D. Worsley, Norsk Hydro, 0246 Oslo, Norway (Email David. Worsley@hydro.com); T. Agdestein, Norsk Chevron, Ktlrenslyst Alle 2-4 Oslo, Norway, (Email tagd@chevron.com); /. Gjelberg, Norsk Hydro Forskningssenter, P.O. Box 7190, 5020 Bergen, Norway. (Email John.Gjelberg@hydro.com); K. Kirkemo, Statoi� 4035 Stavanger, Norway (Email kkirk@statoil.no); A. Mørk, SINTEF Petroleum Research, 7465 Trondheim, Norway (Email atle.mork@iku.sintef no); I. Nilsson, Norsk Hydro, P. O.Box 117, 4065 Stavanger, Norway (Email Inger.Nilsson@hydro.com); S. Olaussen, Norsk Hydro, present address: Norsk Agip, P. O.Box l O l Forus, 4064 Stavanger (Email Snorre. Olaussen@norskagip.agip. it); R./. Steel, University ofWyoming, Dept. of Geology & Geophysics, Laramie, WY 82072-3355, U.S.A. (Email rsteel@uwyo.edu); L. Stemmerik, GEUS, Thoravej 8, DK-2400 København NV, Denmark (Email ls@geus.dk).

The aim of this study was to describe a nurse-led rheumatology clinic's impact on empowering patients with rheumatoid arthritis (RA). Rheumatoid arthritis is a chronic, inflammatory disease that attacks many joints, causing considerable functional restrictions for patients. Consequently, these patients are dependent on a wide variety of health-care services. A descriptive, qualitative design inspired by phenomenography was chosen. The conceptions were collected through interviews with 16 strategically selected patients with RA. Three descriptive categories comprising eight conceptions emerged: teaching (gaining insight and receiving information), regular review (receiving security, realizing regularity, and achieving accessibility), and attention (getting a holistic assessment, receiving coordinated care, and getting sufficient time). A nurse-led rheumatology clinic can be a source for empowering patients with RA to adopt new stances to alternative actions and achieve a higher level of faith in their own abilities.

New fusulinid data from the Kap Jungersen and Foldedal Formations in southern Amdrup Land, eastern North Greenland allow the establishment of a detailed fusulinid-based zonation of the Upper Carboniferous succession in the Wandel Sea Basin. The fusulinid fauna is quite similar to that of the Russian Platform, the Ural Mountains, Spitsbergen, Bjørnøya, and the offshore areas of the Barents Sea, and therefore the Greenland strata are confidently correlated to the these regions. The Kap Jungersen Formation and the lower part of the Foldedal Formation are dated as late early Moscovian to latest Moscovian in age. The locally more than 450 m thick Moscovian part of the succession comprises four fusulinid zones: the Profusulinella prisca – Neostaffella subquadrata Zone and the Citrinoides paraozawai Zone of early Moscovian age, and the Fusulinella bocki – Pseduofusulinella pulchra Zone and the Protriticites ovatus Zone of late Moscovian age. Lower and middle Kasimovian deposits, characterized by two fusulinid assemblages of the Obsoletes obsoletus – Protriticites pseudomontiparus Zone and the Montiparus paramontiparus Zone, are recognised for the first time in Amdrup Land. The thin lower Gzelian succession is represented by two fusulinid assemblages that definine the Rugosofusulina flexuosa Zone and the Daixina crispa – Rauserites stuckenbergi Zone. The youngest Carboniferous strata, belonging to the Orenburgian part of the Gzelian are characterised by an assemblage of the Schellwienia ulukensis Zone.

The small island of Bjornoya ("Bear Island"), situated in the Barents Sea almost midway between northern Norway and Spitsbergen, displays a Precambrian to Triassic succession in a continuous series of spectacular cliff exposures. These exposures provide a key not only to the evolution of the Stappen High (on which Bjornoya rests) but also to the development of analogous structures along the major lineaments that subsequently contributed to the formation of both the Norwegian-Greenland Sea and the Arctic Ocean. Precambrian to Ordovician dolomites, limestones, quartzites and shales form the basement on which the Upper Palaeozoic succession of Bjornoya was deposited. In latest Devonian and early Carboniferous times the area subsided asymmetrically, probably in response to NE-SW extension; a southwestwards downtilted half-graben developed over the present-day island, with the basinal axis dipping gently NNW. Some 600 m of sandstones, coals and shales are preserved in two upward coarsening sequences. These represent the repeated progradations of sandy fan systems over floodplains with lakes and northward meandering river channels. Mid-Carboniferous (Serpukhovian) uplift was followed by renewed rifting and the same western hinterland again shed debris over its faulted eastern margins. A shift from humid to a semi-arid climate is reflected by the predominantly red colouration of the resultant 200 m thick succession of conglomerates, sandstones and shales, with caliche horizons. Penecontemporaneous regional sea level rise resulted in the gradual replacement of the alluvial floodbasin deposits by shallow marine siliciclastics and carbonates of shoreline, tidal flat and shallow shelf origin. Continued transgression through the Moscovian, perhaps also with decreasing subsidence rates and only intermittent tectonism, is indicated by the gradual change to a marine carbonate-dominated succession, with cherty biomicrites reflecting the establishment of an open carbonate shelf over the entire area. A marked rejuvenation of tectonic activity in the late Moscovian established a different depositional mosaic faulting affected exposures on the present island along N-S to NE-SW lineaments, with differential subsidence down to the west. This produced erosion of earlier deposits over the eastern part of Bjornoya and deposition of conglomerates, sandstones, shales and dolomites in alluvial gully, coastal and shallow shelf environments to the west. A 200 m thick succession is preserved in western areas and eroded remnants are also preserved as outliers elsewhere on the island. Conglomerate clasts indicate derivation by successive stripping and redeposition of mid-Carboniferous to uppermost Devonian and then basement strata. By the latest Carboniferous the region had again stabilized and platform carbonate deposition resumed, with the development of paleoa-plysinid carbonate build-ups. Early Permian flexuring, uplift and peneplanation followed, probably with some transpressive movements. The highly condensed mid-to Upper Permian marine succession of mixed siliciclastics and carbonates oversteps all older strata. The Stappen High then remained a positive feature through to the late Triassic, the youngest beds preserved being of Carnian age. The high subsequently subsided significantly during the Mesozoic, but it again became a positive feature as a result of one or more phases of uplift during the Cenozoic. Much of the Carboniferous succession of Bjornoya, with non-marine rifted sequences giving way in the mid-Carboniferous to a marine carbonate shelf development, mirrors time-equivalent successions throughout the Barents Shelf, northeastern Greenland and the Sverdrup Basin. Late Carboniferous and early Permian faulting, flexuring and uplift, and the development of overlying, condensed and stratigraphically incomplete Upper Permian/Lower Triassic platform sequences are however atypical features - only found on local structural highs which together form elements of a major circum-Arctic fault complex along which Paleogene continental separation took place. A better understanding of the late Palaeozoic evolution of these highs may contribute significantly to further hydrocarbon exploration in this frontier petroleum province.

A new set of descriptions has been prepared for five of the IKU cores, a series of shallow stratigraphic cores penetrating the Upper Carboniferous-Permian Finnmark carbonate platform succession near its southern erosional truncation against the Norwegian mainland. These data are compared with core descriptions previously published from the thicker 'stratigraphic reference section' of the exploration well 7128/6-1 (Ehrenberg et al. 1998a), New fusulinid datings from 7128/6-1 are correlated with existing fusulinid data from the IKU cores to provide a consistent time-stratigraphic framework for landward correlation of depositional sequences previously defined in the 7128/6-1 reference section. These correlations reveal a limited two-dimensional image of depositional sequence geometry for the inner platform. Of the 7 major sequences previously defined in the Kasimovian through Upper Permian section of well 7128/6-1, 2 sequences are suggested to pinch out before reaching the IKU cores, while the remaining 5 sequences thin by 32-63% and show landward loss of lithologic resolution of systems tracts. Thinning is probably accomplished by increasing magnitude and frequency of hiatuses both within and bounding each sequence, reflecting gradual uplift of the Norwegian mainland and seaward tilting of the platform throughout the depositional history. Landward changes in lithology, dolomitization, and porosity are relatively subtle, suggesting that platform deposition extended well beyond the present southern termination of carbonate strata.

The Wandel Sea Basin in eastern North Greenland is the northernmost of a series of fault-bounded Late Palaeozoic – Early Tertiary basins exposed along the eastern and northern margin of Greenland (Fig. 1). The basin and the surrounding shelf areas are located in a geologically complex region at the junction between the N–S trending Caledonian fold belt in East Greenland and the E–W trending Ellesmerian fold belt in North Greenland, and along the zone of later, Tertiary, continental break-up. The Wandel Sea Basin started to develop during the Carboniferous as a result of extension and rifting between Greenland and Norway, and Greenland and Spitsbergen (Håkansson & Stemmerik 1989), and was an area of accumulation during the Early Carboniferous – Early Tertiary period. Two main epochs of basin evolution have been recognised during previous studies of the basin fill: an early (late Palaeozoic – early Triassic) epoch characterised by a fairly simple system of grabens and half-grabens, and a late (Mesozoic) epoch dominated by strike-slip movements (Håkansson & Stemmerik 1989). The Mesozoic epoch only influenced the northern part of the basin, north of the Trolle Land fault zone (Fig. 1). Thus the northern and southern parts of the basin have very different structural and depositional histories, and accordingly different thermal histories and hydrocarbon potential. This paper summarises the results of a project supported by Energy Research Program (EFP-94), the purpose of which was to model the Wandel Sea Basin with special emphasis on hydrocarbon potential and late uplift history, and to provide biostratigraphic and sedimentological data that could improve correlation with Svalbard and the Barents Sea. It is mainly based on material collected during field work in Holm Land and Amdrup Land in the south-eastern part of the Wandel Sea Basin during 1993–1995 with additional data from eastern Peary Land (Stemmerik et al. 1996). Petroleum related field studies have concentrated on detailed sedimentological and biostratigraphic studies of the Carboniferous–Permian Sortebakker, Kap Jungersen, Foldedal and Kim Fjelde Formations in Holm Land and Amdrup Land (Fig. 2; Døssing 1995; Stemmerik 1996; Stemmerik et al. 1997). They were supplemented by a structural study of northern Amdrup Land in order to improve the understanding of the eastward extension of the Trolle Land fault system and possibly predict its influence in the shelf areas (Stemmerik et al. 1995a; Larsen 1996). Furthermore, samples for thermal maturity analysis and biostratigraphy were collected from the Mesozoic of Kap Rigsdagen and the Tertiary of Prinsesse Thyra Ø (Fig. 1).

The Upper Palaeozoic Foldedal and Kim Fjelde formations in eastern Peary Land are redefined on the basis of new biostratigraphic data, including fusulinids, conodonts, palynomorps and small foraminifera. The Foldedal Formation in its new definition includes all late Moscovian to Gzelian deposits in the region. It is separated by a major hiatus from the redefined Kim Fjelde Formation which includes mid-Permian (late Artinskian - Kungurian) carbonates and chert deposits. The Upper Carboniferous succession is dominated by cyclically interbedded siliciclastics and carbonates with minor tabular build-ups. The mid and Upper Permian succession consists of cool-water carbonates, spiculitic chert and shales.

Six depositional sequences, each with a duration of approximately 1-1.5 m.y., have been identified in the Gzelian-Asselian successions of North Greenland, Bjørnøya, Spitsbergen and the Finnmark Platform. Correlation of the sediments in these widely separated areas is based on a refined fusulinid zonation. A total of four Gzelian and three Asselian fusulinid zones have been defined in the region and correlated to the Russian standard zonation. The depositional sequences are composed of restricted to open marine subtidal carbonates, Palaeoaplysina build-ups and minor evaporites. Each sequence comprises up to nine cycles, each less than 10 m thick, in the inner platform areas of the Finnmark Platform. No such cyclicity has been developed in the time-equivalent outer ramp settings of North Greenland, where each sequence comprises an upward-shoaling, 15-30 m thick unit. The sequences are interpreted to have formed in response to 3rd order fluctuations in relative sea level.

The prevalence of protein-energy malnutrition (PEM) was examined in 1206 randomly selected elderly people aged 65 to 80 years living in their own homes. Nutritional assessment was based on weight loss, weight index, triceps skin fold, arm muscle circumference, serum albumin and prealbumin, and delayed cutaneous hypersensitivity (DCH) reaction. The prevalence of PEM was 5 per cent. If people with signs of inflammation were excluded, the prevalence of PEM was 3.5 per cent. When other nutritional indices, used by other authors among hospitalized patients, were applied to our sample prevalence values from 2.6 to 4.1 per cent were obtained. the prevalence was not related to sex or age. DCH increased the sensitivity of the screening method but causes of anergy other than PEM must be taken into account. It is concluded that PEM, in a degree shown to impair the prognosis at hospital, does occur among elderly people at home in an industrialized country.