Publications from Institute of Health and Society

• Camassa, Laura Maria Azzurra; Ervik, Torunn Kringlen; Zegeye, Fikirte Debebe; Mdala, Ibrahimu; Valen, Håkon; Ansteinsson, Vibeke Elise & Zienolddiny, Shanbeh (2021). Characterization and toxicity evaluation of air-borne particles released by grinding from twodental resin composites in vitro. Dental Materials.  ISSN 0109-5641. . doi: 10.1016/j.dental.2021.03.011 Show summary

  Objective The project aims to evaluate whether inhalation of particles released upon grinding of dental composites may pose a health hazard to dentists. The main objective of the study was to characterize the dust from polymer-based dental composites ground with different grain sized burs and investigate particle uptake and the potential cytotoxic effects in human bronchial cells. Methods Polymerized blocks of two dental composites, Filtek™ Z250 and Filtek™ Z500 from 3M™ ESPE, were ground with super coarse (black) and fine (red) burs inside a glass chamber. Ultrafine airborne dust concentration and particle size distribution was measured real-time during grinding with a scanning mobility particle sizer (SMPS). Filter-collected airborne particles were characterized with dynamic light scattering (DLS) and scanning electron microscopy (SEM). Human bronchial epithelial cells (HBEC-3KT) were exposed to the dusts in dose-effect experiments. Toxicity was measured with lactate dehydrogenase (LDH) assay and cell counting kit-8 (CCK8). Cellular uptake was observed with transmission electron microscopy (TEM). Results Airborne ultrafine particles showed that most particles were in the size range 15−35 nm (SMPS). SEM analysis proved that more than 80% of the particles have a minimum Feret diameter less than 1 μm. In solution (DLS), the particles have larger diameters and tend to agglomerate. Cell toxicity (LDH, CCK8) is shown after 48 h and 72 h exposure times and at the highest doses. TEM showed presence of the particles within the cell cytoplasm.

• Broch, Line; Simonsen, Cecilia Smith; Flemmen, Heidi Øyen; Berg-Hansen, Pål; Skardhamar, Åshild; Ormstad, Heidi & Celius, Elisabeth Gulowsen (2021). High prevalence of fatigue in contemporary patients with multiple sclerosis. Multiple Sclerosis Journal, Experimental, Translational and Clinical.  ISSN 2055-2173.  7(1) . doi: 10.1177/2055217321999826 Show summary

  Objective: The prevalence of multiple sclerosis (MS)-related fatigue may have changed due to new diagnostic criteria and new disease modifying drugs. We aimed to assess the prevalence of fatigue in a contemporary MS cohort, and to explore associations between fatigue and clinical and demographic factors. Methods: This is a cross-sectional study of the MS population in three Norwegian counties. Fatigue was assessed with the Fatigue Scale for Motor and Cognitive Functions (FSMC). We also assessed self-reported anxiety, depression and daytime sleepiness. Results: The response rate was 64% (1599/2512). The mean age of the participants was 52 ± 13 years, median EDSS was 2.5 (IQR 1.5-3.0) and median disease duration from onset was 16 years (IQR 8-25). We found a prevalence of fatigue of 81%. Women had a higher prevalence of fatigue than men (83% vs 78%, p = 0.02). The prevalence increased with age (p < 0.001) and with increasing disease severity (p < 0.001), but in multivariate analyses, only sex and disease severity remained independent determinants of fatigue. Anxiety, depression, and daytime sleepiness were more prevalent in patients with fatigue than in those without fatigue (all p-values < 0.001). Conclusion: The prevalence of fatigue is high in contemporary patients with MS. Fatigue is associated with female sex and level of disability, as well as with anxiety, depression and excessive daytime sleepiness.

• Hedenstierna, Louise; Bellocco, Rino; Ye, Weimin; Adami, Hans Olov; Åkerstedt, Torbjørn; Trolle Lagerros, Ylva & Hedström, Anna Karin (2021). Effects of alcohol consumption and smoking on risk for RA: Results from a Swedish prospective cohort study. RMD Open.  ISSN 2056-5933.  7(1), s 1- 7 . doi: 10.1136/rmdopen-2020-001379
• Aksnes, Mari; Tiiman, Ann; Edwin, Trine Holt; Terenius, Lars; Bogdanovic, Nenad; Vukojevic, Vladana & Knapskog, Anne Brita (2021). Comparison of cerebrospinal fluid amyloidogenic nanoplaques with core biomarkers of Alzheimer's disease. Frontiers in Aging Neuroscience.  ISSN 1663-4365.  12:608628, s 1- 11 . doi: 10.3389/fnagi.2020.608628
• Edwin, Trine Holt; Strand, Bjørn Heine; Persson, Karin Ester Torun; Engedal, Knut; Selbæk, Geir & Knapskog, Anne Brita (2021). Neuropsychiatric symptoms and comorbidity: Associations with dementia progression rate in a memory clinic cohort. International Journal of Geriatric Psychiatry.  ISSN 0885-6230. . doi: 10.1002/gps.5500 Full text in Research Archive. Show summary

  Objectives Neuropsychiatric symptoms (NPS) are associated with dementia severity and progression rate. NPS clusters have different neurobiological underpinnings; therefore, their effect on dementia progression may differ. Further, little is known about whether individual comorbidities affect progression rate. We investigated the effect of NPS clusters and individual comorbidities on dementia progression. Methods A memory clinic cohort with all‐cause dementia (N = 442), was followed for up to three years from diagnosis. Previously, we found trajectory groups of dementia progression in this cohort: one with slow progression and two with rapid progression. In the present study, using principal component analysis, three symptom clusters of NPS were on the Neuropsychiatric Inventory Questionnaire (NPI‐Q): agitation, affective, and psychosis symptom clusters. Data regarding comorbidity were collected by linkage to the Norwegian patient registry. Multinomial logistic regression was applied to explore the association between NPS clusters and comorbidity with trajectory‐group membership. Results Adjusted for demographics, dementia aetiology, comorbidity, and cognition, we found that, at the time of dementia diagnosis, for every point within the psychosis symptom cluster of the NPI‐Q, the risk of rapid progression increased by 53%; for every point within the affective symptom cluster, the risk of rapid progression increased by 29%. A previous diagnosis of mental and behavioural disorders (excluding dementia) decreased the risk of rapid dementia progression by 65%. Conclusions Psychosis and affective symptom clusters at the time of diagnosis were associated with rapid progression of dementia. Previous diagnoses of mental and behavioural disorders (excluding dementia) were associated with slow progression.

• Herber, Oliver Rudolf; Bradbury-Jones, Caroline; Böling, Susanna; Combes, Sarah; Hirt, Julian; Koop, Yvonne; Nyhagen, Ragnhild; Veldhuizen, Jessica D. & Taylor, Julie (2020). What feedback do reviewers give when reviewing qualitative manuscripts? A focused mapping review and synthesis. BMC Medical Research Methodology.  ISSN 1471-2288.  20(1) . doi: 10.1186/s12874-020-01005-y
• Borgen, Ida Maria Henriksen; Løvstad, Marianne; Røe, Cecilie; Forslund, Marit Vindal; Hauger, Solveig; Sigurdardottir, Solrun; Winter, Larraine & Kleffelgård, Ingerid (2020). Needs and treatment options in chronic traumatic brain injury: A feasibility trial of a community-based intervention. Cogent Medicine.  ISSN 2331-205X.  7(1) . doi: 10.1080/2331205X.2020.1731222
• Alves, Daniele Evelin; Nilsen, Wendy; Fure, Silje Christine Reistad; Enehaug, Heidi; Howe, Emilie Isager; Løvstad, Marianne; Fink, Louisa; Andelic, Nada & Spjelkavik, Øystein (2020). What characterizes work and workplaces that retain their employees following acquired brain injury? Systematic review. Annals of Occupational and Environmental Medicine (AOEM).  ISSN 2052-4374.  77, s 122- 130 . doi: http://dx.doi.org/10.1136/oemed-2019-106102
• Hesselberg, Jan Ole; Dalsbø, Therese Kristine; Strømme, Hilde; Svege, Ida & Fretheim, Atle (2020). Reviewer training for improving grant and journal peer review. Cochrane Database of Systematic Reviews.  ISSN 1469-493X. . doi: 10.1002/14651858.MR000056 Full text in Research Archive.
• Edwin, Trine Holt; Henjum, Kristi; Nilsson, Lars; Watne, Leiv; Persson, Karin Ester Torun; Eldholm, Rannveig Sakshaug; Saltvedt, Ingvild; Halaas, Nathalie Bodd; Selbæk, Geir; Engedal, Knut; Strand, Bjørn Heine & Knapskog, Anne Brita (2020). A high cerebrospinal fluid soluble TREM2 level is associated with slow clinical progression of Alzheimer's disease. Alzheimer's & Dementia.  ISSN 1552-5260.  12(1) . doi: 10.1002/dad2.12128 Full text in Research Archive. Show summary

  Introduction: The progression rate of Alzheimer's disease (AD) varies and might be affected by the triggering receptor expressed on myeloid cells (TREM2) activity. We explored if cerebrospinal fluid (CSF) soluble TREM2 (sTREM2), a proxy of microglial activity, is associated with clinical progression rate. Methods: Patients with clinical AD (N = 231) were followed for up to 3 years after diagnosis. Cognitively healthy controls (N = 42) were followed for 5 years. CSF sTREM2 was analyzed by enzyme-linked immunosorbent assay. Group-based trajectory modeling revealed distinct clinical progression groups. Results: Higher CSF sTREM2 was associated with slow clinical progression. The slow- and medium-progressing groups had higher CSF sTREM2 than the cognitively healthy, who had a similar level to patients with rapid clinical progression. Discussion: CSF sTREM2 levels were associated with clinical progression in AD, regardless of core biomarkers. This could be useful in assessing disease development in relation to patient care and clinical trial recruitment. Keywords: Alzheimer's disease; Clinical Dementia Rating scale; disease progression; soluble triggering receptor expressed on myeloid cells 2 (sTREM2); trajectories.

• Lee, Yunsung; Jacobsen, Kristine Løkås; Denault, William Robert Paul; Nustad, Haakon Egdetveit; Page, Christian; Lyle, Robert; Lee-Ødegård, Sindre; Moen, Gunn-Helen; Prasad, Rashmi B.; Groop, Leif C.; Sletner, Line; Sommer, Christine; Magnus, Maria Christine; Gjessing, Håkon K.; Harris, Jennifer Ruth; Magnus, Per; Håberg, Siri Eldevik; Jugessur, Astanand & Bohlin, Jon (2020). Blood-based epigenetic estimators of chronological age in human adults using DNA methylation data from the Illumina MethylationEPIC array. BMC Genomics.  ISSN 1471-2164.  21(1) . doi: 10.1186/s12864-020-07168-8 Full text in Research Archive.
• Johansen, Reidun Harr; Olsen, Karoline; Bergh, Sverre; Saltyte Benth, Jurate; Selbæk, Geir & Helvik, Anne-Sofie (2020). Course of activities of daily living in nursing home residents with dementia from admission to 36-month follow-up. BMC Geriatrics.  ISSN 1471-2318.  20(1) . doi: 10.1186/s12877-020-01877-1 Full text in Research Archive. Show summary

  Background: Dementia is affecting both the person with the disease and the family members. It is associated with nursing home admission, and a reduced ability to perform personal activities of daily living (P-ADL). The aim of this study was to examine the association between the severity of dementia and P-ADL function, and to study if additional factors such as neuropsychiatric symptoms, type of nursing home unit, and use of medication were associated with P-ADL function. Methods: A total of 582 nursing home residents with dementia, included at admission to the nursing home, were followed with biannual assessments for 36 months. P-ADL was assessed using the Physical Self-Maintenance scale, and severity of dementia was measured with the Clinical Dementia Rating scale. In addition, neuropsychiatric symptoms, general physical health, and use of medications were assessed at the same time points. Demographic information was collected at baseline. Linear mixed models were estimated. Results: There was a significant (p < 0.05) non-linear decline in P-ADL function over time in analysis not adjusting for any characteristics. More severe dementia at baseline and at the follow-up assessments was associated with lower P-ADL function (p < 0.001), with the association being stable over time. A higher level of neuropsychiatric symptoms, not using anti-dementia medication, being in a regular care unit as compared to a special care unit and having poor/fair general physical health as compared to good/excellent, were associated with a lower P-ADL function. Conclusion: The association between more severe dementia and lower P-ADL function was stable over a 36-month follow-up period of nursing home residents with dementia. Health care planners and clinicians should be aware of this when planning for and treating nursing home residents. Keywords: Behavioural symptoms; CDR; Cognitive impairment; Elderly; Functional decline; Functional impairment; Home for the aged; Long term care; PSMS; Psychotropic medication.

• Simonsen, Cecilia Smith; Flemmen, Heidi Øyen; Broch, Line; Brunborg, Cathrine; Berg-Hansen, Pål; Moen, Stine Marit & Celius, Elisabeth Gulowsen (2020). The course of multiple sclerosis rewritten: a Norwegian population-based study on disease demographics and progression. Journal of Neurology.  ISSN 0340-5354.  s 1- 12 . doi: 10.1007/s00415-020-10279-7 Full text in Research Archive. Show summary

  Objectives: Over the past few decades, there has been an improvement in the rate of disability progression in multiple sclerosis (MS) patients, and most studies relate this evolvement to the introduction of disease-modifying therapies. However, several other factors have changed over this period, including access to MRI and newer diagnostic criteria. The aim of this study is to investigate changes in the natural course of MS over time in a near-complete and geographically well-defined population from the south-east of Norway. Methods: We examined disease progression and demographics over two decades and assessed the effect of disease-modifying therapies using linear mixed-effect models. Results: In a cohort of 2097 patients, we found a significant improvement in disability as measured by the Expanded Disability Status Scale (EDSS) stratified by age, and the improvement remained significant after adjusting for time on disease-modifying medications, gender and progressive MS at onset. The time from disease onset to EDSS 6 in the total cohort was 29.8 years (95% CI 28.5-31.1) and was significantly longer in patients diagnosed after 2006 compared to patients diagnosed before. There are significant differences between patient demographics, as well as time to EDSS 6, in the near-complete, geographically well-defined population compared to an additional cohort from the capital Oslo and its suburbs. Conclusion: The natural course of MS is improving, but the improvement seen in disease progression has multifaceted explanations. Our study underlines the importance of completeness of data, relevant timeframes and demographics when comparing different MS populations. Studies on incomplete populations should be interpreted with caution.

• Nsangi, Allen; Oxman, Andrew David; Oxman, Matt; Rosenbaum, Sarah Ellen; Semakula, Daniel; Ssenyonga, Ronald; Mugisha, Michael; Chelagat, Faith; Kaseje, Margaret; Nyirazinyoye, Laetitia; Chalmers, Iain & Sewankambo, Nelson Kaulukusi (2020). Protocol for assessing stakeholder engagement in the development and evaluation of the Informed Health Choices resources teaching secondary school students to think critically about health claims and choices. PLOS ONE.  ISSN 1932-6203.  15:e0239985(10), s 1- 15 . doi: 10.1371/journal.pone.0239985
• Gamboa, Danil; Jørgenrud, Benedicte Marie; Bryun, Evgeny A.; Vindenes, Vigdis; Koshkina, Evgenya A.; Nadezhdin, Aleksei V.; Kabashi, Saranda; Tetenova, Elena J.; Berg, Thomas; Nyman, Anna Armika Tussilago; Kolgashkin, Alexey J.; Petukhov, Aleksei E.; Perekhodov, Sergey N.; Davydova, Elena N.; Lerdal, Anners; Nordby, Gudmund & Bogstrand, Stig Tore (2020). Prevalence of psychoactive substance use among acutely hospitalised patients in Oslo and Moscow: a cross-sectional, observational study. BMJ Open.  ISSN 2044-6055.  10:e032572(9), s 1- 15 . doi: 10.1136/bmjopen-2019-032572 Full text in Research Archive.
• Røsvik, Janne-Kathrin; Michelet, Mona; Engedal, Knut; Bergh, Sverre; Bieber, Anja; Gonçalves-Pereira, Manuel; Portolani, Daniel Michael; Hopper, Louise; Irving, Kate; Jelley, Hannah; Kerpershoek, Liselot; Meyer, Gabriele; Marques, Maria J.; Sjölund, Britt-Marie; Sköldunger, Anders; Stephan, Astrid; Verhey, Frans; de Vugt, Marjolein; Woods, Bob; Wolfs, Claire; Zanetti, Orazio & Selbæk, Geir (2020). Development of best practice recommendations to enhance access to and use of formal community care services for people with dementia in Europe: a Delphi process conducted by Actifcare project. Aging & Mental Health.  ISSN 1360-7863.  s 1- 12 . doi: 10.1080/13607863.2020.1822286 Full text in Research Archive. Show summary

  Objectives: Home-dwelling people with dementia and their informal carers experience barriers impeding access to community care services. This study is a part of the Actifcare project where eight countries participated. The aim was to achieve consensus on best practice recommendations for enhancing access to and use of formal community care services. Method: A Delphi consensus process was conducted. A total of 48 professional experts, 14 people with dementia and 20 informal carers rated the importance of 72 statements on a 7-point Likert scale. Consensus was based on the median and level of dispersion. Results: Sixty-two statements reached consensus, resulting in three categories of recommendations. An appointed contact person was central in Recommendations to enhance access. Coordination and flexibility in setting and type of services were among the Recommendations to enhance use. Training of health care personnel and person-centred care were central Recommendations that can facilitate access or use indirectly. Conclusion: The Actifcare Best Practice Recommendations suggest practical measures that can be taken by decision makers to enhance access and use of community care services, and thereby enhance quality of care and quality of life for home dwelling people with dementia and their informal carers. Keywords: Delphi process; Dementia; access; best practice; consensus; services.

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• Andries, Aristomo; Van Walsem, Marleen Regina; Ørstavik, Kristin & Frich, Jan C (2021). Funksjonsevne og fysisk aktivitet hos personer med limb-girdle muskeldystrofi og Charcot-Marie-Tooth i Norge.
• Hagen, Terje P. & Hofmann, Bjørn (2020). Norway’s Response to the Coronavirus Pandemic.
• Neumark, Tom (2020). The hype and hope of data for healthcare in Africa. Somatosphere: Science, Medicine and Anthropology.
• Lycholip, Edita; Aamodt, Ina Thon; Lie, Irene; Hellesø, Ragnhild; Simbelyte, Toma; Puronaité, Roma; Strømberg, Anna; Jaarsma, Tiny & Celutkiene, Jelena (2020). Young and computer-literate healthcare professionals have the greatest expectations for heart failure tele monitoring. European Heart Journal-Digital Health.  1, s 6- 7 . doi: 10/1093/ehjdh/ztaa001

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