Land-use change and floods: what do we need most, research or management?

Land-cover change (urbanisation, deforestation, and cultivation) results in increased flood frequency and severity. Mechanisms include reduced infiltration capacity, lower soil porosity, loss of vegetation, and forest clearing, meaning lower evapotranspiration. Major research challenges lie in quantification of effects in terms of flood characteristics under various conditions, ascertaining the combined effects of gradual changes over long time periods, and developing model tools suitable for land-use management.

The Tromsø study: registration of fractures, how good are self-reports, a computerized radiographic register and a discharge register?

In order to compare different methods of fracture registration, we sought all nonvertebral fractures suffered during 8 years (1988-95) among 21,441 persons invited to a survey in 1979/80. We registered a total of 54 hip fracture cases through three separate sources (self-report, computer linkage to the local radiographic archives, discharge register), whereas forearm fractures (a total of 291 cases) were registered through two separate sources (self-report, computer linkage to the radiographic archives). The registration of fractures at other sites (a total of 1321 cases) were from one source (computer linkage to the local radiographic archives), and we have compared three ways of obtaining data from this single source (no ascertainment, ascertainment of records coded as fracture, ascertainment of all records).

Forearm bone mineral density by age in 7,620 men and women: the Tromsø study, a population-based study.

Population-based studies of adult forearm bone mineral density (BMD) by age are scarce, and standardized reference values are lacking. In this cross-sectional study, men aged 55-74 years, women aged 50-74 years, and representative 5-10% samples of remaining age groups between 25 and 84 years living in Tromsø, Norway, were invited for forearm BMD measurement in 1994-1995. The authors measured 3,062 men and 4,558 women (response rate, 78%) by single x-ray absoptiometry at distal and ultradistal forearm sites.

The Tromsø study: determinants of precision in bone densitometry.

Studies of precision determinants in bone densitometry are scarce. A total of 111 subjects recruited from the population-based multipurpose Tromsø Study (Norway), 27-75 years of age, had repeated forearm bone single X-ray absorptiometry (SXA) measurements. Measurement conditions were systematically varied in series up to eight scans.

Hormone replacement therapy: knowledge, attitudes, self-reported use - and sales figures in Nordic women.

Objectives: To evaluate knowledge about, attitudes towards and use of hormone replacement therapy (HRT) in Norwegian women - and to compare self-reported use with sales statistics of HRT in the Nordic countries during recent years.

Material And Methods: Random samples of Norwegian women age 16-79 were interviewed by the Central Bureau of Statistics in 1994 (n=737), in 1996 (n=665) and in 1998 (n=680). Statistics on the sale of estrogen were provided by the Norwegian Medical Depot and Nordic Council on Medicines.

The Tromsø Study: artifacts in forearm bone densitometry--prevalence and effect.

Suboptimal performance of bone densitometer, operator and/or subject may cause artifacts of consequence both for individual patient management and research. The prevalence and effects of such artifacts are largely unknown in densitometry. A cross-sectional population-based study was carried out of artifacts in forearm bone densitometry with single X-ray Absorptiometry (SXA) of the nondominant hand (distal and ultradistal site).

The Tromsø Study: body height, body mass index and fractures.

Tall persons suffer more hip fractures than shorter persons, and high body mass index is associated with fewer hip and forearm fractures. We have studied the association between body height, body mass index and all non-vertebral fractures in a large, prospective, population-based study. The middle-aged population of Tromsø, Norway, was invited to surveys in 1979/80, 1986/87 and 1994/95 (The Tromsø Study).

The Tromsø Study: physical activity and the incidence of fractures in a middle-aged population.

We have studied the relation of occupational and recreational physical activity to fractures at different locations. All men born between 1925 and 1959 and all women born between 1930 and 1959 in the city of Tromsø were invited to participate in surveys in 1979-1980 and 1986-1987 (The Tromsø Study). Of 16,676 invited persons, 12,270 (73.

[Hormone replacement therapy among Norwegian women. Self-reported use and sales of estrogen preparations].

In order to analyse the use of hormone replacement therapy (HRT) and the predicting factors for its use, two random samples of Norwegian women (30-79 years) were interviewed by the Central Bureau of Statistics in 1994 (n = 565) and in 1996 (n = 470). The extent of use of HRT was compared with statistics for sales of oestrogen in Norway and the Nordic countries. In the age group 45-69 years the use of hormone replacement therapy increased from 16.

[Estrogen replacement].

Recent research on long-term postmenopausal hormone replacement therapy (HRT) indicates a positive effect on both total mortality and morbidity. This has raised the question of widespread preventive long-term use of HRT. Possible side-effects and ideological issues related to preventive HRT have led to debate and uncertainty among health professionals, in the media, and in the population at large.

[Postmenopausal hormone substitution--for many or for a few? II. Relevant indications for long-term hormone substitution].

In a theoretical model, women on long-term HRT will experience 28 per cent reduction in morbidity and a 1-2-year increase in life expectancy. The costs incurred by HRT are comparable with other preventive medication regimens. However, the decision to recommend or use HRT depends not only on the above-mentioned beneficial effects, but also on issues that defy objective assessment: the validity of observational studies; changes in quality of life among HRT users; and the medicalisation of postmenopausal women.

[Postmenopausal hormone substitution--for many of for few? I. Effects of long-term hormone substitution].

Users of hormone replacement therapy (HRT) are characterised by a 20-50 per cent reduction in all-cause mortality, and a 50 per cent reduction in the risk of coronary disease and osteoporotic fracture. The risk of Alzheimer's dementia or of cerebrovascular disease has also been reported to be reduced, though published findings have been inconsistent. In contrast, the risk of breast cancer or venous thrombosis is probably increased.

[Osteoporosis. Knowledge and attitudes of the Norwegian population].

In March 1994, a random sample of 1,514 Norwegians aged 16-79 years were interviewed about their knowledge of osteoporosis and their attitudes towards prevention of this disease. About 85% answered correctly that osteoporosis can be prevented, but only 57% knew that it cannot be cured. Women had better knowledge of osteoporosis than men had.

What do Norwegian women and men know about osteoporosis?

A survey of a random sample of 1514 Norwegian women and men aged 16-79 years was undertaken to investigate knowledge of osteoporosis and attitudes towards methods for preventing this disease. The interviews were carried out by Central Bureau of Statistics of Norway as part of their monthly national poll using a structured questionnaire. Women knew more about osteoporosis than did men (p < 0.

Writing a scientific paper as part of the medical curriculum.

The curriculum at the Medical School, University of Tromsø reserves 23 weeks for optional studies, including a period of 12 weeks at the end of the fifth year when the students carry out an independent study and write a short thesis. Of the first 417 doctors (graduation year 1979-89) from Tromsø 84.6% answered a postal questionnaire asking them to evaluate this part of the curriculum.

Effects of ovarian stimulation on blood pressure and plasma catecholamine levels.

Effects of ovarian stimulation for in vitro fertilization on blood pressure and plasma catecholamine levels were studied in 10 women. The examinations were carried out before hormonal treatment with human menopausal gonadotropin (day three of the menstrual cycle, mean serum oestradiol concentration 0.2 nmol l-1, and on the day after ovulation induction with human chorionic gonadotropin (cycle days 10-12, mean serum oestradiol concentration 7.

Evidence for altered transcapillary fluid balance in women with the premenstrual syndrome.

Redistribution of body fluids has been suggested as a possible pathophysiological mechanism for the premenstrual syndrome (PMS). To elucidate this hypothesis, transcapillary fluid balance was studied in ten women with well defined PMS. Wick-methods were used for measuring colloid osmotic and hydrostatic interstitial pressures on the thorax and on the leg.

Rural doctor recruitment: does medical education in rural districts recruit doctors to rural areas?

The impact of the University of Tromsø Medical School on the distribution of doctors in rural areas in northern Norway was evaluated by a postal questionnaire. The survey covered 11 graduation years (417 doctors), and the response rate was 84.2%.

[Evaluations and examinations at the Tromsø medical school. Evaluation by students after graduation].

The medical curriculum at the University of Tromsø is based on an organ-system model with full integration of the three main disciplines (basic science, clinical and community medicine). There are only three examinations during the six-year course. We present the results of a survey among the first 417 physicians educated at the Medical School in Tromsø.

[Elective periods in the medical curriculum. Madness or academic challenge?].

The medical curriculum at the University of Tromsø reserves 23 weeks, divided into four periods, for elective work, including 12 weeks at the end of the fifth year, when the student carries out an independent study and writes a short thesis. 84.2% of 417 physicians (graduation year 1979-89) answered a mailed questionnaire asking them to evaluate these periods.