Sociodemographic factors, health indicators and lifestyle factors among participants in BreastScreen Norway 2006-2016 – a cohort profile

Purpose: To collect information on sociodemographic factors, health indicators, and lifestyle factors in women who attended the nationwide breast cancer-screening program, BreastScreen Norway, with the aim of investigating how these factors influence the risk of breast cancer, other cancer types, and cancer-related outcomes. Participants: The cohort data includes self-reported responses to questionnaires from 554,149 women aged 50- 69 years, who attended BreastScreen Norway during the data collection period, 2006-2016. Findings to date: Information about sociodemographic factors, health indicators, and lifestyle factors was collected for the current time and retrospectively back to birth. For the cohort, we have complete mammographic screening data, including information about 24,000 breast cancer cases and other cancer types from the Cancer Registry of Norway. These outcomes are aggregating continuously. Data from the cohort have been utilized in studies related to breast cancer and menopausal status. Future projects: Data will be utilized in studies related to tumour growth and risk of breast cancer as well as other cancer types, in addition to overall and cancer-specific death. Registration: The cohort profile is not registered in Clinical Trials

Personalized Breast Cancer Screening: A Risk Prediction Model Based on Women Attending BreastScreen Norway

Background: We aimed to develop and validate a model predicting breast cancer risk for women targeted by breast cancer screening. Method: This retrospective cohort study included 57,411 women screened at least once in BreastScreen Norway during the period from 2007 to 2019. The prediction model included information about age, mammographic density, family history of breast cancer, body mass index, age at menarche, alcohol consumption, exercise, pregnancy, hormone replacement therapy, and benign breast disease. We calculated a 4-year absolute breast cancer risk estimates for women and in risk groups by quartiles. The Bootstrap resampling method was used for internal validation of the model (E/O ratio). The area under the curve (AUC) was estimated with a 95% confidence interval (CI). Results: The 4-year predicted risk of breast cancer ranged from 0.22–7.33%, while 95% of the population had a risk of 0.55–2.31%. The thresholds for the quartiles of the risk groups, with 25% of the population in each group, were 0.82%, 1.10%, and 1.47%. Overall, the model slightly overestimated the risk with an E/O ratio of 1.10 (95% CI: 1.09–1.11) and the AUC was 62.6% (95% CI: 60.5–65.0%). Conclusions: This 4-year risk prediction model showed differences in the risk of breast cancer, supporting personalized screening for breast cancer in women aged 50–69 years

Lærerrollen og elevens motivasjon: Hva sier forskning om betydningen av elevens opplevelse av lærerstøtte for deres motivasjon?

Formålet med denne oppgaven var å undersøke om det var noen sammenheng mellom elevers opplevelse av lærerens støtte, både faglig og emosjonelt, og elevenes motivasjon. Hvilken betydning læreren har for elevenes motivasjon, var et spørsmål jeg ble nysgjerrig på å finne ut av. Et mål med oppgaven vil være å bidra til økt kunnskap om hvordan vi som lærere kan bidra til å øke elevenes motivasjon. Med bakgrunn i dette ble følgende problemstilling utformet: «Hva sier forskning om betydningen av elevens opplevelse av lærerstøtte, for deres motivasjon? For å belyse problemstillingen har jeg har benyttet meg av et litteraturstudie. Ved å bruke litteraturstudie som metode benytter jeg meg av allerede eksisterende forskning og teori, blant annet selvbestemmelsesteorien. Forskningsresultatene som blir presentert i denne oppgaven viser positiv sammenheng mellom opplevd lærerstøtte og elevenes motivasjon. Det blir også gjort funn som blir viser flere indikatorer på økt elev motivasjon og engasjement, når behovene for kompetanse, tilhørighet og selvbestemmelse blir dekt

Overensstemmelse mellom selvrapportert og objektivt målt fysisk form blant pakistanske innvandrerkvinner i Oslo

Sammendrag Bakgrunn: Metabolsk syndrom (MetS) og livsstilssykdommer som type 2 diabetes (T2D) og hjerte-karsykdommer (HKS) er viktige folkehelseutfordringer i Norge og i verden generelt, og innvandrere fra Sør-Asia har særlig høy risiko. Fysisk aktivitet og god fysisk form kan redusere risikoen for disse sykdommene, men sørasiatiske innvandrere i Norge er antatt å være mindre fysisk aktive og i dårligere fysisk form enn etniske nordmenn. Kartlegging av fysisk form blir ofte gjort med spørreskjema, men samsvar mellom selvrapportering via spørreskjema, og objektive målinger av fysisk form blant pakistanske innvandrerkvinner i Norge, er ikke evaluert. Når det skal iverksettes helsefremmende og sykdomsforebyggende tiltak er det viktig å nå ut til den ønskede målgruppen, og for å velge et egnet måleinstrument er det viktig å vurdere samsvar mellom ulike målemetoder for fysisk form. Hensikt: Hensikten med studien var å vurdere samsvar mellom selvrapportering og objektive målinger av fysisk form i en gruppe pakistanske innvandrerkvinner i Oslo, Norge, samt å undersøke hvilke sosiodemografiske og helserelaterte variabler som var korrelert med god fysisk form. Metode: Tverrsnittstudien kartla 198 pakistanske kvinner i alderen 25 – 65 år, bosatt i bydel Søndre Nordstrand i Oslo. Deltagerne besvarte spørreskjemaer som dekket sosiodemografiske og helserelaterte variabler. Det ble tatt antropometriske mål og samlet inn bloddata. Deltagerne rapporterte sin fysiske form på en 5 punkts skala. Fysisk form ble også målt objektivt med hjertefrekvens og Borgs skala på en tredemølletest. Samsvar mellom selvrapportert og objektivt målt fysisk form ble testet med Kappa-statistikk og korrelasjonstester (Pearson og Spearman), og sammenhengen mellom fysisk form og sosiodemografiske og helserelaterte variabler ble testet med Spearman-korrelasjon. ANOVA og Kruskal-Wallis-test ble benyttet for å sammenligne ulike grupper. Resultater: Det var ikke samsvar mellom selvrapportert og objektivt målt fysisk form. Kun 50 (25.3 %) av de 198 deltagerne var i stand til å gjennomføre tredemølletesten. Det var negativ korrelasjon mellom selvrapportert fysisk form og BMI, livvidde, systolisk- og diastolisk blodtrykk, risiko for T2D, subjektive helseplager og psykisk helse. I tillegg var det en positiv korrelasjon mellom selvrapportert fysisk form og antall timer fysisk aktivitet i uka, antall år på skole/studier og holdninger til fysisk aktivitet. For objektivt målt fysisk form ble det ikke funnet noen korrelasjon med sosiodemografiske og helserelaterte variabler. Den gruppen med deltagere som både rapporterte at de var i god form og som var i god form målt på tredemølle, skilte seg ut i positiv retning med lavest BMI, nest lavest risiko for T2D, best psykisk helse og nest lavest forekomst av subjektive helseplager. Konklusjon: Denne studien viste ikke samsvar mellom selvrapportert og objektivt målt fysisk form for pakistanske innvandrerkvinner. Det var selvrapportert form som korrelerte med sosiodemografiske og helserelaterte variabler. Selvrapportert fysisk form kan være egnet til å fange opp de som har dårlig helsestatus, men er ikke egnet til å kartlegge den objektive fysiske formen til pakistanske innvandrerkvinner. Det er behov for å gjøre flere og større studier som eventuelt kan bekrefte eller avkrefte disse funnene. Abstract Background: Metabolic Syndrome (MetS) and lifestyle related diseases such as type 2 diabetes (T2D) and cardiovascular diseases are important public health problems in Norway and all over the world, and the risk in South Asian immigrants is high. Physical activity and good physical fitness may reduce the risk of these diseases. South Asian immigrants in Norway are presumed to have lower physical activity level and physical fitness compared to ethnic Norwegians. Questionnaires are often used map the level of physical fitness, but the agreement between self-rated and objectively measured physical fitness among female Pakistani immigrants in Norway have not been evaluated. In order to design effective public health programs, measurement instruments for physical fitness have to be valid and reliable as to monitor prevalence and change. Objective: The objective of this study was to assess the correlation between self-rated and objective measurement instruments for physical fitness among Pakistani women living in Oslo, Norway. In addition we wanted to investigate the correlation between sosiodemografic and health related variables and good physical fitness. Methods: The cross-sectional study used data collection from 198 female Pakistani immigrants, 25-65 years old, living in Søndre Nordstrand in Oslo. The participants filled in questionnaires covering sosiodemographic and health related variables, and anthropometric measurements and blood data were collected. Physical fitness was measured objectively by a treadmill performance using heart rate and Borgs rating of perceived exertion as well as by a self-reported question on a 5 point scale. The agreement between self-rated and objective measured physical fitness was evaluated by Kappa-statistic and correlation tests (Pearson and Spearman), and the relationships between physical fitness and sosiodemographic and health related variables were assessed using Spearman correlation. ANOVA and Kruskal-Wallis test were used to compare different groups. Results: There was no correlation between physical fitness reported by self-rated measures and objective measurements on the treadmill. Only 50 participants (25,3%) of the 198 were able to complete the treadmill test. A negative relationship was found between self-rated physical fitness and BMI, waist circumference, systolic- and diastolic blood pressure, risk of T2D, subjective health complaints and mental health. There was also a positive relationship between self-rated physical fitness and hours of physical activity a week, years of education and attitudes towards physical activity. For the objective measured fitness, there were no correlation with sosiodemographic and health related variables. The group rating their fitness as good, and had a good objective measured fitness had the lowest BMI, second lowest risk of T2D, best mental health and second lowest prevalence of subjective health complaints. Conclusion: In this study, there was no agreement between self-rated and objective measured physical fitness among female Pakistani immigrants. The self-rated fitness correlated to sosiodemographic and health related variables. Self-rated physical fitness may be suitable to assess health status, but not to measure the physical fitness of female Pakistani immigrants. Additional studies are needed to confirm or disprove these results

Agreement between self-rated and objectively measured physical fitness among female Pakistani immigrants in Oslo

Masteroppgave i FolkehelsevitenskapSammendrag Bakgrunn: Metabolsk syndrom (MetS) og livsstilssykdommer som type 2 diabetes (T2D) og hjerte-karsykdommer (HKS) er viktige folkehelseutfordringer i Norge og i verden generelt, og innvandrere fra Sør-Asia har særlig høy risiko. Fysisk aktivitet og god fysisk form kan redusere risikoen for disse sykdommene, men sørasiatiske innvandrere i Norge er antatt å være mindre fysisk aktive og i dårligere fysisk form enn etniske nordmenn. Kartlegging av fysisk form blir ofte gjort med spørreskjema, men samsvar mellom selvrapportering via spørreskjema, og objektive målinger av fysisk form blant pakistanske innvandrerkvinner i Norge, er ikke evaluert. Når det skal iverksettes helsefremmende og sykdomsforebyggende tiltak er det viktig å nå ut til den ønskede målgruppen, og for å velge et egnet måleinstrument er det viktig å vurdere samsvar mellom ulike målemetoder for fysisk form. Hensikt: Hensikten med studien var å vurdere samsvar mellom selvrapportering og objektive målinger av fysisk form i en gruppe pakistanske innvandrerkvinner i Oslo, Norge, samt å undersøke hvilke sosiodemografiske og helserelaterte variabler som var korrelert med god fysisk form. Metode: Tverrsnittstudien kartla 198 pakistanske kvinner i alderen 25 – 65 år, bosatt i bydel Søndre Nordstrand i Oslo. Deltagerne besvarte spørreskjemaer som dekket sosiodemografiske og helserelaterte variabler. Det ble tatt antropometriske mål og samlet inn bloddata. Deltagerne rapporterte sin fysiske form på en 5 punkts skala. Fysisk form ble også målt objektivt med hjertefrekvens og Borgs skala på en tredemølletest. Samsvar mellom selvrapportert og objektivt målt fysisk form ble testet med Kappa-statistikk og korrelasjonstester (Pearson og Spearman), og sammenhengen mellom fysisk form og sosiodemografiske og helserelaterte variabler ble testet med Spearman-korrelasjon. ANOVA og Kruskal-Wallis-test ble benyttet for å sammenligne ulike grupper. Resultater: Det var ikke samsvar mellom selvrapportert og objektivt målt fysisk form. Kun 50 (25.3 %) av de 198 deltagerne var i stand til å gjennomføre tredemølletesten. Det var negativ korrelasjon mellom selvrapportert fysisk form og BMI, livvidde, systolisk- og diastolisk blodtrykk, risiko for T2D, subjektive helseplager og psykisk helse. I tillegg var det en positiv korrelasjon mellom selvrapportert fysisk form og antall timer fysisk aktivitet i uka, antall år på skole/studier og holdninger til fysisk aktivitet. For objektivt målt fysisk form ble det ikke funnet noen korrelasjon med sosiodemografiske og helserelaterte variabler. Den gruppen med deltagere som både rapporterte at de var i god form og som var i god form målt på tredemølle, skilte seg ut i positiv retning med lavest BMI, nest lavest risiko for T2D, best psykisk helse og nest lavest forekomst av subjektive helseplager. Konklusjon: Denne studien viste ikke samsvar mellom selvrapportert og objektivt målt fysisk form for pakistanske innvandrerkvinner. Det var selvrapportert form som korrelerte med sosiodemografiske og helserelaterte variabler. Selvrapportert fysisk form kan være egnet til å fange opp de som har dårlig helsestatus, men er ikke egnet til å kartlegge den objektive fysiske formen til pakistanske innvandrerkvinner. Det er behov for å gjøre flere og større studier som eventuelt kan bekrefte eller avkrefte disse funnene. Abstract Background: Metabolic Syndrome (MetS) and lifestyle related diseases such as type 2 diabetes (T2D) and cardiovascular diseases are important public health problems in Norway and all over the world, and the risk in South Asian immigrants is high. Physical activity and good physical fitness may reduce the risk of these diseases. South Asian immigrants in Norway are presumed to have lower physical activity level and physical fitness compared to ethnic Norwegians. Questionnaires are often used map the level of physical fitness, but the agreement between self-rated and objectively measured physical fitness among female Pakistani immigrants in Norway have not been evaluated. In order to design effective public health programs, measurement instruments for physical fitness have to be valid and reliable as to monitor prevalence and change. Objective: The objective of this study was to assess the correlation between self-rated and objective measurement instruments for physical fitness among Pakistani women living in Oslo, Norway. In addition we wanted to investigate the correlation between sosiodemografic and health related variables and good physical fitness. Methods: The cross-sectional study used data collection from 198 female Pakistani immigrants, 25-65 years old, living in Søndre Nordstrand in Oslo. The participants filled in questionnaires covering sosiodemographic and health related variables, and anthropometric measurements and blood data were collected. Physical fitness was measured objectively by a treadmill performance using heart rate and Borgs rating of perceived exertion as well as by a self-reported question on a 5 point scale. The agreement between self-rated and objective measured physical fitness was evaluated by Kappa-statistic and correlation tests (Pearson and Spearman), and the relationships between physical fitness and sosiodemographic and health related variables were assessed using Spearman correlation. ANOVA and Kruskal-Wallis test were used to compare different groups. Results: There was no correlation between physical fitness reported by self-rated measures and objective measurements on the treadmill. Only 50 participants (25,3%) of the 198 were able to complete the treadmill test. A negative relationship was found between self-rated physical fitness and BMI, waist circumference, systolic- and diastolic blood pressure, risk of T2D, subjective health complaints and mental health. There was also a positive relationship between self-rated physical fitness and hours of physical activity a week, years of education and attitudes towards physical activity. For the objective measured fitness, there were no correlation with sosiodemographic and health related variables. The group rating their fitness as good, and had a good objective measured fitness had the lowest BMI, second lowest risk of T2D, best mental health and second lowest prevalence of subjective health complaints. Conclusion: In this study, there was no agreement between self-rated and objective measured physical fitness among female Pakistani immigrants. The self-rated fitness correlated to sosiodemographic and health related variables. Self-rated physical fitness may be suitable to assess health status, but not to measure the physical fitness of female Pakistani immigrants. Additional studies are needed to confirm or disprove these results

Screening outcome for interpretation by the first and second reader in a population-based mammographic screening program with independent double reading

Background - Double reading of screening mammograms is associated with a higher rate of screen-detected cancer than single reading, but different strategies exist regarding reader pairing and blinding. Knowledge about these aspects is important when considering strategies for future use of artificial intelligence in mammographic screening. Purpose - To investigate screening outcome, histopathological tumor characteristics, and mammographic features stratified by the first and the second reader in a population based screening program for breast cancer. Material and Methods - The study sample consisted of data from 3,499,048 screening examinations from 834,691 women performed during 1996–2018 in BreastScreen Norway. All examinations were interpreted independently by two radiologists, 272 in total. We analyzed interpretation score, recall, and cancer detection, as well as histopathological tumor characteristics and mammographic features of the cancers, stratified by the first and second readers. Results - For Reader 1, the rate of positive interpretations was 4.8%, recall 2.3%, and cancer detection 0.5%. The corresponding percentages for Reader 2 were 4.9%, 2.5%, and 0.5% (P  Conclusion - Despite reaching statistical significance, mainly due to the large study sample, we consider the differences in interpretation scores, recall, and cancer detection between the first and second readers to be clinically negligible. For practical and clinical purposes, double reading in BreastScreen Norway is independent

Experience of pain during mammographic screening by three different compression paddles

Introduction - Experience of pain during screening mammography is shown to affect further attendance negatively. We aimed to explore the experience of pain during screening mammography using three different breast compression paddles. Methods - Using a self-report questionnaire, we collected information on pain experienced during mammography from 938 women screened in Bodø at Nordland Hospital County in 2018, as a part of BreastScreen Norway. Pain was assessed by a numeric rating scale (NRS, 0–10). A fixed paddle, a flexible paddle or a fixed paddle standardizing pressure (study paddle) were used during screening. Compression force (kg) was recorded by the radiographers for each screening examination. Log-binomial regression was used to determine the relative risk (RR) of severe (≥7 on NRS) versus mild/moderate ( Results - Mean score of self-reported experienced pain was 2.8 for the fixed, 2.3 for the flexible and 2.8 for the study paddle (p Conclusion - Women screened with the flexible paddle reported lower experience of pain than those screened with the fixed or study paddle

Interval breast cancer rates and histopathologic tumor characteristics after false-positive findings at mammography in a populationbased screening program

Purpose To compare rates and tumor characteristics of interval breast cancers (IBCs) detected after a negative versus false-positive screening among women participating in the Norwegian Breast Cancer Screening Program. Materials and Methods The Cancer Registry Regulation approved this retrospective study. Information about 423 445 women aged 49–71 years who underwent 789 481 full-field digital mammographic screening examinations during 2004–2012 was extracted from the Cancer Registry of Norway. Rates and odds ratios of IBC among women with a negative (the reference group) versus a false-positive screening were estimated by using logistic regression models adjusted for age at diagnosis and county of residence. Results A total of 1302 IBCs were diagnosed after 789 481 screening examinations, of which 7.0% (91 of 1302) were detected among women with a false-positive screening as the most recent breast imaging examination before detection. By using negative screening as the reference, adjusted odds ratios of IBCs were 3.3 (95% confidence interval [CI]: 2.6, 4.2) and 2.8 (95% CI: 1.8, 4.4) for women with a false-positive screening without and with needle biopsy, respectively. Women with a previous negative screening had a significantly lower proportion of tumors that were 10 mm or less (14.3% [150 of 1049] vs 50.0% [seven of 14], respectively; P < .01) and grade I tumors (13.2% [147 of 1114] vs 42.9% [six of 14]; P < .01), but a higher proportion of cases with lymph nodes positive for cancer (40.9% [442 of 1080] vs 13.3% [two of 15], respectively; P = .03) compared with women with a previous false-positive screening with benign biopsy. A retrospective review of the screening mammographic examinations identified 42.9% (39 of 91) of the false-positive cases to be the same lesion as the IBC. Conclusion By using a negative screening as the reference, a false-positive screening examination increased the risk of an IBC three-fold. The tumor characteristics of IBC after a negative screening were less favorable compared with those detected after a previous false-positive screening

Personalized Breast Cancer Screening: A Risk Prediction Model Based on Women Attending BreastScreen Norway

Background: We aimed to develop and validate a model predicting breast cancer risk for women targeted by breast cancer screening. Method: This retrospective cohort study included 57,411 women screened at least once in BreastScreen Norway during the period from 2007 to 2019. The prediction model included information about age, mammographic density, family history of breast cancer, body mass index, age at menarche, alcohol consumption, exercise, pregnancy, hormone replacement therapy, and benign breast disease. We calculated a 4-year absolute breast cancer risk estimates for women and in risk groups by quartiles. The Bootstrap resampling method was used for internal validation of the model (E/O ratio). The area under the curve (AUC) was estimated with a 95% confidence interval (CI). Results: The 4-year predicted risk of breast cancer ranged from 0.22–7.33%, while 95% of the population had a risk of 0.55–2.31%. The thresholds for the quartiles of the risk groups, with 25% of the population in each group, were 0.82%, 1.10%, and 1.47%. Overall, the model slightly overestimated the risk with an E/O ratio of 1.10 (95% CI: 1.09–1.11) and the AUC was 62.6% (95% CI: 60.5–65.0%). Conclusions: This 4-year risk prediction model showed differences in the risk of breast cancer, supporting personalized screening for breast cancer in women aged 50–69 years