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

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

Antipsychotic use in pregnancy and risk of attention/ deficit-hyperactivity disorder and autism spectrum disorder: a Nordic cohort study

Background Antipsychotics are increasingly used among women of childbearing age and during pregnancy. Objective To determine whether children exposed to antipsychotics in utero are at increased risk of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorder (ASD), accounting for maternal diagnoses of bipolar, psychotic and other psychiatric disorders. Design Population-based cohort study, including a sibling analysis. Setting Nationwide data on all pregnant women and their live-born singletons in Denmark (1997-2017), Finland (1996-2016), Iceland (2004-2017), Norway (2004-2017), and Sweden (2006-2016). Participants 4 324 086 children were eligible for inclusion to the study cohort. Intervention Antipsychotic exposure in utero, assessed by pregnancy trimester, type of antipsychotic, and varying patterns of use. Main outcome measures Non-mutually exclusive diagnoses of ADHD and ASD. We used Cox proportional hazard models to calculate hazard ratios (HRs) controlling for maternal psychiatric disorders and other potential confounding factors. Findings Among 4 324 086 singleton births, 15 466 (0.4%) were exposed to antipsychotics in utero. During a median follow-up of 10 years, we identified 72 257 children with ADHD and 38 674 children with ASD. Unadjusted HRs were raised for both outcomes but shifted substantially towards the null after adjustment; 1.10 (95%CI 1.00 to 1.27) for ADHD and 1.12 (0.97 to 1.29) for ASD. Adjusted HRs remained consistent by trimester of exposure and type of antipsychotic. Comparing in utero exposure with pre-pregnancy use yielded HRs of 0.74 (0.62 to 0.87) for ADHD and 0.88 (0.70 to 1.10) for ASD. Sibling analyses yielded HRs of 1.14 (0.79 to 1.64) for ADHD and 1.34 (0.75 to 2.39) for ASD. Discussion Our findings suggest little or no increased risk of child ADHD or ASD after in utero exposure to antipsychotics. Clinical implications Results regarding child neurodevelopment are reassuring for women who need antipsychotics during pregnancy.publishedVersio

Cancer risk among insulin users : comparing analogues with human insulin in the CARING five-country cohort study

Aims/hypothesis The aim of this work was to investigate the relationship between use of certain insulins and risk for cancer, when addressing the limitations and biases involved in previous studies. Methods National Health Registries from Denmark (1996-2010), Finland (1996-2011), Norway (2005-2010) and Sweden (2007-2012) and the UK Clinical Practice Research Datalink database (1987-2013) were used to conduct a cohort study on new insulin users (N = 327,112). By using a common data model and semi-aggregate approach, we pooled individual-level records from five cohorts and applied Poisson regression models. For each of ten cancer sites studied, we estimated the rate ratios (RRs) by duration (6 years) of cumulative exposure to insulin glargine or insulin detemir relative to that of human insulin. Results A total of 21,390 cancer cases occurred during a mean follow-up of 4.6 years. No trend with cumulative treatment time for insulin glargine relative to human insulin was observed in risk for any of the ten studied cancer types. Of the 136 associations tested in the main analysis, only a few increased and decreased risks were found: among women, a higher risk was observed for colorectal (RR 1.54, 95% CI 1.06, 2.25) and endometrial cancer (RR 1.78, 95% CI 1.07, 2.94) for 6 years (RR 0.22, 95% CI 0.05, 0.92). Comparisons of insulin detemir with human insulin also showed no consistent differences. Conclusions/interpretation The present multi-country study found no evidence of consistent differences in risk for ten cancers for insulin glargine or insulin detemir use compared with human insulin, at follow-up exceeding 5 years.Peer reviewe

Prenatal opioid exposure and risk of asthma in childhood: a population-based study from Denmark, Norway, and Sweden

Background: Opioids may modulate the immune function through opioid receptors on immune cells. Long-term consequences of prenatal opioid exposure on the immune system, such as childhood asthma, are unknown.Objectives: To investigate whether prenatal opioid exposure is associated with the risk of childhood asthma.Methods: Cohort study using linked nationwide registers in Denmark (1996–2015), Norway (2005–2015), and Sweden (2006–2013). Children born by mothers who were chronic opioid analgesics users before pregnancy (n = 14,764) or who were receiving opioid maintenance therapy (OMT) before or during pregnancy (n = 1,595) were identified based on information from each of the medical birth registers and prescription registers. Long-term opioid analgesics exposed children were compared to short-term exposed or unexposed, whereas OMT exposed children were compared to OMT unexposed. Asthma among children ≥1 years of age was defined as two or more filled prescriptions of antiasthmatic medication within 365 days, or a diagnosis of asthma. Hazard ratios (HRs) were calculated using Cox proportional hazards regression with attained age as the time scale. Inverse probability of treatment weights based on propensity scores were applied to adjust for measured confounders. Individual level data from Norway and Sweden were pooled, whereas individual level data from Denmark were analyzed separately. For the opioid analgesics comparisons, adjusted HRs (aHR) from the combined Norwegian/Swedish data and the Danish data were pooled in a fixed-effects meta-analysis.Results: For the opioid analgesics cohort, no increased risk of asthma was observed in long-term exposed children neither compared with unexposed [aHR = 0.99 (95% CI 0.87-1.12)], nor compared with short-term exposed [aHR = 0.97 (0.86-1.10)]. No increased risk of asthma was observed in OMT exposed compared with OMT unexposed children [Norway/Sweden: aHR = 1.07 (0.60-1.92), Denmark: aHR = 1.25 (0.87-1.81)]. Results from sensitivity analyses, where potential misclassification of the outcome and misclassification of OMT exposure were assessed, as well as starting follow-up at 6 years of age, showed that the estimates of association were generally robust.Conclusion: We found no association between prenatal exposure to opioids and risk of childhood asthma. Results were consistent across two different opioid exposure groups with different confounder distributions