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Aim Orthorexia Nervosa (ON) describes a pathological obsession with proper and high-quality nutrition that is necessary to research further in order to elucidate its prevalence and correlates which may bear implications for prevention and treatment. The aim of this study was to review studies that report the prevalence of ON in people who exercise, calculate an overall prevalence through a random-effects meta-analysis approach and investigate the association of ON prevalence using a random-effects meta-regression. In addition, a sub-group-analysis based on ON-instruments and a sensitivity analysis excluding students samples, were conducted. Method Systematic searches were conducted in the following online databases: PubMed, Embase, Web of Science, PsychInfo, CINAHL, Google Scholar and OpenNet. The following search terms were used: Orthore* AND (prevalenc* OR incidenc* OR frequen* OR cut-off OR epidem*). A total of 613 unique hits were reviewed by two blinded authors, and 24 studies were coded and assessed for risk of bias (Holy et.al). The meta-regression included three independent variables (sex, type of sport, and sample size). Results The overall prevalence of ON in the exercising population was 55.3% (95% CI 43.2–66.8). Cochran’s Q was 11,436.38 ( df  = 23, p  < 0.0000), and the I 2 was 98.4%, indicating high heterogeneity across studies. The sensitivity showed an overall prevalence of 51.3% (95% CI 51.3–70.0). There was a significant difference in prevalence estimates based on the instruments used (Q bet  = 33.6, df  = 2, p  < 0.01). Discussion The overall prevalence of ON in exercising populations was very high. The between-study disparity was large and was partly explained by the ON-instrument administered. One fourth of the studies had a moderate risk of bias. The majority of the studies did not specify relevant demographic information about the sample, and information about the type of sport was frequently missing. Plain English summary Orthorexia Nervosa (ON) describes a pathological obsession with proper and high quality nutrition that is characterized by a restrictive diet, ritualized patterns of eating, and rigid avoidance of foods believed to be unhealthy or impure. This obsession is found among sports athletes in some studies, and there is an assumed link between ON and exercise in general. In this study, the term exercise is defined as any activity requiring physical effort, carried out to sustain or improve health and fitness. In this systematic review and meta-analysis, we examined the overall prevalence of ON in the exercising population. Searching in scientific databases resulted in 613 articles, of which 24 met the rigorous inclusion criteria. The overall prevalence of ON in the general exercising population was 55.3%. The prevalence was thought to be predictable by sex, type of sport, and sample size, but no significant associations were found. This may be due to poor study quality and a lack of demographic information on the participants in some of the included studies. Other predictors worth investigating might be age, student status, status as vegetarian/vegan, psychiatric comorbidity, and intensity/frequency of exercise. This knowledge may bear implications for the prevention and right treatment for people at risk of developing ON.

Role ambiguity and role conflict are linked to negative outcomes such as distress, job dissatisfaction, and turnover intentions, but little research has examined how role stressors relate to sleep disturbances across time. This prospective study determined the direction and magnitude of the time-lagged associations between role stressors and symptoms of insomnia among 388 municipal child welfare employees in Oslo, Norway. Comparing forward, reverse, and reciprocal associations between role stressors and insomnia symptoms showed that a model where role stressors were associated with subsequent changes in insomnia symptoms exhibited the best fit to the data. Role conflict, but not role ambiguity, was significantly associated with an increase in insomnia symptoms across time. Insomnia symptoms were not associated with any significant changes in levels for the role-stressors. A limitation is that the two-wave cross-lagged panel design cannot separate within-person dynamics from between-person stability and therefore does not permit conclusions about causal effects. Still, the findings suggest that to reduce symptoms of insomnia among employees, child welfare organizations should avoid placing inconsistent demands on workers and ensure compatibility across requirements. To address role conflict, organizations should provide resources that can help workers reduce and handle role conflicts inherent in their work.

Earlier studies have demonstrated that the oldest in a competition class are more likely to succeed than the youngest, a phenomenon called relative age effect (RAE). Track and field give us an opportunity to investigate the advantage of being born early in the year based upon actual performance, since objective criteria are the performance indicators. Hence, the aim of the present study was to investigate the occurrence of RAE in Norwegian track and field athletes in events where physical capacity is important for success. All individual season best results from the register of The Norwegian Athletics Federation (n = 28 999) obtained in all competition classes from the age of 10 years to senior in both sexes on 60m and 600m from 2011 to 2020 were downloaded. One-way ANOVA and LSD post hoc analyses were used to analyze performance differences according to birth quartiles between athletes. Further, odds ratios (OR) were used to calculate the odds of being among the top-100 for athletes for those born in the first quartile of the year compared to the last. The RAE was present in several of the competition classes in sprint compared to middle-distance running, and in more male than female competition classes. Overall, the OR of being among the top-100 in one of the competition classes on 60m sprint when born in first quartile compared to last quartile was 2.88 [2.30-3.62] for males and 1.54 [1.26-1.89] for females. Being born early in the year in events with high demand for specific physical capacities is an advantage in both sexes in most of the youngest competition classes. In males, the advantage of being born early in the year lasted longer in sprint than in middle-distance running, indicating that puberty affects performance in sprint and middle-distance running differently.

ObjectivesThe purpose of this study was to use objective registry data to prospectively investigate the effects of quick returns (QR, <11 hours of rest between shifts) and night shifts on sick leave.MethodsA total of 1538 nurses (response rate =41.5%) answered questionnaires on demographics and personality and provided consent to link this information to registry data on shift work and sick leave from employers' records. A multilevel negative binomial model was used to investigate the predictive effect of exposure to night shifts and QR every month for 1 year, on sick leave the following month.ResultsExposure to QR the previous month increased the risk for sick leave days (incidence rate ratio (IRR)=1.066, 95% CI 1.022 to 1.108, p<0.01) and sick leave spells (IRR=1.059, 95% CI 1.025 to 1.097, p<0.001) the following month, whereas night shifts did not. 83% per cent of the nurses experienced QR within a year, and on average they were exposed to 3.0 QR per month (SD=1.6). Personality characteristics associated with shift work tolerance (low on morningness, low on languidity and high on flexibility) were not associated with sick leave, and did not moderate the relationship between QR and sick leave.ConclusionsWe found a positive linear relationship between QR and sick leave. Avoiding QR may help reduce workers' sick leave. The restricted recovery opportunity associated with QR may give little room for beneficial effects of individual characteristics usually associated with shift work tolerance.

ObjectiveWorkplace bullying has been established as a significant correlate of sleep problems. However, little is known regarding the causal direction between bullying and sleep. The aim of this study was to examine temporal relationships between bullying and symptoms of insomnia.MethodsReciprocal and prospective associations between exposure to workplace bullying and symptoms of insomnia were investigated in a national probability sample comprising 1149 Norwegian employees. Data stemmed from a two-wave full panel survey study with a 6-month time interval between the baseline and follow-up assessments. Models with stabilities, forward-, reverse-, and reciprocal associations were tested and compared using Structural Equation Modelling. Analyses were adjusted for age, gender, and the stability in the outcome variables over time. Workplace bullying was assessed with the nine-item Short Negative Acts Questionnaire. Insomnia was assessed with a previously validated three item scale reflecting problems with sleep onset, sleep maintenance, and early morning awakening.ResultsThe forward association model, which showed that exposure to workplace bullying prospectively increased levels of insomnia (b = 0.08; p < 0.001), had best fit with the data [CFI = 0.94; TLI = 0.93; RMSEA = 0.049 (0.046–0.052)]. The reverse association model where insomnia influences risk of being subjected to bullying was not supported.ConclusionWorkplace bullying is a risk factor for later insomnia. There is a need for further studies on moderating and mediating variables that can explain how and when bullying influence sleep.

Objective This study aimed to investigate how change in the number of quick returns [(QR) <11 hours between consecutive shifts] longitudinally is associated with risk of occupational accidents among nurses. Methods Two-year follow-up data from 1692 nurses participating in the Survey of Shiftwork, Sleep and Health among Norwegian nurses (SUSSH) (mean age 40.2, standard deviation 8.3 years, 91% female) were used. Negative binomial regression analyses were conducted to investigate the association between changes in the number of QR after two years and occupational accidents, controlling for demographics, work factors, and occupational accidents at baseline. Results An increase from having no or a moderate number of QR (1-34 per year) from baseline to the two-year follow-up assessment was associated with an increased risk of occupational accidents, compared to experiencing no change in the number of QR. Those with a moderate number of QR at baseline who experienced an increase after two years had an increased risk of causing harm to patients/others [incident rate ratio (IRR) 8.49, 95% confidence interval (CI) 2.79-25.87] and equipment at work (IRR 2.89, 95% CI 1.13-7.42). Those who had many QR (>34 per year) at baseline but experienced a reduction after two years had a reduced risk of causing harm to themselves (IRR 0.35, 95% CI 0.16-0.73) and patients/others (IRR 0.27, 95% CI 0.12-0.59). Conclusion A fairly consistent pattern was demonstrated in which changes in the number of QR over the two-year follow-up period was associated with a corresponding change in the risk of occupational accidents.

: Previous studies have shown associations of physical fitness and cognition in children and in younger and older adults. However, knowledge about associations in high-school adolescents and young adults is sparse. Thus, the aim of this study was to evaluate the association of physical fitness, measured as maximal oxygen uptake ([Formula: see text]), muscle mass, weekly training, and cognitive function in the executive domains of selective attention and inhibitory control, in healthy male high-school students. : Fifty-four males (17.9 ± 0.9 years, 72 ± 11 kg and 182 ± 7 cm) completed a [Formula: see text] test, a body composition test and a visual cognitive task based on the Posner cue paradigm with three types of stimuli with different attentional demands (i.e., stimuli presentation following no cue, valid cue or invalid cue presentations). The task consisted of 336 target stimuli, where 56 (17%) of the target stimuli appeared without a cue (no cue), 224 (67%) appeared in the same rectangle as the cue (valid cue) and 56 (17%) appeared in the rectangle opposite to the cue (invalid cue). Mean reaction time (RT) and corresponding errors was calculated for each stimuli type. Total task duration was 9 min and 20 s In addition, relevant background information was obtained in a questionnaire. : Linear mixed model analyses showed that higher [Formula: see text] was associated with faster RT for stimuli following invalid cue (Estimate = -2.69, SE = 1.03, = 0.011), and for stimuli following valid cue (Estimate = -2.08, SE = 1.03, = 0.048). There was no association of muscle mass and stimuli ( = 1.01, = 0.397) or of weekly training and stimuli ( = 0.99, = 0.405). : The results suggest that cardiorespiratory fitness is associated with cognitive performance in healthy male high-school students in the executive domains of selective attention.

Background Shift work disorder (SWD) is highly prevalent among shift-working nurses and has multiple negative health-related effects. There is a dearth of insight into career-related decisions made by nurses suffering from SWD, for instance in terms of their intention to quit work (turnover intention). In this study, we aimed to investigate the association between SWD and turnover intention among nurses, and the individual and work-related correlates of turnover intention. Method Data were derived from the ongoing longitudinal cohort study “SUrvey of Shift work, Sleep and Health (SUSSH)” among Norwegian nurses. An annual survey was initiated in 2008/2009 ( N  = 2965). The present study used data collected in year 2015 (wave 7) and 2016 (wave 8). Nurses were included if: 1) they were working as nurses in both 2015 and 2016, and 2) had completed a three-item scale adapted from the Michigan Organizational Assessment Questionnaire assessing turnover intention (in wave 8), and 3) did not only work day-shifts. SWD was measured in wave 7 with three questions based on the minimal criteria from the third edition of the International Classification of Sleep Disorders. Job demands, decision latitude, and social support at the workplace were measured with subscales of the Swedish Demand-Control-Support Questionnaire. Results Eight Hundred eighty-nine nurses were included. The results from the hierarchical linear regression showed that SWD predicted turnover intention one year later, i.e. from 2015 to 2016 (F 1,835  = 6.00, p  < 0.05; β = 0.084, p  = 0.015). The findings remained significant when controlling for age, sex, organizational tenure, number of nights worked, shift work schedule and workplace social support, job demands and decision latitude. Conclusion This study showed that SWD is associated with turnover intention, even when controlling for individual and work-related variables.

PurposeThe aim of this study was to investigate the effects of long working hours (≥ 12 h shifts) on sick leave using objective records of shift work exposure and of sick leave.MethodsA total of 1538 nurses (mean age 42.5, SD 12.0; response rate 42%) participated. Payroll and archival sick leave data over a 4-year period were retrieved from employers’ records and aggregated over every third calendar month. A multilevel negative binomial model was used to investigate the effects of exposure to long working hours, on subsequent sick leave rates the following 3 months. Covariates included prior sick leave, number of shifts worked, night and evening shifts, personality, and demographic characteristics.ResultsExposure to long working hours was associated with fewer sick leave days in the subsequent 3 months [adjusted model, incidence rate ratio (IRR) = 0.946, 95% CI 0.919–0.973, p < 0.001]. The interaction long working hours by a number of work days showed that sick leave days the subsequent 3 months was higher by long shifts when number of shifts was high compared to when number of shifts was low [adjusted model, IRR 1.002, 95% CI 1.000–1.004, p < 0.05].DiscussionLong working hours was associated with fewer sick leave days. The restorative effects of extra days off with long working hours are discussed as possible explanations to this relationship.

Prior research shows that work on board vessels of the Royal Norwegian Navy (RNoN) is associated with noise exposure levels above recommended standards. Further, noise exposure has been found to impair cognitive performance in environmental, occupational, and experimental settings, although prior research in naval and maritime settings is sparse. The aim of this study was to evaluate cognitive performance after exposure to noise among personnel working on board vessels in the RNoN. Altogether 87 Navy personnel (80 men, 7 women; 31 ± 9 years) from 24 RNoN vessels were included. Noise exposure was recorded by personal noise dosimeters at a minimum of 4 h prior to testing, and categorized into 4 groups for the analysis: <72.6 dB(A), 72.6-77.0 dB(A), 77.1-85.2 dB(A), and >85.2 dB(A). The participants performed a visual attention test based on the Posner cue-target paradigm. Multivariable general linear model (GLM) analyses were performed to analyze whether noise exposure was associated with response time (RT) when adjusting for the covariates age, alertness, workload, noise exposure in test location, sleep the night before testing, use of hearing protection device (HPD), and percentage of errors. When adjusting for covariates, RT was significantly increased among personnel exposed to >85.2 dB(A) and 77.1-85.2 dB(A) compared to personnel exposed to <72.6 dB(A).