Avdeling for helseledelse og helseøkonomi

• Fossmo, Hanne Ludt; Robinson, Hilde Stendal; Bjåstad, Karianne Grûner; Varhaug, Kristin Nielsen; Frich, Jan C & Ørstavik, Kristin (2026). Muscle Strength and Outcome Measures for Upper Limb Function in Adults With Myotonic Dystrophy Type 1: A Cross-Sectional Study. European Journal of Neurology. ISSN 1351-5101. 33(11). doi: 10.1111/ene.70799. Fulltekst i vitenarkiv Vis sammendrag

  Background: Myotonic dystrophy Type 1 (DM1) is a multisystem neuromuscular disorder with progressive distal and proximal weakness, including in the upper limbs. Limited research has been conducted on hand function and outcome measures. Methods: Eighty nine adult DM1 participants were included in this cross-sectional study. The study describes upper limb strength and function and examines associations between motor impairments and clinical outcome measures, including comparing strength measurement methods. Disease severity was classified with the muscular impairment rating scale (MIRS) and the Brooke upper extremity scale was used as a classification scale of upper limb function. Muscle strength was measured using handheld dynamometers, and fine motor function with the Nine-Hole Peg Test and Nut and Bolt task. Upper limb function was rated with the Revised Upper Limb Module and global motor function with the Motor Function Measure 32. Patient-reported outcome measures included ABILHAND-NMD, ACTIVLIM, and the Myotonia behavior scale. Results: Participants showed a wide spectrum of motor impairment from minimal distal to severe proximal weakness. Strength measures correlated significantly with functional tests, while PROMs reflected perceived limitations but showed ceiling effects. Disease duration correlated with muscle strength and upper limb function, while age and subtype were less important. Myotonia severity showed only weak correlation with functional outcomes. Conclusion: No single measure fully captures upper limb function in DM1. A combination of strength testing, dexterity tasks, and PROMs provides a multidimensional assessment framework. Muscle strength assessment remains essential, and these findings support integrating multiple standardized measures for clinical trial endpoints and therapeutic evaluation in DM1.

• Moger, Tron Anders; Tjerbo, Trond; Vøllestad, Nina Køpke; Hellesø, Ragnhild; Holte, Jon Helgheim & Amundsen, Olav [Vis alle 18 forfattere av denne artikkelen] (2026). From data collection to action: Health registry data in chronic care management and policy. Journal of Public Health Research. ISSN 2279-9028. 15(4). doi: 10.1177/22799036261495552. Fulltekst i vitenarkiv

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• Andersen, Maria Lyster; Torvik, Fartein Ask & Hart, Rannveig Kaldager (2026). Family Transitions, Mental Health, and Work: Evidence from Parenthood, Grandparenthood, and Assisted Reproduction in Norway. Universitetet i Oslo. Fulltekst i vitenarkiv Vis sammendrag

  Many countries have experienced substantial declines in fertility, later transitions to parenthood, and increased use of assisted reproductive technologies (ART). These changes can matter for demographic patterns, but also for health, wellbeing, and labour market trajectories across the life course. Family formation may affect health and employment in different, potentially opposing, ways. Parenthood and grandparenthood can provide meaning and social support, but they may also involve stress, care responsibilities, and economic costs. Similarly, difficulties conceiving and undergoing fertility treatment might affect mental health and working life well beyond the treatment period. Yet we do not fully understand how these different experiences of family formation are associated with health and labour-market outcomes over the life course. Consequently, this thesis examines how different family formation processes relate to health, sick leave, and employment, with a particular focus on gender differences. The three papers of this thesis consider distinct but connected stages of the family life course: parenthood, grandparenthood, and infertility treatment. Paper 1 studies differences in mental health between parents and childless individuals across the full adult life course. Parents have a consistently lower risk of mental disorders than the childless, even when adjusting for important confounders such as socioeconomic status and marital status. We find the lowest risk of mental disorders among individuals who have not yet become parents. This suggests that the observed parent–childless gap at least partly reflects selection into parenthood rather than a protective causal effect of having children on mental health. Importantly, we also find differences in the association depending on the specific mental health condition studied, with certain symptoms such as stress more likely among parents. Paper 2 examines the causal effects of becoming a grandparent on health and labour market outcomes, again with particular attention to gender. The results show that grandparenthood affects both health and employment, although the magnitude and direction of effects vary across outcomes. Becoming a grandparent is associated with an increased risk of respiratory infections, a reduction in cardiovascular-related health care use, and a slightly lower risk of mental disorders. It also marks a clear transition in labour market attachment: both women and men become more likely to work part-time and experience reductions in income. The employment effects are substantially larger among grandmothers. These gender differences may reflect women’s greater involvement in informal childcare. (Paper 3: not published) Taken together, the three papers show that family formation is linked to health and working life in varying ways across the life course. The papers also illustrate how family formation reflects gendered processes. The thesis highlights the importance of selection into parenthood, identifies grandparenthood as a meaningful life-course transition with health and economic consequences, and shows that unsuccessful fertility treatment may have lasting effects on mental health and employment. By examining these processes together, the thesis shows that family formation is not only an isolated reproductive event, but also a potential source of gender differences and inequalities in health and economic wellbeing.

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