SIHF Vitenarkiv
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Matproduksjon, mattrygghet og miljø - innspill om kunnskapsbehov til gjennomføringen av det grønne skiftet - Uttalelse fra hovedkomiteen i Vitenskapskomiteen for mat og miljø (VKM)
Get PDFDenne rapporten er utarbeidet av Vitenskapskomiteen for mat og miljø (VKM), en uavhengig, tverrfaglig komité som utarbeider
kunnskapsgrunnlag for den norske mat- og miljøforvaltningen på områdene matproduksjon, mattrygghet og biologisk mangfold.
De siste tiårene har FNs klimapanel, Det internasjonale naturpanelet, Det internasjonale ressurspanelet og flere andre paneler og organisasjoner levert rapporter
som dokumenterer at befolkningsvekst og menneskelig aktivitet fører med seg store og økende utfordringer på miljø-, klima- og ressursområdet. Endringer innen
disse områdene påvirker matproduksjon, matsikkerhet, mattrygghet, folkehelse og naturverdier i alle deler av verden (UNEP, 2021).
Samtidig som utfordringene er globale, vil mange av de spesifikke problemstillingene og kunnskapsbehovene variere på bakgrunn av
lokale forutsetninger, behov, og muligheter. I denne rapporten ser vi på problemstillinger og kunnskapsbehov som er relevante for Norge.
Vi legger imidlertid til grunn at utvikling av kunnskap om bærekraftig matproduksjon i Norge, også vil kunne benyttes i andre land, og til å avhjelpe globale utfordringer. Ett
eksempel på det er norsk sjømatproduksjon, som er tett sammenvevd med internasjonal sjømat- og fôrproduksjon. Kunnskap og nye metoder som er utviklet i Norge, vil derfor kunne tas i bruk og få konsekvenser for marin og landbasert bioproduksjon andre steder. Rapporten er basert på konseptet én helse, en
helthetlig og tverrfaglig tilnærming som handler om at helsa til mennesker og dyr, og tilstanden til økosystemet vi lever i, er tett knyttet sammen
og avhengig av hverandre. Tilnærmingen inkluderer både human-, landdyr-, fiske-, plante-, jord-, vann- og økosystemhelse, og tar sikte på
å balansere og optimalisere helsa til mennesker, dyr og økosystemer på en bærekraftig måte. I rapporten presenterer vi noen sentrale
kunnskapsbehov innenfor områdene dyrehelse, dyrevelferd, plantehelse, human helse, biologisk mangfold og økosystemer. Vi mener at følgende
må ligge til grunn for det grønne skiftet og overgang til bærekraftig matproduksjon: • Tilnærmingen må være tverrsektoriell, helhetlig og kritisk, fordi en endring som
er gunstig innenfor én sektor kan ha uheldige effekter innenfor en annen sektor, og endringer i matsystemet i ett land kan få konsekvenser for systemet i andre
land. Derfor må vi samarbeide på tvers av sektorer og se nasjonale utfordringer i en internasjonal sammenheng. • Sentrale kunnskapsbehov må
identifiseres og dekkes, og kunnskapen må gjøres tilgjengelig. • All relevant, tilgjengelig kunnskap må tas i bruk for å velge løsninger som
erhensiktsmessige for samfunnet som helhet.publishedVersio
Nitrous oxide in labour predicted newborn screening total homocysteine and is a potential risk factor for infant vitamin B12 deficiency
Get PDFAim: Risk factors for vitamin B12 deficiency in infants are not fully understood. The aim of the study was to assess predictors of total homocysteine and methylmalonic acid analysed in newborn screening dried blood spots. Methods: In a Norwegian case control study, we analysed total homocysteine and methylmalonic acid in newborn screening dried blood spots of 86 infants clinically diagnosed with vitamin B12 deficiency during 2012-2018. Results were compared to 252 healthy infants and 400 dried blood spot controls. Medical records were reviewed, and mothers completed questionnaires. Results: Both total homocysteine and methylmalonic acid were significantly higher on newborn screening dried blood spots in infants later clinically diagnosed with vitamin B12 deficiency than controls. Multiple regression analysis showed that the dose of nitrous oxide during labour was the strongest predictor for total homocysteine level in newborn screening dried blood spots for all infants, with larger effect in infants later clinically diagnosed with vitamin B12 deficiency than controls. Conclusion: Nitrous oxide dose during labour was a predictor for total homocysteine and may impact the interpretation of total homocysteine analysis in newborn screening. Nitrous oxide is suggested as a contributing risk factor for infants prone to develop vitamin B12 deficiency. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2022 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.Nitrous oxide in labour predicted newborn screening total homocysteine and is a potential risk factor for infant vitamin B12 deficiencypublishedVersio
Current outcomes of live-born children with double outlet right ventricle in Norway
Get PDFObjectives: This population-based, comprehensive, retrospective study presented the clinical outcomes of all children born in Norway between 2003 and 2017 with double outlet right ventricle (DORV). Methods: All children born with DORV between 2003 and 2017 were identified in the Oslo University Hospital registry. Patients' characteristics, interventions, complications and deaths were recorded. Echocardiographic data were reviewed for classification according to current standards. We investigated time-dependent surgical reintervention and mortality using Kaplan-Meier analyses and determinants of treatment complications, reintervention and death using regression analyses. Results: Ninety-three children with DORV represented an annual median prevalence of 1.18 per 10 000 births in Norway. Six children received palliative care. With an intention to treat, a surgical route with the primary biventricular repair was followed for 62 children, staged biventricular repair for 15 and univentricular repair for 10 children. Major complications occurred in 1.0% and 6.2% of children following catheter or surgical intervention, respectively. No significant determinants of the complications were identified. Overall survival following treatment was 91.9%, 90.8%, 89.5% and 89.5% and corresponding freedom from surgical reintervention was 88.0%, 79.0%, 74.9% and 69.4% at 1, 2, 5 and 10 years, respectively. The presence of atrioventricular septal defect predicted an increased risk of mortality (hazard ratio: 7.16) but did not increase the risk of surgical reintervention. Conclusions: In Norway, most children receive tailored treatment for DORV with low rates of complications, surgical reinterventions and mortality. However, atrioventricular septal defect remains a potential determinant of postoperative death. Keywords: Biventricular; Complication; DORV; Double outlet right ventricle; Reintervention; Univentricular. © The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.publishedVersio
The stability of the Bayley scales in early childhood and its relationship with future intellectual abilities in a low to middle income country
Get PDFBackground The Bayley Scales of Infant and Toddler Development is widely used worldwide. The objective of the current study was to measure the stability of the Bayley Scales during early childhood and its relationship with intellectual abilities at four years in young Nepalese children. Methods In a prospective cohort we used the Bayley 3rd edition to measure early child development in 529 Nepalese children at 6–11, 18–23 and 30–35 months. At four years, we used the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) to measure intellectual abilities. We expressed the stability of the Bayley scores by intraclass correlation coefficients (ICCs) and concordance correlation coefficients (CCCs). The relationship between the Bayley scores and the WPPSI full-scale IQ (FSIQ) at four years was examined in regression models. Results The ICCs between the Bayley scores across timepoints were 0.01 (95 % CI -0.06, 0.04), 0.19 (95 % CI 0.15, 0.26) and 0.22 (95 % CI 0.17, 0.28) for the Cognitive, Language and Motor composite scores. The CCC for the composite scores ranged from 0.05 to 0.20 between 6 and 11 and 30–35 months and from 0.20 to 0.36 between 18 and 23 and 30–35 months. The Bayley scores at 6–11, 18–23 and 30–35 months explained 3 %, 20 % and 36 % of the variation of the FSIQ. Conclusion The stability of the Bayley scales is poor in early childhood, and its relationship with future intellectual abilities is poor in infancy but improves slightly with age in early childhood. Findings from this large community-based cohort of healthy at-risk children are relevant when measuring early child development worldwide.This work was supported by Thrasher Research Fund (award # 11512), the GC Rieber foundation, the University of Bergen (UoB), and the Research Council of Norway through a grant to Centre for Intervention Science in Maternal and Child Health (CISMAC).publishedVersio
Effectiveness of the advisory display SmartPilot® view in the assessment of anesthetic depth in low risk gynecological surgery patients: a randomized controlled trial
Get PDFBackground: Assessment of appropriate anesthetic depth is crucial to prevent harm to patients. Unnecessary deep anesthesia can be harmful, potentially causing acute renal failure, myocardial injury, delirium, and an increased mortality rate. Conversely, too light anesthesia combined with muscle relaxants can result in intraoperative patient awareness and lead to serious psychological trauma. This trial aimed to ascertain the efectiveness of the advisory display SmartPilot View (SPV), as a supplemental measure in the assessment of anesthetic depth in low risk gynecological surgery patients. The hypothesis was that the use of the SPV would increase the precision of assessment, and result in a higher mean arterial pressure. Methods: This trial used a randomized, controlled, single-blind design with a homogeneous sample. Patients undergoing minor, low risk gynecological surgery were randomly assigned to two groups: a test group wherein current standards were supplemented with the advisory display SPV and a control group assessed using only the current standards. Female patients aged between 18 and 75 years with American Society of Anesthesiologists Physical Status Classifcation System scores of 1–3 undergoing planned general anesthesia using the total intravenous anesthetic method, combining propofol and remifentanil, were included. The exclusion criteria included a body mass index≥35 kg/m2 , a history of alcoholism, drug intake afecting propofol and remifentanil dynamics, and inability to consent. The independent sample t-test and chi-square test or Fisher’s exact test were used to assess the statistical signifcance of diferences between the two groups. Results: A total of 114 patients were included in the analysis (test group n=58, control group n=56). No signifcant diferences in the mean arterial pressure, heart rate, bispectral index, extubation delay, or post-anesthesia care unit stay were found between groups. Conclusions: The addition of the advisory display SmartPilot® View to current standards in the evaluation of anesthetic depth had no signifcant efect on the outcome. Trial registration: The trial was registered on January 16th 2019 with ClinicalTrials.gov (ref: NCT03807271).The trial was funded by Innlandet Hospital Trust and the Norwegian University for Science and Technology (NTNU). The funders had no role in the design of the study, data collection, analysis, interpretation of the data or writing the manuscript.publishedVersio
Psychometric properties of the person-centred coordinated care experience questionnaire (P3CEQ) in a Norwegian radiotherapy setting
Get PDFThe number of older adults with cancer is increasing. Radiotherapy is an important treatment modality for cancer and may cause side effects and distress. Patient-reported experience measures aim to measure patients’ experiences with health care. This can help healthcare services to improve in line with patients’ needs. To assess how Norwegian patients receiving radiotherapy experience their care, a valid and reliable tool is required. We selected the person-centred coordinated care experience questionnaire as a tool. Objective The aim of the study is to validate the Norwegian version of the person-centred coordinated care experience questionnaire in a radiotherapy setting. Methods A feasibility study of the person-centred coordinated care experience questionnaire and a cross-sectional study—testing psychometric properties of the questionnaire in a Norwegian radiotherapy setting—were conducted. Participants were recruited from two different hospitals in Norway. Patient characteristics and item scores are described using descriptive statistics. We performed an exploratory factor analysis and applied principal component analysis with a varimax rotation. Cronbach’s α was used to assess internal consistency. Results In total, 24 patients participated in the feasibility test, and 176 were included in the cross-sectional study where we explored the psychometric properties of the person-centred coordinated care experience questionnaire. Three factors were identified. Internal consistency was established for the 10-item scale, with Cronbach’s α = 0.698. Conclusions Conclusions must consider the Norwegian setting and healthcare context. We found that the Norwegian version of the person-centred coordinated care experience questionnaire is a relevant, valid and reliable tool to provide insight into different areas of patients’ experiences upon receiving radiotherapy. However, further testing on a larger sample is necessitated. © The Author(s) 2022. Published by Oxford University Press on behalf of International Society for Quality in Health Care. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.Psychometric properties of the person-centred coordinated care experience questionnaire (P3CEQ) in a Norwegian radiotherapy settingpublishedVersio
En mann i 30-årene med gjenta hjerneabscesser
Get PDFBackground: Brain abscess is a life-threatening condition. Congenital cardiovascular malformations can create right-to-left shunting and be an underlying cause.
Case presentation: A young man was admitted due to headache and deteriorating general condition. He had a history of a surgically treated brain abscess 19 years earlier. Investigations now showed a new brain abscess. The patient was operated and received a peripherally inserted central catheter in his left arm for antibiotic treatment. A chest X-ray showed abnormal positioning of the catheter lying in a persistent left superior vena cava. One day later he experienced headache and photophobia. MRI showed reoccurrence of the brain abscess and he was reoperated. Persistent left superior vena cava was considered to be the cause of the brain abscesses and he underwent endovascular embolisation and placement of a vascular plug in his left superior vena cava.
Interpretation: The oxygen-rich pulmonary circulation and its immune system make it difficult for anaerobic bacteria to pass to the arterial side. In most cases persistent left superior vena cava drains into the right atrium and is asymptomatic. In 10 % of patients the persistent left superior vena cava drains directly to the left atrium and gives a right-to-left shunt. This may cause arterial bacteraemia and brain abscesses.publishedVersio
Association between depression symptoms and moderately increased levels of the inflammation marker albuminuria is explained by age and comorbidity
Get PDFThe study aimed to examine whether there are associations between depression symptoms and levels of the inflammation marker albuminuria. The 8303 participants in this cross-sectional study were subjects from the second survey of the Trøndelag Health Study (HUNT, Norway). Depression symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS). Logistic regression analysis was performed to estimate the odds ratio (OR) for moderately increased albuminuria (ACR ≥ 3.0 mg/mmol) according to different HADS-depression (D) subgroups and -scores. Unadjusted ORs for moderately increased albuminuria were significantly increased in those with HADS-D ≥ 8 (OR 1.27, 95% CI 1.05-1.54, p = 0.013) and HADS-D ≥ 11 (OR 1.59, 95% CI 1.19-2.14, p = 0.002). After adjusting for age and sex, only HADS-D ≥ 11 was significantly associated with ACR ≥ 3.0 mg/mmol (OR 1.46, 95% CI 1.08-1.98, p = 0.014), and after multivariable adjustments for cardiovascular risk factors and comorbidity, there were no significant associations. However, adjusting for the interaction between age and HADS-D strengthened the association in linear regression models. The positive and significant association between moderately increased albuminuria and symptoms of depression found in unadjusted analyses weakened and disappeared after adjustments. Although individuals with depressive symptoms had albuminuria more often than individuals without such symptoms, and the association seemed to change with age, albuminuria may reflect other comorbidity and inflammation conditions than the depression symptomatology measured in this study. © 2022. The Author(s). Tis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Te images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.publishedVersio
Development of quantitative assay for simultaneous measurement of purine metabolites and creatinine in biobanked urine by liquid chromatography-tandem mass spectrometry
Get PDFPurine metabolism is essential for all known living creatures, including humans in whom elevated serum concentration of purine break-down product uric acid (UA) is probably an independent risk factor for mortality, type 2 diabetes and cardiovascular events. An automated multiplex assay that measures several purine metabolites could therefore prove useful in many areas of medical, veterinary and biological research. The aim of the present work was to develop a sensitive LC-MS/MS method for simultaneous quantitation of xanthine, hypoxanthine, UA, allantoin, and creatinine in biobanked urine samples. This article describes details and performance of the new method studied in 55 samples of human urine. Archival sample preparation and effect of storage conditions on stability of the analytes are addressed. The intra-day and inter-day coefficients of variation were small for all the analytes, not exceeding 1% and 10%, respectively. Measurements of UA and creatinine in biobanked urine showed good agreement with values obtained using routine enzymatic assays on fresh urine. Spearman's correlation coefficients were 0.869 (p < .001) for creatinine and 0.964 (p < .001) for UA. Conclusion: the newly developed LC-MS/MS method allows reliable quantitative assessment of xanthine, hypoxanthine, allantoin, UA and creatinine. The proposed pre-analytical processing makes the method suitable for both fresh and biobanked urine stored frozen at -80 °C for at least 5.5 years. Keywords: Liquid chromatography; allantoin; biological specimen bank; creatinine; hydrophilic interaction; hypoxanthine; mass spectroscopy; purines; reference ranges; solubility; uric acid; urine; xanthine.The study has been funded by the following: 1. Helse Nord research foundation, 2017, project number: HNF1388-17. 2. Helse Nord research foundation, 2018, project number: HNF1430-18. 3. Familien Blix Fond, Project title: URIC ACID IN HEART AND KIDNEY DISEASE: development of new diagnostics and treatment. 4. UiT – The Arctic University of Norway and the Tromsø Research Foundation [Grant no. 311333/A22349].publishedVersio