Tor-Ivar Karlsen

• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Bolstad, Silje-Håvard; Karlsen, Tor-Ivar & Giami, Alain (2024). Gender Identity Orientation and Sexual Activity—A Survey among Transgender and Gender-Diverse (TGD) Individuals in Norway. Healthcare. ISSN 2227-9032. 12(4). doi: 10.3390/healthcare12040482.
• Kiland, Charlotte; Karlsen, Tor-Ivar & Kvåle, Gro (2024). Organisational Conditions for Boundary Spanning in Public Health. Scandinavian Journal of Public Administration (SPJA). ISSN 2001-7405. 28(1), p. 43–59. doi: 10.58235/sjpa.2023.12541.
• Karlsen, Tor-Ivar; Kiland, Charlotte; Kvåle, Gro & Torjesen, Dag Olaf (2022). ‘Health in All Policies’ and the Urge for Coordination: The Work of Public Health Coordinators and Their Impact and Influence in Local Public Health Policies: A Cross-Sectional Study. Societies. ISSN 2075-4698. 12(1). doi: 10.3390/soc12010011. Full text in Research Archive Show summary

  : Building heavily on the Health in All Policies (HiAP) approach, Norway implemented the Public Health Act in 2012 to reduce social inequalities in health. Local public health coordinators (PHCs) at municipal levels were seen as tools to provide local intersectoral public health work. In this study, we examine factors related to intersectoral agency and if intersectoral work is understood as relevant to securing social justice in local policy outcomes. A national web-based survey in 2019 of all Norwegian PHCs (n = 428) was conducted with a response rate of 60%. Data were analysed through multiple linear regression, hierarchical regression modelling and structural equation modelling. Neither factors relating to community contexts nor individual characteristics were associated with intersectoral agency. Organisational factors, especially position size, being organised at the top level and having a job description, were significantly associated with perceptions of intersectoral agency. PHCs seeing themselves as intersectoral agents also found themselves able to affect annual budgets and policy outcomes. We conclude that municipal PHC positions can be important HiAP tools in local public health policies. However, organisational factors affect how PHCs perceive their influence and role in the municipal organisation and thereby their possibilities to influence local policymaking through intersectoral agency

• Vatnøy, Torunn Kitty; Dale, Bjørg; Skinner, Marianne Sundlisæter & Karlsen, Tor-Ivar (2022). Associations between nurse managers’ leadership styles, team culture and competence planning in Norwegian municipal in-patient acute care services: A cross-sectional study. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 36(2), p. 482–492. doi: 10.1111/scs.13064. Full text in Research Archive Show summary

  Background Increased complexity in the primary healthcare services has followed in the wake of health reforms and reveals the need for competence enhancement in the nursing services. Effective and visionary leadership, sufficiently qualified staff and cooperation among professionals are considered as key measures to safeguard quality in the services. Aims To identify which leadership styles characterise first-line nurse managers in Norwegian municipal in-patient acute care (MipAC) units and to investigate how first-line nurse managers’ leadership styles are associated with team culture and documented nursing competence planning. Methods A cross-sectional survey was distributed to all the first-line nurse managers in Norwegian MipAC units (n = 229). Data were collected between March and June 2019. The response rate was 80.5% (n = 182). First-line managers’ background information and data about their focus on team culture and competence planning were recorded. Furthermore, we noted organisational structural characteristics, and managers’ transformational (relational) leadership and transactional (task-oriented) leadership styles. Results The managers exhibited a high degree of transformational leadership behaviour, which was significantly associated with team culture. No significant associations between leadership behaviours and documented competence planning were found. Notably, we found a significant correlation between transformational and transactional leadership styles, indicating that the managers adapt their leadership behaviours to actual requirements and situations. Organisational structural factors: the share of registered nurses (RNs) on the staff and having a position for a professional development nurse were positively associated with competence planning. Conclusion A relational leadership style promotes team culture and both factors may empower the professional nursing environment. However, first-line nurse managers need to acknowledge nursing competence planning as a central part of effective leadership. Having a professional development nurse position seems to complement leadership and ease the manager's responsibilities regarding team culture and competence planning.

• Torjesen, Dag Olaf; Karlsen, Tor-Ivar; Kiland, Charlotte & Balle Hansen, Morten (2021). Public service motivation among Danish and Norwegian local government administrative managers. In Pinheiro, Romulo & Trondal, Jarle (Ed.), Organizing and Governing Governmental Institutions. Fagbokforlaget. ISSN 978-82-450-3532-2. p. 88–107.
• Arntsen, Bjørnulf; Torjesen, Dag Olaf & Karlsen, Tor-Ivar (2021). Asymmetry in inter-municipal cooperation in health services – how does it affect service quality and autonomy? Social Science and Medicine. ISSN 0277-9536. 273. doi: 10.1016/j.socscimed.2021.113744. Full text in Research Archive
• Nordstrand, Sebjørg Elizabeth Hesla; Juvodden, Hilde Therese; Viste, Rannveig; Rootwelt-Revheim, Terje; Karlsen, Tor-Ivar & Thorsby, Per Medbøe [Show all 10 contributors for this article] (2020). Obesity and other medical comorbidities among NT1 patients after the Norwegian H1N1 influenza epidemic and vaccination campaign. Sleep. ISSN 0161-8105. 43(5). doi: 10.1093/sleep/zsz277.
• Vatnøy, Torunn Kitty; Skinner, Marianne Sundlisæter; Karlsen, Tor-Ivar & Dale, Bjørg (2020). Nursing competence in municipal in-patient acute care in Norway: a cross-sectional study. BMC Nursing. ISSN 1472-6955. 19. doi: 10.1186/s12912-020-00463-5. Full text in Research Archive
• Arntsen, Bjørnulf; Torjesen, Dag Olaf & Karlsen, Tor-Ivar (2020). Associations between structures, processes and outcomes in inter-municipal cooperation in out-of-hours services in Norway: A survey study. Social Science and Medicine. ISSN 0277-9536. 258. doi: 10.1016/j.socscimed.2020.113067. Full text in Research Archive Show summary

  Inter-municipal cooperation (IMC) has gained widespread recognition as a beneficial strategy for improving efficiency and quality in the provision of out-of-hours emergency care services (OOH services). Little attention, however, has been given to the additional costs of cooperation and the relational processes through which benefits and costs are likely to result. Based on survey data from 266 (77%) Norwegian municipalities involved in IMC in OOH services in 2015, this study aimed to investigate how the structure (governance form, complexity and stability) and quality (trust and consensus) of cooperation processes interact to influence the perceived outcomes (benefits and costs) of IMC in OOH services. Using Structural equation modeling, we found trust and consensus fully mediated the association between the structure and outcomes of IMC. More specifically, the results suggest that cooperation structures characterized by centralized governance, stability over time, and reduced complexity were likely to enhance the benefits and reduce the costs of IMC through trust and consensus.

• Lorentzen, Jolanta Halabowska; Medhus, Asle Wilhelm; Hertel, Jens Kristoffer; Borgeraas, Heidi; Karlsen, Tor-Ivar & Kolotkin, Ronette Loganzo [Show all 12 contributors for this article] (2020). Erosive Esophagitis and Symptoms of Gastroesophageal Reflux Disease in Patients with Morbid Obesity with and without Type 2 Diabetes: a Cross-sectional Study. Obesity Surgery. ISSN 0960-8923. 30, p. 2667–2675. doi: 10.1007/s11695-020-04545-w. Full text in Research Archive Show summary

  Background Type 2 diabetes (T2DM) is associated with gastroesophageal reflux disease (GERD) in the general population, but the relationship between these conditions in candidates for bariatric surgery is uncertain. We compared the prevalence of GERD and the association between GERD symptoms and esophagitis among bariatric candidates with and without T2DM. Methods Cross-sectional study of baseline data from the Oseberg study in Norway. Both groups underwent gastroduodenoscopy and completed validated questionnaires: Gastrointestinal Symptom Rating Scale and Gastroesophageal Reflux Disease Questionnaire. Participants with T2DM underwent 24-h pH-metry. Results A total of 124 patients with T2DM, 81 women, mean (SD) age 48.6 (9.4) years and BMI 42.3 (5.5) kg/m2, and 64 patients without T2DM, 46 women, age 43.0 (11.0) years and BMI 43.0 (5.0) kg/m2, were included. The proportions of patients reporting GERD-symptoms were low (< 29%) and did not differ significantly between groups, while the proportions of patients with esophagitis were high both in the T2DM and non-T2DM group, 58% versus 47%, p = 0.16. The majority of patients with esophagitis did not have GERD-symptoms (68–80%). Further, 55% of the patients with T2DM had pathologic acid reflux. Among these, 71% also had erosive esophagitis, whereof 67% were asymptomatic. Conclusions The prevalence of GERD was similar in bariatric patients with or without T2DM, and the proportion of patients with asymptomatic GERD was high independent of the presence or absence of T2DM. Accordingly, GERD may be underdiagnosed in patients not undergoing a preoperative endoscopy or acid reflux assessment

• Vatnøy, Torunn Kitty; Karlsen, Tor-Ivar & Dale, Bjørg (2019). Exploring nursing competence to care for older patients in municipal in-patient acute care: a qualitative study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. doi: 10.1111/jocn.14914. Full text in Research Archive
• Vatnøy, Torunn Kitty; Karlsen, Tor-Ivar & Dale, Bjørg (2019). Exploring nursing competence to care for older patients in municipal in‐patient acute care: A qualitative study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 28(17-18), p. 3339–3352. doi: 10.1111/jocn.14914.
• Nordstrand, Sebjørg Elizabeth Hesla; Hansen, Berit M Hjelde; Rootwelt-Revheim, Terje; Karlsen, Tor-Ivar; Swanson, David & Nilsen, Kristian Bernhard [Show all 7 contributors for this article] (2019). Psychiatric symptoms in patients with post-H1N1 narcolepsy type 1 in Norway. Sleep. ISSN 0161-8105. 42(4), p. 1–9. doi: 10.1093/sleep/zsz008. Show summary

  Study Objectives Several studies have reported psychiatric comorbidity in patients with narcolepsy type 1 (NC1). The primary aim of this study was to explore the extent of psychiatric symptoms in a cohort of Norwegian NC1 patients, most of whom were H1N1-vaccinated. We also wanted to explore possible causes of the psychiatric symptoms seen in NC1. Methods Cross-sectional study. Psychiatric symptoms were assessed by the Achenbach System of Empirically Based Assessment (ASEBA) Child Behavior Check List (CBCL) in children and by Adult Self Report (ASR) in adults. Results The mean (SD) total T-scores were 58.6 (9.2) for children and 57.0 (9.8) for adults, these being mainly driven by internalizing problems. Internalizing symptom T-scores showed that 37.5% of the children and 33.3% of the adults were in the clinical range of concern. T-scores were lower when the questionnaire’s sleep-related items were excluded. However, 27.5% of children and 22.2% of adults still remained within the total psychiatric symptoms clinical range. Psychiatric symptoms and excessive daytime sleepiness were not associated. However, in children fragmented sleep, measured by sleep-stage shift index was significantly negatively associated with all the psychiatric summary scores (all p ≤ 0.020), and awakening index was negatively associated with externalizing (p = 0.042) and total summary scores (p = 0.042). In adults, awakening index, but not sleep-stage shift index, was positively associated with internalizing score (p = 0.015). Hypocretin-1 levels showed no association with psychiatric symptoms. Conclusions We found a high prevalence of psychiatric symptoms in NC1 patients. Fragmented sleep was significantly associated with psychiatric symptoms. Keywords: narcolepsy type 1, narcolepsy with cataplexy, psychiatric symptoms, Pandemrix, H1N1

• Borgeraas, Heidi; Hjelmesæth, Jøran; Birkeland, Kåre I.; Fatima, Farhat; Grimnes, John Olav & Gulseth, Hanne Løvdal [Show all 22 contributors for this article] (2019). Single-centre, triple-blinded, randomised, 1-year, parallel-group, superiority study to compare the effects of Roux-en-Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function in subjects with morbid obesity: a protocol for the Obesity surgery in Tønsberg (Oseberg) study . BMJ Open. ISSN 2044-6055. 9(6). doi: 10.1136/bmjopen-2018-024573. Full text in Research Archive Show summary

  Introduction Bariatric surgery is increasingly recognised as an effective treatment option for subjects with type 2 diabetes and obesity; however, there is no conclusive evidence on the superiority of Roux-en-Y gastric bypass or sleeve gastrectomy. The Oseberg study was designed to compare the effects of gastric bypass and sleeve gastrectomy on remission of type 2 diabetes and β-cell function. Methods and analysis Single-centre, randomised, triple-blinded, two-armed superiority trial carried out at the Morbid Obesity Centre at Vestfold Hospital Trust in Norway. Eligible patients with type 2 diabetes and obesity were randomly allocated in a 1:1 ratio to either gastric bypass or sleeve gastrectomy. The primary outcome measures are (1) the proportion of participants with complete remission of type 2 diabetes (HbA1c≤6.0% in the absence of blood glucose-lowering pharmacologic therapy) and (2) β-cell function expressed by the disposition index (calculated using the frequently sampled intravenous glucose tolerance test with minimal model analysis) 1 year after surgery. Ethics and dissemination The protocol of the current study was reviewed and approved by the regional ethics committee on 12 September 2012 (ref: 2012/1427/REK sør-øst B). The results will be disseminated to academic and health professional audiences and the public via publications in international peer-reviewed journals and conferences. Participants will receive a summary of the main findings. Trial registration number NCT01778738;Pre-results. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial

• Benestad, Beate; Karlsen, Tor-Ivar; Småstuen, Milada Cvancarova; Lekhal, Samira; Hertel, Jens Kristoffer & Steinsbekk, Silje [Show all 9 contributors for this article] (2019). Health-related quality of life after camp-based family obesity treatment: an RCT . BMJ Paediatrics Open. ISSN 2399-9772. 3(1). doi: 10.1136/bmjpo-2018-000413. Full text in Research Archive
• Nordstrand, Sebjørg Elizabeth Hesla; Hansen, Berit M Hjelde; Kamaleri, Yusman; Nilsen, Kristian Bernhard; Rootwelt-Revheim, Terje & Karlsen, Tor-Ivar [Show all 7 contributors for this article] (2018). Changes in quality of life in individuals with narcolepsy type 1 after the H1N1-influenza epidemic and vaccination campaign in Norway: a two-year prospective cohort study. Sleep Medicine. ISSN 1389-9457. 50, p. 175–180. doi: 10.1016/j.sleep.2018.05.037. Full text in Research Archive Show summary

  Objective Cross-sectional studies show a lower health-related quality of life (HRQoL) in individuals with narcolepsy. We aimed to describe changes in HRQoL after two years of multidisciplinary follow-up in a cohort of mainly post-H1N1 vaccination narcolepsy type-1 (NT1) patients in Norway. Methods Prospective-cohort study. Narcolepsy diagnosis was based on the International Classification of Sleep Disorders (third edition). Psychiatric comorbidity was assessed using the Achenbach System of Empirically Based Assessment (ASEBA). HRQoL was evaluated with the Pediatric Quality of Life Inventory (PedsQL™ Generic Core Scales 4.0) at baseline and follow-up. Mean follow-up time was 20.7 (2.7) months. Results Thirty one patients (18 females) with NT1, mean age 14.6 (SD = 4.8) years answered questionnaires at baseline and follow-up. On a group level, the PedsQL Total Health Summary score significantly improved by a mean of 5.9 (95%CI = 0.4, 11.9), p = 0.038; this was mainly driven by improvements in the Physical Health Summary score by 9.8 (3.0, 16.5) points, p = 0.006 and the School Functioning Scale score by 7.5 (1.0, 13.9) points p = 0.025. The Total ASEBA score was correlated with PedsQL Total Health Summary score at baseline, but not with changes in HRQoL. Sodium oxybate (Xyrem®) treatment at follow up was positively associated with changes in PedsQL Total Health Summary score, after adjusting for age and gender, p = 0.027. Conclusion HRQoL in NT1 patients improved after two years of follow-up. The use of sodium oxybate (Xyrem®) at follow-up was associated with increases in HRQoL. Psychiatric comorbidity was correlated with HRQoL at baseline but did not predict changes in HRQoL at follow-up.

• Karlsen, Tor-Ivar; Tveide, Marit Bolstad & Fensli, Rune Werner (2018). Factors affecting seniors' attitudes on the use of information technology. Linköping Electronic Conference Proceedings. ISSN 1650-3686. 2018(145), p. 78–81.
• Hjelmesæth, Jøran; Åsberg, Anders; Andersson, Shalini; Sandbu, Rune; Robertsen, Ida & Johnson, Line Kristin [Show all 16 contributors for this article] (2018). Impact of body weight, low energy diet and gastric bypass on drug bioavailability, cardiovascular risk factors and metabolic biomarkers: protocol for an open, non-randomised, three-armed single centre study (COCKTAIL). BMJ Open. ISSN 2044-6055. 8:e021878(5), p. 1–10. doi: 10.1136/bmjopen-2018-021878. Full text in Research Archive
• Arntsen, Bjørnulf; Torjesen, Dag Olaf & Karlsen, Tor-Ivar (2018). Drivers and Barriers of Inter-Municipal Cooperation in Health Services – The Norwegian Case. Local Government Studies. ISSN 0300-3930. 44(3), p. 371–390. doi: 10.1080/03003930.2018.1427071.
• Dagsland, Vigdis Halvorsen; Andenæs, Randi & Karlsen, Tor-Ivar (2018). Generic Health-Related Quality of Life May Not Be Associated with Weight Loss 4 Years After Bariatric Surgery: a Cross-Sectional Study. Obesity Surgery. ISSN 0960-8923. p. 1–9. doi: 10.1007/s11695-018-3332-7. Full text in Research Archive
• Øgård-Repål, Anita; Strand, Ståle Arvill & Karlsen, Tor-Ivar (2017). Karakterpress, kroppspress og gjengpress - Fokusgruppeintervju av jenter i 9. klassetrinn etter funn fra Ungdata undersøkelsen. Tidsskrift for psykisk helsearbeid. ISSN 1503-6707. 14(2), p. 109–120. doi: 10.18261/issn.1504-3010-2017-02-03.
• Svanevik, Marius; Risstad, Hilde; Karlsen, Tor-Ivar; Kristinsson, Jon Adalsteinn; Småstuen, Milada C & Kolotkin, Ronette L. [Show all 10 contributors for this article] (2017). Patient-reported outcome measures 2 years after standard and distal gastric bypass-a double-blind randomized controlled trial. Obesity Surgery. ISSN 0960-8923. 28(3), p. 606–614. doi: 10.1007/s11695-017-2891-3.
• Skeivoll Christiansen, Wenche; Karlsen, Tor-Ivar & Larsen, Inger Beate (2017). Materiell og profesjonell stigmatisering av mennesker med sykelig overvekt. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 13(2). doi: 10.7557/14.4195.
• Risstad, Hilde; Svanevik, Marius; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; AASHEIM, ERLEND T. & Hofsø, Dag [Show all 11 contributors for this article] (2016). Standard vs distal roux-en-Y gastric bypass in patients with body mass index 50 to 60 a double-blind, randomized clinical trial. JAMA Surgery. ISSN 2168-6254. 151(12), p. 1146–1155. doi: 10.1001/jamasurg.2016.2798.
• Andersen, John Roger; Aasprang, Anny; Karlsen, Tor-Ivar; Natvig, Gerd Karin; Våge, Villy & Kolotkin, Ronette Loganzo (2015). Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies. Surgery for Obesity and Related Diseases. ISSN 1550-7289. 11(2), p. 466–473. doi: 10.1016/j.soard.2014.10.027. Full text in Research Archive
• Almås, Cecilie Brøvig; Almås, Elsa Mari; Karlsen, Tor-Ivar & Giami, Alain (2014). La sexologie en Norvège entre 2001et 2011: Une étude comparative = Sexology in Norway in 2001 and 2011: A comparative and cross-sectional study. Sexologies: revue europeenne de sante sexuelle - european journal of sexual health. ISSN 1158-1360. 23(1), p. 14–17. doi: 10.1016/j.sexol.2013.12.001.
• Andersen, John Roger; Karlsen, Tor-Ivar & Kolotkin, Ronette Loganzo (2014). Obesity and Its Impact Upon Quality of Life, Integrative Weight Management. Springer. ISSN 978-1-4939-0547-8. doi: 10.1007/978-1-4939-0548-5_15.
• Almås, Cecilie Brøvig; Almås, Elsa Mari; Karlsen, Tor-Ivar & Giami, Alain (2014). Sexology in Norway in 2001 and 2011: A comparative and cross-sectional study. Sexologies: revue europeenne de sante sexuelle - european journal of sexual health. ISSN 1158-1360. 23(1), p. e9–e17. doi: 10.1016/j.sexol.2013.12.002. Show summary

  a comparative cross-sectional study Norwegian sexology practitioners have been studied in 2001 and in 2011 concerning professional background, sexology training, therapeutic approaches and clinical sexology problems. The Norwegian sexology professional group is small and the Norwegian Association of Clinical Sexology counted around 150 members in 2011. In 2001, a two-year half time further education program in sexology counselling started at the university of Agder. Since 2001, 164 sexology counsellors have been educated from this program. The objective of the study was to understand how these changes might have influenced the field of sexology in Norway. The participants in the 2011 study are significantly different from those who responded in 2001. More female sexology practitioners have entered the field. There are more respondents with a social and health bachelor degree, and fewer physicians and psychologists among the respondents. The participants use a wider range of therapeutic approaches, but not significantly more sexology treatment methods. The problems the participants see are in many ways similar in 2001 and 2011, but they report overall more problems from their female clients and more relational problems and problems with sexual desire from their male clients in 2011. Based on the importance of interdisciplinary work, described by the biopsychosocial model, the authors recommend recruitment of different professional groups, and the importance of maintaining the interests of psychologists and physicians and other experienced professionals in the field of sexology in Norway.

• Karlsen, Tor-Ivar; Søhagen, Maryon & Hjelmesæth, Jøran (2013). Predictors of weight loss after an intensive lifestyle intervention program in obese patients: a 1-year prospective cohort study. Health and Quality of Life Outcomes. ISSN 1477-7525. 11. doi: 10.1186/1477-7525-11-165. Show summary

  Abstract Background: Studies of lifestyle intervention programs in morbid obesity report large variations in weight loss outcomes. This is reported not only between but also within standardized programs. Such reports point to participants’ characteristics as possible predictors of this outcome. The aim of this prospective cohort study was to identify predictors of weight loss after a 1-year partly residential intensive lifestyle intervention program (ILI). Methods: Morbidly obese patients (n=199), all Caucasian, 71% women, mean (SD) age 45.2 (11.1) years, body mass index (BMI) 42.0 (6.2) kg/m2, and excess body weight (>BMI=25 kg/m2) 49.4 (19.6) kg, were referred from public hospitals to a rehabilitation center and enrolled consecutively. The 1-year ILI comprised of four (n=104) or five (n=95) stays at the rehabilitation center. In both cases there was one main stay for 4 weeks and the remaining stays lasted 1 week each. In the home periods the patients were followed up by telephone and by their general practitioners (GP). The patients were also encouraged to use a predefined paper based diary. Health related quality of life (HRQL), diagnostic, anthropometric, socio-demographic, psychosocial and intervention characteristics were measured at baseline, 12 weeks and 1 year. Multiple linear regression analyses were performed to extract possible predictors of weight loss at 1-year. Direct and indirect effects of these predictors were tested through structural equation modeling. Results: The mean (SD) 1-year weight loss was 10 (11) kg, corresponding to an 8 (8) % reduction of body weight from baseline. Mean excess weight loss (EWL) was 20 (22) % ranging from 104% to −77%. The adherence to a diary (r=.16), type 2 diabetes (r=−.14) and frequency of GP-visits (r=.23) were significantly associated with EWL at 12 weeks. Predictors of 1-year EWL were 12 week EWL (r=.66), occupational status (r=.11), age (r=.19), and mental HRQL (r=−.16), all p<.05. The path model explained 50% of the variation (r2=.50) of 1-year EWL. Conclusion: Larger 12 week weight loss, being employed, lower mental HRQL and being older predicts larger weight loss after 1 year in morbidly obese patients following ILI. Not having type 2 diabetes, using a diary combined with regular GP follow-up influence the 12-week weight loss.

• Karlsen, Tor-Ivar; Lund, Randi Størdal; Røislien, Jo; Tonstad, Serena; Natvig, Gerd Karin & Sandbu, Rune [Show all 7 contributors for this article] (2013). Health related quality of life after gastric bypass or intensive lifestyle intervention: a controlled clinical study. Health and Quality of Life Outcomes. ISSN 1477-7525. 11. doi: 10.1186/1477-7525-11-17. Show summary

  Background There is little robust evidence relating to changes in health related quality of life (HRQL) in morbidly obese patients following a multidisciplinary non-surgical weight loss program or laparoscopic Roux-en-Y Gastric Bypass (RYGB). The aim of the present study was to describe and compare changes in five dimensions of HRQL in morbidly obese subjects. In addition, we wanted to assess the clinical relevance of the changes in HRQL between and within these two groups after one year. We hypothesized that RYGB would be associated with larger improvements in HRQL than a part residential intensive lifestyle-intervention program (ILI) with morbidly obese subjects. Methods A total of 139 morbidly obese patients chose treatment with RYGB (n=76) or ILI (n=63). The ILI comprised four stays (seven weeks) at a specialized rehabilitation center over one year. The daily schedule was divided between physical activity, psychosocially-oriented interventions, and motivational approaches. No special diet or weight-loss drugs were prescribed. The participants completed three HRQL-questionnaires before treatment and 1 year thereafter. Both linear regression and ANCOVA were used to analyze differences between weight loss and treatment for five dimensions of HRQL (physical, mental, emotional, symptoms and symptom distress) controlling for baseline HRQL, age, age of onset of obesity, BMI, and physical activity. Clinical relevance was assessed by effect size (ES) where ES<.49 was considered small, between .50-.79 as moderate, and ES>.80 as large. Results The adjusted between group mean difference (95% CI) was 8.6 (4.6,12.6) points (ES=.83) for the physical dimension, 5.4 (1.5–9.3) points (ES=.50) for the mental dimension, 25.2 (15.0–35.4) points (ES=1.06) for the emotional dimension, 8.7 (1.8–15.4) points (ES=.37) for the measured symptom distress, and 2.5 for (.6,4.5) fewer symptoms (ES=.56), all in favor of RYGB. Within-group changes in HRQOL in the RYGB group were large for all dimensions of HRQL. Within the ILI group, changes in the emotional dimension, symptom reduction and symptom distress were moderate. Linear regression analyses of weight loss on HRQL change showed a standardized beta-coefficient of –.430 (p<.001) on the physical dimension, –.288 (p=.004) on the mental dimension, –.432 (p<.001) on the emotional dimension, .287 (p=.008) on number of symptoms, and .274 (p=.009) on reduction of symptom pressure. Conclusions Morbidly obese participants undergoing RYGB and ILI had improved HRQL after 1 year. The weaker response of ILI on HRQL, compared to RYGB, may be explained by the difference in weight loss following the two treatments.

• Gjevestad, Espen Svendsen; Karlsen, Tor-Ivar; Røislien, Jo; Mæhlum, S. & Hjelmesæth, Jøran (2013). The effectiveness of secondary and tertiary care lifestyle intervention in morbidly obese patients: a 1-year non-randomized controlled pragmatic clinical trial. Clinical Obesity. ISSN 1758-8103. 3(1-2), p. 39–50. doi: 10.1111/cob.12011.
• Karlsen, Tor-Ivar; Tveitå, Einar; Natvig, Gerd Karin; Tonstad, Serena & Hjelmesæth, Jøran (2011). Validity of the SF-36 in Patients with Morbid Obesity. Obesity Facts. ISSN 1662-4025. 4(5), p. 346–351. doi: 10.1159/000333406. Show summary

  Background: The Medical Outcome Study 36-Item Short Form Health Survey (SF-36) is one of the most commonly applied generic quality of life instruments. The construct validity of the instrument in patients with morbid obesity is not established. Participants and Methods: A total of 475 morbidly obese patients (68% women) with a mean (standard deviation) age of 44.7 (11.8) years, weight of 123.5 (24.1) kg and BMI of 41.7 (6.3) kg/m2, who had been referred to a rehabilitation center, completed the SF-36 form. Exploratory factor analyses were performed to examine the underlying component structure of the questionnaire. Confirmatory factor analyses were performed to assess model fit. Results: The analysis suggested a 6-component structure rather than the 8-component structure used in the original SF-36. The first component consisted of items from the physical functioning subscale, the role physical subscale and the general health subscale, and explained 31% of the variance. The 6 components explained 61% of the total variance. The items loaded as expected in a physical and mental component. The assessment of model fit confirmed these findings. Conclusion: The 2 summary scales of the SF-36 have satisfactory validity in patients with morbid obesity. However, the validity of the 8 subscales is questionable, and the subscales should be interpreted with care.

• Lund, Randi Størdal; Karlsen, Tor-Ivar; Hofsø, Dag; Fredheim, Jan Magnus; Røislien, Jo & Sandbu, Rune [Show all 7 contributors for this article] (2011). Employment Is Associated with the Health-Related Quality of Life of Morbidly Obese Persons. Obesity Surgery. ISSN 0960-8923. 21(11), p. 1704–1709. doi: 10.1007/s11695-010-0289-6.
• Karlsen, Tor-Ivar (2011). Obesity and its consequences. In Salvini, Andrea & Andersen, Anders Johan Wickstrøm (Ed.), Interactions, Health and Community. EDIZIONI PLUS Pisa University Press. ISSN 9788884928023. p. 115–138.

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• Kvåle, Gro; Kiland, Charlotte; Karlsen, Tor-Ivar & Torjesen, Dag Olaf (2023). Implementing intersectoral agency in local public health work.
• Vatnøy, Torunn Kitty; Dale, Bjørg; Skinner, Marianne Sundlisæter & Karlsen, Tor-Ivar (2022). Kompetanseutvikling og ledelse i sykepleietjenesten i KAD.
• Karlsen, Tor-Ivar (2022). Skam, depresjon og selvmord i transbefolkningen.
• Vatnøy, Torunn Kitty; Skinner, Marianne Sundlisæter; Karlsen, Tor-Ivar & Dale, Bjørg (2020). Correction to: Nursing competence in municipal in-patient acute care in Norway: a cross-sectional study (BMC Nursing, (2020), 19, 1, (70), 10.1186/s12912-020-00463-5). BMC Nursing. ISSN 1472-6955. 19(1). doi: 10.1186/s12912-020-00519-6.
• Vatnøy, Torunn Kitty; Dale, Bjørg; Karlsen, Tor-Ivar & Skinner, Marianne Sundlisæter (2020). Sykepleiekompetanse ved kommunale akutt døgnplasser .
• Torjesen, Dag Olaf; Karlsen, Tor-Ivar; Kiland, Charlotte & Hansen, Morten Balle (2020). Antecedents of public service motivation, institutional differences and characteristics among Danish and Norwegian local government administrative top-managers .
• Lorentzen, Jolanta Halabowska; Medhus, Asle Wilhelm; Hertel, Jens Kristoffer; Karlsen, Tor-Ivar; Borgeraas, Heidi & Sandbu, Rune [Show all 10 contributors for this article] (2019). Gastroesophageal reflux disease in patients With severe obesity and type 2 diabetes one year after sleeve gastrectomy or roux-en-y gastric bypass. A Randomized controlled trial. Surgery for Obesity and Related Diseases. ISSN 1550-7289. 15, p. S3–S3. doi: 10.1016/j.soard.2019.08.052.
• Karlsen, Tor-Ivar; Giami, Alain; Benestad, Esben Esther Pirelli; Bolstad, Silje-Håvard & Almås, Elsa Mari (2019). Paths leading to suicide attempts among Norwegian trans people.
• Bolstad, Silje-Håvard; Karlsen, Tor-Ivar; Benestad, Esben Esther Pirelli; Almås, Elsa Mari & Giami, Alain (2019). Gender Self Definition for Measuring Transition Pathways in Norway.
• Giami, Alain; Panjo, Henri; Scandurra, Cristiano; Valerio, Paolo; Almås, Elsa Mari & Benestad, Esben Esther Pirelli [Show all 10 contributors for this article] (2019). Access to health care among trans population in Europe.
• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Karlsen, Tor-Ivar; Bolstad, Silje-Håvard & Giami, Alain (2019). Mental health in gender incongruent individuals below 20 years of age.
• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Karlsen, Tor-Ivar; Bolstad, Silje-Håvard & Giami, Alain (2019). Sexual excitement and sexual attraction in individuals who experience gender incongruence in Norway.
• Karlsen, Tor-Ivar (2019). Hvordan systematisere og bruke ny kunnskap fra befolkningsundersøkelser .
• Karlsen, Tor-Ivar (2019). Hva forstår vi med et systematisk folkehelsearbeid?
• Karlsen, Tor-Ivar (2019). Hvilke faktorer er assosiert med folkehelsearbeidernes egenopplevde gjennomslag i kommunenes folkehelsearbeid? Data fra nasjonal kartlegging i prosjektet: Folkehelsearbeid i norske kommuner 2019 (FLINK 2019).
• Kiland, Charlotte; Torjesen, Dag Olaf & Karlsen, Tor-Ivar (2019). The interplay between top civil servants and civil society in local government in the age of New Public Governance .
• Enriques-Estrada, Victor Manuel; Benestad, Esben Esther Pirelli; Almås, Elsa Mari; Karlsen, Tor-Ivar; Bolstad, Silje-Håvard & Giami, Alain (2019). “Born in the right or the wrong country?” A comparison of quality of life for the trans populations in Mexico and Norway with Born in the right or the wrong country. Comparison of the quality of life for the trans populations in Mexico and Norway with focus on psychological measures in relation to societal changes that has taken place. .
• Giami, Alain; Bolstad, Silje Håvard; Panjo, Henri; Almås, Elsa Mari; Karlsen, Tor-Ivar & Benestad, Esben Esther Pirelli [Show all 8 contributors for this article] (2019). Access to health care among trans population in Europe Trans: Health and Citizenship.
• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Bolstad, Silje Håvard; Karlsen, Tor-Ivar & Giami, Alain (2019). Mental health in gender incongruent individuals in Norway.
• Benestad, Esben Esther Pirelli; Almås, Elsa Mari; Bolstad, Silje-Håvard; Karlsen, Tor-Ivar & Giami, Alain (2019). Paths leading to suicide attempts among Norwegian trans people.
• Karlsen, Tor-Ivar & Frivold, Gro (2019). Family members’ reporting of anxiety and depression after intensive care units stay—a cross-sectional survey study.
• Torjesen, Dag Olaf; Saxi, Hans Petter; Torsteinsen, Harald & Karlsen, Tor-Ivar (2018). Norwegian local government CEOs 1988-2017: Stablemates and administrative entrepreneurs in complementary cooperation with the mayor.
• Benestad, Esben Esther Pirelli; Almås, Elsa Mari; Karlsen, Tor-Ivar & Bolstad, Silje Håvard (2018). Født i «feil kropp» i feil land: Ny undersøkelse om kjønnsinkongruens i Norge gir alarmerende resultater. Aftenposten (morgenutg. : trykt utg.). ISSN 0804-3116.
• Karlsen, Tor-Ivar (2018). Folkehelse, fedme og livskvalitet.
• Vatnøy, Torunn Kitty; Karlsen, Tor-Ivar & Dale, Bjørg (2018). KRITISKE ASPEKTER VED SYKEPLEIEKOMPETANSEN I KOMMUNALE AKUTTE DØGNENHETER. SYKEPLEIERE OG LEGERS ERFARINGER.
• Almås, Elsa Mari; Benestad, Esben Esther Pirelli; Bolstad, Silje Håvard; Karlsen, Tor-Ivar & Giami, Alain (2018). Gender Health and Citizenship.
• Torjesen, Dag Olaf; Karlsen, Tor-Ivar; Kiland, Charlotte & Hansen, Morten Balle (2018). Public service motivation among senior executives in Danish and Norwegian local government – challenged but still viable?
• Karlsen, Tor-Ivar (2018). Neste generasjon eldre og holdninger til internett-teknologi.
• Karlsen, Tor-Ivar (2018). Folkehelse, livskvalitet og fedme.
• Karlsen, Tor-Ivar (2017). Alvorlig fedme og livskvalitet. Indremedisineren. ISSN 1891-1617. 2017(4).
• Karlsen, Tor-Ivar; Tveide, Marit Bolstad & Fensli, Rune Werner (2017). Factors affecting seniors' attitudes on the use of information technology.
• Nordstrand, Sebjørg Elizabeth Hesla; Hansen, Berit M Hjelde; Kamaleri, Yusman; Nilsen, Kristian Bernhard; Karlsen, Tor-Ivar & Knudsen, Stine (2017). Changes in Quality of Life in individuals with narcolepsy in Norway after H1N1-influensa epidemic in 2009- a 2-year prospective cohort study.
• Karlsen, Tor-Ivar; Dagsland, Vigdis & Randi, Andenaes (2017). CONTRADICTING THE IFSO-STATEMENT: WEIGHT LOSS DOES NOT PREDICT IMPROVEMENT OF GENERIC QUALITY OF LIFE.
• Lorentzen, Jolanta Halabowska; Medhus, Asle Wilhelm; Hjelmesæth, Jøran; Hofsø, Dag; Karlsen, Tor-Ivar & Sandbu, Rune [Show all 8 contributors for this article] (2016). GERDQ- og GSRS-skjemaer kan være utilstrekkelig til å diagnostisere gastroøsofageal reflukssykdom (GØRS). Oseberg Refluksstudie, Tønsberg.
• Svanevik, Marius; Risstad, Hilde; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; Aasheim, Erlend Eithun & Hofsø, Dag [Show all 11 contributors for this article] (2016). Livskvalitet og tarmfunksjon etter proksimal og distal gastrisk bypass – en dobbeltblind randomisert kontrollert studie.
• Risstad, Hilde; Svanevik, Marius; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; Aasheim, Erlend Eithun & Hofsø, Dag [Show all 11 contributors for this article] (2016). Vekttap og markører for kardiometabolsk risiko 2 år etter proksimal og distal gastrisk bypass hos pasienter med KMI 50 til 60 kg/m2 i en dobbeltblindet, randomisert klinisk studie.
• Risstad, Hilde; Svanevik, Marius; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; AASHEIM, ERLEND T. & Hofsø, Dag [Show all 11 contributors for this article] (2015). Proximal versus distal gastric bypass in patients with body mass index 50-60 kg/m2: A double-blind, randomized clinical trial. Surgery for Obesity and Related Diseases. ISSN 1550-7289. 11(6), p. S1–S2. doi: 10.1016/j.soard.2015.10.003. Show summary

  Patients with a body mass index (BMI, kg/m2) of 50 or more experience substantial weight loss, but often remain morbidly obese after proximal Roux’en Y gastric bypass (RYGB). We tested whether a distal RYGB improves patient outcomes in a double-blind randomized clinical trial.

• Sandbu, Rune; Seip, Birgitte Karen Berggreen; Medhus, Asle Wilhelm; Lorentzen, Jolanta Halabowska; Hjelmesæth, Jøran & Hofsø, Dag [Show all 7 contributors for this article] (2015). Esophageal motility in morbidly obese patients with type 2 diabetes. United European Gastroenterology Journal (UEG Journal). ISSN 2050-6406.
• Lorentzen, Jolanta Halabowska; Hjelmesæth, Jøran; Medhus, Asle Wilhelm; Hofsø, Dag; Karlsen, Tor-Ivar & Sandbu, Rune [Show all 7 contributors for this article] (2015). Questionnaires may be insufficient to diagnose gastroesophageal reflux disease (GERD) in morbidly obese patients with type 2 diabetes. United European Gastroenterology Journal (UEG Journal). ISSN 2050-6406.
• Svanevik, Marius; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; Aasheim, Erlend T; Hofsø, Dag & Søvik, Torgeir Thorson [Show all 11 contributors for this article] (2015). Proximal versus distal gastric bypass in patients with body mass index 50-60 kg/m2: A double-blind, randomized clinical trial.
• Karlsen, Tor-Ivar (2015). Hvordan skal statistikk forstås, analyseres og anvendes i kommuneplanarbeidet?
• Karlsen, Tor-Ivar (2015). Prioriteringer av folkehelseutfordringer.
• Karlsen, Tor-Ivar (2015). Helserelatert livskvalitet etter fedmekirurgi, status.
• Lorentzen, Jolanta; Medhus, Asle Wilhelm; Hjelmesæth, Jøran; Hofsø, Dag; Karlsen, Tor-Ivar & Sandbu, Rune [Show all 7 contributors for this article] (2015). Esophageal motility in morbidly obese patients with type 2 diabetes.
• Lorentzen, Jolanta; Hjelmesæth, Jøran; Medhus, Asle Wilhelm; Hofsø, Dag; Karlsen, Tor-Ivar & Sandbu, Rune [Show all 7 contributors for this article] (2015). Questionnaires may be insufficient to diagnose gastroesophageal reflux disease (GERD) in morbidly obese patients with type 2 diabetes.
• Svanevik, Marius; Risstad, Hilde; Kristinsson, Jon Adalsteinn; Hjelmesæth, Jøran; AASHEIM, ERLEND T. & Hofsø, Dag [Show all 11 contributors for this article] (2015). Helserelatert livskvalitet og tarmfunksjon etter proksimal og distal gastrisk bypass – en dobbelt blind randomisert kontrollert studie.
• Larsen, Catharina; Karlsen, Tor-Ivar; Benestad, Beate; Lekhal, Samira & Hjelmesæth, Jøran (2015). Quality of life in obese children and adolescents. A systematic literature review of randomized clinical trials.
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Sandbu, Rune & Hjelmesæth, Jøran (2014). Health related quality of life 5 years after bariatric surgery and intensive lifestyle intervention for morbid obesity.
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Sandbu, Rune & Hjelmesæth, Jøran (2014). Health related quality of life 5 years after bariatric surgery and intensive lifestyle intervention for morbid obesity. Obesity Facts. ISSN 1662-4025. 7.
• Svanevik, Marius; Risstad, Hilde; Solheim, Brita; Kristinsson, Jon Adalsteinn; Karlsen, Tor-Ivar & Søvik, Torgeir Thorson [Show all 10 contributors for this article] (2013). Proximal versus distal laparoscopic gastric bypass in superobesity – perioperative results from a randomized controlled trial.
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Røislien, Jo; Tonstad, Serena; Natvig, Gerd Karin & Sandbu, Rune [Show all 7 contributors for this article] (2013). Changes in health related quality of life after gastric bypass or comprehensive lifestyle intervention: a controlled clinical study.
• Karlsen, Tor-Ivar & Hjelmesæth, Jøran (2013). Predictors of weight loss after an intensive lifestyle intervention program in obese patients: a 1-year prospective cohort study.
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Røislien, Jo; Tonstad, Serena; Sandbu, Rune & Hjelmesæth, Jøran (2012). Changes in health related quality of life after gastric bypass or intensive lifestyle intervention: A controlled clinical study.
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Røislien, Jo; Tonstad, Serena; Natvig, Gerd Karin & Sandbu, Rune [Show all 7 contributors for this article] (2012). Health related quality of life after gastric bypass or intensive lifestyle intervention: a controlled clinical study. Obesity Facts. ISSN 1662-4025. 5(12), p. 184–184.
• Karlsen, Tor-Ivar (2012). Validity of SF-36 in morbid obesity.
• Karlsen, Tor-Ivar (2011). Fedmeforskning.
• Karlsen, Tor-Ivar & Hjelmesæth, Jøran (2011). Comment on Søvik T et. al. Weight Loss, Cardiovascular Risk Factors, and Quality of Life After Gastric Bypass and Duodenal Switch: A Randomized Trial. Ann Intern Med 2011;155:281-291. Annals of Internal Medicine. ISSN 0003-4819.
• Karlsen, Tor-Ivar; Lund, Randi Størdal; Hofsø, Dag & Hjelmesæth, Jøran (2011). One year changes in quality of life after gastric bypass surgery and intensive lifestyle intervention: a comparative study. Obesity Reviews. ISSN 1467-7881.
• Karlsen, Tor-Ivar; Natvig, Gerd Karin; Tonstad, Serena & Hjelmesæth, Jøran (2010). Validity of the SF-36 in morbid obesity. Obesity. ISSN 1930-7381. 18.
• Karlsen, Tor-Ivar; Natvig, Gerd Karin; Tonstad, Serena & Hjelmesæth, Jøran (2010). Validity of the SF-36 in morbid obesity.
• Hofsø, Dag; Nordstrand, Njord; Johnson, Line Kristin; Karlsen, Tor-Ivar; Hager, Helle & Godang, Kristin [Show all 9 contributors for this article] (2010). Type 2 diabetes and obesity related cardiovascular risk factors after gastric bypass surgery and intensive lifestyle intervention: a non-randomized controlled clinical trial. Obesity Reviews. ISSN 1467-7881. 11.
• Karlsen, Tor-Ivar (2017). Folkehelseplanlegging i kommunene. Idéhefte om helseoversikter og planstrategi. Kommuneforlaget AS. ISSN 978-82-446-2359-9.
• Karlsen, Tor-Ivar (2014). Morbid obesity and health related quality of life. Akademika forlag. ISSN 978-82-8264-718-2.
• Kingswick, Irene & Karlsen, Tor-Ivar (2012). Individets resurser i sentrum - Å kunne se våre livserfaringer som potensielle kilder til nye motstandsresurser. En kvalitativ studie av Aron Antonovskys salutogenetiske modell – SOC(Sence og coherence/ opplevelsen av sammenheng). Universitetet i Agder.
• Søhagen, Maryon & Karlsen, Tor-Ivar (2012). Predictors of weight loss after 12 months intensive lifestyle intervention: a prospective cohort study. Universitetet i Agder.
• Skeivold, Wenche; Karlsen, Tor-Ivar & Larsen, Inger Beate (2012). Sykelig overvekt, kjønn og stigmatisering. Hvilke erfaringer har norske kvinner og menn med sykelig overvekt i forhold til stigmatisering? Universitetet i Agder.

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