Factors affecting older adults' hearing-aid use

Hearing impairment is one of the most common disabilities among Western populations and represents a considerable communication disorder. Increasing human longevity is expected to raise the number of elderly people suffering from hearing loss. A major challenge of audiological rehabilitation has been to encourage those who have fitted hearing aids to use them. The aim of the present study was to describe hearing-aid use among older adults and to identify motivational factors associated with hearing-aid use. A 17-item questionnaire was developed. Ninety participants (=65 years of age) were recruited from a waiting list for hearing-aid refitting. Twenty-two percent had used their previously fitted hearing aids for less than one hour per day. A factor analysis revealed four factors related to hearing-aid use (Cronbach's alpha): ‘accepted need’–defined as the acknowledgement of a need for hearing aids (0.869); ‘follow-up support’–defined as organized check-ups and accessibility to professionals (0.900); ‘social assessment’ (0.552); and ‘consciousness’ (0.505). The first two factors explained 25% and 24% of the variance, respectively. Logistic regression revealed that the use of hearing aids was significantly associated with ‘accepted need’ and ‘follow-up support’, suggesting that these factors are important and should be emphasized in rehabilitation programmes

Migraine and sleep apnea in the general population

Objective is to investigate the relationship between migraine and obstructive sleep apnea in the general population. A cross-sectional population-based study. A random age and gender stratified sample of 40,000 persons aged 20–80 years residing in Akershus, Hedmark or Oppland County, Norway, were drawn by the National Population Register. A postal questionnaire containing the Berlin Questionnaire was used to classify respondents to be of either high or low risk of obstructive sleep apnea. 376 persons with high risk and 157 persons with low risk of sleep apnea aged 30–65 years were included for further investigations. They underwent an extensive clinical interview, a physical and a neurological examination by physicians, and in-hospital polysomnography. Those with apnea hypopnoea index (AHI) ≥5 were classified with obstructive sleep apnea. Migraine without aura (MO) and migraine with aura (MA) was diagnosed according to the International Classification of Headache Disorders. MO and MA occurred in 12.5 and 6.8% of the participants with obstructive sleep apnea. The logistic regression analyses showed no relationship between the two types of migraine and obstructive sleep apnea, with adjusted odds ratios for MO 1.15 (0.65–2.06) and MA 1.15 (0.95–2.39). Further, estimates using cutoff of moderate (AHI ≥ 15) and severe (AHI ≥ 30) obstructive sleep apnea, did not reveal any significant relationship between migraine and the AHI. Migraine and obstructive sleep apnea are unrelated in the general population

Tension-type headache and sleep apnea in the general population

The main objective of this study is to investigate the relationship between tension-type headache and obstructive sleep apnea in the general population. The method involves a cross-sectional population-based study. A random age and gender stratified sample of 40,000 persons aged 20–80 years residing in Akershus, Hedmark or Oppland County, Norway were drawn by the National Population Register. A postal questionnaire containing the Berlin Questionnaire was used to classify respondents to be of either high or low risk of obstructive sleep apnea. Included in this study were 297 persons with high risk and 134 persons with low risk of sleep apnea, aged 30–65 years. They underwent an extensive clinical interview, a physical and a neurological examination by physicians, and in-hospital polysomnography. Those with apnea hypopnoea index (AHI) ≥5 were classified with obstructive sleep apnea. Tension-type headache was diagnosed according to the International Classification of Headache Disorders. Results showed the prevalence of frequent and chronic tension-type headache was 18.7 and 2.1% in the participants with obstructive sleep apnea. The logistic regression analyses showed no significant relationship between tension-type headache and obstructive sleep apnea, with adjusted odds ratios for frequent tension-type headache of 0.95 (0.55–1.62) and chronic tension-type headache of 1.91 (0.37–9.85). The results did not change when using cut-off of moderate (AHI ≥15) and severe (AHI ≥30) obstructive sleep apnea. Thus, we did not find any significant relationship between tension-type headache and the AHI. The presence and severity of sleep apneas seem not to influence presence and attack-frequency of tension-type headache in the general population

Sykehusreformen : tankevekkende tilpasning av ØNH-kirurgi 1999-2002

Bakgrunn: Hovedmålet med innføring av stykkprisfinansiering i 1997 var å stimulere til økt aktivitet, reduserte ventetider og bedre utnyttelse av ressursene. Med utgangspunkt i rater for øre-nese-halsprosedyrer har vi beskrevet aktiviteten innenfor et klinisk fagområde ØNH-faget etter innføringen av DRG. Spesielt ønsket vi å identifisere pasientgrupper som ikke har hatt ønsket behandlingsvekst. Materiale og metode: Nasjonale aktivitetstall på øre-nese-hals prosedyrer utført på innlagte eller polikliniske pasienter i perioden 1999-2002 ble analysert og andelen pasienter med søvnapne og snorking som fikk ganeplastikk estimert. Resultater: I perioden 1999 til 2002 var det en aktivitetsøkning innenfor registrerte ØNH-prosedyrer 6 %. Spredningen varierte fra 110 % økning i ganeplastikk rater til 12 % reduksjon av tonsillktomier. Aktivitetsøkningen var størst for inngrep som ikke krevde full narkose og prosedyrer som ikke krevde kirurgisk spesialkompetanse. Selv om økningen i antall ganeplastikker var stor, ble indikasjon for kirurgi funnet i like stor andel pasienter med diagnosen søvnapne/snorking som tidligere. Fortolkning: Det store aktivitetsøkningen innenfor enkelt prosedyrer kan ha ulike forklaringer; forbedret behandlingsteknologi, oppdemmet behov for behandling innenfor et område som tidligere har hatt utilfredsstillende tilbu

A cross-sectional population-based survey of migraine and headache in 21,177 Norwegians: the Akershus sleep apnea project

The objective was to investigate the prevalence and interrelation of migraine and headache in the general population. Forty thousand men and women aged 20–80 years from the Norwegian general population received a mailed questionnaire with questions about migraine and headache. The questionnaire response rate was 54.5%. The lifetime prevalence of migraine was 26.5% (95% CI 25.9–27.1%), i.e., 18.1% (95% CI 17.3–18.9%) in men and 34.1% (95% CI 33.2–35.0%) in women. The prevalence of migraine decreased slightly in both men and women after an age of 45. The 1 year prevalence of headache was 77.2%, i.e., 69.6% (95% CI 68.7–70.6%) in men and 84.0% (95% CI 83.3–84.7%) in women. The frequency of headache decreased with age, but some of the elders aged 70 or above experienced more frequent headache. The prevalence of being headache free increased from 19.1% (95% CI 14.2–25.6%) to 74.7% (95% CI 70.0–78.8%) in 20 and 80 years old men without co-occurrence of migraine, and from 5.1% (95% CI 2.9–8.8%) to 61.4% (95% CI 54.9–67.6%) in 20 and 80 years old women without co-occurrence of migraine. Co-occurrence of migraine significantly increased the frequency of headache and decreased the prevalence of being headache free. Published Open Access with SpringerOpe

Relationship between Maternal and First Year of Life Dispensations of Antibiotics and Antiasthmatics

Antibiotics are the most frequent prescription drugs used by pregnant women. Our objective was to investigate if the dispensation of antibiotics and antiasthmatics in children less than 1 year of age is associated with prenatal antibiotic exposure. A secondary aim was to explore the incidence of dispensed antibiotics in pregnancy and dispensed antibiotics and antiasthmatics in children. We conducted an observational study using the Peer Academic Detailing study database to select patients eligible for match in the Medical Birth Registry of Norway, a total of 7747 mother-and-child pairs. Details on antibiotic and antiasthmatic pharmacy dispensations were obtained from the Norwegian Prescription Database. One quarter (1948 of 7747) of the mothers in the study had been dispensed antibiotics during pregnancy. In their first year of life, 17% (1289) of the children had had an antibiotic dispensation, 23% (1747) an antiasthmatic dispensation, and 8% (619) of the children had had both. We found a significant association between dispensed antibiotics in pregnancy and dispensed antibiotics to the child during their first year of life; OR = 1.16 (95% CI: 1.002–1.351). The association was stronger when the mothers were dispensed antibiotics at all, independent of the pregnancy period; OR = 1.60 (95% CI: 1.32–1.94). We conclude that the probability for dispensation of antibiotics was increased in children when mothers were dispensed antibiotics, independent of pregnancy. Diagnostic challenges in the very young and parental doctor-seeking behavior may, at least in part, contribute to the association between dispensations in mothers and children below the age of one year