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Haugen A.J.,Ostfold Hospital Trust | Grovle L.,Ostfold Hospital Trust | Brox J.I.,University of Oslo | Natvig B.,Diakonhjemmet Hospital | And 5 more authors.
European Spine Journal | Year: 2011

The objectives were to estimate the cut-off points for success on different sciatica outcome measures and to determine the success rate after an episode of sciatica by using these cut-offs. A 12-month multicenter observational study was conducted on 466 patients with sciatica and lumbar disc herniation. The cut-off values were estimated by ROC curve analyses using Completely recovered or Much better on a 7-point global change scale as external criterion for success. The cut-off values (references in brackets) at 12 months were leg pain VAS 17.5 (0-100), back pain VAS 22.5 (0-100), Sciatica Bothersomeness Index 6.5 (0-24), Maine-Seattle Back Questionnaire 4.5 (0-12), and the SF-36 subscales bodily pain 51.5, and physical functioning 81.7 (0-100, higher values indicate better health). In conclusion, the success rates at 12 months varied from 49 to 58% depending on the measure used. The proposed cut-offs may facilitate the comparison of success rates across studies. © The Author(s) 2011.


Kjelland V.,University of Agder | Ytrehus B.,National Veterinary Institute | Skarpaas T.,Sorlandet Hospital Health Enterprise | Slettan A.,University of Agder
Ticks and Tick-borne Diseases | Year: 2011

As part of a larger survey, ears from 18 roe deer (Capreolus capreolus) and 52 moose (Alces alces) shot in the 2 southernmost counties in Norway were collected and examined for Ixodes ricinus ticks. Seventy-two adult ticks, 595 nymphs, and 267 larvae from the roe deer, and 182 adult ticks, 433 nymphs, and 70 larvae from the moose were investigated for infection with Borrelia burgdorferi sensu lato (s.l.). The results showed the presence of B. burgdorferi s.l. DNA in 2.9% of the nymphs collected from roe deer and in 4.4% of the nymphs and 6.0% of the adults collected from moose. The spirochetes were not detected in adult ticks from roe deer, or in larvae feeding on roe deer or moose. In comparison, the mean infection prevalences in questing I. ricinus collected from the same geographical area were 0.5% infection in larvae, 24.5% in nymphs, and 26.9% in adults. The most prevalent B. burgdorferi genospecies identified in ticks collected from roe deer was B. afzelii (76.5%), followed by B. garinii (17.6%), and B. burgdorferi sensu stricto (5.9%). Only B. afzelii (76.7%) and B. garinii (23.3%) were detected in ticks collected from moose. The present study indicates a lower prevalence of B. burgdorferi infection in I. ricinus ticks feeding on roe deer and moose compared to questing ticks. This is the first study to report B. burgdorferi s.l. prevalence in ticks removed from cervids in Norway. © 2011 Elsevier GmbH.


Haugen A.J.,Ostfold Hospital Trust | Brox J.I.,University of Oslo | Grovle L.,Ostfold Hospital Trust | Keller A.,University of Oslo | And 5 more authors.
BMC Musculoskeletal Disorders | Year: 2012

Background: Few studies have investigated prognostic factors for patients with sciatica, especially for patients treated without surgery. The aim of this study was to identify factors associated with non-success after 1 and 2years of follow-up and to test the prognostic value of surgical treatment for sciatica. Methods. The study was a prospective multicentre observational study including 466 patients with sciatica and lumbar disc herniation. Potential prognostic factors were sociodemographic characteristics, back pain history, kinesiophobia, emotional distress, pain, comorbidity and clinical examination findings. Study participation did not alter treatment considerations for the patients in the clinics. Patients reported on the questionnaires if surgery of the disc herniation had been performed. Uni- and multivariate logistic regression analyses were used to evaluate factors associated with non-success, defined as Maine-Seattle Back Questionnaire score of 5 (0-12) (primary outcome) and Sciatica Bothersomeness Index 7 (0-24) (secondary outcome). Results: Rates of non-success were at 1 and 2years 44% and 39% for the main outcome and 47% and 42% for the secondary outcome. Approximately 1/3 of the patients were treated surgically. For the main outcome variable, in the final multivariate model non-success at 1year was significantly associated with being male (OR 1.70 [95% CI; 1.062.73]), smoker (2.06 [1.313.25]), more back pain (1.0 [1.011.02]), more comorbid subjective health complaints (1.09 [1.031.15]), reduced tendon reflex (1.62 [1.032.56]), and not treated surgically (2.97 [1.755.04]). Further, factors significantly associated with non-success at 2years were duration of back problems>;1year (1.92 [1.113.32]), duration of sciatica>;3months (2.30 [1.403.80]), more comorbid subjective health complaints (1.10 [1.031.17]) and kinesiophobia (1.04 [1.001.08]). For the secondary outcome variable, in the final multivariate model, more comorbid subjective health complaints, more back pain, muscular weakness at clinical examination, and not treated surgically, were independent prognostic factors for non-success at both 1 and 2years. Conclusions: The results indicate that the prognosis for sciatica referred to secondary care is not that good and only slightly better after surgery and that comorbidity should be assessed in patients with sciatica. This calls for a broader assessment of patients with sciatica than the traditional clinical assessment in which mainly the physical symptoms and signs are investigated. © 2012 Haugen et al.; licensee BioMed Central Ltd.


Kjelland V.,University of Agder | Ytrehus B.,National Veterinary Institute | Vikoren T.,National Veterinary Institute | Skarpaas T.,Sorlandet Hospital Health Enterprise | Slettan A.,University of Agder
Journal of Wildlife Diseases | Year: 2011

The mountain hare (Lepus timidus) population in southern Norway appears to be in decline. Necropsy and laboratory examinations of 36 hares found dead or diseased during 2007- 2009 in Vest- and Aust-Agder counties showed that disease and deaths were attributed to multiple causes, with no specific etiology emerging as a cause for population decline. To investigate whether Borrelia burgdorferi sensu lato (s.l.) infection is associated with mortality in mountain hares, tissues and ticks collected from hares were investigated for infection with the spirochete. Borrelia burgdorferi s.l. DNA was not detected in samples from internal organs, whereas Borrelia afzelii, B. burgdorferi sensu stricto (s.s.), and the not-yet-defined Borrelia sp. SV1 were found in skin samples from hares and in adult and nymphal Ixodes ricinus feeding on hares. Only B. burgdorferi s.s. and Borrelia sp. SV1 were detected in larvae feeding on hares. Our results indicate that disseminated Borrelia infection in hares rarely occurs and, presumably, does not play a central role in the suspected population decline. The results also suggest that the mountain hare to some degree functions as a transmission host for B. burgdorferi s.s. and Borrelia sp. SV1. © Wildlife Disease Association 2011.


Kjelland V.,University of Agder | Skarpaas T.,Sorlandet Hospital Health Enterprise | Slettan A.,University of Agder
Scandinavian Journal of Infectious Diseases | Year: 2010

From April to October 2007, host-seeking Ixodes ricinus ticks were collected from 4 locations in southern Norway: Farsund, Mandal, Søgne and Tromøy. Two hundred and ten larvae, 1130 nymphs and 449 adults were investigated for infection with Borrelia burgdorferi sensu lato (s.l.) by real-time polymerase chain reaction (PCR) amplification of the 16S rRNA gene. The total percentage of B. burgdorferi s.l. in nymphal and adult ticks was determined to be 31.3% in Farsund, 25.2% in Mandal, 22.3% in Søgne and 22.1% in Tromøy. Larvae were pooled in groups of 10 before analysis, and Borrelia infection was detected in 1 of the 21 larvae pools. B. burgdorferi s.l. were genotyped by melting curve analysis after real-time PCR amplification of the hbb gene, or by direct sequencing of the PCR amplicon generated from the rrs (16S)rrl (23S) intergenetic spacer. The most prevalent B. burgdorferi genospecies identified were B. afzelii (61.6%), followed by B. garinii (23.4%) and B. burgdorferi sensu stricto (10.6%). B. valaisiana (4.5%) was identified in Norwegian ticks for the first time. Mixed infections were observed in 0.3% of the infected ticks. A higher prevalence of B. burgdorferi s.l. was found in the present study than what has been reported in previous Nordic studies. © 2010 Informa UK Ltd.


Gabrielsen L.E.,Sorlandet Hospital Health Enterprise | Watten R.G.,Lillehammer University College | Ulleberg P.,University of Oslo
International Journal of Psychiatry in Clinical Practice | Year: 2013

Objective. This study aimed to determine similarities and differences on perceived importance and perceived attainability of life goals between a clinical and non-clinical adolescent sample. Method. 244 students and 54 adolescent patients completed the Adolescent Life Goal Profile Scale (ALGPS). The ALGPS measures perceived importance and perceived attainability of four main life goal categories: Relations, Generativity, Religion, and Achievements. As a control, we used five measures of mental health, quality of life, and personality. Results. There were no differences on perceived importance on the Generativity, Religion, and Achievement life goal factor, but patients perceived relation-oriented goals less important than non-patients. Perceived attainability of life goals factors was lower for patients on all life goals except for Generativity. Compared to non-patients, patients were less happy and satisfied and had lower sense of coherence and self-efficacy. Patients were also less emotionally stable, had lower conscientiousness, but higher intellect. Conclusions. Though patients appear less content with life in general than non-patients, chances are that they uphold their concern and care for others, remain devoted in their religious stand, and stay committed to their achievement-related goals. The lower perceived importance of relations within the patient group should be awarded clinical attention. © 2013 Informa Healthcare.


Kjelland V.,University of Agder | Kjelland V.,Sorlandet Hospital Health Enterprise | Rollum R.,University of Agder | Korslund L.,University of Agder | And 2 more authors.
Ticks and Tick-borne Diseases | Year: 2015

From April to October 2007, host-seeking Ixodes ricinus ticks were collected from four locations in southern Norway; Farsund, Mandal, Søgne and Tromøy, respectively. Larvae (n = 210), nymphs (n = 1130) and adults (n = 449) were investigated for infection with Borrelia miyamotoi by real-time polymerase chain reaction (PCR) amplification of part of the 16S rRNA gene. Results were verified by direct sequencing of the PCR amplicon generated from the rrs (16S)-rrl (23S) intergenetic spacer. B. miyamotoi was detected at all sites and throughout the period of questing activity, with infection prevalence (≤1.26%) similar to what has been seen in other European countries. Detection of the relapsing fever spirochete at all locations indicates a wide distribution in southern Norway. This is the first report of B. miyamotoi prevalence in ticks collected from Norway. As not much is known about the spatiotemporal dynamics of this relatively recently discovered pathogen, the conclusions of this study significantly add to the knowledge regarding B. miyamotoi in this region. © 2015 Elsevier GmbH.


PubMed | University of Agder, Academy of Sciences of the Czech Republic, Norwegian Veterinary Institute, Sorlandet Hospital Health Enterprise and 2 more.
Type: Journal Article | Journal: Infectious diseases (London, England) | Year: 2016

A modified microscopy protocol (the LM-method) was used to demonstrate what was interpreted as Borrelia spirochetes and later also Babesia sp., in peripheral blood from patients. The method gained much publicity, but was not validated prior to publication, which became the purpose of this study using appropriate scientific methodology, including a control group.Blood from 21 patients previously interpreted as positive for Borrelia and/or Babesia infection by the LM-method and 41 healthy controls without known history of tick bite were collected, blinded and analysed for these pathogens by microscopy in two laboratories by the LM-method and conventional method, respectively, by PCR methods in five laboratories and by serology in one laboratory.Microscopy by the LM-method identified structures claimed to be Borrelia- and/or Babesia in 66% of the blood samples of the patient group and in 85% in the healthy control group. Microscopy by the conventional method for Babesia only did not identify Babesia in any samples. PCR analysis detected Borrelia DNA in one sample of the patient group and in eight samples of the control group; whereas Babesia DNA was not detected in any of the blood samples using molecular methods.The structures interpreted as Borrelia and Babesia by the LM-method could not be verified by PCR. The method was, thus, falsified. This study underlines the importance of doing proper test validation before new or modified assays are introduced.


Soleng A.,Norwegian Institute of Public Health | Kjelland V.,University of Agder | Kjelland V.,Sorlandet Hospital Health Enterprise
Ticks and Tick-borne Diseases | Year: 2013

Ticks are important vectors of disease for both humans and animals. In Europe, Lyme borreliosis is the most abundant tick-borne human disease, whereas anaplasmosis, or tick-borne fever, is the most widespread tick-borne infection in domestic animals. However, knowledge about the prevalence of the causative disease agents in questing ticks in the northern range of their distribution in Norway is missing. Ixodes ricinus ticks were therefore collected by flagging vegetation in Brønnøysund, an area near the Arctic Circle in Norway where ticks have been abundant for decades. Ticks were analysed for infection with Borrelia burgdorferi sensu lato and Anaplasma phagocytophilum by real-time PCR amplification of the 16S rRNA gene of B. burgdorferi and the msp2 gene of A. phagocytophilum. B. burgdorferi s.l. were subsequently genotyped by conducting a melt curve analysis of the PCR-amplified hbb gene or by directly sequencing the PCR-amplified rrs (16S)-rrl (23S) intergenetic spacer. A. phagocytophilum was genotyped by msp2 gene sequencing. B. burgdorferi s.l. isolates were detected in 11.3% (15/133) of the nymphal ticks and in 33.3% (29/87) of the adult ticks. Of the 44 Borrelia-infected ticks collected, B. afzelii was identified in 42 ticks (95.5%), whereas B. garinii was detected in only 2 ticks (4.5%). A. phagocytophilum was detected in 0.8% of nymphal ticks (1/133) and in 4.6% of adult ticks (4/87). Mixed infections of more than one B. burgdorferi genospecies were not observed. One adult tick was co-infected with B. afzelii and A. phagocytophilum. © 2013 Elsevier GmbH.


Sigvartsen J.,University of Agder | Gabrielsen L.E.,Sorlandet Hospital Health Enterprise | Abildsnes E.,University of Bergen | Stea T.H.,University of Agder | And 2 more authors.
BMC Public Health | Year: 2016

Background: Two models were developed to increase high school students' participation in physical education (PE): "motion enjoyment" and "sport enjoyment". The first model focuses on increasing knowledge about the health benefits of a physically active lifestyle and thereby promoting a positive attitude towards physical activity, whereas the second model focuses on techniques and practices for enhancing athletic performance. The aims of the present study are to investigate and understand the similarities and differences between students selecting "motion enjoyment" vs. "sport enjoyment" and to examine the extent to which life goals and reported physical activity are associated with health-related quality of life (HRQOL). Method: A total of 156 high school students (mean age, 16 years [standard deviation = 0.8], 123 girls and 33 boys) were included in this cross-sectional study. HRQOL and life goals were measured using KIDSCREEN-10 and the Adolescent Life Goal Profile Scale, respectively. Physical activity was measured using a self-reporting questionnaire intended to describe the students' leisure-time activity. Independent sample t-tests, chi-square, one-way analyses of variance and multiple regression analysis were applied. Results: Self-reported physical activity level and HRQOL were higher among students in the "sport enjoyment" program, while the perceived importance of life goals was the same regardless of the preferred PE model. Multiple regression analyses revealed that the perceived importance of relations-oriented life goals (B = -5.61; 95 % confidence interval CI = -10.53 to -0.70; p =.026), perceived importance of generativity-oriented life goals (B = 4.14.; 95 % CI = 0.85 to 7.422; p =.014), perceived attainability of relations-oriented life goals (B = 7.28; 95 % CI = 2.49 to 12.07; p =.003), age (B = -7.29; 95 % CI = -11.38 to -3.20; p =.001) and gender, with boys as the reference group (B = -12.10; 95 % CI = -19.09 to -5.11; p =.001), were independently associated with increased HRQOL. In exploring the relationships of self-reported physical activity during leisure time, stage of change (B = 3.53; 95 % CI = 1.49 to 5.51; p =.001), gender, with boys as the reference group (B = -8.90; 95 % CI = -15.80 to -2.00; p =.012), and age (B = -6.62; 95 % CI = -10.57 to -2.66; p =.001) were independently associated with increased HRQOL. Conclusion: Self-reported physical activity habits and life goals were associated with HRQOL to a limited extent. However, the perceived importance of life goals appears to reflect other aspects of individual well-being than HRQOL. © 2016 The Author(s).

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