Long-Term Effectiveness of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality in Women and Men: A Randomized Trial.

Background: The long-term effects of sigmoidoscopy screening on colorectal cancer (CRC) incidence and mortality in women and men are unclear.

Objective: To determine the effectiveness of flexible sigmoidoscopy screening after 15 years of follow-up in women and men.

Design: Randomized controlled trial.

Can oxytocin augmentation modify the risk of epidural analgesia by maternal age in cesarean sections?

Introduction: Maternal age is an established risk factor for cesarean section; epidural analgesia and oxytocin augmentation may modify this association. We investigated the effects and interactions of oxytocin augmentation, epidural analgesia and maternal age on the risk of cesarean section.

Material And Methods: In all, 416 386 nulliparous women with spontaneous onset of labor, ≥37 weeks of gestation and singleton infants with a cephalic presentation during 2000-2011 from Norway and Denmark were included [Ten-group classification system (Robson) group 1].

Causes of iron overload in blood donors - a clinical study.

Background And Objectives: Despite the obligate iron loss from blood donation, some donors present with hyperferritinaemia that can result from a wide range of acute and chronic conditions including hereditary haemochromatosis (HH). The objective of our study was to investigate the causes of hyperferritinaemia in the blood donor population and explore the value of extensive HH mutational analyses.

Materials And Methods: Forty-nine consecutive donors (f = 6, m = 43) were included prospectively from the Capital Regional Blood Center.

Less periprosthetic bone loss following the anterolateral approach to the hip compared with the direct lateral approach.

Background and purpose - The loss of bone mineral in the proximal femur following hip arthroplasty may increase the fracture risk around uncemented stems. We hypothesized that the surgical approach to the hip might influence bone mineral changes around the femoral stem in patients with a femoral neck fracture (FNF). Patients and methods - This was a pre-specified subgroup analysis (n = 51) of an ongoing randomized trial (n = 120) in patients with FNF.

Maintaining immobilisation devices on trauma patients during CT: a feasibility study.

Background: To reduce the possibility of secondary deterioration of spinal injuries, it is desirable to maintain the spinal immobilisation that is applied in the prehospital setting throughout computed tomography (CT) scanning. A previous study found that metallic components within the inflation valve of the vacuum mattresses caused CT artefacts. The aim of our study was to investigate the effect of vacuum mattresses with plastic valves on CT artefacts, the radiation dose, and noise compared to a trauma transfer board and the spine boards currently used in our trauma system.

Effects of antenatal diet and physical activity on maternal and fetal outcomes: individual patient data meta-analysis and health economic evaluation.

Background: Diet- and physical activity-based interventions in pregnancy have the potential to alter maternal and child outcomes.

Objectives: To assess whether or not the effects of diet and lifestyle interventions vary in subgroups of women, based on maternal body mass index (BMI), age, parity, Caucasian ethnicity and underlying medical condition(s), by undertaking an individual patient data (IPD) meta-analysis. We also evaluated the association of gestational weight gain (GWG) with adverse pregnancy outcomes and assessed the cost-effectiveness of the interventions.

Quality of multiple sclerosis out-patient health care services with focus on patient reported experiences.

Background: To investigate multiple sclerosis (MS) patients' satisfaction with out-patient follow-up in a general neurological hospital department. Patients with definite MS living in Vest-Agder county, Norway were invited to answer a questionnaire comprising one question regarding overall satisfaction, and 24 questions regarding demographics, disease characteristics, and experiences with different aspects of the health care services.

Results: Out of 330 invited patients, 159 responded (48%).

Cecum intubation rate as quality indicator in clinical versus screening colonoscopy.

Background And Study Aims: Some guidelines recommend a minimum standard of 90 % cecal intubation rate (CIR) in routine clinics and 95 % in screening colonoscopy, while others have not made this distinction - both with limited evidence to support either view. This study questions the rationale for making such differentiation.

Patients And Methods:  We assessed cecum intubation rates amongst colonoscopies recorded in the Norwegian national quality register Gastronet by 35 endoscopists performing both clinical and screening colonoscopies.

To Make Room or Not to Make Room: Clients' Narratives About Exclusion and Inclusion of Spirituality in Family Therapy Practice.

This empirical article presents four narratives from an ongoing qualitative PhD project about spirituality and family therapeutic practice. Using case studies and narrative vignettes, the article presents client perspectives on being able to discuss their spirituality in therapy, and the repercussions when therapists exclude it. The article refers to current research and provides some reflections on how we can understand spirituality in the context of family therapeutic practice; therapists for holistic, cultural, and ethical reasons should acknowledge the client's spirituality.

Patient-reported adverse events after colonoscopy in Norway.

 Patient-reported outcome measures are increasingly important in healthcare. European guidelines have recommended inclusion of patient feedback to capture adverse events due to colonoscopy, but this is rarely implemented.  The Norwegian Quality Assurance network for endoscopy (Gastronet) collects patient-reported outcome for colonoscopies.

Effectiveness of flexible sigmoidoscopy screening in men and women and different age groups: pooled analysis of randomised trials.

Objective:  To compare the effectiveness of flexible sigmoidoscopy in screening for colorectal cancer by patient sex and age.

Design:  Pooled analysis of randomised trials (the US Prostate, Lung, Colorectal and Ovarian cancer screening trial (PLCO), the Italian Screening for Colon and Rectum trial (SCORE), and the Norwegian Colorectal Cancer Prevention trial (NORCCAP)).

Data Sources:  Aggregated data were pooled from each randomised trial on incidence of colorectal cancer and mortality stratified by sex, age at screening, and colon subsite (distal v proximal).

Methodological considerations for surveillance in GI practice.

Surveillance is recommended for various GI cancers, and substantial resources are invested. However, little is known about the effect of surveillance, neither for good, nor for bad. Most evidence stems from observational studies, but observational studies of surveillance can be subject to various biases that may severely influence the results.

A potential founder variant in in three Norwegian families with warts, molluscum contagiosum, and T-cell dysfunction.

Background: Four patients from three Norwegian families presented with a common skin phenotype of warts, molluscum contagiosum, and dermatitis since early childhood, and various other immunological features. Warts are a common manifestation of (HPV), but when they are overwhelming, disseminated and/or persistent, and presenting together with other immunological features, a primary immunodeficiency disease (PIDD) may be suspected.

Methods And Results: The four patients were exome sequenced as part of a larger study for detecting genetic causes of primary immunodeficiencies.

Level of education and multiple sclerosis risk over a 50-year period: Registry-based sibling study.

Background: The conflicting results from studies on socioeconomic status (SES) and multiple sclerosis (MS) risk might be due to a change in the distribution of environmental exposures over time or to methodological limitations in previous research.

Objective: To examine the association between SES and MS risk during 50 years.

Methods: We included patients registered in Norwegian MS registries and prevalence studies born between 1930 and 1979, and identified their siblings and parents using the Norwegian Population Registry.

An explorative study from the Norwegian Quality Register Gastronet comparing self-estimated versus registered quality in colonoscopy performance.

Background And Study Aims: The value of a colonoscopy quality assurance (QA) register may be questioned if it brings no new information on which to act for quality improvement, e. g. if self-assessed quality of colonoscopy performance correlates perfectly with registered performance.

Bounding the per-protocol effect in randomized trials: an application to colorectal cancer screening.

Background: The per-protocol effect is the effect that would have been observed in a randomized trial had everybody followed the protocol. Though obtaining a valid point estimate for the per-protocol effect requires assumptions that are unverifiable and often implausible, lower and upper bounds for the per-protocol effect may be estimated under more plausible assumptions. Strategies for obtaining bounds, known as "partial identification" methods, are especially promising in randomized trials.

Bystander first aid in trauma - prevalence and quality: a prospective observational study.

Background: Bystander first aid and basic life support can likely improve victim survival in trauma. In contrast to bystander first aid and out-of-hospital cardiac arrest, little is known about the role of bystanders in trauma response. Our aim was to determine how frequently first aid is given to trauma victims by bystanders, the quality of this aid, the professional background of first-aid providers, and whether previous first-aid training affects aid quality.

Study protocol: a randomised controlled trial comparing the long term effects of isolated hip strengthening, quadriceps-based training and free physical activity for patellofemoral pain syndrome (anterior knee pain).

Background: Patellofemoral pain syndrome (PFPS), also known as Anterior Knee Pain, is a common cause of recurrent or chronic knee pain. The etiology is considered to be multifactorial but is not completely understood. At the current time the leading theory is that pathomechanics in the patellofemoral joint leads to PFPS.

Is sense of coherence a predictor of lifestyle changes in subjects at risk for type 2 diabetes?

Objective: To determine whether the sense of coherence (SOC) could predict the outcome of an 18-month lifestyle intervention program for subjects at risk of type 2 diabetes.

Methods: Subjects at high risk of type 2 diabetes mellitus were recruited to a low-intensity lifestyle intervention program by their general practitioners. Weight reduction ≥ 5% and improvement in exercise capacity of ≥ 10% from baseline to follow-up indicated a clinically significant lifestyle change.

Opioids for chronic noncancer pain: still no evidence for superiority of sustained-release opioids.

Opioids are controversial in the treatment of chronic pain due to the risk of addiction, misuse, and death. Long-acting formulations of opioids have been hypothesized to improve pain relief, sleep quality, and lower the risk of side effects and addiction compared to short-acting formulations of opioids. Thus, several guidelines have recommended the use of long-acting opioid formulations over short-acting ones in the treatment of chronic noncancer pain.

Volumetric glioma quantification: comparison of manual and semi-automatic tumor segmentation for the quantification of tumor growth.

Background: Volumetric magnetic resonance imaging (MRI) is now widely available and routinely used in the evaluation of high-grade gliomas (HGGs). Ideally, volumetric measurements should be included in this evaluation. However, manual tumor segmentation is time-consuming and suffers from inter-observer variability.

Long-term colorectal-cancer mortality after adenoma removal.

Background: Although colonoscopic surveillance of patients after removal of adenomas is widely promoted, little is known about colorectal-cancer mortality among these patients.

Methods: Using the linkage of the Cancer Registry and the Cause of Death Registry of Norway, we estimated colorectal-cancer mortality among patients who had undergone removal of colorectal adenomas during the period from 1993 through 2007. Patients were followed through 2011.

Effect of flexible sigmoidoscopy screening on colorectal cancer incidence and mortality: a randomized clinical trial.

Importance: Colorectal cancer is a major health burden. Screening is recommended in many countries.

Objective: To estimate the effectiveness of flexible sigmoidoscopy screening on colorectal cancer incidence and mortality in a population-based trial.