Individbasert statistikk for pleie- og omsorgstjenesten i kommunene (IPLOS) : Foreløpige resultater fra arbeidet med IPLOS-data for 2009

Den nye versjonen av IPLOS inneholder noen opplysninger som er nye i forhold til tidligere, blant annet om man har behov for bistand/assistanse etter sosialtjenesteloven §4-2a. Den nye versjonen av IPLOS inneholder noen opplysninger som er nye i forhold til tidligere, blant annet om man har behov for bistand/assistanse etter sosialtjenesteloven §4-2a. I tillegg er det gjennomført en endring i måten opphold i bolig rapporteres. Fordi den nye versjonen ble introdusert for kommunene mot slutten av året, er de nye opplysningene ufullstendig rapportert, og det presenteres derfor ikke resultater for disse. Det er planlagt nytt uttak og innsending av data for 2009 i november, og presentasjon av endelige resultater tilknyttet publisering av KOSTRA i mars 2011

Individbasert statistikk for pleie- og omsorgstjenesten i kommunene (IPLOS) : Foreløpige resultater fra arbeidet med IPLOS-data for 2010

I 2010 er mange av problemene avdekket i fjor rettet opp for flertallet av kommunene. Fortsatt er det en del mangler knyttet til de nye opplysningene innført i 2009, men omfanget av dette er med betydelig mangler på dette feltet. Nyinnsending av 2009 data på slutten av 2010 bedret rapporterinbetydelig redusert. Kommunene har også gjennomført omfattende rettelser av registrering av beboerer i boliger, men ennå finnes kommunergen, men løste ikke problemene i en slik størrelsesorden at SSB har funnet det tilrådelig å publisere 2009 tall for beboere i boliger. Det har vært en økning i antall mottakere av pleie- og omsorgstjenester i perioden 2007-2010 på vel 5 prosent. Sammensetningen av mottakerne etter alder, kjønn og bistandsbehov har ikke endret seg nevneverdig, men det ser ut til at innføring av mulighetene for å registrere bistandsbehov som ”ikke relevant” medfører at antall brukere med uoppgitt bistandsbehov er redusert. Men blant de som har langtidsopphold i institusjon, har det vært en økning i andelen som har omfattende bistandsbehov. Mottakere av hjemmesykepleie og praktisk bistand med omfattende bistandsbehov er blitt tildelt et økende antall timer med hjelp per uke i perioden 2007-2010. Det kan se ut som kommunene i stadig større grad satser på å gi mye hjelp til de som trenger det mest

The relationship between Fibroblast Growth Factor 23 (FGF23) and cardiac MRI findings following primary PCI in patients with acute first time STEMI

Background Fibroblast growth factor 23 (FGF23) is a regulator of mineral metabolism, that has been linked to myocardial remodeling including development of left ventricular (LV) hypertrophy and myocardial fibrosis. The aim of this study was to investigate the relationship between intact FGF23 (iFGF23), myocardial infarct size and LV remodeling following a first acute ST-elevation myocardial infarction (STEMI). Methods and results Forty-two consecutive patients with first-time STEMI, single vessel disease, successfully treated with primary percutaneous coronary intervention were included. Cardiac magnetic resonance (CMR) imaging was performed at day 2, 1 week, 2 months and 1 year post MI, and blood samples were drawn at admittance and at the same time points as the CMRs. The cohort was divided according to the presence or not of heart failure post MI. In the total cohort, iFGF23 (mean ± SD) was significantly lower at day 0 (33.7 ± 20.6 pg/ml) and day 2 (31.5 ± 23.4 pg/ml) compared with a reference interval based on 8 healthy adults (43.9 pg/ml ± 19.0 pg/ml). iFGF23 increased to normal levels (55.8 ± 23.4 pg/ml) seven days post MI. In the subset of patients with signs of acute heart failure, FGF23 was higher at all measured timepoints, reaching significantly higher FGF23 levels at 2 months and 1 year following revascularization. Conclusion There was a reduction in iFGF23 levels during the acute phase of MI, with a normalization at seven days following revascularization. During one-year follow-up, there was a gradual increase in iFGF23 levels in patients with heart failure.publishedVersio

“The challenge is the complexity” – A qualitative study about decision-making in advanced lung cancer treatment

Introduction The value of shared decision-making and decision aids (DA) has been well documented yet remain difficult to integrate into clinical practice. We wanted to investigate needs and challenges regarding decision-making about advanced lung cancer treatment after first-line therapy, focusing on DA applicability. Methods Qualitative data from separate, semi-structured focus groups with patients/relatives and healthcare professionals were analysed using systematic text condensation. 12 patients with incurable lung cancer, seven relatives, 12 nurses and 18 doctors were recruited from four different hospitals in Norway. Results The participants described the following needs and challenges affecting treatment decisions: 1) Continuity of clinician-patient-relationships as a basic framework for decision-making; 2) barriers to information exchange; 3) negotiation of autonomy; and 4) assessment of uncertainty and how to deal with it. Some clinicians feared DA would steal valuable time and disrupt consultations, arguing that such tools could not incorporate the complexity and uncertainty of decision-making. Patients and relatives reported a need for more information and the possibility both to decline or continue burdensome therapy. Participants welcomed interventions supporting information exchange, like communicative techniques and organizational changes ensuring continuity and more time for dialogue. Doctors called for tools decreasing uncertainty about treatment tolerance and futile therapy. Conclusion Our study suggests it is difficult to develop an applicable DA for advanced lung cancer after first-line therapy that meets the composite requirements of stakeholders. Comprehensive decision support interventions are needed to address organizational structures, communication training including scientific and existential uncertainty, and assessment of frailty and treatment toxicity.publishedVersio

Micro- and macro-habitat selection of Atlantic salmon, (Salmo salar), post-smolts in relation to marine environmental cues

Atlantic salmon is an economically and culturally important species. The species encounters several natural and man-made threats during its migration between fresh water and the ocean, which in combination may explain its ongoing decline. With the aim to better understand whether post-smolt behaviour is influenced by physical oceanographic conditions, the migratory behaviour of 173 post-smolts in a high-latitude Norwegian fjord was investigated, combining acoustic telemetry with site- and time-specific environmental variables from an oceanographic model. Most post-smolts (94%) performed a unidirectional migration out the fjord. Progression rates were relatively high (0.42–2.41 km h−1; 0.84–3.78 BL s−1) and increased with distance from the river. While post-smolts had an affinity for lower salinities in the inner fjord, statistical models failed to detect any significant relationship between the small-scale (within arrays) migratory behaviour and salinity, temperature, or coastal surface currents within the fjord. In the outer part, the post-smolts predominantly exited the fjord system through the strait with the highest surface salinities and lowest temperatures, independently of the current direction. Our findings indicate that the macro-habitat selection of the Atlantic salmon post-smolts was influenced by environmental factors: the post-smolts directed their migration towards “ocean cues.” However, this was not confirmed on the micro-habitat level.publishedVersio

Subtype-specific surface proteins on adipose tissue macrophages and their association to obesity-induced insulin resistance

A chronic low-grade inflammation, originating in the adipose tissue, is considered a driver of obesity-associated insulin resistance. Macrophage composition in white adipose tissue is believed to contribute to the pathogenesis of metabolic diseases, but a detailed characterization of pro- and anti-inflammatory adipose tissue macrophages (ATMs) in human obesity and how they are distributed in visceral- and subcutaneous adipose depots is lacking. In this study, we performed a surface proteome screening of pro- and anti-inflammatory ATMs in both subcutaneous- (SAT) and visceral adipose tissue (VAT) and evaluated their relationship with systemic insulin resistance. From the proteomics screen we found novel surface proteins specific to M1-like- and M2-like macrophages, and we identified depot-specific immunophenotypes in SAT and VAT. Furthermore, we found that insulin resistance, assessed by HOMA-IR, was positively associated with a relative increase in pro-inflammatory M1-like macrophages in both SAT and VAT.publishedVersio

Panel-based Assessment of Ecosystem Condition of the North Sea Shelf Ecosystem

The System for Assessment of Ecological Condition, coordinated by the Norwegian Environment Agency, is intended to form the foundation for evidence-based assessments of the ecological condition of Norwegian terrestrial and marine ecosystems not covered by the EU Water Framework Directive. The reference condition is defined as “intact ecosystems”, i.e., a condition that is largely unimpacted by modern industrial anthropogenic activities. An ecosystem in good ecological condition does not deviate substantially from this reference condition in structure, functions or productivity. This report describes the first operational assessment of the ecological condition of the marine shelf ecosystem in the Norwegian sector of the North Sea and Skagerrak. The assessment method employed is the Panel-based Assessment of Ecosystem Condition (PAEC1) and the current assessment has considered to what extent the North Sea and Skagerrak shelf ecosystem deviates from the reference condition2 by evaluating change trajectories.Panel-based Assessment of Ecosystem Condition of the North Sea Shelf EcosystempublishedVersio

Panel-based Assessment of Ecosystem Condition of the North Sea Shelf Ecosystem - Appendices

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Mudanças climáticas e o fitoplâncton marinho : uma revisão

Orientador: Prof. Dr. Carlos Roberto SanquettaMonografia (especialização) - Universidade Federal do Paraná, Setor de Ciências Agrárias, Curso de Especialização em Projetos Sustentáveis, Mudanças Climáticas e Mercado de CarbonoInclui referênciasResumo: Uma revisão bibliográfica de artigos nacionais e internacionais foi realizada objetivando avaliar os principais impactos e respostas provocados pelas mudanças climáticas sobre o fitoplâncton marinho. Compreender como o ambiente marinho é afetado pelas alterações ambientais é fundamental, pois os oceanos são responsáveis pela absorção de mais de 80% do calor adicionado ao clima. A busca dos artigos foi realizada nas bases de dados Portal de Periódicos Capes, SciELO e Sciencedirect, entre maio e agosto de 2012 para o período compreendido entre 1980 e 2012. O fitoplâncton, além de bioindicador ambiental, é a base da cadeia alimentar e quaisquer alterações em sua composição ou abundância podem provocar graves consequências para os demais níveis tróficos, inclusive o homem. Dentre os impactos no ambiente marinho, observa-se o aquecimento da superfície da água do mar, provocando a estratificação da coluna de água e impedindo a ciclagem dos nutrientes; o aumento da temperatura atmosférica, favorecendo maiores índices de precipitação, o derretimento das geleiras e o aumento do nível do mar; a acidificação e a desoxigenação da água do mar. As respostas do fitoplâncton às mudanças climáticas compreendem alterações na taxa de crescimento, mudanças na composição específica e distribuição biogeográfica das espécies, maior risco de ocorrência de florações nocivas e de bioinvasões, dentre outras. Apesar de crescente o número de publicações sobre mudanças climáticas nos últimos anos, muitas são as incertezas sobre a real extensão desses impactos e quais outras ameaças podem decorrer das mudanças climáticas sobre o fitoplâncton marinho

Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)

Purpose Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia in ICU patients. Methods We conducted a prospective cohort study in adult ICU patients in 52 ICUs across 10 countries. We assessed frequencies of thrombocytopenia, use of platelet transfusions and clinical outcomes including mortality. We evaluated pre-selected potential risk factors for the development of thrombocytopenia during ICU stay and associations between thrombocytopenia at ICU admission and 90-day mortality using pre-specified logistic regression analyses. Results We analysed 1166 ICU patients; the median age was 63 years and 39.5% were female. Overall, 43.2% (95% confidence interval (CI) 40.4–46.1) had thrombocytopenia; 23.4% (20–26) had thrombocytopenia at ICU admission, and 19.8% (17.6–22.2) developed thrombocytopenia during their ICU stay. Non-AIDS-, non-cancer-related immune deficiency, liver failure, male sex, septic shock, and bleeding at ICU admission were associated with the development of thrombocytopenia during ICU stay. Among patients with thrombocytopenia, 22.6% received platelet transfusion(s), and 64.3% of in-ICU transfusions were prophylactic. Patients with thrombocytopenia had higher occurrences of bleeding and death, fewer days alive without the use of life-support, and fewer days alive and out of hospital. Thrombocytopenia at ICU admission was associated with 90-day mortality (adjusted odds ratio 1.7; 95% CI 1.19–2.42). Conclusion Thrombocytopenia occurred in 43% of critically ill patients and was associated with worse outcomes including increased mortality. Platelet transfusions were given to 23% of patients with thrombocytopenia and most were prophylactic.publishedVersio