Hordaland County Council

Objective To identify regional differences in, and determinants of dental caries among children in western Norway Material and methods We studied dental caries in 705 children aged 12 years and 18 years living in the southern region (n = 403) and other parts of Hordaland County (n = 302) in Norway. Information on oral hygiene, fluoride intake, and sugar consumption was collected using questionnaires. We also collected information from the Public Dental Service (PDS) on the history of decayed, missing, or filled teeth; professional fluoride application; recall and regular check-up intervals and treatment visits. Residence (southern region versus the rest of Hordaland, the reference) was the independent variable. We analysed regional differences in (i) caries prevalence and severity, (ii) potential contributors to caries, and (iii) procedures and routines in PDS. Results Caries prevalence and severity were higher in the southern region (67% and 24%, respectively). Self-reported brushing habits, fluoride use, and sugar consumption patterns were similar between regions. We observed more frequent application of professional fluoride (incidence rate ratio [IRR] = 3.05, 95% CI: 1.99–4.66], fewer check-ups [IRR = 0.88, 95% CI: 0.81–0.95], and fewer treatment visits [IRR = 0.77, 95% CI: 0.60–0.98] among participants in the southern region, compared to the rest of Hordaland. The recall intervals in the southern region were 10% longer among 12-year-olds and 10% shorter among 18-year-olds, compared to their respective counterparts in Hordaland. Conclusions The observed regional gradients in caries experience mirrored regional differences in dental routines and procedures. Caries-related risk behaviours did not explain the observed differences in caries experience.

BackgroundRisks associated with polypharmacy and drug–drug interactions represent a challenge in drug treatment, especially in older adults. The aim of the present study was to assess the use of prescription and non-prescription drugs and the frequency of potential drug–drug interactions in home-dwelling older individuals.MethodsA cross-sectional study design was applied. Data were collected during preventive home visits among individuals aged ≥75 in three separate communities of Western Norway. A questionnaire, which was filled out by the individual, their next-of-kin, and the nurse performing the home visit was used for the collection of demographic and clinical data (age, sex, medication use, diagnoses, need of assistance with drug administration). Potential drug–drug interactions were identified electronically by IBM Micromedex Drug Interaction Checking. Point prevalence of potential drug–drug interactions and polypharmacy (≥5 drugs) were calculated. Binary logistic regression analyses were performed to assess factors potentially associated with polypharmacy or potential drug–drug interactions.ResultsAmong the 233 individuals (mean age 78±3 years, 46% male) included in the study, 43% used ≥5 drugs, 3.4% ≥10 drugs, while 4.3% used no drugs. In 54% of the 197 individuals using two or more drugs, at least one potential drug–drug interaction was detected. Low-dose aspirin and simvastatin were most frequently involved in potential drug–drug interactions. In total, 25% of the individuals reported current use of drugs sold over the counter of which more than 95% were analgesic drugs. Potential drug–drug interactions involving ibuprofen were identified in nine of 11 (82%) individuals using over-the-counter ibuprofen.ConclusionThe study revealed a high prevalence of polypharmacy and potential drug–drug interactions with both prescription and non-prescription drugs in older home-dwelling individuals. Close monitoring of the patients at risk of drug–drug interactions, and increased awareness of the potential of over-the-counter drugs to cause drug–drug interactions, is needed.

The present study investigated how adults with congenital craniofacial anomalies (CFAs) and parents experience the long-term and complex treatment offered by a multidisciplinary team (MDT). Exploratory-descriptive qualitative study based on individual semistructured interviews. Centralized national follow-up and treatment of CFAs by a multidisciplinary craniofacial team from which participants were systematically recruited. The sample included 48 parents of children with CFAs and 16 adults with CFAs (N = 64). In general, participants reported to be satisfied with the follow-up and treatment they received from the MDT. Still, some aspects of treatment were experienced as demanding such as the large number of health professionals present during the consultation and being the object of their scrutinizing attention. Health professionals' communication skills were described as central for participants' involvement in, and satisfaction with, treatment. Participants also expressed a need for more treatment-related information regarding future treatment. Findings could have implications for the organization of care for parents and patients with rare CFAs. The many advantages of MDTs also create unique challenges for patients and parents that need to be addressed. Patients and families should be prepared for the first consultation with the MDT. Health professionals should be aware of their communication style when interacting with patients and be aware of individual differences and needs regarding treatment-related experiences and expectations.

Archaeological heritage in Norway is seen as a national treasure and non-renewable resource, and according to the Norwegian Cultural Heritage Act of 1978 § 10, developers – regardless whether they represent public or private sector – should cover expenses for surveys and eventually salvage excavations. This general understanding is a part of the idea that polluter pays, though the public sector actually covers the entire cost of small projects. Misperceptions regarding this legislation have created an unwanted gap between the field of cultural heritage and the rest of society. Many developers perceive archaeology as a source of trouble, something that delays their projects and consumes a considerable portion of their finances, particularly when they believe that they have to pay for the archaeological investigations not only once but twice (first for surveys and thereafter for excavations). Although the majority is interested in archaeological heritage, they fear it because – in their eyes – it represents a possible economic burden and potential delays.

This study examines the features of school leadership as it evolved in an upper secondary school attempting to enhance school improvement through a dedicated team of developmental leaders. We study the team leadership’s tools and design over one school year and report on the evolution of a collective approach to leadership for school improvement. Researchers in a formative intervention research project supported the change process. Cultural-historical activity theory and a set of new technologies inspired the intervention design. The study describes how conceptions and practices of leadership gradually emerged as a collective and distributed approach to leading educational change and school improvement. In particular, new tools and designs for school team leadership were explored and implemented. The study addresses the need to develop shared and collaborative conceptions of leadership in schools. The study concludes that careful planning and skilful orchestration of human, cultural and technological resources are needed in order to make sustainable improvements in schools.

Educational management at the secondary school level in Norway is quite similar for all the counties in Norway. Not only are systems used in secondary education integrated, they are also integrated with many other systems used in government and education at various levels. This positional paper describes these systems and how they work together.

The quality of radiographic diagnosis of occlusal carries was examined with special attention to the diagnosis of lesions in dentin. Eighty-four extracted teeth, most of them with occlusal caries of different severity and some apparently sound, were radiographed. For validation purposes, the lesion depths were recorded during a drilling procedure. Ten dentists interpreted the radiographs. On average, 12% of the sound surfaces were wrongly diagnosed radiographically as having caries (false positives), 33% of the enamel lesions were identified on radiographs, and 62% of the small dentin lesions and 100% of the big dentin lesions were diagnosed radiographically (true positives). There was wide variation in the ability to identify dentin caries correctly between the observers; the sensitivity values ranged from 0.77 to 1.0 (mean 0.90) and the specificity values from 0.45 to 0.93 (mean 0.76). The dentist demonstrating the highest diagnostic quality (measured by the area beneath the receiver operating characteristics curve) had only about 9% false positives (1-specificity), while the dentist who had the lowest diagnostic quality scored caries in about 55% of the teeth in the control group. Both of them had 96% true positives. The tendency to make false-positive registrations in the dentin adjacent to enamel seems to be a major problem in radiographic diagnosis of occlusal caries. The radiograph has significant value in the diagnosis of occlusal dentin caries, but the great variations between observers indicate the need for training and calibration.