Exploring the utilization of healthcare resources in elderly patients with COPD

Background: Chronic obstructive pulmonary disease (COPD) remains a major health problem worldwide (1) and the prevalence of COPD continues to increase (2, 3). It is a major cause of multimorbidity and mortality in Norway (4) and the healthcare utilization by COPD- patients is expected to increase in the future (5). To effectively allocate healthcare resources, it is necessary to have knowledge about how the resources are utilized (6). The present study aimed to describe and explore how elderly patients with COPD utilize healthcare in the health region of South-East in Norway. And to isolate the effect of having COPD by comparing this group of patients with the general population. Methods: This cross-sectional study was based and conducted on data from three different Norwegian registers (KUHR, NPR and DSF). The study sample consisted of COPD-patients aged 66-105 years old, who had at least one contact regarding COPD with either the primary- or specialist healthcare sector between 2012 and 2016. Descriptive analyses were used to describe the sample of COPD-patients and the prevalence of type of contact they generated. Costs related to treatment in the specialist healthcare sector was based on DRG-codes and regression analyses were conducted to investigate the association between number of additional diagnoses, age, sex, and the costs related to treatment. Results: There was a total of 35 185 COPD-patients registered in either the primary- or specialist healthcare sector from 2012 to 2016. This equals on average 6 442 and 2 789 unique COPD-patients registered in KUHR and NPR each year, respectively. The distribution between the sexes were equal, with 44,5% males. Mean birthyear was 1940 and average age was about 74 years old for both sexes. COPD-patients generated on average more than 13 events in the primary healthcare sector and more than five events in specialist healthcare sector, each year. The total cost for treating COPD-patients in the specialist healthcare sector in 2016 exceeded 1.1 billion and the average cost of treatment per COPD-patient in the specialist healthcare sector was 82 247 NOK in 2015. The average cost for females was 5865 NOK lower than it was for males and the average cost per patient increased with 5 293 NOK for each additional diagnose that was added. The costs were more than 3.5 times higher for COPD-patients than it was for the general population. Concentration curves reveals that 20% of the COPD-patients in KUHR are accountable for almost half of the events, and 20% of the COPD-patients in NPR are accountable for 60% of the events. The top 30% of COPD-patients who utilize most healthcare resources have a mean cost of treatment that is almost two times higher than the mean cost of treatment for the average COPD-patient. Conclusion: The number of events COPD-patients generates in the primary- and specialist healthcare sector and the high costs related to treatment in hospitals confirms that COPD- patients imposes significant social and economic burden on patients and society. The results indicates that future research and allocation should focus on COPD-patients with multimorbidity and the share of COPD-patients that utilize the most healthcare resources

En litteraturstudie om fedre og spedbarnskolikk. Hvilken erfaring har fedre med det å ha et spedbarn med kolikk?

- Tittel: En litteraturstudie om fedre og spedbarnskolikk. Hvilken erfaring har fedre med det å ha et spedbarn med kolikk? - Bakgrunn: Å bli foreldre innebærer store livsforandringer. Ulike utfordringer rundt spedbarnet kan gjøre det ekstra utfordrende for nybakte foreldre å tilpasse seg disse endringene. Selv om det er livets harde fakta at spedbarn gråter, kan mange foreldre bli bekymret og usikker når deres spedbarn gråter mye og ikke lar seg trøste. Så mange som 10-25% av alle spedbarn rammes av det som kalles spedbarnskolikk. - Hensikt: Å utforske hvilke erfaringer fedre har med det å leve med et spedbarn med kolikk. Formålet med denne studien er belyse et kunnskapsområde som per i dag er tilsynelatende mangelfullt, og som det behøves mer kunnskap om. - Metode: Denne studien er en litteraturstudie med en systematisk tilnærming basert på Aveyard sin fremgangsmåte til metoden. Det er gjort søk i seks databaser; CINAHL, EMBASE, Maternity and Infant Care, Psycinfo, SweMed+ og Medline. Dette gav seks artikler som danner grunnlaget for denne studien. - Funn: Funnene i denne studien peker på at fedrene synes å bli påvirket av spedbarnskolikk omtrent på samme måte som mødre. Overdreven gråt kan resultere i samspillsutfordringer og redusere fedrenes self-efficacy. Erfaringer som fedre har gjenfortalt i de inkluderte artiklene vitner også om lite eller mangelfull oppfølging fra fagfolk, og et stort behov for støtte og informasjon før, under og etter kolikkperioden. - Nøkkelord: Fedre, erfaring, spedbarnskolikk

“I base my life on sadness”: Apparently paradoxical sources of resilience among young Haitians

Haitian expressions of resilience also hold deep knowledge of human vulnerability. This longitudinal, qualitative study with young Haitians from urban shantytowns combines ethnographic and participatory methods to explore the complexities behind such idioms. Artistic and creative products made by or with the youth facilitated interviews, focus group discussions, and workshops. Through the life stories of participants and rich ethnographic material, this study presents locally situated idioms of resilience (and distress). By including local social ecology, the idioms were framed as historically and culturally rooted, thus shaping contextual, pragmatic, and gendered coping strategies grounded in embodied experiences of vulnerability and resistance. The study adds essential insights into Haitian resilience, revealing the local logics behind seemingly paradoxical statements. By drafting a conceptual framework for further studies on idioms of resilience, the study also makes a theoretical contribution to international resilience research

A blended learning teaching strategy strengthens the nursing students’ performance and self-reported learning outcome achievement in an anatomy, physiology and biochemistry course – A quasi-experimental study

In nursing, bioscience is regarded as one of the cornerstones of nursing practice. However, bioscience disciplines as anatomy, physiology and biochemistry are considered challenging for students and the failure rate is high. In this study we explore a blended learning teaching strategy in an anatomy, physiology and biochemistry course for first year Bachelor nursing students. In the blended learning teaching strategy, short narrated online digital resources of bioscientific terms and concepts were integrated into the teaching design along with digital metacognitive evaluations of learning outcomes. Results show that compared to students receiving traditional face-to-face teaching, the students with a blended learning approach performed better on their national exam with a small to medium effect size (Cohen’s d=0.23). Student course evaluations supported the blended learning delivery with small to medium effect sizes. The students reported that the digital resources supported their learning outcome achievement, that they better understood the teacher’s expectations and that they were more satisfied with their virtual learning environment. This study adds to the growing literature of blended learning effectiveness in higher education, and suggests the use of digital resources as an enrichment of teaching and enhancement of students’ study experience.publishedVersio

The effect of SME internationalization motivators on initial and successive international market entry mode choice

Source at https://vkm.no/In preparation for a legal implementation of EU-regulation 1829/2003, the Norwegian Environment Agency (former Norwegian Directorate for Nature Management) has requested the Norwegian Food Safety Authority (NFSA) to give final opinions on all genetically modified organisms (GMOs) and products containing or consisting of GMOs that are authorized in the European Union under Directive 2001/18/EC or Regulation 1829/2003/EC within the Authority’s sectoral responsibility. The Norwegian Food Safety Authority has therefore, by letter dated 13 February 2013 (ref. 2012/150202), requested the Norwegian Scientific Committee for Food Safety (VKM) to carry out scientific risk assessments of 39 GMOs and products containing or consisting of GMOs that are authorized in the European Union. The request covers scope(s) relevant to the Gene Technology Act. The request does not cover GMOs that VKM already has conducted its final risk assessments on. However, the Agency requests VKM to consider whether updates or other changes to earlier submitted assessments are necessary.I forbindelse med forberedelse til implementering av EU-forordning 1829/2003 i norsk rett har Miljødirektoratet (tidligere Direktoratet for Naturforvalting) bedt Mattilsynet om vurderinger av allegenmodifiserte organismer (GMOer) og avledete produkter som inneholder eller består av GMOer som er godkjent under forordning 1829/2003 eller direktiv 2001/18 som er godkjent for ett eller flere bruksområder som omfattes av genteknologiloven. På den bakgrunnen har Mattilsynet, i brev av 13. februar 2013 (ref. 2012/150202), bedt Vitenskapskomiteen for mattrygghet (VKM) om å utarbeide endelige vitenskapelige risikovurderinger av 39 GMOer og avledete produkter som inneholder eller består av genmodifiserte organismer, innen Mattilsynets sektoransvar. VKM er bedt om endelige risikovurderinger for de EU-godkjente søknader hvor VKM ikke har avgitt endelig risikovurdering. I tillegg er VKM bedt om å vurdere hvorvidt det er nødvendig med oppdatering eller annen endring av de endelige risikovurderingene som VKM tidligere har lever

Serological screening for tick-borne encephalitis virus in eight Norwegian herds of semi-domesticated reindeer

Tick-borne encephalitis virus (TBEV) is found in Ixodes ricinus ticks throughout the area where viable tick populations exist. In Norway, TBEV is found in I. ricinus from the south coast until Brønnøy municipality in Nordland County and the range of the vector is expanding due to changes in climate, vegetation, host animals and environmental conditions. TBEV might thus have the potential to establish in new areas when I. ricinus expand its geographical distribution. At present, there is little knowledge on the status of the virus in high-altitude areas of inland regions in Norway. It has previously been indicated that reindeer may be an important sentinel species and indicator of the spread of ticks and TBEV in high-altitude regions. In this study, 408 semi-domesticated Eurasian tundra reindeer (Rangifer tarandus tarandus) from eight herds, from Tana in Troms and Finnmark County in northern Norway to Filefjell in Innlandet and Viken Counties in southern Norway, were screened for TBEV antibodies using a commercial enzyme-linked immunosorbent assay (ELISA). We found 16 TBEV reactive reindeer samples by ELISA; however, these results could not be confirmed by the serum neutralization test (SNT). This could indicate that a flavivirusand not necessarily TBEV, may be circulating among Norwegian semi-domesticated reindeer. The results also indicate that TBEV was not enzootic in Norwegian semi-domesticated reindeer in 2013–2015. This knowledge is important as an information base for future TBEV and flavivirus surveillance in Norway

Food/feed and environmental risk assessment of insect-resistant and herbicide-tolerant genetically modified maize MIR604 x GA21 in the European Union under Regulation (EC) No 1829/2003 (EFSA/GMO/UK/2007/48)

Source at https://vkm.no/In preparation for a legal implementation of EU-regulation 1829/2003, the Norwegian Environment Agency (former Norwegian Directorate for Nature Management) has requested the Norwegian Food Safety Authority (NFSA) to give final opinions on all genetically modified organisms (GMOs) and products containing or consisting of GMOs that are authorised in the European Union under Directive 2001/18/EC or Regulation 1829/2003/EC within the Authority’s sectoral responsibility. The Norwegian Food Safety Authority has therefore, by letter dated 13 February 2013 (ref. 2012/150202), requested the Norwegian Scientific Committee for Food Safety (VKM) to carry out scientific risk assessments of 39 GMOs and products containing or consisting of GMOs that are authorised in the European Union. The request covers scope(s) relevant to the Gene Technology Act. The request does not cover GMOs that VKM already has conducted its final risk assessments on. However, the Agency requests VKM to consider whether updates or other changes to earlier submitted assessments are necessary.I forbindelse med forberedelse til implementering av EU-forordning 1829/2003 i norsk rett har Miljødirektoratet (tidligere Direktoratet for Naturforvalting) bedt Mattilsynet om vurderinger av allegenmodifiserte organismer (GMOer) og avledete produkter som inneholder eller består av GMOer som er godkjent under forordning 1829/2003 eller direktiv 2001/18, og som er godkjent for ett eller flere bruksområder som omfattes av genteknologiloven. På den bakgrunnen har Mattilsynet, i brev av 13. februar 2013 (ref. 2012/150202), bedt Vitenskapskomiteen for mattrygghet (VKM) om å utarbeide endelige vitenskapelige risikovurderinger av 39 GMOer og avledete produkter som inneholder eller består av genmodifiserte organismer, innen Mattilsynets sektoransvar. VKM er bedt om endelige risikovurderinger for de EU-godkjente søknader hvor VKM ikke har avgitt endelig risikovurdering. I tillegg er VKM bedt om å vurdere hvorvidt det er nødvendig med oppdatering eller annen endring av de endelige risikovurderingene som VKM tidligere har levert

Food/feed and environmental risk assessment of insect-resistant and herbicide-tolerant genetically modified maize Bt11 from Syngenta Seeds for food and feed uses, import and processing under Regulation (EC) No 1829/2003 (EFSA/GMO/RX/Bt11)

Source at https://vkm.no/In preparation for a legal implementation of EU-regulation 1829/2003, the Norwegian Scientific Committee for Food Safety (VKM) has been requested by the Norwegian Environment Agency (former Norwegian Directorate for Nature Management) and the Norwegian Food Safety Authority (NFSA) to conduct final food/feed and environmental risk assessments for all genetically modified organisms (GMOs) and products containing or consisting of GMOs that are authorized in the European Union under Directive 2001/18/EC or Regulation 1829/2003/EC. The request covers scope(s) relevant to the Gene Technology Act. The request does not cover GMOs that VKM already has conducted its final risk assessments on. However, the Agency and NFSA requests VKM to consider whether updates or other changes to earlier submitted assessments are necessary.I forbindelse med forberedelse til implementering av EU-forordning 1829/2003 i norsk rett, er Vitenskapskomiteen for mattrygghet (VKM) bedt av Miljødirektoratet (tidligere Direktoratet for naturforvalting (DN)) og Mattilsynet om å utarbeide endelige helse- og miljørisikovurderinger av alle genmodifiserte organismer (GMOer) og avledete produkter som inneholder eller består av GMOer som er godkjent under forordning 1829/2003 eller direktiv 2001/18, og som er godkjent for ett eller flere bruksområder som omfattes av genteknologiloven. Miljødirektoratet og Mattilsynet har bedt VKM om endelige risikovurderinger for de EU-godkjente søknader hvor VKM ikke har avgitt endelige risikovurderinger. I tillegg er VKM bedt om å vurdere hvorvidt det er nødvendig med oppdatering eller annen endring av de endelige helse- og miljørisikovurderingene som VKM tidligere har levert

Food/feed and environmental risk assessment of insect-resistant and herbicide-tolerant genetically modified maize Bt11 from Syngenta Seeds for food and feed uses, import and processing under Regulation (EC) No 1829/2003 (EFSA/GMO/RX/Bt11)

Source at https://vkm.no/In preparation for a legal implementation of EU-regulation 1829/2003, the Norwegian Scientific Committee for Food Safety (VKM) has been requested by the Norwegian Environment Agency (former Norwegian Directorate for Nature Management) and the Norwegian Food Safety Authority (NFSA) to conduct final food/feed and environmental risk assessments for all genetically modified organisms (GMOs) and products containing or consisting of GMOs that are authorized in the European Union under Directive 2001/18/EC or Regulation 1829/2003/EC. The request covers scope(s) relevant to the Gene Technology Act. The request does not cover GMOs that VKM already has conducted its final risk assessments on. However, the Agency and NFSA requests VKM to consider whether updates or other changes to earlier submitted assessments are necessary.I forbindelse med forberedelse til implementering av EU-forordning 1829/2003 i norsk rett, er Vitenskapskomiteen for mattrygghet (VKM) bedt av Miljødirektoratet (tidligere Direktoratet for naturforvalting (DN)) og Mattilsynet om å utarbeide endelige helse- og miljørisikovurderinger av alle genmodifiserte organismer (GMOer) og avledete produkter som inneholder eller består av GMOer som er godkjent under forordning 1829/2003 eller direktiv 2001/18, og som er godkjent for ett eller flere bruksområder som omfattes av genteknologiloven. Miljødirektoratet og Mattilsynet har bedt VKM om endelige risikovurderinger for de EU-godkjente søknader hvor VKM ikke har avgitt endelige risikovurderinger. I tillegg er VKM bedt om å vurdere hvorvidt det er nødvendig med oppdatering eller annen endring av de endelige helse- og miljørisikovurderingene som VKM tidligere har levert

Food and environmental risk assessment of herbicide-tolerant genetically modified maize NK603 for food uses, import and processing under Directive 2001/18 /EC (Notification C/ES/00/01)

Source at https://vkm.no/In preparation for a legal implementation of EU-regulation 1829/2003, the Norwegian Scientific Committee for Food Safety (VKM) has been requested by the Norwegian Environment Agency (former Norwegian Directorate for Nature Management) and the Norwegian Food Safety Authority (NFSA) to conduct final food/feed and environmental risk assessments for all genetically modified organisms (GMOs) and products containing or consisting of GMOs that are authorised in the European Union under Directive 2001/18/EC or Regulation 1829/2003/EC. The request covers scope(s) relevant to the Gene Technology Act. The request does not cover GMOs that VKM already has conducted its final risk assessments on. However, the Agency and NFSA requests VKM to consider whether updates or other changes to earlier submitted assessments are necessary.I forbindelse med forberedelse til implementering av EU-forordning 1829/2003 i norsk rett, er Vitenskapskomiteen for mattrygghet (VKM) bedt av Miljødirektoratet (tidligere Direktoratet for naturforvalting [DN]) og Mattilsynet om å utarbeide endelige helse- og miljørisikovurderinger av alle genmodifiserte organismer (GMOer) og avledete produkter som inneholder eller består av GMOer som er godkjent i EU under forordning 1829/2003 eller direktiv 2001/18, og som er godkjent for ett eller flere bruksområder som omfattes av genteknologiloven. Miljødirektoratet og Mattilsynet har bedt VKM om endelige risikovurderinger for de EU-godkjente søknader hvor VKM ikke har avgitt endelige risikovurderinger. I tillegg er VKM bedt om å vurdere hvorvidt det er nødvendig med oppdatering eller annen endring av de endelige helse- og miljørisikovurderingene som VKM tidligere har levert