Is relatively young age within a school year a risk factor for mental health problems and poor school performance? A population-based cross-sectional study of adolescents in Oslo, Norway

BACKGROUND: Several studies have shown that children who are relatively young within a school year are at greater risk for poorer school performance compared with their older peers. One study also reported that relative age within a school year is an independent risk factor for emotional and behavioral problems. The objective of this study was to test the hypothesis that relatively younger adolescents in the multiethnic population of Oslo have poorer school performance and more mental health problems than their relatively older classmates within the same school year. METHODS: This population-based cross-sectional study included all 10(th)-grade pupils enrolled in 2000 and 2001 in the city of Oslo. The participation rate was 88%. Of the 6,752 pupils in the study sample, 25% had a non-Norwegian background. Mental health problems were quantified using the abbreviated versions of Symptom Check List-25 (SCL-10) and the Strength and Difficulties Questionnaire (SDQ). Information on school performances and mental health problems were self-reported. We controlled for confounding factors including parental educational level, social support, gender, and ethnicity. RESULTS: The youngest one-third of pupils had significantly lower average school grades than the middle one-third and oldest one-third of their classmates (p < 0.001). Of the mental health problems identified in the questionnaires, the groups differed only on peer problems; the youngest one-third reported significantly more problems than the middle and oldest groups (p < 0.05). Age within a school year and gender showed significant interactions with total SDQ score, SDQ peer problems score, SDQ pro social score, and SCL-10 score. After stratifying for gender, the peer problem scores differed significantly between age groups only among boys. The SCL-10 score was significant, but only in girls and in the opposite direction to that expected, with the oldest pupils having significantly higher scores than the other two groups (p < 0.05). CONCLUSION: In adolescents from a multicultural city in Norway, relative age within a school year significantly influenced academic performance. In contrast to data from Great Britain, relative age within a school year was not an important risk factor for mental health problems in adolescents in Oslo

Will emergency and surgical patients participate in and complete alcohol interventions? A systematic review

<p>Abstract</p> <p>Background</p> <p>In the everyday surgical life, staff may experience that patients with Alcohol Use Disorders (AUDs) seem reluctant to participate in alcohol intervention programs. The objective was therefore to assess acceptance of screening and intervention as well as adherence to the intervention program among emergency department (ED) and surgical patients with AUDs.</p> <p>Methods</p> <p>A systematic literature search was followed by extraction of acceptance and adherence rates in ED and surgical patients. Numbers needed to screen (NNS) were calculated. Subgroup analyses were carried out based on different study characteristics.</p> <p>Results</p> <p>The literature search revealed 33 relevant studies. Of these, 31 were randomized trials, 28 were conducted in EDs and 31 evaluated the effect of brief alcohol intervention. Follow-up was mainly conducted after six and/or twelve months.</p> <p>Four in five ED patients accepted alcohol screening and two in three accepted participation in intervention. In surgical patients, two in three accepted screening and the intervention acceptance rate was almost 100%. The adherence rate was above 60% for up to twelve months in both ED and surgical patients. The NNS to identify one eligible AUD patient and to get one eligible patient to accept participation in alcohol intervention varied from a few up to 70 patients.</p> <p>The rates did not differ between randomized and non-randomized trials, brief and intensive interventions or validated and self-reported alcohol consumption. Adherence rates were not affected by patients' group allocation and type of follow-up.</p> <p>Conclusions</p> <p>Most emergency and surgical patients with AUD accept participation in alcohol screening and interventions and complete the intervention program.</p

Velferdsindikatorer for oppdrettslaks: Hvordan vurdere og dokumentere fiskevelferd - Del A. fiskevelferd og oppdrettslaks, kunnskap og teoretisk bakgrunn

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An Extended Model and a New Matheuristic for the Offshore Helicopter Routing Problem with Split Deliveries

Olje- og gassindustrien er den største industrien i Norge, og det er forventet at den forblir viktig i flere tiår fremover. Utvinningen av petroleum foregår på den norske kontinentalsokkelen, og offshore-installasjoner er sentrale for produksjonen. I denne masteroppgaven blir transport av personell til og fra disse installasjonene ved hjelp av helikopter studert. Forespørsler om transport av personell er samlet i ordrer, som er definert som personell som skal til eller fra samme installasjon på samme tidspunkt. En heterogen flåte med helikoptre stasjonert ved flere heliporter brukes til transporten. Sekvensen av heliporter og installasjoner som besøkes av et helikopter i løpet av en dag kalles for en flyvesekvens. Hvert helikopter kan benytte flere heliporter, men må starte og slutte sin flyvesekvens på den samme heliporten. Hvilke heliporter som brukes til å hente/levere ordre er valgfritt. Når installasjonene i en flyvesekvens byttes ut med ordrene som håndteres på hver installasjon, får vi det som kalles en rute. En ordre kan splittes mellom flere helikoptre. Målet er å minimere de totale kostnadene av å leie og bruke helikoptrene, samtidig som alle ordre fullføres og alle reguleringer og restriksjoner overholdes. En litteraturstudie for det generelle pickup and delivery-problemet og offshore helikoptertransport blir presentert, med fokus på relevante utvidelser og heuristiske løsningsmetoder. Det å tillate at helikoptre benytter flere heliporter og gjøre det valgfritt hvilke heliporter som skal brukes til å hente/levere hver ordre, er nye utvidelser som ikke er funnet i litteraturen. En komplett matematisk beskrivelse av problemet er gitt av en arc-flow-modell. I tillegg er en ny matheuristikk foreslått som en løsningsmetode for problemet. En dekomponeringsmetode er brukt for matheuristikken, og problemet er dekomponert i tre deler. I den første endres flyvesekvensene fra den nåværende løsningen, og i den andre blir en labeling-algoritme brukt til å generere ruter fra de endrede flyvesekvensene. Til slutt løses et blandet heltallsproblem for å finne den beste kombinasjonen av ruter og passasjerer. Disse tre delene utgjør en iterasjon, og matheuristikken utfører så mange iterasjoner som mulig før termineringskriteriet er nådd. Arc-flow-modellen er kun i stand til å finne optimal løsning for instanser med opptil åtte ordre inkludert, og matheuristikken løser nesten alle de samme instansene til optimalitet. Tester viser at matheuristikken konsekvent finner tilnærmet de samme løsningene for hver kjøring av instanser med opptil 40 ordre. Inkludering av de nye utvidelsene reduserer gjennomsnittlig objektivverdi med omtrent 9 % og det totale antallet helikoptre som trengs med 0,70. Splitting av ordre viser seg derimot å ha liten innvirkning på objektivverdien. Basert på resultatene virker det som de nye utvidelsene kan være nyttige tilskudd ved planlegging av offshore helikoptertransport

Preoperative alcohol cessation prior to elective surgery

Background Hazardous drinking has been associated with an increased postoperative complication rate after surgery. Common complications include postoperative infections, cardiopulmonary complications, and bleeding episodes. Preoperative abstinence may to some degree reverse alcohol-induced pathophysiological processes and thus prevent postoperative complications. Objectives To assess the effect of preoperative alcohol cessation interventions on the rate of postoperative complications including mortality in hazardous drinkers. To assess the effect of preoperative alcohol cessation interventions for hazardous drinkers on alcohol use in the postoperative period and in the long term. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 9); Ovid MEDLINE (1966 to September 2011); Ovid EMBASE (1966 to September 2011); CINAHL via EBSCOhost (1982 to September 2011). We combined the MEDLINE search strategy with the Cochrane highly sensitive search strategy, as contained in the Cochrane Handbook for Systematic Reviews of Interventions, to identify randomized controlled trials (RCTs). Selection criteria We included all randomized controlled trials (RCTs) that evaluated the effects of a preoperative alcohol cessation intervention on postoperative complications or postoperative alcohol consumption, or both, in the short and long term in hazardous drinkers. We excluded intraoperative and postoperative alcohol interventions. Data collection and analysis Three authors independently assessed studies to determine eligibility and extracted data using a tool based on guidance in the Cochrane Handbook for Systematic Reviews of Interventions. Where required, we obtained additional information through collaboration with the original author. We presented the main outcomes as dichotomous variables. Where data were available, we planned to conduct subgroup analyses as well as a sensitivity analysis to explore risk of bias. Main results We included two studies which involved 69 patients. Both studies were RCTs evaluating the effect of intensive alcohol cessation interventions including pharmacological strategies for alcohol withdrawal and relapse prophylaxis. Our primary outcome measure was postoperative complications and in-hospital and 30-day mortality. Meta-analysis showed an effect on the overall complication rates (odds ratio (OR) 0.22; 95% confidence interval (CI) 0.08 to 0.61; P = 0.004). There was no significant reduction of in-hospital and 30-day mortality (OR 0.39; 95% CI 0.06 to 2.83; P = 0.35). Secondary outcomes included length of stay and postoperative alcohol use. No significant reduction was found. Authors' conclusions Based on the finding of two studies, it appears that intensive preoperative alcohol cessation interventions, including pharmacological strategies for relapse prophylaxis and withdrawal symptoms, may significantly reduce postoperative complication rates. No effect was found on mortality rates and length of stay. The effect of preoperative alcohol cessation intervention should be further explored in an effort to reduce the adverse effect of alcohol use on surgical outcomes. The number needed to screen to identify eligible patients for alcohol intervention studies in surgical settings seems to be extremely high. This may indicate that these studies are difficult to perform. Nevertheless, timing, duration and intensity of alcohol cessation interventions need to be subject to further investigation

Hazardous drinkers in Norwegian hospitals - a cross-sectional study of prevalence and drinking patterns among somatic patients

Background: High alcohol intake has been associated with increased risk of hospital admission, increased complication rates, and prolonged hospital stay. Thus, hospital admission may present a relevant opportunity for alcohol intervention. To understand the potential of alcohol interventions we need knowledge about patients’ drinking patterns. The aim of this study was therefore to determine the drinking patterns in a Norwegian hospital population.Methods: A multicentre cross-sectional survey was carried out at three university hospitals. Patients were asked about alcohol intake one month prior to admission/outpatient treatment. The questionnaire included weekly alcohol intake calculated by frequency X quantity as well as episodes of binge drinking (drinking more than 5 AU during a single day). AUDIT-C was used to determine the frequency of patients having a hazardous drinking pattern during the 12 months prior to hospital treatment.Results: In total we assessed 2,932 patients for eligibility. A total of 2,350 patients fulfilled the inclusion criteria. We included 1,522 patients (65%) in the analyses. Six percent of the women and 11% of the men reported drinking more than the weekly limits of nine alcohol units (AU) for women and 14 AU for men. Fourteen percent of the women and 29% of the men reported binge drinking during the last month. The frequency of women scoring more or equal to 4 points on AUDIT-C was 20%. The frequency of men scoring more or equal to 5 points was 25%.Conclusion: Hazardous drinking among Norwegian hospital patients may be more prevalent than what has been reported for the Norwegian population in general. Binge drinking is the dominant drinking pattern

Hazardous drinkers in Norwegian hospitals - a cross-sectional study of prevalence and drinking patterns among somatic patients

Background: High alcohol intake has been associated with increased risk of hospital admission, increased complication rates, and prolonged hospital stay. Thus, hospital admission may present a relevant opportunity for alcohol intervention. To understand the potential of alcohol interventions we need knowledge about patients’ drinking patterns. The aim of this study was therefore to determine the drinking patterns in a Norwegian hospital population.Methods: A multicentre cross-sectional survey was carried out at three university hospitals. Patients were asked about alcohol intake one month prior to admission/outpatient treatment. The questionnaire included weekly alcohol intake calculated by frequency X quantity as well as episodes of binge drinking (drinking more than 5 AU during a single day). AUDIT-C was used to determine the frequency of patients having a hazardous drinking pattern during the 12 months prior to hospital treatment.Results: In total we assessed 2,932 patients for eligibility. A total of 2,350 patients fulfilled the inclusion criteria. We included 1,522 patients (65%) in the analyses. Six percent of the women and 11% of the men reported drinking more than the weekly limits of nine alcohol units (AU) for women and 14 AU for men. Fourteen percent of the women and 29% of the men reported binge drinking during the last month. The frequency of women scoring more or equal to 4 points on AUDIT-C was 20%. The frequency of men scoring more or equal to 5 points was 25%.Conclusion: Hazardous drinking among Norwegian hospital patients may be more prevalent than what has been reported for the Norwegian population in general. Binge drinking is the dominant drinking pattern

Patient education for alcohol cessation intervention at the time of acute fracture surgery:study protocol for a randomised clinical multi-centre trial on a gold standard programme (Scand-Ankle)

Patients with hazardous alcohol intake are overrepresented in emergency departments and surgical wards. These patients have an increased risk of postoperative complications with prolonged hospital stays and admissions to intensive care unit after surgery. In elective surgery, preoperative alcohol cessation interventions can reduce postoperative complications, but no studies have investigated the effect of alcohol cessation intervention at the time of acute fracture surgery. This protocol describes a randomised clinical trial that aims to evaluate the effect of a new gold standard programme for alcohol cessation intervention in the perioperative period regarding postoperative complications, alcohol intake and cost-effectiveness

Health and the need for health promotion in hospital patients

BACKGROUND: Integrated health promotion improves clinical outcomes after hospital treatment. The first step towards implementing evidence-based health promotion in hospitals is to estimate the need for health promoting activities directed at hospital patients. The aim of this study was to identify the distribution and association of individual health risk factors in a Norwegian hospital population and to estimate the need for health promotion in this population. METHODS: We used a validated documentation model (HPH-DATA Model) to identify the prevalence of patients with nutritional risk (measurements of waist and weight), self-reported physical inactivity, daily smoking and hazardous drinking. We used logistic regression to describe the associations between health risk factors and demographic characteristics. RESULTS: Out of 10 included patients, 9 (N = 1522) had one or more health risk factors. In total 68% (N = 1026) were overweight, 44% (N = 660) at risk of under-nutrition, 38% (N = 574) physically inactive, 19% (N = 293) were daily smokers and 4% (N = 54) hazardous drinkers. We identified a new clinical relevant association between under-nutrition and smoking. The association between hazardous drinking and smoking was sustained. CONCLUSION: Nearly all patients included in this study had one or more health risk factors that could aggravate clinical outcomes. There is a significant need, and potential, for health-promoting interventions. Multi-factorial interventions may be frequently indicated and should be the subject of interventional studies