Editorial Board

Source at http://dx.doi.org/10.1186/s12888-017-1345-8 Background: The duration of untreated psychosis is determined by both patient and service related factors. Few studies have considered the geographical accessibility of services in relation to treatment delay in early psychosis. To address this, we investigated whether treatment delay is co-determined by straight-line distance to hospital based specialist services in a mainly rural mental health context. Methods: A naturalistic cross-sectional study was conducted among a sample of recent onset psychosis patients in northern Norway (n = 62). Data on patient and service related determinants were analysed. Results: Half of the cohort had a treatment delay longer than 4.5 months. In a binary logistic regression model, straight-line distance was found to make an independent contribution to delay in which we controlled for other known risk factors. Conclusions: The determinants of treatment delay are complex. This study adds to previous studies on treatment delay by showing that the spatial location of services also makes an independent contribution. In addition, it may be that insidious onset is a more important factor in treatment delay in remote areas, as the logistical implications of specialist referral are much greater than for urban dwellers. The threshold for making a diagnosis in a remote location may therefore be higher. Strategies to reduce the duration of untreated psychosis in rural areas would benefit from improving appropriate referral by crisis services, and the detection of insidious onset of psychosis in community based specialist services

Classification of bipolar disorder in psychiatric hospital. a prospective cohort study

<p>Abstract</p> <p>Background</p> <p>This study has explored the classification of bipolar disorder in psychiatric hospital. A review of the literature reveals that there is a need for studies using stringent methodological approaches.</p> <p>Methods</p> <p>480 first-time admitted patients to psychiatric hospital were found eligible and 271 of these gave written informed consent. The study sample was comprised of 250 patients (52%) with hospital diagnoses. For the study, expert diagnoses were given on the basis of a structured diagnostic interview (M.I.N.I.PLUS) and retrospective review of patient records.</p> <p>Results</p> <p>Agreement between the expert's and the clinicians' diagnoses was estimated using Cohen's kappa statistics. 76% of the primary diagnoses given by the expert were in the affective spectrum. Agreement concerning these disorders was moderate (kappa ranging from 0.41 to 0.47). Of 58 patients with bipolar disorder, only 17 received this diagnosis in the clinic. Almost all patients with a current manic episode were classified as currently manic by the clinicians. Forty percent diagnosed as bipolar by the expert, received a diagnosis of unipolar depression by the clinician. Fifteen patients (26%) were not given a diagnosis of affective disorder at all.</p> <p>Conclusions</p> <p>Our results indicate a considerable misclassification of bipolar disorder in psychiatric hospital, mainly in patients currently depressed. The importance of correctly diagnosing bipolar disorder should be emphasized both for clinical, administrative and research purposes. The findings questions the validity of psychiatric case registers. There are potential benefits in structuring the diagnostic process better in the clinic.</p

Qualified and Unqualified (N-R C) mental health nursing staff - minor differences in sources of stress and burnout. A European multi-centre study

<p>Abstract</p> <p>Background</p> <p>Unqualified/non-registered caregivers (N-R Cs) will continue to play important roles in the mental health services. This study compares levels of burnout and sources of stress among qualified and N-R Cs working in acute mental health care.</p> <p>Methods</p> <p>A total of 196 nursing staff - 124 qualified staff (mainly nurses) and 72 N-R Cs with a variety of different educational backgrounds - working in acute wards or community mental teams from 5 European countries filled out the Maslach Burnout Inventory (MBI), the Mental Health Professional Scale (MHPSS) and the Psychosocial Work Environment and Stress Questionnaire (PWSQ).</p> <p>Results</p> <p>(a) The univariate differences were generally small and restricted to a few variables. Only Social relations (N-R Cs being less satisfied) at Work demands (nurses reporting higher demands) were different at the .05 level. (b) The absolute scores both groups was highest on variables that measured feelings of not being able to influence a work situation characterised by great demands and insufficient resources. Routines and educational programs for dealing with stress should be available on a routine basis. (c) Multivariate analyses identified three extreme groups: (i) a small group dominated by unqualified staff with high depersonalization, (ii) a large group that was low on depersonalisation and high on work demands with a majority of qualified staff, and (iii) a small N-R C-dominated group (low depersonalization, low work demands) with high scores on professional self-doubt. In contrast to (ii) the small and N-R C-dominated groups in (i) and (iii) reflected mainly centre-dependent problems.</p> <p>Conclusion</p> <p>The differences in burnout and sources of stress between the two groups were generally small. With the exception of high work demands the main differences between the two groups appeared to be centre-dependent. High work demands characterized primarily qualified staff. The main implication of the study is that no special measures addressed towards N-R Cs in general with regard to stress and burnout seem necessary. The results also suggest that centre-specific problems may cause more stress among N-R Cs compared to the qualified staff (e.g. professional self-doubt).</p

Norsk kystsonekart. Forsøksområde Flora kommune Prosjektrapport nr 1: Basiskart i målestokk 1:20.000

Endret bruk av arealer i kystsonen stiller nye krav til kartproduktene. Kommunene har fått et økt ansvar for forvaltning og planlegging i kystsonen. Det omtales ulike metoder for å produsere et basiskart ifra kystsonen. Dette kartet er et nedfotografert økonomisk kartverk i M = 1:20.000, og på sjøarealene viser kartet bunntopografi, sjømerker o.a. Det antas at et slikt kart vil bli et nyttig redskap for flere bruksformål

Eigna område for oppdrett i sjøen i Selje kommune Kystsoneplan for Selje

Fleire sjøområde i Selje kommune er svært godt egna for lokalisering av oppdrettsanlegg. Deler av kyststrekninga er for eksponert og einskilde innelukka område har dårlig vassutskifting. I dei beste områda for oppdrett er det gjeldande avstandsreglar mellom anlegg som i hovudsak verkar begrensande for nyetableringar

Utfylling med sprengstein langs Sandvinvatnet. Mulige endringer av vannkvalitet

Utfylling med sprengstein langs Sandvinvatnet i Odda kommune kan føre til økt turbiditet i drikkevatnet, økt nitratinnhold i vannet, og at settefisk utsettes for skarpkantete partikler. Vi antar at alle effekter blir små, men anbefaler at en utfører endel effektreduserende tiltak. Det foreslås også at en vurderer å foreta oppfølgende undersøkelser under anleggsfasen

Norsk Kystsonekart. Kartlegging av arealbruk. Prosjektrapport nr 2

Fysisk planlegging i kystsonen må bl. a. bygge på en oversikt over eksisterende arealbruk. Det omtales hvilke arealbruksformer som synes mest aktuelle å kartlegge, hvordan data kan skaffes og hvordan en kan presentere informasjonen. Kartlegging av arealbruk på sjøen reiser en del nye problemstillinger, bl. a. m.h.t. ajourføring og fullstendighet i kartene, og vansker med nøyaktig å avgrense en rekke av arealbruksformene. Rapporten retter seg i hovedsak mot et detaljeringsnivå tilsvarende innenfor en kommune.Norges Fiskeriforskningsråd (NFFR

Kystsoneplan for Sunnhordaland. Vasskvalitet i Sunnhordaland og Fusa. Regional gransking av vasskvalitet for setjefiskanlegg

101 ferskvasskjelder er analysert og klassifisert ut frå forsuringsgrad og grad av risiko ved bruk av vatnet til fiskeoppdrett. 60 % av kjeldene er klassifisert som "mindre godt eigna" eller "ueigna" for setjefiskoppdrett. 40 % av vasskjeldene er klassifisert som "godt eigna" eller "eigna"for setjefiskoppdrett. Det er påvist samanheng mellom nedbørpåverknad, berggrunnsgeologi, lausmassegeologi og vasskvalitet

Kommunedelplan for kystsona i ytre Bremanger. Del 2: Sektorutgreiing om akvakulturnæringa. Naturgrunnlag, infrastruktur, ringverknader

Rapporten gir ei tiltaksretta utviding av kommunedelplanen for kystsona i ytre Bremanger. Med utgangspunkt i dagens akvakulturnæring i området og i dei naturgjevne tilhøva blir potensialet for ei videre utvikling av næringa drøfta. Det blir tilrådd tiltak som m.a. går ut på ei sterkare integrering av det øvrige næringslivet i ytre Bremanger for å sikre ei større lokal utnytting av dei ringverknadene som akvakulturverksemda vil føre med seg.Bremanger kommun