Diagnostic laboratory testing for Charcot Marie Tooth disease (CMT): the spectrum of gene defects in Norwegian patients with CMT and its implications for future genetic test strategies.

This article is part of Rune Østern's doctoral thesis which is available in Munin at http://hdl.handle.net/10037/6965The importance of diagnosing and treating co-occurring psychiatric disorders among substance abusers in treatment has received much attention. The aim of this study was to investigate to which extent co-occurring psychiatric disorders are diagnosed in a clinical population of substance abusers, and which factors (including the use of MINI-Plus) that influence the diagnosing of co-occurring psychiatric disorders. Patients (N = 275) who received inpatient substance use treatment in five different units in Northern Norway participated in the study. The patients’ clinicians gave information on diagnoses given during the stay in the units, and whether a systematic diagnostic tool was used for the diagnosing (MINI-Plus). Predictors of independent co-occurring psychiatric disorders were examined utilizing hierarchical regression analysis. One third of the patients were given an independent psychiatric diagnosis. Less than half of the patients were assessed using a diagnostic tool. The main predictor of diagnosing of independent psychiatric disorders was the use of the diagnostic tool MINI-Plus. Younger patients and patients that used less alcohol, were given independent psychiatric diagnoses more frequently. The number of co-occurring independent psychiatric diagnoses was lower compared to other studies using standardized diagnostic tools. The low number of patients assessed by such a tool, and the strong relationship between the use of such a tool and the diagnosing of co-occurring psychiatric disorders, suggest that the implementation of standardized diagnostic tools should be addressed in the units. Generally, patients suffering from substance use disorders should be systematically screened for other psychiatric disorders, in order to improve their treatment and health

A positive Real-Time Elastography (RTE) combined with a Prostate Cancer Gene 3 (PCA3) score above 35 convey a high probability of intermediate- or high-risk prostate cancer in patient admitted for primary prostate biopsy

Background: The standard of care in patients with suspected prostate cancer (PCa) is systematic prostate biopsies. This approach leads to unnecessary biopsies in patients without PCa and also to the detection of clinical insignificant PCa. Better tools are wanted. We have evaluated the performance of real-time elastography (RTE) combined with prostate cancer gene 3 (PCA3) in an initial biopsy setting with the goal of better identifying patients in need of prostate biopsies. Methods: 127 patients were included in this study; three were excluded because of not measureable PCA3 score leading to 124 evaluable patients. A cut-off value of 35 was used for PCA3. All patients were examined with a Hitachi Preirus with an endfire probe for RTE, a maximum of five targeted biopsies were obtained from suspicious lesions detected by RTE. All patients then had a 10-core systematic biopsy performed by another urologist unaware of the RTE results. The study includes follow-up data for a minimum of three years; all available histopathological data are included in the analysis. Results: There was a significant difference in PCA3 score: 26.6 for benign disease, 73.6 for cancer patients (p < 0.001). 70 patients (56 %) were diagnosed with prostate cancer in the study period, 21 (30 %) low-risk, 32 (46 %) intermediate-risk and 17 (24 %) high-risk. RTE and PCA3 were significant markers for predicting intermediate- and high-risk PCa (p = 0.001). The combination of RTE and PCA3 had a sensitivity of 96 % and a negative predictive value (NPV) of 90 % for the group of intermediate- and high-risk PCa together and a NPV for high-risk PCa of 100 %. If both parameters are positive there is a high probability of detecting intermediate- or high-risk PCa, if both parameters are negative there is only a small chance of missing prostate cancer with documented treatment benefit. Conclusions: RTE and PCA3 may be used as pre-biopsy examinations to reduce the number of prostate biopsies.publishedVersio

Erfaringsgjennomgang etter utvalgte utbrudd av covid-19 i Norge, desember 2020 – mars 2021

Source at https://www.fhi.no/Denne rapporten beskriver en erfaringsgjennomgang av utvalgte covid-19 utbrudd i Norge, desember 2020 – mars 2021. Rapporten har blitt ledet av en intern arbeidsgruppe ved Folkehelseinstituttet (FHI) og er gjennomført i samarbeid med Helsedirektoratet, utvalgte kommuner og tilhørende statsforvaltere våren 2021. Hensikten har vært å oppsummere erfaringer og lære underveis, særlig knyttet til håndtering av utbrudd med den engelske virusvarianten og bruk av forsterket TISK (testing, isolering, smittesporing og karantene). Denne prosessen har gitt relevant innsikt

Changes in Norges Bank’s Role and Activities in Cash Supply and Distribution

This Staff Memo is a slightly adjusted version of an article published in Norwegian in 2010. Due to great interest of colleagues from other central banks, we present the changes in the Norwegian cash cycle in English.Norges Bank has made considerable changes in its role and activities in cash supply and distribution since the turn of the century, with the aim of enhancing efficiency in cash distribution and the payment system as a whole. Norges Bank’s cash distribution responsibilities have been clarified, and the Bank has assumed a defined role as wholesaler. In addition, Norges Bank has outsourced note and coin processing services to a considerable extent compared with other central banks and currently relies on purchasing these services from external operators. This article presents the changes and reviews the assessments and reasoning behind the choices made in the light of Norges Bank’s responsibilities. The final section examines the consequences of the changes. The overall assessment is that the changes have increased efficiency in the cash supply and enhanced efficiency in the payment system as a whole

Endringer i Norges Banks rolle og virksomhet på kontantområdet

Norges Bank har etter århundreskiftet gjennomført store endringer i sin rolle og virksomhet på kontantområdet. Siktemålet har vært å øke effektiviteten innen kontantforsyningen og i det samlede betalingssystemet. Banken har inntatt en tydeligere grossistrolle, og avviklet tilbud og tjenester som mer naturlig er en del av detaljistleddet i kontantforsyningen. I tillegg har Norges Bank endret organiseringen av de oppgavene banken har ansvaret for. Norges Bank har gått langt i å utkontraktere tjenester på seddel- og myntområdet sammenlignet med andre sentralbanker, og baserer seg i dag i stor grad på kjøp av tjenester på dette området. Denne artikkelen presenterer endringene og gjennomgår vurderinger og begrunnelser som ligger bak de valg som er gjort, med utgangspunkt i Norges Banks ansvar. Avslutningsvis pekes det på konsekvenser av endringene. I hovedsak er vurderingen at omleggingene har gitt en effektivisering i kontantforsyningen og lagt til rette for økt effektivitet i det samlede betalingssystemet

Changes in Norges Bank’s Role and Activities in Cash Supply and Distribution

Norges Bank has made considerable changes in its role and activities in cash supply and distribution since the turn of the century, with the aim of enhancing efficiency in cash distribution and the payment system as a whole. Norges Bank’s cash distribution responsibilities have been clarified, and the Bank has assumed a defined role as wholesaler. In addition, Norges Bank has outsourced note and coin processing services to a considerable extent compared with other central banks and currently relies on purchasing these services from external operators. This article presents the changes and reviews the assessments and reasoning behind the choices made in the light of Norges Bank’s responsibilities. The final section examines the consequences of the changes. The overall assessment is that the changes have increased efficiency in the cash supply and enhanced efficiency in the payment system as a whole

Endringer i Norges Banks rolle og virksomhet på kontantområdet

Norges Bank har etter århundreskiftet gjennomført store endringer i sin rolle og virksomhet på kontantområdet. Siktemålet har vært å øke effektiviteten innen kontantforsyningen og i det samlede betalingssystemet. Banken har inntatt en tydeligere grossistrolle, og avviklet tilbud og tjenester som mer naturlig er en del av detaljistleddet i kontantforsyningen. I tillegg har Norges Bank endret organiseringen av de oppgavene banken har ansvaret for. Norges Bank har gått langt i å utkontraktere tjenester på seddel- og myntområdet sammenlignet med andre sentralbanker, og baserer seg i dag i stor grad på kjøp av tjenester på dette området. Denne artikkelen presenterer endringene og gjennomgår vurderinger og begrunnelser som ligger bak de valg som er gjort, med utgangspunkt i Norges Banks ansvar. Avslutningsvis pekes det på konsekvenser av endringene. I hovedsak er vurderingen at omleggingene har gitt en effektivisering i kontantforsyningen og lagt til rette for økt effektivitet i det samlede betalingssystemet

Enhancing potential impact of hospital discharge interventions for patients with COPD: a qualitative systematic review

Abstract Background Patients with chronic obstructive pulmonary disease (COPD) are frequently readmitted to hospital resulting in avoidable healthcare costs. Many different interventions designed to reduce hospital readmissions are reported with limited evidence for effectiveness. Greater insight into how interventions could be better designed to improve patient outcomes has been recommended. Aim To identify areas for optimisation within previously reported interventions provided to reduce COPD rehospitalisation to improve future intervention development. Methods A systematic review was conducted by searching Medline, Embase, CINAHL, PsycINFO, and CENTRAL in June 2022. Inclusion criteria were interventions provided to patients with COPD in the transition from hospital to home or community. Exclusion criteria were lack of empirical qualitative results, reviews, drug trials, and protocols. Study quality was assessed using the Critical Appraisal Skills Programme tool and results were synthesised thematically. Results A total of 2,962 studies were screened and nine studies included. Patients with COPD experience difficulties when transitioning from hospital to home. It is therefore important for interventions to facilitate a smooth transition process and give appropriate follow-up post-discharge. Additionally, interventions should be tailored for each patient, especially regarding information provided. Conclusion Very few studies specifically consider processes underpinning COPD discharge intervention implementation. There is a need to recognise that the transition itself creates problems, which require addressing, before introducing any new intervention. Patients report a preference for interventions to be individually adapted—in particular the provision of patient information. Whilst many intervention aspects were well received, feasibility testing may have enhanced acceptability. Patient and public involvement may address many of these concerns and greater use of process evaluations should enable researchers to learn from each other’s experiences. Trial registration The review was registered in PROSPERO with registration number CRD42022339523