Oslo Metropolitan University
Recent publications
Background: Trauma-affected refugee patients benefit from psychological treatment to different degrees. Only a handful of studies has investigated potential predictors of treatment outcome that could throw light on the great variability in outcomes reported for this group. Such knowledge may be vital to better tailor prevention and treatment efforts to the needs of different individuals and subgroups among these patients. Objective: In a naturalistic and longitudinal study, the aim was to analyse demographics and traumatic exposure as potential predictors of the participants’ long-term trajectories of mental health symptoms and quality of life. Method: A group of 54 multi-origin adult refugee patients with complex traumatic exposure, such as armed conflicts, persecution, torture, and childhood adversities, were interviewed face to face over up to 10 years; at therapy admittance, and at varying points in time during and after psychotherapy. Checklists of war-related and childhood trauma, mental health symptoms, and quality of life were included in the interviews. In linear mixed effects analyses, interaction was analysed with potential predictors included separately because of the sample size. Time was modelled as continuous from inclusion into the study. Results: Gender predicted the course of symptoms of post-traumatic stress, anxiety, and depression, and of quality of life in physical health and social relationships. Childhood family violence and experiences of torture predicted the course of depression, whereas the extent of exposure to war-related trauma events and having experienced torture predicted the course of anxiety. Conclusions: The results indicated greater chronicity in male refugees, in refugees who had experienced domestic violence during childhood, in refugees who had experienced torture, and in refugees with more numerous types of potentially traumatic war-related experiences. The findings highlight the need for gender-sensitive research, rehabilitative efforts, and treatment.
Disability and distress caused by chronic low back pain (LBP) lacking clear pathoanatomical explanations cause huge problems both for patients and society. A subgroup of patients has Modic changes (MC), identifiable by MRI as vertebral bone marrow lesions. The cause of such changes and their relationship to pain are not yet understood. We explored the pathobiology of these lesions using profiling of gene expression in blood, coupled with an edema-sensitive MRI technique known as short tau inversion recovery (STIR) imaging. STIR images and total RNA from blood were collected from 96 patients with chronic LBP and MC type I, the most inflammatory MC state. We found the expression of 37 genes significantly associated with STIR signal volume, ten genes with edema abundancy (a constructed combination of STIR signal volume, height, and intensity), and one gene with expression levels significantly associated with maximum STIR signal intensity. Gene sets related to interferon signaling, mitochondrial metabolism and defense response to virus were identified as significantly enriched among the upregulated genes in all three analyses. Our results point to inflammation and immunological defense as important players in MC biology in patients with chronic LBP.
Much health communication during the COVID-19 pandemic has been designed to persuade people more than to inform them. For example, messages like “masks save lives” are intended to compel people to wear face masks, not to enable them to make an informed decision about whether to wear a face mask or to understand the justification for a mask mandate. Both persuading people and informing them are reasonable goals for health communication. However, those goals can sometimes be in conflict. In this article, we discuss potential conflicts between seeking to persuade or to inform people, the use of spin to persuade people, the ethics of persuasion, and implications for health communication in the context of the pandemic and generally. Decisions to persuade people rather than enable them to make an informed choice may be justified, but the basis for those decisions should be transparent and the evidence should not be distorted. We suggest nine principles to guide decisions by health authorities about whether to try to persuade people.
With the rapid growth of electric vehicles (EVs) in the past decade, many new traffic safety challenges are also emerging. With the crash data of Norway from 2011 to 2018, this study gives an overview of the status quo of EV crashes. In the survey period, the proportion of EV crashes in total traffic crashes had risen from zero to 3.11% in Norway. However, in terms of severity, EV crashes do not show statistically significant differences from the Internal Combustion Engine Vehicle (ICEV) crashes. Compared to ICEV crashes, the occurrence of EV crashes features on weekday peak hours, urban areas, roadway junctions, low-speed roadways, and good visibility scenarios, which can be attributed to the fact that EVs are mainly used for urban local commuting travels in Norway. Besides, EVs are confirmed to be much more likely to collide with cyclists and pedestrians, probably due to their low-noise engines. Then, the separate logistic regression models are built to identify important factors influencing the severity of ICEV and EV crashes, respectively. Many factors show very different effects on ICEV and EV crashes, which implies the necessity of re-evaluating many current traffic safety strategies in the face of the EV era. Although the Norway data is analyzed here, the findings are expected to provide new insights to other countries also in the process of the complete automotive electrification.
Background The imminent emergence of connected and autonomous vehicles (CAVs) highlights the need for preparing the road infrastructure for traffic flows mixed with CAVs and human-driven vehicles. A dedicated lane (DL) for CAVs is one of the practical and potential ways to upgrade the road infrastructure for the mixed traffic. Methods This paper proposes a theoretical method to discuss the influence of implementing a CAV DL policy on the freeway traffic efficiency. In detail, the impact was measured by capacity and throughput. The calculation methods of these efficiency measurements under different CAV DL policies were proposed. Experiments Numerical experiments were conducted under various compositions of CAV DL policies and traffic conditions. More specifically, the relationship between the traffic conditions (i.e., traffic demand, market penetration rate (MPR) of CAVs, platoon intensity of CAVs, willingness of CAVs using the CAV DL) and the CAV DL policies (i.e., lane configuration, DL access control policy) were discussed. Results and Conclusion The results have led to some interesting findings, including the critical values of MPR that are valuable to guide an appropriate implementation of a CAV DL policy under a specific traffic condition.
The main objective of this study is to investigate the structural performance of reinforced concrete (RC) beam specimens strengthened with 3D-fiberglass as compared with fiber-reinforced polymers (FRP) sheets. For this purpose, six RC beams were fabricated, strengthened, and tested under a four-point bending machine. One of the beams served as the control beam (REF), while the others were strengthened with carbon FRP (RCFRP), glass FRP (RGFRP), 3D-fiberglass and epoxy resin (R3DTR), 3D-fiberglass and epoxy resin extended to the sides (R3DTRB), and 3D-fiberglass and concrete repair (R3DTG). Failure mode, crack development, flexural capacity, ductility, the effectiveness of wrapping configurations, and the performance of epoxy resin in comparison with concrete repairer were studied between various beams. The results attest to the better performance and effectiveness of 3D-fiberglass over FRP in terms of flexural capacity, crack pattern, and ductility. The R3DTR and RGFRP specimens, compared to the control specimen, had the highest and lowest flexural capacity growth, with 19% and 8.4%, respectively. In addition, the failure modes observed in this study were in good agreement with the failure modes present in ACI.440.2R-17. Moreover, finite element (FE) models were proposed to predict the residual capacity of the specimens strengthened with FRP, using Abaqus software.
Background Multiple sclerosis (MS) is an autoimmune, neurodegenerative disorder with a strong genetic component that acts in a complex interaction with environmental factors for disease development. CD4 ⁺ T cells are pivotal players in MS pathogenesis, where peripherally activated T cells migrate to the central nervous system leading to demyelination and axonal degeneration. Through a proteomic approach, we aim at identifying dysregulated pathways in activated T cells from MS patients as compared to healthy controls. Methods CD4 ⁺ T cells were purified from peripheral blood from MS patients and healthy controls by magnetic separation. Cells were left unstimulated or stimulated in vitro through the TCR and costimulatory CD28 receptor for 24 h prior to sampling. Electrospray liquid chromatography-tandem mass spectrometry was used to measure protein abundances. Results Upon T cell activation the abundance of 1801 proteins was changed. Among these proteins, we observed an enrichment of proteins expressed by MS-susceptibility genes. When comparing protein abundances in T cell samples from healthy controls and MS patients, 18 and 33 proteins were differentially expressed in unstimulated and stimulated CD4 ⁺ T cells, respectively. Moreover, 353 and 304 proteins were identified as proteins exclusively induced upon T cell activation in healthy controls and MS patients, respectively and dysregulation of the Nur77 pathway was observed only in samples from MS patients. Conclusions Our study highlights the importance of CD4 ⁺ T cell activation for MS, as proteins that change in abundance upon T cell activation are enriched for proteins encoded by MS susceptibility genes. The results provide evidence for proteomic disturbances in T cell activation in MS, and pinpoint to dysregulation of the Nur77 pathway, a biological pathway known to limit aberrant effector T cell responses.
Background The opioid antagonist extended-release naltrexone (XR-NTX) in the treatment of opioid use disorder (OUD) is effective in terms of safety, abstinence from opioid use and retention in treatment. However, it is unclear how patients experience and adjust to losing the possibility of achieving an opioid effect. This qualitative study is the first to explore how people with opioid dependence experience XR-NTX treatment, focusing on the process of treatment over time. Methods Using a purposive sampling strategy, semi-structured interviews were undertaken with 19 persons with opioid use disorder (15 men, four women, 22–55 years of age) participating in a clinical trial of XR-NTX in Norway. The interviewees had received at least three XR-NTX injections. Qualitative content analysis with an inductive approach was used. Findings Participants described that XR-NTX treatment had many advantages. However they still faced multiple challenges, some of which they were not prepared for. Having to find a new foothold and adapt to no longer gaining an effect from opioids due to the antagonist medication was challenging. This was especially true for those struggling emotionally and transitioning into the harmful use of non-opioid substances. Additional support was considered crucial. Even so, the treatment led to an opportunity to participate in society and reclaim identity. Participants had strong goals for the future and described that XR-NTX enabled a more meaningful life. Expectations of a better life could however turn into broken hopes. Although participants were largely optimistic about the future, thinking about the end of treatment could cause apprehension. Conclusions XR-NTX treatment offers freedom from opioids and can facilitate the recovery process for people with OUD. However, our findings also highlight several challenges associated with XR-NTX treatment, emphasizing the importance of monitoring emotional difficulties and increase of non-opioid substances during treatment. As opioid abstinence in itself does not necessarily equal recovery, our findings underscore the importance of seeing XR-NTX as part of a comprehensive, individualized treatment approach. Trial registration : Clinicaltrials.gov # NCT03647774, first Registered: Aug 28, 2018.
With the fast growth of high-speed rail in recent years, derailment has become the first hidden danger of high-speed rail transportation. The high-speed train passes near the station building. So the train may derail and hit the station building. Building a high-speed railway station usually uses a reinforced concrete structure. As a result of high impact energy on the impact body, the reinforced concrete (RC) member may fail; the impact point is near the member's foot; the structural member's constraint can be considered fixed support. This paper investigates the dynamic behavior of four types of circular reinforced concrete members under unequal lateral impact loads. The RC member's failure mechanism and dynamic response addressed the significance of unequal lateral impact load. The usual circular reinforced concrete members are used as the model to perform the drop-weight impact test. The specimens' crack pattern, failure mechanism, impact, deflection, and strain time–history curves are obtained. Findings show that between the impact point and the adjacent support, shear fractures occur that fail in shear mode. Shear cracks are based on impact velocity, longitudinal reinforcement ratio, and stirrup ratio. One type is more destructive to members and nodes. A shear fracture occurs when a longitudinal reinforcement fractures towards the closer support. The effects of impact velocity, longitudinal reinforcement ratio, and stirrup ratio on the dynamic impact response are studied. The experimental results may help improve structural member impact resistance. The critical section (right side) computed the static shear resistance using shear force, whereas the maximum external load resistance determines static bending moment resistance. Understanding how circular members fail to be subjected to unequal lateral impact loads provides insight into circular RC members' impact design and damage evaluation.
Travel time is less costly if it is comfortable or can be used productively. One could hence argue that the value of travel time (VTT) of car travellers in economic appraisal should be differentiated by road type, reflecting differences in road quality. We explain the theoretical foundation for such a differentiation, review the relevant literature and show the results of an empirical case study based on actual route choice of highway drivers in Norway. We find little existing literature discussing the link between road type and VTT, but closely related findings suggest that that the impact on VTT could be substantial. Our empirical case study also suggests that the VTT is lower on higher quality road types. Applying this to economic appraisal would imply higher user benefits of road projects that improve road quality.
Local governments are now facing a need for societal transition to meet the challenges of climate change and lack of social cohesion. Institutional innovation in urban development is needed, especially in terms of more involving processes to achieve the UN sustainable development goals. In this article we ask how institutional innovation can ensure more involving urban transformations. We also discuss what the conditions are for such institutional innovations to increase the transformative capacity of cities. The discussion departs from the collaborative public sector innovation literature, and the collaborative planning literature, and attempts to bridge these in analyzing the cases. The analysis is based upon two qualitative case studies of new institutional practices in urban development projects – in Roskilde (Denmark) and in Enschede (the Netherlands). Both projects were a response to the local governments' subjection to a critical juncture, or crisis. Findings suggest that long-term and permanent organizational changes can be achieved when local governments implement institutional innovations to remedy the critical juncture.
Purpose To study the prevalence and directionality of comorbid epilepsy and psychosis in Norway. Methods The Norwegian Prescription Database (NorPD) provided individual-based information on all antiseizure medications (ASMs) and antipsychotic drugs (APDs) dispensed during 2004–2017. Subjects were ≥18 years of age at the end of the study period. Diagnosis-specific reimbursement codes from the 10th revision of the International Classification of Diseases/2nd edition of the International Classification of Primary Care (ICD-10/ICPC-2) combined with ATC codes were used as indicators of diagnosis. Subjects had collected ASMs for epilepsy or APDs for psychosis at least four times, at least once issued with an ICD-10 code from the specialist healthcare service. Directionality was analyzed in subjects receiving both treatments. To reduce prevalent comorbidity bias, we employed a four-year comorbidity-free period (2004–2007). The use of specific ASMs and APDs was analyzed. Results A total of 31,289 subjects had collected an ASM for epilepsy at least four times, 28,889 an APD for psychosis. Both the prevalence of treatment for epilepsy and of treatment for psychosis was 0.8%. Further, 891 subjects had been treated for both conditions; 2.8% with epilepsy had been treated for psychosis, and 3.1% with psychosis had been treated for epilepsy. Among 558 subjects included in the analyses of directionality, 56% had collected the first APD before an ASM, whereas 41% had collected an ASM first. During the last year prior to comorbidity onset, levetiracetam, topiramate, or zonisamide had been used for epilepsy by approximately 40%, whereas olanzapine and quetiapine were most used in patients with psychosis, and clozapine in 13%. Conclusion The proportion of patients with prior antipsychotic treatment at onset of epilepsy is higher than previously acknowledged, as demonstrated in this nation-wide study. Apart from a shared neurobiological susceptibility, the bidirectionality of epilepsy and psychosis may be influenced by various environmental factors, including the interaction of pharmacodynamic effects. APDs may facilitate seizures; ASMs may induce psychiatric symptoms. In patients with combined treatment, these potential drug effects should receive ample attention, along with the psychosocial consequences of the disorders. A prudent multi-professional approach is required.
Despite the existence of methods for estimating the behavior of steel circular tubes subjected to pure bending, analytical models are still restricted due to the problem’s complexity and significant nonlinearity. Using the random forest (RF) as the basic model, novel intelligent models are constructed to estimate the ultimate pure bending capacity of circular steel tubes in this study. The RF model’s parameters are optimized using three nature inspired optimization algorithms, namely, the particle swarm optimization (PSO), ant colony optimization (ACO) and whale optimization algorithm (WOA). In the experimental part, a database of 104 tests that comprise 49 and 55 pure bending tests conducted on fabricated and cold-formed steel circular tubes, respectively, are evaluated and utilized to investigate the applicability of the hybrid RF-models. A single RF model is also built for comparative reasons in order to estimate the ultimate pending capacity. Various statistical and graphical measures are used to evaluate the performance of the developed models. The results show that the proposed RF-based nature-inspired algorithms can outperform the original RF predictive model. When the hybrid-RF models were assessed, it was discovered that the RF-WOA performed best. In addition, the influence of each parameter on the prediction findings based on the best RF-model is investigated via sensitivity analysis. Taking into account the overall findings, the hybrid RF-models may be used as powerful tools to predict the ultimate bending capacity of circular steel tubes and may be viable to aid technicians in making proper judgments.
While European consumers generally support the principles underpinning Food Quality Schemes (FQS) sales of certified products remain modest. This phenomenon is known as ‘attitude-behaviour gap’ and considerable scholarly and policy efforts have been geared towards ‘filling’ or ‘bridging’ the gap. This study aims at casting new light on this ‘discrepancy’ between consumers' sayings and doings through a study of everyday food practices connected to FQS. We used a qualitative, multi-method research design comprising extensive ethnographic fieldwork data, gathered from 41 households across seven European countries, including interviews, walk-along tours, and food diaries, in order to understand consumers' perceptions of FQS in relation to their everyday food consumption practices. Building on convention theory and Thévenot's work, we showed that food practices can be understood through different ‘regimes of engagement’, namely different ways of thinking and behaving, following different logics corresponding to varying levels of knowledge and interest. We thus argue that the ‘attitude-behaviour gap’ should be reconceptualised as the co-existence of multiple regimes of engagement, namely a dynamic and always evolving process of adjustment through which consumers understand and engage with FQS in everyday food practices.
The responsiveness of house prices to monetary policy shocks depends on the nature of the shock—expansionary versus contractionary—and on local housing supply elasticities. These findings are established using a panel of 263 US metropolitan areas. Expansionary monetary policy shocks have a larger impact on house prices in supply-inelastic areas. Contractionary shocks are orthogonal to housing supply elasticities. In supply-elastic areas, contractionary shocks have a greater impact on house prices than expansionary shocks do. The opposite holds true in supply-inelastic areas. We attribute this to asymmetric housing supply adjustments. (JEL E32, E43, E52, R21, R31)
Background: Alcohol consumption is a major public health challenge; the majority of employees consume alcohol regularly and a considerable proportion of employees can be characterized as risky drinkers in need of interventions. Occupational health services (OHS) are uniquely positioned for implementing alcohol prevention interventions targeting employees, but rarely do so. Studies have shown that lack of knowledge among OHS personnel is a barrier to alcohol prevention activity. This study aimed to explore OHS personnels' levels of theoretical and practical alcohol knowledge, and whether these two ways of knowing were differentially associated with alcohol prevention activity. Methods: In this cross-sectional study, survey data were collected from 322 OHS personnel in Norway in 2018 (response rate = 53.6%). The survey included variables of two ways of knowing (theoretical and practical) and three types of doing (intervention frequency, conducting individual interventions, and conducting group interventions). Data were analyzed with descriptive statistics, paired sample t-tests, bivariate correlations, and adjusted linear and logistic regression analyses. Results: OHS personnel rated their theoretical alcohol knowledge higher than their practical knowledge (η2 = 0.33, p < 0.001). Higher reported levels of practical knowledge were associated with higher intervention frequency (b = 0.39, β = 0.60, p < 0.001) and greater likelihood of conducting individual interventions (OR = 1.60, p < .001) as well as group interventions (OR = 1.84, p < 0.001). Theoretical knowledge was not associated with conducting interventions, and there was no evidence of an interaction between the two ways of knowing in their association with doing. Sensitivity analyses did not indicate clustering effects of OHS personnel being employed within different units. Conclusions: Different ways of knowing about alcohol among OHS personnel were dissimilarly associated with conducting alcohol prevention interventions in occupational health settings. For doing, knowing how seems to be more important than knowing that. Training programs for OHS personnel should emphasize knowledge about how to deal with alcohol-related issues and how to conduct prevention interventions, rather than focus on detrimental effects of alcohol.
Collaboration between schools and enterprises in vocational education and training (VET) is a challenge in many countries, Norway included. There is a tendency to organise VET in separate theoretical and practical learning arenas that lack mutual coherence. This article presents the findings of a four-year action research study in which 30 vocational teachers, who were taking an in-service master’s degree programme in vocational pedagogy, completed systematic research-based projects on developing partnerships between schools and enterprises in the school-based part of Norwegian VET. The goal was to strengthen the relevance of vocational education by creating stronger links between the content of the education and the content of the vocation. The study was based on a pragmatic, holistic perspective on vocational competence and education where essential, authentic vocational tasks to which theory is related are regarded as the core educational content, both in the enterprises and in schools. The findings are based on an analysis of 30 master’s degree theses documenting each of the teachers’ development projects. The results show examples of and principles for how collaboration between schools and enterprises can be organised around vocational tasks. Core principles include formal agreements on collaboration between schools and enterprises, regular dialogues between vocational teachers, instructors and students about educational tasks and content, joint planning and follow-up of students’ placements in enterprises, and exchanges of experience and competence between teachers and instructors. The results show that, according to students, instructors and vocational teachers, the application of such principles contributed to vocational relevance and students’ motivation and learning outcomes.
Background & Aims Malnutrition is underdiagnosed and undertreated in Norway. In a revision of a national guideline on malnutrition, the Norwegian Directorate of Health aimed for a harmonization and standardization of the malnutrition screening practice, including a recommendation of one malnutrition screening tool to be used among all adults in Norwegian health and care services. Methods A working group was appointed by the Norwegian Directorate of Health. Evidence-based practice, a pragmatic decision-making process based on a literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE), and the DECIDE decision-making model was used as a guidance in order to convert evidence into recommendations. Results The criteria and properties of the four most frequently validated malnutrition screening tools were identified and ranked by the working group. The tools were prioritized in the following order: 1: Malnutrition Screening Tool (MST), 2: Malnutrition Universal Screening Tool (MUST), 3: Nutritional Risk Screening 2002 (NRS-2002), and 4: Mini-Nutritional Assessment short form (MNA). Conclusions The Norwegian Directorate of Health recommends use of MST for screening for malnutrition among all adults (≥18 years), across all health care settings, and diagnoses or conditions in Norway.
Background & Aims The Norwegian Directorate of Health has identified a need to harmonize and standardize the malnutrition screening practice in Norwegian hospitals and primary health care settings, in order to provide a seamless communication of malnutrition screening along the patient pathway. Our aim was to perform a systematic review of the validity and reliability of screening tools used to identify risk of malnutrition across health care settings, diagnoses or conditions and adult age groups, as a first step towards a national recommendation of one screening tool. Methods A systematic literature search for articles evaluating validity, agreement, and reliability of malnutrition screening tools, published up to August 2020, was conducted in: MEDLINE, Embase, APA PsycInfo, Cinahl, Cochrane Databases, Web of Science, Epistemonikos, SveMed+, and Norart. The systematic review was registered in PROSPERO (CRD42022300558). For critical appraisal of each included article, the Quality Criteria Checklist by The Academy of Nutrition and Dietetics was used. Results The review identified 105 articles that fulfilled the inclusion and exclusion criteria. The most frequently validated tools were Mini Nutritional Assessment short form (MNA), Malnutrition Universal Screening Tool (MUST), Malnutrition Screening Tool (MST), and Nutritional Risk Screening 2002 (NRS-2002). MNA, MST and NRS-2002 displayed overall moderate validity, and MUST low validity. All four tools displayed low agreement. MST and MUST were validated across health care settings and age groups. In general, data on reliability was limited. Conclusions The screening tools MST and NRS-2002 displayed moderate validity for the identification of malnutrition in adults, of which MST is validated across health care settings. In addition, MNA has moderate validity for the identification of malnutrition in adults 65 years or older.
Diagnosis of depression using electroencephalography (EEG) is an emerging field of study. When mental health facilities are unavailable, the use of EEG as an objective measure for depression management at an individual level becomes necessary. However, the limited availability of the openly accessible EEG datasets for depression and the non-standard task paradigm confine the scope of the research. This study contributes to the area by presenting a dataset that includes EEG data of subjects in the resting state and Patient Health Questionnaire (PHQ)-9 scores. These recordings incorporate EEG signals under both eyes open (EO) and eyes closed (EC) conditions. Moreover, this work documents high performance on various benchmark depression classification tasks with the help of traditional supervised machine learning algorithms, namely Decision Tree, Random Forest, k-Nearest Neighbours, Naive Bayes, Support Vector Machine, Multi-Layer Perceptron, and extreme gradient boosted trees (XGBoost) using the newly created dataset, where the class label of each patient is determined by the PHQ-9 score of the person. Then, feature selection is performed on twenty-three linear, nonlinear, time domain, and frequency domain features using ANOVA test and correlation analysis to identify statistically significant features, which are further fed into algorithms mentioned above separately for distinguishing healthy subjects from depressed. Among these classifiers, the performance of the XGBoost is found to be the best, with an accuracy of 87% for the EO state. The obtained results demonstrate that the proposed method outperforms fourteen existing approaches. The dataset presented in this work can be downloaded via https://drive.google.com/drive/folders/1ANUC-6hq02QG728ZWv2a1UWTLUbRrq_y?usp=sharing.
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Nils Pharo
  • Department of Archivistics, Library and Information Science
Wendy Nilsen
  • Work Research Institute
Erik Bohemia
  • Department of Art, Design and Drama
Kaare M Nielsen
  • Faculty of health sciences and department of Life sciences and health
P.O. Box 4 St. Olavs plass, N-0130, Oslo, Norway
Head of institution
Prof. Curt Rice