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Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disorders
No full textBackground: Depression and anxiety disorders are highly prevalent among young adults, with evidence suggesting sleep problems as key risk factors.
Objective: This study aimed to examine the association between insomnia and sleep characteristics with major depressive episode (MDE) and anxiety disorders, and the association after accounting for baseline mental health symptoms.
Methods: We conducted a prospective cohort study using data from the Students’ Health and Wellbeing Study (SHoT), surveying Norwegian higher education students aged 18 to 35 (N = 53,362). A diagnostic assessment of 10,460 participants was conducted in 2023. Self-reported insomnia, sleep duration, sleep onset latency, and wake after sleep onset were recorded in 2022. MDE and five types of anxiety disorders were assessed after one year using a self-administered CIDI 5.0. Analyses adjusted for age, sex, baseline mental health symptoms, and somatic conditions.
Results: Insomnia in young adults was associated with a significantly increased risk of MDE (adjusted RR = 3.50, 95 % CI = 3.18–3.84) and generalized anxiety disorder (GAD) (adjusted RR = 2.82, 95 % CI = 2.55–3.12) one year later. Sleep duration showed a reversed J-shaped association with mental disorders, with both short and, to a lesser extent, long sleep durations linked to elevated risks, even after adjusting for baseline mental health symptoms and somatic conditions. Although the associations were attenuated after adjustment, they remained statistically significant.
Conclusion: Sleep disturbances, including insomnia and abnormal sleep durations, predict mental health issues in young adults, even after accounting for baseline mental health and somatic health. Addressing sleep problems early may help prevent subsequent mental health conditions in this population.publishedVersio
Catastrophic health payments in Ghana post-National Health Insurance Scheme implementation: An analysis of service-specific health expenditures
No full textBackground: Ghana implemented several health reforms in the 1970s and 1990s. Still, several access barriers persist, including high out-of-pocket (OOP) spending, which led to the implementation of the National Health Insurance Scheme (NHIS) in 2003 to achieve Universal Health Coverage and lower OOP spending. This study evaluates the incidence and intensity of catastrophic health expenditure (CHE) among Ghanaian households post-NHIS, considering OOP health spending on different health services.
Methods: Data came from the Ghana Living Standards Surveys rounds 6 (2012/2013) and 7 (2016/2017) and the Annual Household Income and Expenditure Survey 2022/2023. Key variables were OOP spending on three health service categories (medical products, outpatient and inpatient) and total expenditure. The incidence and intensity of CHE for various health service categories were calculated using service-specific thresholds. A household incurs CHE for each service when OOP health spending as a share of total expenditure exceeds the service-specific threshold.
Results: Overall, at the 10% threshold, CHE headcount for total OOP health spending increased from 1.26% (95% CI 1.11% to 1.44%) to 11.45% (95% CI 10.86% to 12.07%) between 2012 and 2023. CHE gaps were also substantial for overall and service-specific OOP health spending. Medical supplies account for a large share of total OOP health spending, with CHE headcount rising from 1.34% (95% CI 1.18% to 1.53%) to 12.24% (95% CI 11.64% to 12.89%) between 2012 and 2023 at the 10% original threshold. Although the results were mixed, rural, northern and low-income households experienced substantial financial burdens. At the 20% threshold, the CHE headcount for inpatient services increased from 0.84% (95% CI 0.64% to 1.10%) to 4.38% (95% CI 3.83% to 4.99%) for northern dwellers between 2012 and 2023.
Discussion/conclusions: Despite NHIS coverage, high-cost services like medical supplies, hospital stays and frequently used outpatient services substantially drive CHE in Ghana, particularly for underserved populations. Addressing them requires prioritised policy interventions to expand NHIS coverage for essential services and improve financial protection, especially for rural and low-income households.publishedVersio
Contrasting seasonal patterns in particle aggregation and dissolved organic matter transformation in a sub-Arctic fjord
No full textParticulate (POM) and dissolved (DOM) organic matter in the ocean are important components of the Earth's biogeochemical cycle. The two are in a constant state of dynamic change as a result of physical and biochemical processes; however, they are mostly treated as two distinct entities, separated operationally by a filter. We studied the seasonal transition of DOM and POM pools and their drivers in a sub-Arctic fjord by means of monthly environmental sampling and by performing experiments at selected time points. For the experiments, surface water (5 m) was either pre-filtered through a GF/F filter (0.7 µm) or left unfiltered, followed by 36 h incubations. Before and after incubation, samples were collected for dissolved and particulate organic carbon concentrations (DOC, POC), extracellular polymeric substances (EPSs), microbial community (flow cytometry), and molecular composition of DOM (high-performance liquid chromatography coupled to high-resolution mass spectrometry – HPLC-HRMS). During the biologically productive period, when environmental POC concentrations were high (April, June, September), the filtered water showed an increase in POC concentrations. While POC concentrations increased in September, DOM lability decreased based on changes in the average hydrogen saturation and aromaticity of DOM molecules. In contrast, during the winter period (December and February), when environmental POC concentrations were low, lower concentrations of POC were measured at the end of the experiments compared to at the start. The change in POC concentrations was significantly different between the biologically productive period and the winter period (t test; p<0.05). Simultaneously, the DOM pool became more labile during the incubation period, as indicated by changes in the average hydrogen saturation, aromaticity, and oxygen saturation, with implications for carbon cycling. The change in POC was not directly associated with an antagonistic change in DOC concentrations, highlighting the complexity of organic matter transformations, making the dynamics between POC and DOC difficult to quantify. However, in both periods, bacterial activity and EPS concentrations increased throughout the incubations, showing that bacterial degradation and physical DOM aggregation drive the transformations of POM and DOM in concert but at varying degrees under different environmental conditions.publishedVersio
Teethmarks on leather, and the Ohh!-feeling in archaeology
No full textThe paper explores why some archaeological finds trigger the Ohh!-feeling with recent experiences with early medieval finds of leather as example. It is advocated that researchers and disseminators of archaeology hold on to the Ohh!-feeling as a driving force in archaeological research and dissemination of archaeology to the public.publishedVersio
Assessment of Developmental Prosopagnosia in an Individual with Tourette Syndrome and Attention Deficit Hyperactivity Disorder: A Case Report
Get PDFBackground/Objectives: Prosopagnosia is the inability to recognize people by their faces. Developmental prosopagnosia is the hereditary or congenital variant of the condition. The aim of this study was to demonstrate the assessment of developmental prosopagnosia in a clinical context, using a combination of commercially available clinical assessment tools and experimental tools described in the research literature. Methods: We conducted a comprehensive neuropsychological assessment of a man with Tourette syndrome and attention deficit hyperactivity disorder (ADHD). The patient (ON) had experienced difficulties with face identity recognition throughout his life but believed they were caused by a lack of interest in others. Results: The neuropsychological assessment revealed varying degrees of difficulties primarily related to executive functions, attention, reaction time, and memory processes, as expected in a person with Tourette’s syndrome and ADHD. In addition, ON reported severe problems with face recognition on a prosopagnosia questionnaire and demonstrated severely impaired performance on tests of face memory and face perception commonly used to diagnose prosopagnosia. Interestingly, he reported familial face recognition problems on the maternal side of the family, while tics and ADHD symptoms occurred on the paternal side. This suggests that, in this case, the conditions were likely inherited through different genetic pathways. Conclusions: Proper assessment of face recognition problems, which includes a broad spectrum of clinical assessment tools, could help patients develop awareness and acceptance of themselves and their difficulties, and could serve as a basis for the development of clinical interventions. While ON’s DP, Tourette syndrome, and ADHD may have distinct genetic origins, impairment in face identity recognition has been observed across several neurodevelopmental conditions and is likely more common than currently thought.publishedVersio
Blind to culture. How classed cognition prevents cultural policy initiatives from increasing cultural participation for children
Get PDFSince its first formulation in the post war years, Nordic cultural policy has had a stated aim to democratize culture, but with limited success. A growing literature argues that understanding policy failure is needed for a better functioning cultural policy. The present study uses two waves of panel data on cultural participation for parents and children in Bergen, Norway (N = 4754) to analyze the impact of three locally implemented cultural policy interventions designed in part to democratize culture for children. Using work with cultural policy failure, and tools from Bourdieu’s Sociology of Culture, this study finds that policies fail in systematic ways related to classed cognition. This leads to a ‘Matthew effect’ for cultural goods, as policies enable easier access to culture for those already invested in cultural participation, while the policies fail to even out social inequalities. There are both scientific and policy implications of the findings. First, data show that a cultural reproduction model seems a better fit than a cultural mobility model of cultural participation. Second, policy planners rarely factor in implications of the former in implementation of cultural policies designed to equalize distributions of culture. As a consequence, cultural policy initiatives to reduce inequalities in access to culture may lead to an exacerbation of cultural inequalities.publishedVersio
Understanding news experience: The resonance between content, practices, and situatedness in everyday life
Get PDFPeople relate to news in highly complex ways. Research on news audiences has identified how content reception, user practices, and spatiotemporal contexts influence relations to news. This study aims to see these dimensions as connected, emphasizing the sig- nificance of understanding how news content, practices, and people’s situatedness res- onate in the context of everyday life and how this resonance reflects personal identity. Conceptually, the paper employs the concept of news experience as an analytical lens to understand the multilayered nature of how people relate to news. Empirically, six distinct forms of news experience are identified, all in which content, practices, and situatedness resonate differently: Reassurance, control, social connection, relaxation, diversion, and stress. Drawing on a Norwegian three-step data collection, including recurring interviews, news diaries, data donations, and video-ethnography from the same informants, the article methodologically contributes to a more profound understanding of the dynamics involved in various forms of news experience.publishedVersio
Out-of-pocket expenditures for road traffic trauma care in public and private hospitals in Addis Ababa, Ethiopia
Get PDFM.Phil. in Global Health - ThesisINTH395AMAMD-GLO
Increased expression of CXCL10 and CCL3 salivary gland chemokines in primary Sjögren's syndrome detected and systematically quantified using novel RNAscope® in situ hybridisation
Get PDFPrimary Sjögren’s syndrome is a chronic inflammatory disease characterized by the destruction of exocrine glands. We have previously shown significantly upregulated levels of CXCL10 and CCL3 chemokines in saliva from Sjögren’s syndrome patients. In this study, we examined the expression pattern and localization of these chemokines at the site of inflammation in patients’ minor salivary glands using novel RNAscope® in situ hybridization. Minor salivary glands from 33 primary Sjögren’s syndrome patients and 22 non-Sjögren’s syndrome (non-SS) sicca controls were included. The biopsies were formalin-fixed, paraffin-embedded, and histopathologically evaluated. The CXCL10 and CCL3 mRNA expression in the glandular tissue was investigated using reverse transcription quantitative real-time polymerase chain reaction followed by an RNAscope® in situ hybridization. The mRNA expression of CXCL10 was higher than CCL3 in all patients. Significantly elevated expression of CXCL10 and CCL3 was detected in patients that also expressed autoantibody positivity and a positive biopsy for mononuclear cell infiltrates when compared with non-SS sicca controls. CXCL10 was localized as clusters within focal infiltrates as well as adjacent to acinar and ductal epithelium, while CCL3 was expressed as scattered single mRNA molecules in focal infiltrates and in acinar cells. Our findings suggest CXCL10 as a possible disease biomarker in primary Sjögren’s syndrome due to its upregulated expression in both saliva and minor salivary glands of patients and the localization in the tissue. This should be re-assessed in a larger primary Sjögren’s syndrome patient cohort, followed by additional functional studies to further validate its potential as a disease biomarker.publishedVersio
Aggregation Bias and Socioeconomic Gradients in Waiting Time for Hospital Admissions
Get PDFWaiting time is a rationing mechanism that is used in publicly funded healthcare systems as a mean to ensure equal access for equal need. However, several studies suggest that individuals with higher socioeconomic status wait less. These studies typically measure patients' socioeconomic status as an aggregate measure from patients' residential area and the results are hence vulnerable for aggregation biases. We shed light on the magnitude of the aggregation bias by analyzing socioeconomic gradients in waiting times when education and income are measured on three different levels: the individual level, the population cell level, and the municipal level. Our individual level socioeconomic gradient is modest compared with the literature. When socioeconomic status is measured on an aggregate level, we observe stronger associations with socioeconomic variables and less accurate estimates. A researcher who only has access to the aggregate data runs the risk of overstating the magnitude of the socioeconomic gradients.publishedVersio