Incidence trend and risk factors for campylobacter infections in humans in Norway

BACKGROUND: The objectives of the study were to evaluate whether the increase in incidence of campylobacteriosis observed in humans in Norway from 1995 to 2001 was statistically significant and whether different biologically plausible risk factors were associated with the incidence of campylobacteriosis in the different counties in Norway. METHODS: To model the incidence of domestically acquired campylobacteriosis from 1995 to 2001, a population average random effect poisson model was applied (the trend model). To case data and assumed risk-factor/protective data such as sale of chicken, receiving treated drinking water, density of dogs and grazing animals, occupation of people in the municipalities and climatic factors from 2000 and 2001, an equivalent model accounting for geographical clustering was applied (the ecological model). RESULTS: The increase in incidence of campylobacteriosis in humans in Norway from 1995 to 2001 was statistically significant from 1998. Treated water was a protective factor against Campylobacter infections in humans with an IRR of 0.78 per percentage increase in people supplied. The two-level modelling technique showed no evidence of clustering of campylobacteriosis in any particular county. Aggregation of data on municipality level makes interpretation of the results at the individual level difficult. CONCLUSION: The increase in incidence of Campylobacter infections in humans from 1995 to 2001 was statistically significant from 1998. Treated water was a protective factor against Campylobacter infections in humans with an IRR of 0.78 per percentage increase in people supplied. Campylobacter infections did not appear to be clustered in any particular county in Norway

Treatment outcome of new culture positive pulmonary tuberculosis in Norway

BACKGROUND: The key elements in tuberculosis (TB) control are to cure the individual patient, interrupt transmission of TB to others and prevent the tubercle bacilli from becoming drug resistant. Incomplete treatment may result in excretion of bacteria that may also acquire drug resistance and cause increased morbidity and mortality. Treatment outcome results serves as a tool to control the quality of TB treatment provided by the health care system. The aims of this study were to evaluate the treatment outcome for new cases of culture positive pulmonary TB registered in Norway during the period 1996–2002 and to identify factors associated with non-successful treatment. METHODS: This was a register-based cohort study. Treatment outcome was assessed according to sex, birthplace, age group, isoniazid (INH) susceptibility, mode of detection and treatment periods (1996–1997, 1998–1999 and 2000–2002). Logistic regression was also used to estimate the odds ratio for treatment success vs. non-success with 95% confidence interval (CI), taking the above variables into account. RESULTS: Among the 655 patients included, the total treatment success rate was 83% (95% CI 80%–86%). The success rates for those born in Norway and abroad were 79% (95% CI 74%–84%) and 86% (95% CI 83%–89%) respectively. There was no difference in success rates by sex and treatment periods. Twenty-two patients (3%) defaulted treatment, 58 (9%) died and 26 (4%) transferred out. The default rate was higher among foreign-born and male patients, whereas almost all who died were born in Norway. The majority of the transferred out group left the country, but seven were expelled from the country. In the multivariate analysis, only high age and initial INH resistance remained as significant risk factors for non-successful treatment. CONCLUSION: Although the TB treatment success rate in Norway has increased compared to previous studies and although it has reached a reasonable target for treatment outcome in low-incidence countries, the total success rate for 1996–2002 was still slightly below the WHO target of success rate of 85%. Early diagnosis of TB in elderly patients to reduce the death rate, abstaining from expulsion of patients on treatment and further measures to prevent default could improve the success rate further

Child-centered food systems: reorienting food systems towards healthy diets for children

Current food systems are failing to guide children towards healthy diets. This paper presents a tool to identify the actions needed to reorient food systems to become more child-centred from a nutrition perspective. To connect the dots between children's lives, their food environments and food supply systems, the tool takes a child-centred, food systems approach. Comprising six methodological steps, the tool starts by measuring and understanding children's realities and then working back up into the system to identify how food environments and supply systems could make relevant foods more or less available, affordable, appealing and aspirational in the contexts of children's lives. The paper spells out the mix of methods needed to make this assessment, gives examples of the data and studies already available and type of insights they provide, and discusses the methodological challenges and gaps. It presents a worked example that shows how following these steps in sequence enables the identification of a package of actions that can act coherently to reorient food systems in the way most likely to have impact on child malnutrition

Product-related injuries: Epidemiology, Etiology and Preventive Measures, 1995

The purpose of "Product-related injuries: Epidemiology, Etiology and Preventive Measures, 1995" was to identify key factors that could be of importance on whether a product related accident would happen or not. A product related accident was characterised as an actitvity where a person was injured when a product was involved in the acitivity. The products that were part of the survey were skis and bicycles. Exposure to the product and experience with the use of the product were seen as important factors for if an accident was to happen. Age and sex were important variables as well. To find out if there was a connection between exposure, experience and being prone to accidents, a case-control investigation was made, based on post-enquete surveys, during the spring of 1995

The Effect of Low-Dose Naltrexone on Medication in Inflammatory Bowel Disease: A Quasi Experimental Before-and-After Prescription Database Study

Background and Aims: Low-dose naltrexone [LDN] is a controversial off-label treatment used by many Crohn’s disease [CD] and ulcerative colitis [UC] patients. A small number of preliminary studies indicate that LDN might be beneficial in CD, but evidence is too scarce to demonstrate efficacy. We sought to examine whether initiation of LDN therapy by patients with inflammatory bowel disease [IBD] was followed by changes in dispensing of relevant medication. Methods: We performed a quasi-experimental before-and-after study following a sudden increase in LDN use in the Norwegian population in 2013. IBD patients were identified from among all the patients who had at least one LDN prescription recorded in the Norwegian Prescription Database [NorPD] in 2013. Drug dispensing 2 years before and after the first LDN prescription was compared. Results: We identified 582 IBD patients who had received LDN. Of the 256 patients who became persistent LDN users, there were reductions in the number of users for [i] all examined drugs [–12%], [ii] intestinal anti-inflammatory agents [–17%], [iii] other immunosuppressants [–29%], [iv] intestinal corticosteroids [–32%] and [v] aminosalicylates [–17%]. In subgroups of identified CD and UC patients, there were significant reductions in the number of users of intestinal corticosteroids [CD: –44%, UC: –53%] and systemic corticosteroids [UC: –24%]. No significant differences in cumulative defined daily doses were observed. Conclusions: Our findings imply that the initiation of LDN in IBD is followed by reduced dispensing of several drugs considered essential in the treatment of CD and UC

Supplemental_Material – Supplemental material for Ischemic heart failure as a complication of incident acute myocardial infarction: Timing and time trends: A national analysis including 78,814 Danish patients during 2000–2009

Supplemental material, Supplemental_Material for Ischemic heart failure as a complication of incident acute myocardial infarction: Timing and time trends: A national analysis including 78,814 Danish patients during 2000–2009 by Gerhard Sulo, Enxhela Sulo, Torben Jørgensen, Allan Linnenberg, Eva Prescott, Grethe S. Tell and Merete Osler in Scandinavian Journal of Public Healt