respectively. According to total GSRS–IBS absolute agreement was lowest between clinician’s diagnosis and Salerno cut-off (63%) and highest between Salerno and Monash cut-offs (88%).</p> <p><b>Conclusion:</b> Clinician diagnosed 85% with NCGS. The proportion of NCGS was lower according to the Salerno and Monash cut-offs. The Salerno cut-off should be the starting point for a common definition of symptom change.</p

Arctic state, Arctic nation? Arctic national identity among the post-Cold War generation in Norway

\ua9 2014,Taylor &amp; Francis. In Norway, the Arctic has taken centre stage as a primary political priority. Claiming status as an ‘Arctic state’ may not be controversial based on formal geographical and legal definitions; however, the way in which the Arctic has thus been incorporated in the public\u27s sense of Norwegian national identity is less clear. Against the background of the Norwegian government\u27s discursive construction of a national Arctic identity in its High North strategy, this study assesses the reception this official identity has received. Over 200 young Norwegians, having largely grown up in a post-Cold War world marked by rapidly changing Arctic climate and geopolitics, were asked about their sense of Arctic identity. Contrary to governmental efforts to frame the Arctic as a fundamentally national matter, the respondents\u27 insights highlight the multifaceted nature of identities, as a sense of Arctic identity contextually shifts between sub-national, national and supranational scales. This study thus suggests a balancing act faced by states across the region as they seek to legitimize state-level primacy and national unity in the circumpolar North