Psychoactive substances have major impact on injuries in rural arctic Norway – A prospective observational study

Background - Rural areas have increased injury mortality with a high pre-hospital death rate. Knowledge concerning the impact of psychoactive substances on injury occurrence is lacking for rural arctic Norway. These substances are also known to increase pre-, per- and postoperative risk. The aim was by prospective observational design to investigate the prevalence and characteristics of psychoactive substance use among injured patients in Finnmark county. Methods - From January 2015 to August 2016, patients ≥18 years admitted to hospitals in Finnmark due to injury were approached when competent. Blood was analysed for ethanol, sedatives, opioids, hypnotics and illicit substances in consenting patients, who completed a questionnaire gathering demographic factors, self-reported use/behaviour and incident circumstances. Results - In 684 injured patients who consented to participation (81% consented), psychoactive substances were detected in 35.7%, alcohol being the most prevalent (23%). Patients in whom substances were detected were more often involved in violent incidents (odds ratio 8.92 95% confidence interval 3.24-24.61), indicated harmful use of alcohol (odds ratio 3.56, 95% confidence interval 2.34-5.43), reported the incident being a fall (odds ratio 2.21, 95% confidence interval 1.47-3.33) and presented with a reduced level of consciousness (odds ratio 3.91, 95% confidence interval 1.58-9.67). Subgroup analysis revealed significant associations between testing positive for a psychoactive substance and being diagnosed with a head injury or traumatic brain injury. Conclusion - A significant proportion of injured patients had used psychoactive substances prior to admission. Use was associated with violence, falls, at-risk alcohol consumption, decreased level of consciousness on admittance and head injury

Ten‐Year Cardiovascular Disease Risk Trajectories by Obstetric History:A Longitudinal Study in the Norwegian HUNT Study

BACKGROUND: Women with a history of obstetric complications are at increased risk of cardiovascular disease, but whether they should be specifically targeted for cardiovascular disease (CVD) risk screening is unknown. METHODS AND RESULTS: We used linked data from the Norwegian HUNT (Trøndelag Health) Study and the Medical Birth Registry of Norway to create a population‐based, prospective cohort of parous women. Using an established CVD risk prediction model (A Norwegian risk model for cardiovascular disease), we predicted 10‐year risk of CVD (nonfatal myocardial infarction, fatal coronary heart disease, and nonfatal or fatal stroke) based on established risk factors (age, systolic blood pressure, total and high‐density lipoprotein cholesterol, smoking, antihypertensive use, and family history of myocardial infarction). Predicted 10‐year CVD risk scores in women aged between 40 and 60 years were consistently higher in those with a history of obstetric complications. For example, when aged 40 years, women with a history of preeclampsia had a 0.06 percentage point higher mean risk score than women with all normotensive deliveries, and when aged 60 years this difference was 0.86. However, the differences in the proportion of women crossing established clinical thresholds for counseling and treatment in women with and without a complication were modest. CONCLUSIONS: Findings do not support targeting parous women with a history of pregnancy complications for CVD screening. However, pregnancy complications identify women who would benefit from primordial and primary prevention efforts such as encouraging and supporting behavioral changes to reduce CVD risk in later life

Association of Conventional Cardiovascular Risk Factors With Cardiovascular Disease After Hypertensive Disorders of Pregnancy:Analysis of the Nord-Trøndelag Health Study

Importance Women with a history of hypertensive disorders of pregnancy (HDP) have higher risk of cardiovascular disease (CVD). It is not known how much of the excess CVD risk in women with a history of HDP is associated with conventional cardiovascular risk factors. Objective To quantify the excess risk of CVD in women with a history of HDP and estimate the proportion associated with conventional cardiovascular risk factors. Design, Setting, and Participants Prospective cohort study with a median follow-up of 18 years. Population-based cohort of women participating in the Nord-Trøndelag Health Study in Norway. We linked data for 31 364 women from the Nord-Trøndelag Health Study (1984-2008) to validated hospital records (1987-2015), the Cause of Death Registry (1984-2015), and the Medical Birth Registry of Norway (1967-2012). A total of 7399 women were excluded based on selected pregnancy characteristics, incomplete data, or because of emigrating or experiencing the end point before start of follow-up, leaving 23 885 women for study. Data were analyzed between January 1, 2018, and June 6, 2018. Exposures Experiencing 1 or more pregnancies complicated by HDP before age 40 years vs only experiencing normotensive pregnancies. Main Outcomes and Measures We used Cox proportional hazards models to estimate the hazard ratios (HRs) for the association between HDP and CVD. The proportion of excess risk associated with conventional cardiovascular risk factors was estimated using an inverse odds ratio weighting approach. Results Our study population consisted of 23 885 parous women from Nord-Trøndelag County, Norway. A total of 21 766 women had only normotensive pregnancies, while 2199 women experienced ever having an HDP. From age 40 to 70 years, women with history of HDP had an increased risk of CVD compared with women with only normotensive pregnancies (HR, 1.57; 95% CI, 1.32-1.87) but not at older age (β = 0.98; 95% CI, 0.96-1.00; P for interaction by age = .01). Blood pressure and body mass index were associated with up to 77% of the excess risk of CVD in women with history of HDP, while glucose and lipid levels were associated with smaller proportions. Conclusion and Relevance In this study, the risk of excess CVD in women with history of HDP was associated with conventional cardiovascular risk factors, indicating that these risk factors are important targets for cardiovascular prevention in these women

Measuring the intensity of conflicts in conservation

Conflicts between the interests of biodiversity conservation and other human activities pose a major threat to natural ecosystems and human well‐being, yet few methods exist to quantify their intensity and model their dynamics. We develop a categorization of conflict intensity based on the curve of conflict, a model originally used to track the escalation and deescalation of armed conflicts. Our categorization assigns six intensity levels reflecting the discourse and actions of stakeholders involved in a given conflict, from coexistence or collaboration to physical violence. Using a range of case studies, we demonstrate the value of our approach in quantifying conflict trends, estimating transition probabilities between conflict stages, and modeling conflict intensity as a function of relevant covariates. By taking an evidence‐based approach to quantifying stakeholder behavior, the proposed framework allows for a better understanding of the drivers of conservation conflict development across a diverse range of socioecological scenarios

Infection after primary hip arthroplasty: A comparison of 3 Norwegian health registers

Background and purpose: The aim of the present study was to assess incidence of and risk factors for infection after hip arthroplasty in data from 3 national health registries. We investigated differences in risk patterns between surgical site infection (SSI) and revision due to infection after primary total hip arthroplasty (THA) and hemiarthroplasty (HA). Materials and methods: This observational study was based on prospective data from 2005–2009 on primary THAs and HAs from the Norwegian Arthroplasty Register (NAR), the Norwegian Hip Fracture Register (NHFR), and the Norwegian Surveillance System for Healthcare–Associated Infections (NOIS). The Norwegian Patient Register (NPR) was used for evaluation of case reporting. Cox regression analyses were performed with revision due to infection as endpoint for data from the NAR and the NHFR, and with SSI as the endpoint for data from the NOIS. Results: The 1–year incidence of SSI in the NOIS was 3.0% after THA (167/5,540) and 7.3% after HA (103/1,416). The 1–year incidence of revision due to infection was 0.7% for THAs in the NAR (182/24,512) and 1.5% for HAs in the NHFR (128/8,262). Risk factors for SSI after THA were advanced age, ASA class higher than 2, and short duration of surgery. For THA, the risk factors for revision due to infection were male sex, advanced age, ASA class higher than 1, emergency surgery, uncemented fixation, and a National Nosocomial Infection Surveillance (NNIS) risk index of 2 or more. For HAs inserted after fracture, age less than 60 and short duration of surgery were risk factors of revision due to infection. Interpretation: The incidences of SSI and revision due to infection after primary hip replacements in Norway are similar to those in other countries. There may be differences in risk pattern between SSI and revision due to infection after arthroplasty. The risk patterns for revision due to infection appear to be different for HA and THA

Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use

Tobacco and alcohol use are leading causes of mortality that influence risk for many complex diseases and disorders 1 . They are heritable 2,3 and etiologically related 4,5 behaviors that have been resistant to gene discovery efforts 6–11 . In sample sizes up to 1.2 million individuals, we discovered 566 genetic variants in 406 loci associated with multiple stages of tobacco use (initiation, cessation, and heaviness) as well as alcohol use, with 150 loci evidencing pleiotropic association. Smoking phenotypes were positively genetically correlated with many health conditions, whereas alcohol use was negatively correlated with these conditions, such that increased genetic risk for alcohol use is associated with lower disease risk. We report evidence for the involvement of many systems in tobacco and alcohol use, including genes involved in nicotinic, dopaminergic, and glutamatergic neurotransmission. The results provide a solid starting point to evaluate the effects of these loci in model organisms and more precise substance use measures

A Pilot Study on the Function of Indoor Seating Stairs in Primary School Buildings

Fra at det nesten ikke ble bygget noen skoler med amfi på tidlig 2000 tallet bygges det nå amfier i alle nye grunnskoler i Oslo (Oslo kommune, 2015), og i mange nye skoler i resten landet. Amfiet er en konstruksjon som kan ha mange ulike former og bruksområder og opptre i mange situasjoner.. Hensikten med denne oppgaven er å belyse amfiets funksjon i grunnskolen ved en undersøkelse om hvordan dagens amfier brukes og hvordan de er utformet. Svaret fra undersøkelsen skal gjøre det enklere å bestille og planlegge nye skoler med amfi med riktig form og funksjon for å svare til den enkelte skolens ønskede bruk. Den kvantitative metoden tar for seg datamateriale fra samlet inn fra tjue besøkte norske grunnskoler og kvantifisering av samtaler med ulike brukere ved skolene. Dataene fra samtalene og fra observasjoner ved besøket skal sammenliknes for å se om det finnes en sammenheng mellom bruken og utformingen av amfiet. Den kvalitative metoden består av to dybdeintervjuer med arkitekter som har tegnet besøkte skoler. Funn fra oppgaven viser at utformingen av amfiene kan beskrives på mange forskjellige måter. Summen av innsamlet data fører til kategorien Atriums amfi, skoledeler amfi, lukket amfi, trappeamfi og noen kategoriserte amfier. Bruken av amfiene blir kartlagt og forenkles til å bestå av disse bruksbegrepene. Samling, forestilling, pauser, utleie, sal og scene og film. Resultatene viser at det er lite sammenheng mellom bruk og utforming som areal foran scene, antall sitteplasser i amfiet og rom og funksjoner i tilknytning til amfiet. Det viser seg at det er sammenheng mellom amfikategoriene og bruk av amfiet. Det viser seg også at det er sammenheng mellom skoletypene og bruk av amfiet. Studien innebefatter for få amfier til å konkluder noe generelt om amfier. Resultatene tyder på at det kan trekkes noen sammenhenger mellom bruk og utforming av noen av amfiene i undersøkelsen. Det oppdages også en sammenheng mellom barneskoler og at de ikke brukes i pauser. Studiet blir som en pilotstudie i et felt hvor arbeidet kan tas i flere retninger. Utvalget kan utvides for å kunne se om sammenhengene holder seg, og om det dukker opp nye. Man kan arbeide med en mer detaljert oversikt over bruk som tar høyde for hvor ofte hver enkelt form for bruk inntreffer og hvor mye hver enkelt kategori brukes. Man kan også utvide antall kategorier og definisjonene av de som allerede er presentert i denne studien.Almost all new primary schools in Oslo, and in many other new schools in the rest of the country, are now built with amphitheatres. The purpose of this thesis is to better understand the function of the amphitheatre in primary schools through a survey on how todays amphitheatres are used and how they are shaped. The results from the survey should be helpful in defining form and function for new amphitheatres, that corresponds to the particular need of the specific school. The quantitative method includes data collected from 20 different Norwegian primary schools and a quantification of talks with user at the schools. Data from the talks and observations will be compared to see if there is a correlation between the use of the amphitheatre and its design. The qualitative method includes two in-depth interviews with architects that has worked on projects included in the survey. This thesis shows that the design of the amphitheatres can be described in many ways. The sum of collected data resulted in the categories atrium amphitheatre, separation amphitheatre, closed amphitheatre, and some uncharacterized amphitheatres. Usage of the amphitheatres are shown and simplified enough to aptly fit these categories of use: conventions, shows, breaks, external activities, scenes, and movie theatre Results show that there is little correlation between usage and design regarding the area in front of a scene, number of seats or rom and functions connected to the amphitheatre. There is showed a correlation between the categories of usage and the actual usage. There is shown a correlation between the types of schools and the usage of amphitheatres. This study includes too few amphitheatres to conclude anything in general about amphitheatres. The results imply that there can be made some correlation between usage and design of some of the amphitheatres surveyed. There has been discovered a correlation between lower primary schools and the lack of usage of amphitheatres in breaks at the schools. This thesis is a pilot study in a field where the work can go in differing directions. The sample can be expanded to see if the correlations holds, and if there can be found any new ones. A more detailed survey on the usage that includes how often each use occur and how much each category of usage can be done. Expanding on the numbers of categories and the definitions of those already presented in this study could also be interesting going forwards.M30-B

Thermal Sprayed Aluminium for Subsea Heat Exchanger Surfaces: Effect of Temperature on Protection Current Requirement and Calcareous Development

More and more equipment in the Oil and Gas Industry are being placed Subsea. Thisincludes subsea coolers with high internal temperatures. With high temperatures comewith challenges within material selection and corrosion. Traditional material choices like carbon steel and organic coatings with cathodic protection (CP) is not an option for subsea coolers. This is due to insulating properties to the organic coatings and the dense calcareous deposits which form on the surface of the steel.Thermally sprayed aluminium (TSA) is known to have good corrosion resistance inseawater, and to have a small current demand under CP, which makes the probability ofprecipitating calcareous layer on the surface low. The surface topography for thermallysprayed aluminium is rough, which increases the total surface area for heat transfer. The rough surface also produces turbulent flow close to the surface, which may increase the heat transfer. The combination of these properties makes thermally sprayed aluminium a attractive candidate as a coating for subsea coolers.The drawback of thermally sprayed aluminium is that there is little empirical data onits behaviour at high temperatures, especially when in contact with CP. Therefore, the purpose of this Master Thesis is to provided more documentation on the subject of the properties of thermally sprayed aluminium at high surface temperatures in seawater, with and without CP.For providing more documentation a literature study and experiments on TSA willbe carried out. The principle behind the experimental part of this project is very simple. Pipes of UNS S31245 stainless steel with a TSA coating were internally heated to different temperatures and immersed in slow flowing seawater, to simulate the conditions a subsea cooler would be subjected to. The purpose of the experiments was to find the corrosion potential, the current density requirement for TSA connected to an CP system and the corrosion rate of the freely corroding TSA. After exposure the samples was analysed to quantify the amount, if any, calcareous deposits form on TSA, and to see what effect the exposure had on the thermal conductivity of the samples.This thesis discovered that the corrosion rate of TSA increases with temperature. Initially the corrosion rate of TSA is quite high, but it quickly decreases for all temperatures. The corrosion rate for the 90 C internal temperature was initially 50 micrometers per year but decreased to 8 micrometers per year after 65 days.The current density requirement for TSA is very low compared to steel, with a currentdeensity of 3-5 mA/m2 obtained in this thesis. Temperature increases the current demandslightly. Based on both the experiments and the literature it is safe to say that using theDNV recommended practice for current density requirement for TSA is acceptable, eventhough the recommended practice may be conservative.Calcareous deposits form on TSA at all temperatures. For both the samples connectedto an anode and the freely corroding samples, however, not as a continuous protectivelayer that precipitates on steel, but mostly as thin layers in small areas around intermetallic particles. The temperature affects the amount and type of calcareous deposits which form on TSA. At high temperatures the calcareous deposits mainly consist of Mg(OH)2 and at low temperature the calcareous deposits consist of both CaCO3 and Mg(OH)2.Thermal conductivity measurements shows that the TSA coating and calcareous depositsare negligible when it comes to the overall thermal conductivity of the pipe. The combination of negligible effect on the thermal conductivity, low corrosion rate, and small current density requirement makes TSA a solid choice for corrosion protection of subsea heat exchangers