Pain in care home residents with dementia: an exploration of frequency, prescribing and relatives' perspectives

Objectives: This study aims to determine pain frequency amongst care home residents with dementia, to investigate variables associated with pain, to explore analgesic use among residents and to seek residents' relatives' views on provision of care and management of pain by the care home. Methods: Structured face-to-face interviews were conducted with residents, nursing staff and relatives from nine dementia care homes in Northern Ireland, between May 2010 and March 2012. Demographic information was collected from participants, neuropsychiatric tests were used to assess residents' cognitive functioning, medication use was determined from care home records and residents' pain was assessed using a verbal descriptor scale. Relatives' views were sought on care provision and management of pain. Results: Forty-two residents, 16 nurses/care assistants and 35 relatives participated; the participation rate of residents was low (27.6%). Most residents were suffering moderate-severe dementia, and some residents (26.2%) were unable to provide a self-report of pain. A significantly higher proportion of relatives (57.1%) deemed residents to be experiencing pain at the time of the interview, compared with residents (23.8%, p = 0.005) and nurses/care assistants (42.9%, p = 0.035). Most residents (88.1%) were prescribed with analgesia; non-opioid analgesics were most commonly prescribed. High proportions of residents were prescribed with psychoactive medications. Antipsychotic drug use was associated with presence of pain (p = 0.046). Conclusions: This study has reinforced the challenge of assessing and managing pain in this resident population and highlighted issues to be addressed by long-term care providers and clinicians. Participation of people with dementia, and their families, in healthcare research needs to be improved.

International inter-school competition to encourage children to walk to school: a mixed methods feasibility study.

Background: Active travel to school can be an important contributor to the total physical activity of children but levels have declined and more novel approaches are required to stimulate this as an habitual behaviour. The aim of this mixed methods study was to investigate the feasibility of an international walk to school competition supported by novel swipecard technology to increase children's walking to/from school. Methods: Children aged 9-13 years old participated in an international walk to school competition to win points for themselves, their school and their country over a 4-week period. Walks to and from school were recorded using swipecard technology and a bespoke website. For each point earned by participants, 1 pence (£0.01) was donated to the charity of the school's choice. The primary outcome was number of walks to/from school objectively recorded using the swipecard tracking system over the intervention period. Other measures included attitudes towards walking collected at baseline and week 4 (post-intervention). A qualitative sub-study involving focus groups with children, parents and teachers provided further insight. Results: A total of 3817 children (mean age 11.5±SD 0.7) from 12 schools in three cities (London and Reading, England and Vancouver, Canada) took part in the intervention, representing a 95% intervention participation rate. Results show a gradual decline in the average number of children walking to and from school over the 4-week period (week 1 mean 29%±SD2.5; week 2 mean 18%±SD3.6; week 3 mean 14%±SD4.0; week 4 mean 12%±SD1.1). Post intervention, 97% of children felt that walking to school helped them stay healthy, feel happy (81%) and stay alert in class (76%). These results are supported by qualitative findings from children, parents and teachers. Key areas for improvement include the need to incorporate strategies for maintenance of behaviour change into the intervention and also to adopt novel methods of data collection to increase follow-up rates. Conclusions: This mixed methods study suggests that an international walk to school competition using innovative technology can be feasibly implemented and offers a novel way of engaging schools and motivating children to walk to school.

Exploring the prevalence of and factors associated with pain: a cross-sectional study of community-dwelling people with dementia

Few pain studies have made community-dwelling people with dementia (PWD) their focus. The aim of this study was to determine the prevalence of pain among this patient population and to explore medication use. Moreover, we sought to investigate patient and caregiver variables associated with the presence of pain. Community-dwelling PWD and their caregivers were recruited between May 2009 and July 2012 from outpatient memory clinics in Northern Ireland to take part in a face-to-face structured interview with a researcher. Patients' cognitive status and presence of depression were established. A full medication history was taken. Both patients and caregivers were asked to rate patients' pain, at the time of the interview and on an average day, using a 7-point verbal descriptor scale. From the 206 patients who were eligible to take part, 75 patient-caregiver dyads participated in the study (participation rate = 36.4%). The majority of patients (92.0%) had dementia classed as mild or moderate. Pain was commonly reported among the sample, with 57.3% of patients and 70.7% of caregivers reporting patient pain on an average day. Significant differences were found between patients' and caregivers' reports of pain. Two-fifths of patients (40.0%) were prescribed analgesia. Antipsychotic, hypnotic and anxiolytic drug use was low, whereas antidepressant drugs were prescribed more commonly. Presence of pain was unaffected by dementia severity; however, the use of prescribed analgesic medication was a significant predictor of the presence of pain in these patients, whether reported by the patient or their caregiver 'right now' or 'on an average day' (P < 0.001). Patient and caregiver recruitment was challenging, and remains a barrier to research in this area in the future.

Use of eye care services among diabetic patients in urban and rural China.

OBJECTIVE: To assess the use of eye care and its predictors among diabetic patients in China. DESIGN: Cross-sectional, clinic-based study. PARTICIPANTS: Diabetic patients 18 years of age or older were recruited consecutively from an urban tertiary and community hospitals and from a rural clinic in Guangdong, China. METHODS: Information obtained by questionnaire and chart review included: demographic and socioeconomic status, knowledge about diabetic retinopathy (DR), and ocular and medical history. MAIN OUTCOME MEASURES: Self-reported or chart history of an eye examination ever or within the preceding 12 months. RESULTS: The participation rate among 889 eligible subjects was 92.7%. Among 824 participants (mean age, 62.6+/-12.9 years; 58.8% female), 550 (66.7%) had not been examined in the last year as recommended by the American Academy of Ophthalmology, and 356 (43.2%) had never been examined. For the rural hospital, these figures were 81.1% and 68.7%, respectively. In regression analyses, factors associated with having an eye examination in the last year were: attendance at urban hospitals (odds ratio [OR], 3.46 [P<0.001] and 1.76 [P = 0.021] for the tertiary and community hospitals, respectively, compared with the rural clinic), higher DR knowledge score (OR, 1.24; P = 0.001), greater concern about vision loss (OR, 1.22; P = 0.007), and recommendation of regular eye examinations by the provider (OR, 2.36; P = 0.011). Predictors of ever having an eye examination were similar. Monthly income and health insurance status were not predictive of being examined. CONCLUSIONS: These results suggest that the low proportion of diabetic receiving recommended annual eye examinations in China may be improved through patient and physician education. Copyright © 2010 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Affective Computing to Enhance E-Learning in Segregated Societies

According to UN Women, to build stronger economies, it is essential to empower women to participate fully in economic life across all sectors. Increasing women and girls’ education enhances their chances to participate in the labor market. In certain cultures, like in Saudi Arabia, women contribution to the public economy growth is very limited. According to the World Bank, less than 20 percent of the female population participate in the labor force. This low participation rate has many reasons. One of them, is the educational level and educational quality for females. Although Saudi Arabia has about thirty three universities, opportunities are still limited for women because of the restrictions of access put upon them. A mixture of local norms, traditions, social beliefs, and principles preventing women from receiving full benefits from the educational system. Gender segregation is one of the challenges that limits the women access for education. It causes a problem due to the shortage of female faculty throughout the country. To overcome this problem, male faculty are allowed to teach female students under certain regulations and following a certain method of education delivery and interaction. However, most of these methods lack face-to-face communication between the teacher and students, which lowers the interactivity level and, accordingly, the students’ engagement, and increases the need for other alternatives. The e-learning model is one of high benefit for female students in such societies. Recognizing the students’ engagement is not straightforward in the e-learning model. To measure the level of engagement, the learner’s mood or emotions should be taken into consideration to help understanding and judging the level of engagement. This paper is to investigate the relationship between emotions and engagement in the e-learning environment, and how recognizing the learner’s emotions and change the content delivery accordingly can affect the efficiency of the e-learning process. The proposed experiment alluded to herein should help to find ways to increase the engagement of the learners, hence, enhance the efficiency of the learning process and the quality of learning, which will increase the chances and opportunities for women in such societies to participate more effectively in the labor market.

Dgenco market balancing - cost repartition under light regulation markets

In this paper we present a new methodology, based in game theory, to obtain the market balancing between Distribution Generation Companies (DGENCO), in liberalized electricity markets. The new contribution of this methodology is the verification of the participation rate of each agent based in Nucléolo Balancing and in Shapley Value. To validate the results we use the Zaragoza Distribution Network with 42 Bus and 5 DGENCO.

Elevated blood pressure prevalence in children did not follow the increase in overweight: results from a school-based study in a rapidly developing country, 1998-2006

Background: Blood pressure (BP) is strongly associated with body weight and there is concern that the pediatric overweight epidemic could lead to an increase in children's mean BP. Objectives: We analyzed BP trends from 1998 to 2006 among children of the Seychelles, a rapidly developing middle-income country in Africa. Methods: Serial school-based surveys of weight, height and BP were conducted yearly between 1998-2006 among all students of the country in four school grades (kindergarten, 4th, 7th and 10th years of compulsory school). We used the CDC criteria to define "overweight" (BMI _95th sex-, and age-specific percentile) and the NHBPEP criteria for "elevated BP" (BP _95th sex-, age-, and height specific percentile). Methods for height, weight, and BP measurements were identical over the study period. The trends in mean BMI and mean systolic/diastolic BP were assessed with linear regression. Results: 27,703 children aged 4-18 years (participation rate: 79%) contributed 43,927 observations on weight, height, and BP. The prevalence of overweight increased from 5.1% in 1998-2000 to 8.1% in 2004-2006 among boys, and from 6.1% to 9.1% among girls, respectively. The prevalence of elevated BP was 8.4% in 1998-2000 and 6.9% in 2004-2006 among boys; 9.8% and 7.8% among girls, respectively. Over the 9-years study period, age-adjusted body mass index (BMI) increased by 0.078 kg/m2/year in boys and by 0.083 kg/m2/year in girls (both sexes, P_0.001). Age- and height-adjusted systolic BP decreased by -0.37 mmHg/year in boys and by -0.34 mmHg/year in girls (both sexes, P_0.001). Diastolic BP did not change in boys (-0.02 mmHg/year, P: 0.40) and slightly increased in girls (0.07 mmHg/year, P: 0.003). These trend estimates were altered modestly upon further adjustment for BMI or if analyses were based on median rather than mean values. Conclusion: Although body weight increased markedly between 1998 and 2006 in this population, systolic BP decreased and diastolic BP changed only marginally. This suggests that population increases in body weight are not necessarily associated with corresponding rises in BP in children.

Self-reported health needs and use of primary health care services by adolescents enrolled in post-mandatory schools or vocational training programmes in Switzerland.

BACKGROUND: The second Swiss Multicenter Adolescent Survey on Health (SMASH02) was conducted among a representative sample (n = 7428) of students and apprentices aged 16 to 20 from the three language areas of Switzerland during the year 2002. This paper reports on health needs expressed by adolescents and their use of health care services over the 12 months preceding the survey. METHODS: Nineteen cantons representing 80% of the resident population agreed to participate. A complex iterative random cluster sample of 600 classes was drawn with classes as primary sampling unit. The participation rate was 97.7% for the classes and 99.8% for the youths in attendance. The self-administered questionnaire included 565 items. The median rate of item non-response was 1.8%. Ethical and legal requirements applying to surveys of adolescent populations were respected. RESULTS: Overall more than 90% of adolescents felt in good to excellent health. Suffering often or very often from different physical complaints or pain was also reported such as headache (boys: 15.9%, girls: 37.4%), stomach-ache (boys: 9.7%, girls: 30.0%), joint pain (boys: 24.7%, girls: 29.5%) or back pain (boys: 24.3%, girls: 34.7%). Many adolescents reported a need for help on psychosocial and lifestyle issues, such as stress (boys: 28.5%, girls: 47.7%) or depression (boys: 18.9%, girls: 34.4%). Although about 75% of adolescents reported having consulted a general practitioner and about one-third having seen another specialist, reported reasons for visits do not correspond to the expressed needs. Less than 10% of adolescents had visited a psychiatrist, a family planning centre or a social worker. CONCLUSIONS: The reported rates of health services utilisation by adolescents does not match the substantial reported needs for help in various areas. This may indicate that the corresponding problems are not adequately detected and/or addressed by professionals from the health and social sectors.

Antecedents, psychiatric characteristics and follow-up of adolescents hospitalized for suicide attempt of overwhelming suicidal ideation.

To evaluate the socio-demographic as well as the health and psychiatric profiles of adolescents hospitalised for suicide attempt or overwhelming suicide ideation and to assess repetition of suicide attempt over a period of 18 months. Between April 2000 and September 2001, all patients aged 16 to 21 years admitted to the University Hospitals of Geneva and Lausanne for suicide attempt or ideation were included in the study. At this time (T0) semi-structured face to face interviews were conducted to identify socio-demographic data, mental health and antecedents regarding suicidal conducts. Current psychiatric status was assessed with the MINI (Mini International Neuropsychiatric Instrument). At T1 and T2, reassessments included psychiatric status (MINI) as well as lifestyles, socio-professional situation and suicidal behaviours. At T0, 269 subjects met the study criteria, among whom 83 subjects (56 girls and 27 boys) left the hospital too quickly to be involved or refused to participate in the study (final sample at T0: 149 girls; 37 boys). The participation rate at T1 and T2 was respectively 66% and 62% of the original sample. The percentage of adolescents meeting the criteria for psychiatric diagnoses (91%) was high: affective disorder (78%); anxiety disorder (64%); substance use disorder (39%); eating disorder (9%); psychotic disorder (11%); antisocial personality (7%) with most subjects (85%) having more than one disorder. Around 90% of the subjects interviewed at T1, and/or T2, had received follow-up care after their hospitalisation, either by a primary care physician or a psychotherapist or both. Two subjects died of violent death and 18% made a further suicide attempt. Most adolescents hospitalised for suicidal episodes suffer from psychiatric problems which should be addressed by a careful psychiatric assessment, followed up if needed by a structured after care plan.

Voices of the Undereducated in Adult Education and Training in Ontario: A Phenomenographic Approach

This doctoral study was an exploration of the qualitatively different ways in which undereducated adults (at or below a high school level of formal education) reported their experiences of participation in adult education and training (AET) programmes offered by publicly funded school boards or their arms-length affiliate in the province of Ontario. In light of a low participation rate in the Canadian AET system by undereducated adults, the rationale was to examine whether or not AET programmes are meeting the needs of undereducated adults beyond a narrow focus on an instrumental approach associated with human capital development. This study was located in a theoretical framework consisting of (a) learning theory, (b) motivations for participation, (c) general barriers to participation, (d) structural barriers to participation, and (e) transformative learning. The purposive sample consisted of 11 participants between the ages of 18-58 who were drawn from service providers in 4 geographic regions of Ontario. Data collection consisted of (a) demographics, (b) voice recordings from face-to-face participant interviews, (c) participant weekly critical incident reports, and (d) researcher reflexive journal notes. Data were analyzed in accordance with a phenomenographic approach within a constructivist/interpretivist research paradigm. Findings revealed 4 qualitatively different ways in which undereducated adult learners reported their experiences of participation in AET and were reported as the voice of (a) security, (b) engagement, (c) relationship, and (d) competency. Implications to theory and practice and to further inquiry were outlined.

Ampleur, coûts, facteurs personnels et occupationnels de l’absentéisme dans la fonction publique hospitalière au Cameroun

L'absentéisme parmi le personnel soignant prend de plus en plus d'ampleur dans les institutions sanitaires publiques au Cameroun. Il représente à l'heure actuelle l'une des principales causes de l'effondrement du système de soins de santé. Ce phénomène se doit d'être réduit à des proportions raisonnables; cependant, les informations nationales sur les niveaux d’absentéisme parmi ce personnel, les coûts associés, ainsi que sur les facteurs qui le déterminent restent encore très faibles. Cette recherche avait pour objectifs de mesurer le niveau d’absentéisme parmi les prestataires de soins de santé des hôpitaux publics du Cameroun ; de déterminer l’influence des caractéristiques personnelles et des facteurs occupationnels sur le comportement d’absence parmi ces professionnels ; et d’évaluer les répercussions économiques de l’absentéisme en termes de coûts associés à la perte de productivité pour les employeurs. Elle portait sur du personnel soignant, notamment les médecins, les infirmiers et les aides-soignants exerçant dans les formations sanitaires publiques (hôpitaux) du Cameroun au mois d’octobre 2008. L’absentéisme était mesuré par le nombre d’heures et d’épisodes (fréquence) d’absences et concernait les retards et les absences de trois jours consécutifs et moins. Les facteurs personnels et occupationnels étudiés étaient l’âge, le sexe, le statut civil, les responsabilités familiales (nombre d’enfants), le niveau d’éducation, l’unité de soins, le type d’emploi, le régime d’emploi, l’horaire de travail, le temps supplémentaire, l’ancienneté dans l’hôpital, la taille de l’hôpital et le revenu de l’employé. Les données ont été recueillies dans 15 formations sanitaires publiques réparties dans six régions du Cameroun, sur la période allant du 1er au 31 octobre 2008, à partir des documents officiels émanant du gouvernement et des hôpitaux. Les analyses statistiques comportaient des analyses descriptives, des analyses bivariées et des analyses multivariées. Le taux de participation moyen des employés a été de 50,7%. Sur les 516 personnes qui composaient l’échantillon, 93,4% avaient eu au moins une absence au travail au mois d’octobre 2008. Le taux d’absentéisme global était de 7,2%, et variait entre 2% et 37% dans les hôpitaux. Chaque participant avait en moyenne 12 épisodes d’absences pendant cette période et la durée moyenne d’absences par participant était d’environ 13 heures et 21 minutes. La durée de l’horaire de travail, le fait de travailler dans un hôpital régional, de travailler selon un horaire fixe, d’être un personnel PPTE et de ne pas effectuer du temps supplémentaire, sont associés significativement à une plus grande fréquence des absences. La durée de l’horaire de travail, le fait d’être médecin, de travailler dans un service d’accueil et des urgences, de travailler selon un horaire fixe et d’être une femme, ont un lien significativement positif avec la durée des absences. Cet absentéisme a absorbé environ 8% de la masse salariale d’octobre 2008. On estime à environ 4 088 568 dollars US courants (2008), les dépenses consacrées par le secteur public de la santé du Cameroun à cet absentéisme en 2008, ce qui représentait approximativement 2,1% des dépenses publiques de santé. La réduction de l’absentéisme de courte durée parmi les professionnels de la santé du secteur public au Cameroun passe par l’amélioration du style de gestion des hôpitaux et l’approfondissement des recherches sur le comportement d’absence parmi ces professionnels.

L'impact de la densité syndicale et du salaire minimum sur l'inégalité des revenus dans les provinces canadiennes, 1981-2008

Bien qu'il soit désormais établi que les institutions du travail (tel que la syndicalisation et le salaire minimum) aient eu pour effet de réduire l'inégalité des salaires entre les travailleurs au Canada et dans d'autres pays industrialisés, leur impact sur l'inégalité des revenus entre les familles ou les ménages reste incertain. Cette étude a pour but d'estimer l'impact de la densité syndicale et du salaire minimum réel sur l'évolution de l'inégalité des revenus de marché entre les ménages canadiens durant les années 1981 à 2008. À partir d'une base de données qui intègre des données annuelles agrégées par province, et en maintenant constant un ensemble de facteurs, les estimations par effets fixes indiquent que la densité syndicale a réduit l'inégalité des revenus mesurée au moyen du coefficient de Gini, alors que le salaire minimum réel a plutôt eu pour effet d'accroître celle-ci. Les résultats d'estimation indiquent également que le taux d'activité et la scolarité moyenne sont les principaux facteurs à avoir réduit l'inégalité des revenus, alors que le taux de chômage, le changement technologique (mesuré de différentes façons) et l'immigration récente ont contribué à l'accroître.

Étude-pilote portant sur une intervention de groupe auprès de femmes souffrant d’hyperphagie boulimique et l’évaluation de ses effets potentiels

Cette étude porte sur une intervention de groupe basée sur la thérapie cognitivo-comportementale pour l’hyperphagie boulimique (HB), dont les effets potentiels sur la qualité de vie reliée au poids, la fréquence et la sévérité des crises de boulimie, les symptômes dépressifs, l’image corporelle et le poids corporel ont été mesurés, et le degré d’acceptation par les participantes a été documenté. Ainsi, 11 femmes avec un surplus de poids et répondant aux critères diagnostiques de l’HB ont été recrutées du printemps 2012 à l’hiver 2013, dans la région de Montréal. Le programme comportant huit séances hebdomadaires était dispensé par une nutritionniste et une psychothérapeute. La qualité de vie reliée au poids (Impact of Weight on Quality of Life), la fréquence des crises de boulimie (rappel des sept derniers jours), la sévérité des crises de boulimie (Binge Eating Scale), les symptômes dépressifs (Inventaire de Beck pour la dépression), l’insatisfaction corporelle (Body Shape Questionnaire) et le poids corporel ont été mesurés avant et à la fin de l’intervention. Puis, un questionnaire pour mesurer l’acceptation par les participantes était soumis au terme du programme. Le taux de participation aux séances était aussi colligé. Les résultats montrent que notre programme a permis une amélioration significative du score global de la qualité de vie reliée au poids de 8,4 ± 13,3, ainsi qu’en termes d’estime de soi et de travail. Aussi, une diminution significative de la fréquence des crises de boulimie de 2,1 ± 2,1 jours, de la sévérité des crises de boulimie dont le score a diminué de 10,9 ± 7,7, des symptômes dépressifs dont le score a diminué de 8,3 ± 5,7 et de l’insatisfaction corporelle dont le score a diminué de 32,8 ± 17,1, ont été observées. Toutefois, il n’y a pas eu de perte de poids au terme de l’intervention. Puis, le programme a été bien accepté par les participantes tel que démontré par le taux de participation aux séances de 93,8 % et la satisfaction mesurée par l’appréciation des divers éléments du programme de 4,6 sur 5 et la pertinence de ceux-ci de 4,8 sur 5. Ces données suggèrent que l’intervention de groupe semble être prometteuse pour améliorer les symptômes et conséquences de l’HB, à l’exception du poids.

La santé orale compromise comme facteur de risque potentiel pour le cancer colorectal sporadique (COLDENT) : une étude de faisabilité

Introduction: Le cancer colorectal (CCR) demeure un véritable fardeau de santé publique au Canada. Malgré les énormes avancés scientifiques, l’étiologie du CCR n’est pas encore clairement définie. La prévention du CCR nécessite l’identification de nouveaux facteurs de risque. Durant ces dernières années, des études épidémiologiques ont rapporté l’association entre la santé buccodentaire et le cancer colorectal. Cependant, aucune étude n’a été conçue spécifiquement pour vérifier cette association. Objectifs : L’objectif principal de l’étude était de tester la faisabilité d’une grande étude épidémiologique ultérieure, conçue pour vérifier l’association entre la santé buccodentaire compromise et le risque de CCR. Les objectifs secondaires étaient de standardiser les procédures de l’étude, d’évaluer le taux de participation et le succès des approches proposées pour le recrutement, d’évaluer la faisabilité et la validité des méthodes de la collecte des données sur la santé buccodentaire et de produire des données préliminaires concernant l’association entre la santé buccodentaire compromise et le risque de CCR. Méthodologie: Il s’agit d’une étude de faisabilité, de devis cas-témoins à base populationnelle. Les participants dans le groupe de cas (n=30) ont été recrutés dans deux hôpitaux de Montréal. Les témoins (n=39) ont été recrutés dans la population générale de Montréal. Les données sur la santé buccodentaire ont été collectées aussi bien par un questionnaire sur la santé buccodentaire que par un examen clinique. Les données sur plusieurs facteurs de risque du CCR ont été collectées par des questionnaires validés. Résultats: L’étude de faisabilité a rencontré un taux de participation de 73% (30) chez les cas et de 32,5% (39) chez les témoins. Seulement 26% (7) des participants dans le groupe des cas et 79% (26) des participants dans le groupe de témoins ont complété l’examen dentaire. La santé buccodentaire compromise était associée au risque de CCR chez les participants plus âgés que 59 ans (OR=8,4 ; IC à 95% : 0,94 – 389,4; p=0,036). Les mesures de santé buccodentaire auto-rapportées par les participants par l’utilisation du questionnaire ont montré une bonne validité par rapport aux mesures de l’examen clinique. Conclusion: L’étude épidémiologique ultérieure est jugée faisable en apportant des modifications. Les résultats préliminaires plaident pour une association possible entre la santé buccodentaire compromise par la maladie parodontale et/ou l’édentement et le risque du CCR.

Methods and background characteristics of the TOHNN study : a population-based study of oral health conditions in northern Norway

OBJECTIVES: The aim of the Tromstannen - Oral Health in Northern Norway (TOHNN) study was to investigate oral health and dental-related diseases in an adult population. This article provides an overview of the background of the study and a description of the sample characteristics and methods employed in data collection. STUDY DESIGN: Cross-sectional population-based study including a questionnaire and clinical dental examination. METHODS: A randomly selected sample of 2,909 individuals (20-79 years old) drawn from the population register was invited to participate in the study. The data were collected between October 2013 and November 2014 in Troms County in northern Norway. The questionnaire focused on oral health-related behaviours and attitudes, oral health-related quality of life, sense of coherence, dental anxiety and symptoms from the temporomandibular joint. The dental examinations, including radiographs, were conducted by 11 dental teams in 5 dental offices. The examination comprised of registration of dental caries, full mouth periodontal status, temporomandibular disorders, mucosal lesions and height and weight. The participants were grouped by age (20-34, 35-49, 50-64 and 65-79) and ethnicity (Norwegian, Sámi, other European and other world). RESULTS: From the original sample of 2,909 individuals, 1,986 (68.3%) people participated, of whom 1,019 (51.3%) were women. The highest attendance rate was among women 20-34 years old (80.3%) and the lowest in the oldest age group of women (55.4%). There was no difference in response rate between rural and urban areas. There was a positive correlation between population size and household gross income (p < 0.001) and education level (p < 0.001). The majority of Sámi resided in smaller municipalities. In larger cities, most participants used private dental health care services, whereas, in rural areas, most participants used the public dental health care service. CONCLUSION: The TOHNN study has the potential to generate new knowledge on a wide range of oral health conditions beneficial to the population in Troms County. Due to the high participation rate, generalization both nationally and to the circumpolar area ought to be possible.