Interaction quality and children’s social-emotional competence in Norwegian ECEC

This study investigates whether interaction quality in toddler groups, when children were age three, is associated with changes in children’s social competence from age three to age five years in Norwegian Early Childhood Education and Care (ECEC). ECEC groups (n = 206) were observed with the Infant/ Toddler Environment Rating Scale Revised (ITERS-R). The subscale Interaction was used for this study, including four items: supervision of play and learning; peer interaction; staff-child interaction; and discipline. Children’s social-emotional competence was rated by ECEC teachers using the Norwegian Lamer Social Competence in Preschool scale (LSCIP) with six dimensions: prosocial behavior, self-control, assertiveness, adjustment, empathy, and fairness. Multilevel models were applied to investigate the associations between the ITERS-R scale and social-emotional competence at age three and age five. Results showed an association of interaction quality with empathy at T1, and a marginally significant association between interaction quality and self-control at T2. No other associations were found between interaction quality and social competence. The paper discusses why the associations between interaction quality and outcomes are limited and the need to revise and expand quality measures especially in Norwegian ECEC. This study also stresses the need to further investigate quality of interactions between staff and children, and its associations with children outcomes

Large and non-specific somatic disease burdens among ageing, long-term opioid maintenance treatment patients

Objectives To describe and explore somatic disease burdens of ageing long-term patients in opioid maintenance treatment (OMT), a unique population emerging in countries offering OMT as a long-term treatment. Methods We used data from the Norwegian Cohort of Patient in Opioid Maintenance Treatment and Other Drug Treatment Study (NorComt). 156 patients enrolled for at least three of the past five years provided data during structured interviews, including on chronic conditions, somatic treatment received, mental distress (SCL-25), and treatment satisfaction. A somatic disease burden was calculated from a list measuring the recent severity of 16 somatic complaints. A hierarchical multiple linear regression analysis identified correlates of somatic disease burden. Results Over half of patients reported at least seven somatic complaints. Reported somatic disease burden was associated with higher mental distress, more chronic conditions, fewer years in OMT, and treatment dissatisfaction. Age was unrelated, and there were few gender differences. These five variables explained 43.6% of the variance in disease burden. Conclusion Long-term OMT patients experience a large range of somatic complaints, and at non-acute levels. As OMT secures longevity for opioid-dependent persons, the clinical focus must be adjusted from acute to chronic care. Providers must address how to optimize health and quality of life while in treatment, as treatment may last for many years

Circulating trimethyllysine and risk of acute myocardial infarction in patients with suspected stable coronary heart disease

Background The carnitine precursor trimethyllysine (TML) is associated with progression of atherosclerosis, possibly through a relationship with trimethylamine-N-oxide (TMAO). Riboflavin is a cofactor in TMAO synthesis. We examined prospective relationships of circulating TML and TMAO with acute myocardial infarction (AMI) and potential effect modifications by riboflavin status. Methods By Cox modelling, risk associations were examined amongst 4098 patients (71.8% men) with suspected stable angina pectoris. Subgroup analyses were performed according to median plasma riboflavin. Results During a median follow-up of 4.9 years, 336 (8.2%) patients experienced an AMI. The age- and sex-adjusted hazard ratio (HR) (95% CI) comparing the 4th vs. 1st TML quartile was 2.19 (1.56–3.09). Multivariable adjustment for traditional cardiovascular risk factors and indices of renal function only slightly attenuated the risk estimates [HR (95% CI) 1.79 (1.23–2.59)], which were particularly strong amongst patients with riboflavin levels above the median (Pint = 0.035). Plasma TML and TMAO were strongly correlated (rs = 0.41; P < 0.001); however, plasma TMAO was not associated with AMI risk in adjusted analyses [HR (95% CI) 0.81 (0.58–1.14)]. No interaction between TML and TMAO was observed. Conclusion Amongst patients with suspected stable angina pectoris, plasma TML, but not TMAO, independently predicted risk of AMI. Our results motivate further research on metabolic processes determining TML levels and their potential associations with cardiovascular disease. We did not adjust for multiple comparisons, and the subgroup analyses should be interpreted with caution