Kristiania Open Archive
Not a member yet
2056 research outputs found
Sort by
Cognitive development among children in a low-income setting: Cost-effectiveness analysis of a maternal nutrition education intervention in rural Uganda
Full text linkInadequate nutrition and insufficient stimulation in early childhood can lead to long-term deficits in cognitive and social development. Evidence for policy and decision-making regarding the cost of delivering nutrition education is lacking in low and middle-income countries (LMIC). In rural Uganda, we conducted a cluster-randomized controlled trial (RCT) examining the effect of a maternal nutrition education intervention on developmental outcomes among children aged 6–8 months. This intervention led to significantly improved cognitive scores when the children reached the age of 20–24 months. When considering the potential for this intervention’s future implementation, the desired effects should be weighed against the increased costs. This study therefore aimed to assess the cost-effectiveness of this education intervention compared with current practice. Health outcome data were based on the RCT. Cost data were initially identified by reviewing publications from the RCT, while more detailed information was obtained by interviewing researchers involved in processing the intervention. This study considered a healthcare provider perspective for an 18-months’ time horizon. The control group was considered as the current practice for the future large-scale implementation of this intervention. A cost-effectiveness analysis was performed, including calculations of incremental cost-effectiveness ratios (ICERs). In addition, uncertainty in the results was characterized using one-way and probabilistic sensitivity analyses. The ICER for the education intervention compared with current practice was USD (265.79 and an incremental cognitive composite score of 16.11. The sensitivity analyses indicated the robustness of these results. The ICER was sensitive to changes in cognitive composite score and the cost of personnel. The education intervention can be considered cost-effective compared with the current practice. The outcome of this study, including the cost analysis, health outcome, cost-effectiveness, and sensitivity analysis, can be useful to inform policymakers and stakeholders about effective resource allocation processes in Uganda and possibly other LMIC.publishedVersio
Needling Point Location Used in Sham Acupuncture for Chronic Nonspecific Low Back Pain: A Systematic Review and Network Meta-Analysis
Full text linkImportance
When sham acupuncture is set as a control in evaluating acupuncture, the sham needling technique is usually different from acupuncture. However, the sham procedure is conducted either at the same points that are used for the acupuncture group or at nonindicated points.
Objective
To assess whether the outcome of sham acupuncture varies according to the needling points in sham-controlled trials of acupuncture for chronic nonspecific low back pain (CLBP) as an example.
Data sources
Searches of MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and the Allied and Complementary Medicine Database were conducted on February 12, 2023.
Study selection
Randomized clinical trials (RCTs) assessing the outcomes of acupuncture in sham acupuncture–controlled or waiting list–controlled trials on CLBP were included.
Data extraction and synthesis
Two researchers independently extracted data on study characteristics and outcomes and assessed quality. Sham acupuncture was classified according to whether it was conducted at the same acupuncture points used in the acupuncture group, referred to as sham acupuncture therapy (verum) (SATV) or at different points, referred to as sham acupuncture therapy (sham) (SATS). Clinical similarity, transitivity, and consistency tests were conducted, followed by a random-effects frequentist network meta-analysis (NMA).
Main outcomes and measures
The primary outcome was pain, and the secondary outcome was back-specific function. The first assessment after the end of treatment was chosen for analysis. Effect sizes are reported as standardized mean differences (SMD) with 95% CIs. The risk of bias was assessed using the Cochrane risk of bias tool, and the certainty of evidence for findings was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach.
Results
Ten RCTs involving 4379 participants were included. In comparison with SATS, acupuncture was significantly associated with improvements in both pain (SMD, −0.33; 95% CI, −0.52 to −0.15) and function outcomes (SMD, −0.13; 95% CI, −0.25 to −0.02); however, there were no differences between acupuncture and SATV. In comparison with SATS, SATV was significantly associated with better pain (SMD, −0.45; 95% CI, −0.88 to −0.03) and function outcomes (SMD, −0.30; 95% CI, −0.56 to −0.05). The risk of bias that could affect the interpretation of the results was usually low, and the certainty of evidence was moderate to low.
Conclusions and relevance
In this NMA, sham acupuncture needling at the same points as those in acupuncture was not a true placebo control for assessing the efficacy of acupuncture for CLBP and might underestimate the outcome of acupuncture in clinical settings.publishedVersio
Publication status and reporting quality of case reports on acupuncture-related adverse events: A systematic reviews of case studies
Full text linkIntroduction: Case reports on acupuncture-related adverse events (AEs) have been consistently published in the literature. This review aims to assess the current publication status of case reports on acupuncture-related AEs and evaluate their reporting quality in order to identify areas for improvement.
Methods: This study is a systematic review (SR) of case reports. Studies describing cases for acupuncture-related AEs between 2010 and 2023 (until July) were searched in PubMed, Embase, and local databases (China and Korea), as well as by hand-searching references included in published relevant SRs. A bibliometric analysis was conducted to examine the publication trends of the included literature. The appropriateness of the acupuncture described in the cases, the causality assessment between AEs and acupuncture treatment, and the presence of necessary items from the CAse REport guidelines (CARE) checklist were narratively analyzed.
Results: A total of 169 case reports were included in this review. Over the past decade, an average of 12 case reports on acupuncture-related AEs were published annually. However, only 38.2% of the articles provided sufficient information to determine the appropriateness of the acupuncture treatment used in the reported cases, and considerable numbers of the included case reports did not suggest enough information for the assessment of a causal relationship. The majority of cases did not report the timeline (n =164), patient perspectives (n =157), and informed consent (n = 121) items from the CARE checklist.
Discussion: Acupuncture-related AEs persist in being frequently reported in the literature. Nonetheless, the information concerning acupuncture and causality assessment within these publications is still found to be insufficient. The development of reporting guidelines for future case reports on acupuncture-related AEs is anticipated to promote an academic environment conducive to more comprehensive reporting.publishedVersio
Using Simulations to Help Public Health Students Overcome Language Barriers for Better Health Outcomes
Full text linkGrowing migration into Norway has increasingly strained the country’s health services. Good communication is essential to ensure quality care. Often, healthcare workers and immigrant clients do not share a common language, and it is known that the conditions and expectations of immigrant clients can be different from the majority population. This study aimed to explore the viability of utilizing simulations as a pedagogical tool for educating public health students in effectively navigating a multicultural environment to promote better health outcomes. This study is a component of an extra-curricular training project that utilized a convergent mixed-methods design. The present study focuses on reporting the qualitative component of the findings. The data collection process encompassed the implementation of a stepwise simulation exercise with case-based clinical scenarios focusing on three lifestyle diseases specifically designed for this study. Method triangulation was achieved by using different methodological approaches in the analysis. Our results show the importance of simulation training for healthcare students when working with clients who do not share the same language. Interactions with clients of different backgrounds must be practiced, and simulations can be used to improve healthcare students’ communication skills. The study highlights the need for healthcare education programs to integrate cultural competence simulation training and broaden the scope of medical training to address culturally challenging encounters.publishedVersio
Delineating disorder-general and disorder-specific dimensions of psychopathology from functional brain networks in a developmental clinical sample
Full text linkThe interplay between functional brain network maturation and psychopathology during development remains elusive. To establish the structure of psychopathology and its neurobiological mechanisms, mapping of both shared and unique functional connectivity patterns across developmental clinical populations is needed. We investigated shared associations between resting-state functional connectivity and psychopathology in children and adolescents aged 5–21 (n =1689). Specifically, we used partial least squares (PLS) to identify latent variables (LV) between connectivity and both symptom scores and diagnostic information. We also investigated associations between connectivity and each diagnosis specifically, controlling for other diagnosis categories. PLS identified five significant LVs between connectivity and symptoms, mapping onto the psychopathology hierarchy. The first LV resembled a general psychopathology factor, followed by dimensions of internalising- externalising, neurodevelopment, somatic complaints, and thought problems. Another PLS with diagnostic data revealed one significant LV, resembling a cross-diagnostic case-control pattern. The diagnosis-specific PLS identified a unique connectivity pattern for autism spectrum disorder (ASD). All LVs were associated with distinct patterns of functional connectivity. These dimensions largely replicated in an independent sample (n = 420) from the same dataset, as well as to an independent cohort (n =3504). This suggests that covariance in developmental functional brain networks supports transdiagnostic dimensions of psychopathology.publishedVersio
The Relevance of Technology to Information Verification: Insights from Norwegian Journalism During a National Election
Full text linkGrowing concerns about disinformation have led to the development of new digital tools and systems designed for journalists’ verification and fact-checking needs. Despite these technological developments, research has demonstrated that emerging technologies are not utilised as often and are not as highly valued as industry narratives suggest. There are indications that the typical journalist values traditional skills such as writing and interviewing higher than digital technology skills and that many journalists do not consider the new tools to be very useful in their everyday work. This article takes on a sociotechnical approach to study the interplay between journalists, technology, organisational and professional routines. Specifically, we examine journalists’ use of verification technologies to detect disinformation during an election period. Our findings show a discrepancy between the alleged potential of new technologies and the everyday practices of newswork and fact-checking – also in the digitally advanced Norwegian media industry. We found tensions between established routines and cultures in the newsroom and the push for the renewal of journalistic methods which can be sorted under two headings: strategy vs. practice and proximity vs. distance to the beat and sources.The Relevance of Technology to Information Verification: Insights from Norwegian Journalism During a National ElectionpublishedVersio
Global, regional, and national burden of low back pain, 1990–2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021
Full text linkBackground
Low back pain is highly prevalent and the main cause of years lived with disability (YLDs). We present the most up-to-date global, regional, and national data on prevalence and YLDs for low back pain from the Global Burden of Diseases, Injuries, and Risk Factors Study 2021.
Methods
Population-based studies from 1980 to 2019 identified in a systematic review, international surveys, US medical claims data, and dataset contributions by collaborators were used to estimate the prevalence and YLDs for low back pain from 1990 to 2020, for 204 countries and territories. Low back pain was defined as pain between the 12th ribs and the gluteal folds that lasted a day or more; input data using alternative definitions were adjusted in a network meta-regression analysis. Nested Bayesian meta-regression models were used to estimate prevalence and YLDs by age, sex, year, and location. Prevalence was projected to 2050 by running a regression on prevalence rates using Socio-demographic Index as a predictor, then multiplying them by projected population estimates.
Findings
In 2020, low back pain affected 619 million (95% uncertainty interval 554–694) people globally, with a projection of 843 million (759–933) prevalent cases by 2050. In 2020, the global age-standardised rate of YLDs was 832 per 100 000 (578–1070). Between 1990 and 2020, age-standardised rates of prevalence and YLDs decreased by 10·4% (10·9–10·0) and 10·5% (11·1–10·0), respectively. A total of 38·8% (28·7–47·0) of YLDs were attributed to occupational factors, smoking, and high BMI.
Interpretation
Low back pain remains the leading cause of YLDs globally, and in 2020, there were more than half a billion prevalent cases of low back pain worldwide. While age-standardised rates have decreased modestly over the past three decades, it is projected that globally in 2050, more than 800 million people will have low back pain. Challenges persist in obtaining primary country-level data on low back pain, and there is an urgent need for more high-quality, primary, country-level data on both prevalence and severity distributions to improve accuracy and monitor change.publishedVersio
The COVID-19 Pandemic Decreases Cardiorespiratory Fitness: A 3-Year Follow-Up Study in Industry
Full text linkBackground: We aimed to determine if maximal oxygen uptake (V˙O2max), resting heart rate (RHR), and self-reported leisure- time moderate to vigorous physical activity (MVPA) changed over a 3-year follow-up (FU) among industrial workers. Methods: We assessed cardiorespiratory fitness (CRF) August 2018 and August 2021. The last 17–18 months coincided with the COVID-19 pandemic. Data from 86 participants were collected; demographics by questionnaire and cardiovascular outcomes from medical examination: V˙ O2max, RHR, and fat mass (%). Workers reported on their leisure-time MVPA twice. To assess changes in health outcomes we applied a linear mixed model, adjusting for baseline (BL) age, sex, pack-years, shift work, and a 5-month plant shutdown. Further, we adjusted for actual age instead of BL age. Results: V˙ O2max decreased from 39.6 mL/kg/min at BL to 34.0 at FU, a reduction of 5.6 mL/kg/min (95%CI, −7.6, −3.7). Adjusted for actual age, the corresponding figure for V˙ O2max was 5.4 mL/kg/min, (95%CI, −7.4, −3.4), an annual loss of 4.6%. RHR increased from 61.3 to 64.4 beats per minute (95%CI, 0.8, 5.4). Self-reported MVPA decreased by 43.9 min/week, (95%CI, −73.5, −14.4). Conclusions: We observed a decrease in V˙ O2max, an increase in RHR and a decrease in self-reported MVPA, suggesting physical inactivity during the COVID-19 pandemic.The COVID-19 Pandemic Decreases Cardiorespiratory Fitness: A 3-Year Follow-Up Study in IndustrypublishedVersio
ORGANISING DEVELOPMENT PROCESSES: THE CASE OF PRODUCT-SERVICE SYSTEMS
Full text linkThis study addresses the development of new integrated product–service systems (PSSs). Most empirical research on the organisation of development processes has focussed on new product development, new service development, software development and new business model development in isolation; however, the development of new, complex PSSs that require the integration of these development efforts has received limited research attention. We address this literature gap through a qualitative, in-depth study of five firms operating in the business-to-business context. The findings demonstrate that all new PSS development processes did not implement and use one specific process model. Instead, the organisation of new PSS development processes was contingent upon the type of services to be offered and the target business model. This study proposes a contingency framework for development processes that provides considerable guidance to managers searching for ways to facilitate the processes of developing new PSSs.publishedVersio
Den hybride hverdagen
Full text linkDenne masteroppgaven ser nærmere på hvordan hybride løsninger, det vil si bruken av hjemmekontor og fysisk kontor, har påvirket lederrollen. Med utgangspunkt i primærdata hentet inn gjennom syv semistrukturerte intervjuer, med henholdsvis ledere og medarbeidere tar studien for seg hovedtemaene styring og ledelse, samt roller og forventninger.
Hovedvekten av oppgavens teori omhandler Henry Mintzbergs (1973) tre rollekategorier. Videre legger vi frem teori om blant annet temaene ledelse, fjernarbeid og kommunikasjon. Ledelse er et godt utforsket tema, men det finnes begrenset forskning på hvordan digitale løsninger påvirker lederrollen. Vi har utforsket problemstillingen ved hjelp av to forskningsspørsmål:
1. Hvordan har hybride løsninger påvirket forventningene til både leder og medarbeider?
2. Hvordan har hybride løsninger påvirket kommunikasjonen mellom leder og
medarbeider?
Studiens funn tyder på at som leder i en verden preget av hybride løsninger stilles det nå høyere forventninger til tilgjengelighet og lederens overordnede mellommenneskelige rolle. Gjennom studiet fremkommer det derimot ikke å være 100 % konsensus for hva ledere og medarbeidere tenker om lederens rolle. Videre tyder også studiens funn på at det er oppstått et økt behov for informasjonsdeling og informasjonsflyt. Samtlige av studiens informanter trekker frem at all informasjon som deles digitalt nå gjentas flere ganger. Vi har forstått det slik at ønsket om fleksibilitet i hverdagen vedvarer selv etter korona-pandemien er over, og ser også at flere bedrifter opplever det som fornuftig å benytte seg av hybride løsninger for å skape en balanse mellom arbeid og fritid