Assessing the precision of frequency distributions estimated from trawl-survey samples

In trawl surveys a cluster of fish are caught at each station, and fish caught together tend to have more similar characteristics, such as length, age, stomach contents etc., than those in the entire population. When this is the case, the effective sample size for estimates of the frequency distribution of a population characteristic can, therefore, be much smaller than the number of fish sampled during a survey. As examples, it is shown that the effective sample size for estimates of length-frequency distributions generated by trawl surveys conducted in the Barents Sea, off Namibia, and off South Africa is on average approximately one fish per tow. Thus many more fish than necessary are measured at each station (location). One way to increase the effective sample size for these surveys and, hence, increase the precision of the length-frequency estimates, is to reduce tow duration and use the time saved to collect samples at more stations

Correcting for avoidance in acoustic abundance estimates for herring using a generalized linear model

When a research vessel passes over a herring school or layer, the herring may avoid the vessel by swimming downwards and horizontally. The fish may also change its orientation, which may alter its mean target strength. Consequently, the echo abundance measured by the relatively narrow echo sounder beam does not always reflect the true density of the school. The fish reaction is strongest in the upper parts of the water column. This avoidance behaviour has been quantified in several experiments where a stationary, submerged transducer has been used to measure the changes in echo abundance during the passage of a survey vessel. In this paper two approaches for correcting the echo abundance for avoidance are investigated. The first approach is to correct the echo abundance in each depth layer separately; the second is to correct the total echo abundance, letting the correction depend on the mean depth of the fish at passing. In both approaches generalized linear models are fitted to the experimental data. Since the parameters are estimated with uncertainty, this uncertainty can be taken into account when the fitted models are used for correcting standard survey data

Possible opioid-saving effect of cannabis-based medicine using individual-based data from the Norwegian Prescription Database

Some ecological studies have shown that areas with higher use of cannabis may have lower opioid use and fewer opioid-related problems. Newer studies are questioning this finding. Few individually based studies have been performed. Using data from the Norwegian Prescription Database, this study investigated the individual level effect of prescribed cannabis extract (Sativex®) in prescription opioid users on their opioid use in the following year. Looking at all those filling a prescription for Sativex®, opioid use was only marginally lowered in the follow-up period. Some Sativex® users, however, filled more prescriptions for Sativex® and were able to reduce their opioid use substantially. Further studies are needed to elucidate more details on these patients, so as to know who can benefit from such cannabis-based extracts in reducing their opioid use

Association between medical androgen deprivation therapy and long-term cardiovascular disease and all-cause mortality in nonmetastatic prostate cancer

Studies have suggested that prostate cancer (PCa) patients receiving androgen deprivation therapy (ADT) are at increased risk of developing or exacerbating cardiovascular disease (CVD). We aimed to explore the association between ADT for PCa and subsequent CVD and all-cause mortality in this nationwide, longitudinal study. We also evaluated the role of cardiovascular risk and ADT duration to determine effect modification. Norwegian registry data were used to identify patients with PCa from 2008-18 and who received primary ADT in the first year after diagnosis. The associations between ADT and composite cardiovascular events, and the individual components of myocardial infarction, stroke and heart failure, in addition to atrial fibrillation and all-cause mortality, were explored using time-varying Cox regression models. We included 30 923 PCa patients, of whom 8449 (27%) received primary ADT. Mean follow-up was 2.9 and 3.8 years for CVD events and mortality, respectively. We found an association between ADT and composite CVD (adjusted HR 1.13: 95% CI 1.05-1.21), myocardial infarction (1.18: 1.05-1.32), stroke (1.21: 1.06-1.38), heart failure (1.23: 1.13-1.35) and all-cause mortality (1.49: 1.39-1.61). These associations persisted in those with low and moderate CVD risk and ADT longer than 7 months. A relationship between ADT and composite CVD and all-cause mortality was observed, especially in those with moderate CVD risk and longer treatment duration. Future studies with more detailed cancer data are needed to verify the clinical relevance of these results, especially when considering all-cause mortality within the context of treatment guidelines and benefits of ADT.publishedVersio

Fatal drug overdoses in individuals treated pharmacologically for chronic pain: a nationwide register-based study

Introduction Chronic pain patients may be at an increased risk for drug overdoses as a result of comorbid psychiatric disorders and treatment with risk-increasing prescription medications, such as opioids. We aimed to characterise fatal drug overdoses and investigate factors associated with the deaths among individuals who had been treated pharmacologically for chronic pain. Methods We included all individuals who received analgesics reimbursed for chronic pain in Norway during 2010–9 (n=569 047). Among this population, we identified all individuals with drug overdoses as cause of death (cases). Extracting data from national registries on diagnoses, filled prescriptions, and socioeconomic variables, we used a nested case-control design to compare the cases with age- and sex-matched controls from the study population. Results Overall, 623 (0.11%) individuals in the study population died of an overdose. Most, 66.8%, had overdosed accidentally, and 61.9% as a result of pharmaceutically available opioids. Compared with the controls (n=62 245), overdoses overall were associated strongly with substance use disorders (adjusted odds ratio 7.78 [95% confidence interval 6.20–9.77]), use of combinations of opioids, benzodiazepines and related drugs and gabapentinoids (4.60 [3.62–5.85]), previous poisoning with pharmaceuticals (2.78 [2.20–3.51]), and with living alone the last year of life (2.11 [1.75–2.54]). Intentional overdoses had a stronger association with previous poisonings with pharmaceuticals whereas accidental overdoses were strongly associated with substance use disorders. Conclusions This study shows the need for better identification of overdose and suicide risk in individuals treated for chronic pain. Extra caution is needed when treating complex comorbid disorders, especially with overdose risk-increasing medications.publishedVersio

PENGEMBANGAN INSTRUMEN PENILAIAN OTENTIK UNTUK MENILAI PENGETAHUAN DAN KETERAMPILAN PRAKTIKUM SISWA SMK PADA KONSEP KOLOID

Penelitian ini bertujuan untuk mengembangkan instrumen penilaian otentik dalam menilai pengetahuan dan keterampilan praktikum siswa SMK pada konsep koloid. Metode yang digunakan adalah Research and Development, yang terdiri dari tahap pengembangan instrumen, tahap validasi dan uji coba instrumen, dan tahap aplikasi instrumen. Instrumen yang dikembangkan terdiri dari instrumen tes tertulis dan instrumen tes kinerja. Pada tahap uji coba, sampel penelitian yang menguji coba tes tertulis berjumlah 24 siswa kelas XII Teknik Sepeda Motor (TSM) dan lima rater yang menilai lima siswa yang melakukan praktikum, untuk uji coba instrumen tes kinerja. Sedangkan pada tahap aplikasi terdapat 40 siswa kelas XII Teknik Komputer Jaringan (TKJ) yang diuji menggunakan instrumen tes penilaian otentik, instrumen tes tertulis maupun tes kinerja. Hasil validasi instrumen oleh tujuh validator menunjukkan bahwa instrumen penilaian otentik yang dikembangkan valid, dengan nilai CVR 1,000 dan 0,714. Dari hasil uji coba instrumen, pada instrumen tes tertulis diketahui nilai reliabilitas 25 butir soal pilihan ganda adalah 0,675 dan nilai reliabilitas 2 buah butir soal uraian terbatas adalah 1,000. Pada instrumen tes kinerja, dari 11 task efek Tyndall yang digunakan nilai reliabilitasnya adalah 0,807 sedangkan dari 11 task adsorpsi yang digunakan nilai reliabilitasnya adalah 0,707. Hasil aplikasi instrumen diketahui bahwa pengetahuan siswa berada pada kategori kompeten, sedangkan keterampilan praktikum siswa pada efek Tyndall dan adsorpsi masing-masing berada pada kategori sangat kompeten. Koefisien korelasi Pearson bernilai 0,866 yang artinya nilai pengetahuan tinggi berhubungan dengan nilai keterampilan praktikum siswa. Kata kunci: Instrumen penilaian otentik, pengetahuan, keterampilan praktikum, dan sekolah menengah kejuruan. This research aims to develop an authentic assessment instruments in assessing the knowledge and practical skills of vocational students to the concept of colloid. The method used is Research and Development, comprising the steps of instrument development, the validation and testing instruments, and instrument application stage. The instrument was developed consisting of a written test instruments and test instruments performance. In the test phase, which tested a sample written test consists of 24 students of class XII Motorcycle Engineering (TSM) and five assessing rater five students who perform lab, to test the performance test instruments. While at the application stage there were 40 students of class XII Computer Engineering Network (TKJ) were tested using authentic assessment test instruments, instrument written test and a performance test. Results of the validation instrument by seven validator indicates that the assessment instruments developed authentically valid, the CVR value of 1.000 and 0.714. From the results of the test instrument, the written test instrument known reliability value 25 multiple choice items was 0.675 and the value of reliability 2 pieces item description is limited to 1,000. In the performance test instruments, of 11 task used Tyndall effect the reliability value is 0.807 while the 11 task that used adsorption reliability value is 0.707. Results of application of instruments known that the knowledge of students in the category competent, while the practical skills of students at Tyndall effect and adsorption of each are in the category of very competent. Pearson correlation coefficient of 0.866, which means valuable knowledge of high-value associated with the value of practical skills of the students. Keywords: Authentic assessment instruments, knowledge, practical skills, and senior vocational schools

Drug Use before and after Initiating Treatment with Acetylcholinesterase Inhibitors

Background/Aims: The aim was to study the prevalence of use of different drugs prescribed for behavioral and psychological symptoms of dementia in persistent users of acetylcholinesterase inhibitors (AChEIs) before and after AChEI initiation, and to compare with the use in the general population. Methods: Use of antidepressants, antipsychotics, and analgesics in the 4 years before and 2 years after AChEI initiation was studied based on data from the Norwegian Prescription Database 2004–2016. Results: The prevalence of use of antidepressants and antipsychotics the year before AChEI initiation was twice the prevalence in the age-adjusted general population and continued to rise in the first 2 years after initiation of AChEIs. The prevalence of weak analgesics and antipsychotics increased strongly in the last year before AChEI initiation. The increase in the use of antidepressants started at least 4 years before initiation of AChEIs. Opioid use was generally lower than in the general population and was not influenced by AChEI initiation. Conclusion: Increased use of antidepressants and antipsychotics was observed both before and after initiation of AChEIs and may indicate that behavioral symptoms occur in a preclinical or early phase of Alzheimer’s disease. The prescription pattern of analgesics with a low use of opioids may indicate an undertreatment of pain in people with dementia

Prescribed drugs in 27 000 individuals after diagnosis of colorectal cancer: A population-based cohort study

BACKGROUND: The prevalence of prescribed drugs in survivors of colorectal cancer (CRC) was evaluated. METHODS: Data from the Cancer Registry of Norway were linked to the Norwegian Prescription Database for a study population of 3.52 million individuals. Prevalence ratios (PRs) with 95% confidence intervals (CIs) of prescribed drugs in CRC-survivors compared to the cancer-free population, were estimated by log-binomial regression, adjusting for age and education. RESULTS: Almost 27 000 individuals, aged 20 to 84, were diagnosed with CRC during 2005 to 2014. The first year after diagnosis, the prevalence of prescribed drugs was higher in CRC-survivors compared with the cancer-free population, especially drugs for anxiety and tension, and steroid-responsive conditions. PRs for several drugs, especially drugs used for mental and behavioural disorders, decreased with time since diagnosis. The prevalence of drugs used for anxiety and tension was elevated 10 years after diagnosis; PRs the first year after diagnosis were 20 (95% CI: 18-22) in males and 17 (16-18) in females. Ten years after diagnosis PRs were 5.0 (3.1-7.9) and 2.0 (1.0-3.8), respectively. In absolute numbers, the largest increase, compared to the cancer-free population, was in drugs used for gastric acid disorders and pain. The prevalence of neuromodulatory drugs was higher in CRC-survivors. CONCLUSIONS: The prevalence of several drugs was higher in CRC-survivors than in the cancer-free population 10 years after diagnosis. The largest absolute excess in prevalence was for gastric acid disorder and pain medications, while the relative prevalence of drugs used for anxiety and tension was high in CRC-survivors. Long persisting neuropathia was indicated

Psykiske lidelser og plager ved vedvarende opioidbruk for langvarige ikke-kreftrelaterte smerter – en registerstudie

Bakgrunn Kunnskap om psykiske lidelser blant pasienter med vedvarende opioidbruk for behandling av langvarige ikke-kreftrelaterte smerter er viktig, da psykiske lidelser og plager kan bidra til å forsterke eller vedlikeholde smerte og påvirke evnen til å håndtere egen sykdom. Vi har undersøkt forekomst av psykiske lidelser og plager, inkludert rusmiddellidelser, hos pasienter med vedvarende opioidbruk i 2019. Materiale og metode Personer ≥ 18 år med vedvarende opioidbruk og personer ≥ 18 år med minst én registrert psykisk lidelse i spesialisthelsetjenesten i 2019 ble inkludert. Data ble hentet fra nasjonale helseregistre. Pasienter som fikk opioider for langvarige smerter på blå resept ble sammenlignet med dem som fikk opioider utelukkende på hvit resept. Resultater Forekomsten av psykiske lidelser og plager var 34 % blant 14 403 personer som fikk opioidene forskrevet på blå resept, og 42 % blant 38 001 personer som fikk opioidene på hvit resept. Dette tilsvarer 2–3 ganger økt forekomst sammenlignet med den generelle befolkningen. Det var spesielt høyere forekomst av angstlidelser og rusmiddellidelser. Det var høyest forekomst av psykiske lidelser og plager i aldersgruppen 18–44 år (49–55 %). Fortolkning Blant pasienter med vedvarende opioidbruk var det en stor andel med psykiske lidelser og plager, som er kjente risikofaktorer for å utvikle problematisk opioidbruk og avhengighetssyndrom.publishedVersio

Antipsychotic use during pregnancy and risk of specific neurodevelopmental disorders and learning difficulties in children: a multinational cohort study

Background Antipsychotics are commonly prescribed to treat a range of psychiatric conditions in women of reproductive age and during pregnancy, including schizophrenia, bipolar disorder, anxiety, depression, autism spectrum disorder, and insomnia. This study aimed to evaluate whether children exposed to antipsychotic medication prenatally are at increased risk of specific neurodevelopmental disorders and learning difficulties. Methods Our population-based cohort study used nationwide register data (1 January 2000–31 December 2020) on pregnant women diagnosed with a psychiatric disorder and their live-born singletons from Denmark, Finland, Iceland, Norway, and Sweden. Cox proportional hazard regression yielded propensity score-weighted hazard ratios (aHRs) and 95% confidence intervals (CIs) for risk of intellectual-, speech or language-, learning-developmental disorders, and a composite outcome of the listed disorders. We defined poor performance as scoring within the lowest quartile on national school tests in mathematics and language arts. We estimated propensity score-weighted risk ratios (aRRs) using Poisson regression. We analysed data from Denmark separately and pooled results using random effects meta-analysis. Findings Among 213,302 children (median follow-up: 6.7 years), 11 626 (5.5%) were exposed to antipsychotics prenatally. Adjusted risk estimates did not suggest an increased risk of neurodevelopmental disorders: aHR of 1.06 (95% CI 0.94–1.20) for the composite outcome, or for poor academic performance: aRR of 1.04 (95% CI 0.91–1.18) in mathematics, and of 1.00 (95% CI 0.87–1.15) in language arts. Results were generally consistent across individual medications, trimesters of exposure, sibling- and sensitivity analyses. Interpretation The findings of this large multinational cohort study suggest there is little to no increased risk of child neurodevelopmental disorders or learning difficulties after prenatal exposure to antipsychotics. Our findings can assist clinicians and women managing mental illness during pregnancy.publishedVersio