The use of low-value imaging: the role of referral practice and access to imaging services in a representative area of Norway.

Background: Even though imaging is essential to modern medicine, some examinations are of low value as they do not lead to any change in the management of the patient. The Choosing Wisely (CW) campaign aims to reduce the use of such services. In the Norwegian version of CW, specific magnetic resonance imaging (MRI) of the head, lower back, and knee are amongst others identified as potential low-value examinations.

Exploring sustainable care pathways - a scoping review.

Background: Patients with mental health problems experience numerous transitions into and out of hospital.

Aim: The review studies assessing clinical care pathways between psychiatric hospitalization and community health services.

Methods: We used publications between 2009-2020 to allow a broad scoping review of the published research.

Ethical issues with geographical variations in the provision of health care services.

Geographical variations are documented for a wide range of health care services. As many such variations cannot be explained by demographical or epidemiological differences, they are problematic with respect to distributive justice, quality of care, and health policy. Despite much attention, geographical variations prevail.

Managing the moral expansion of medicine.

Science and technology have vastly expanded the realm of medicine. The numbers of and knowledge about diseases has greatly increased, and we can help more people in many more ways than ever before. At the same time, the extensive expansion has also augmented harms, professional responsibility, and ethical concerns.

An apprenticeship model in the training of psychotherapy students. Study protocol for a randomized controlled trial and qualitative investigation.

Background: One approach towards advancing the quality of mental health care is to improve psychotherapists' skills through education and training. Recently, psychotherapy training has benefitted from adapting training methods from other professions (e.g.

Mode of Application of Peracetic Acid-Based Disinfectants has a Minimal Influence on the Antioxidant Defences and Mucosal Structures of Atlantic Salmon () Parr.

Peracetic acid (PAA) is an oxidative disinfectant with a broad spectrum of antimicrobial activity and low environmental impact. In this study, we investigated the physiological impacts of PAA application in Atlantic salmon () parr reared in freshwater recirculating aquaculture systems over a 4-week period. PAA at a target concentration of 1 mg/L was administered either in pulse (every 3 days) or continuous.

Reducing low-value radiological services in Norway -a qualitative multi-professional study on measures and facilitators for change.

Background: Overuse, underuse, and significant variation in the utilisation of radiological services are well documented in the literature. Several radiological examinations are identified as low-value examinations as they do not lead to a change in diagnosis or course of treatment. Even so, such examinations are frequently performed.

Improving public cancer care by implementing precision medicine in Norway: IMPRESS-Norway.

Background: Matching treatment based on tumour molecular characteristics has revolutionized the treatment of some cancers and has given hope to many patients. Although personalized cancer care is an old concept, renewed attention has arisen due to recent advancements in cancer diagnostics including access to high-throughput sequencing of tumour tissue. Targeted therapies interfering with cancer specific pathways have been developed and approved for subgroups of patients.

Unimolecular Decomposition Reactions of Picric Acid and Its Methylated Derivatives─A DFT Study.

To handle energetic materials safely, it is important to have knowledge about their sensitivity. Density functional theory (DFT) has proven a valuable tool in the study of energetic materials, and in the current work, DFT is employed to study the thermal unimolecular decomposition of 2,4,6-trinitrophenol (picric acid, PA), 3-methyl-2,4,6-trinitrophenol (methyl picric acid, mPA), and 3,5-dimethyl-2,4,6-trinitrophenol (dimethyl picric acid, dmPA). These compounds have similar molecular structures, but according to the literature, mPA is far less sensitive to impact than the other two compounds.

Characterizing and quantifying low-value diagnostic imaging internationally: a scoping review.

Background: Inappropriate and wasteful use of health care resources is a common problem, constituting 10-34% of health services spending in the western world. Even though diagnostic imaging is vital for identifying correct diagnoses and administrating the right treatment, low-value imaging-in which the diagnostic test confers little to no clinical benefit-is common and contributes to inappropriate and wasteful use of health care resources. There is a lack of knowledge on the types and extent of low-value imaging.

What can we learn from the SARS-COV-2 pandemic about the value of specific radiological examinations?

Background: The SARS-COV-2 pandemic provides a natural intervention to assess practical priority setting and internal evaluation of specific health services, such as radiological services. Norway makes an excellent case as it had a very low infection rate and very few cases of COVID-19. Accordingly, the objective of this study is to use the changes in performed outpatient radiological examinations during the first stages of the SARS-COV-2 pandemic to assess the practical evaluation of specific radiological examinations in Norway.

Interventions to reduce low-value imaging - a systematic review of interventions and outcomes.

Background: It is estimated that 20-50% of all radiological examinations are of low value. Many attempts have been made to reduce the use of low-value imaging. However, the comparative effectiveness of interventions to reduce low-value imaging is unclear.

Between stability and change: Tensions in the Norwegian electric mobility transition.

Norway, where a majority of new cars sold are currently electric, has emerged as a rich location for studying transitions towards electric mobility. Such transitions have often been conceptualized through a Multi-Level Perspective (MLP), which generally designates the technology as a disruptive niche with potential to upend the obdurate and problematic automobilty regime. Drawing upon Actor-Network Theory (ANT), this article re-examines this designation and provides nuance to theories of sustainable transition.

Maternal bisphenol urine concentrations, fetal growth and adverse birth outcomes: A population-based prospective cohort.

Background: Exposure to bisphenols may affect fetal growth and development. The trimester-specific effects of bisphenols on repeated measures of fetal growth remain unknown. Our objective was to assess the associations of maternal bisphenol urine concentrations with fetal growth measures and birth outcomes and identify potential critical exposure periods.

ESPEN practical guideline: Clinical Nutrition in cancer.

Background: This practical guideline is based on the current scientific ESPEN guidelines on nutrition in cancer patients.

Methods: ESPEN guidelines have been shortened and transformed into flow charts for easier use in clinical practice. The practical guideline is dedicated to all professionals including physicians, dieticians, nutritionists and nurses working with patients with cancer.

Can a Peritoneal Conduit Become an Artery?

Objective: Current vascular grafts all have limitations. This study examined peritoneum as a potential graft material and the transfer of peritoneum into a functional artery like conduit after end to end anastomosis into the common carotid artery of sheep. The aim was to investigate whether implantation of a peritoneal tube into the arterial tree results in a structure with function, histological findings, and gene expression like an artery, and whether such arterialisation occurs through a conversion of the phenotype of peritoneal cells or from host cell migration into the implant.

Systemic Problem Structuring in a Complex Hospital Environment using Viable System Diagnosis - Keeping the Blood Flowing.

This article presents the application of the systemic problem structuring approach Viable System Diagnosis (VSD) within the Department of Orthopedic Surgery in a large hospital in Norway. It explains why systemic thinking is relevant to this uniquely complex form of human organization. The department was coping with systemic dysfunction and VSD was chosen because previous applications demonstrated VSD excels at diagnosis of what is causing dysfunction.

The self-management work of food hypersensitivity.

Background: Food hypersensitivity (FH) has received considerable attention in the scientific community in recent years. However, little attention has been given to the efforts people make to manage their FH. We aimed to explore these efforts by using Normalization Process Theory, which is a conceptual framework formerly used to describe the self-management 'work' of long-term conditions.

Maternal phthalate urine concentrations, fetal growth and adverse birth outcomes. A population-based prospective cohort study.

Importance: Exposure to phthalates may affect fetal growth, but previous studies are inconsistent and have not explored the trimester-specific effects of phthalates on repeated measures of fetal growth.

Objective: To assess the associations of maternal phthalate metabolites urine concentrations with fetal growth measures and birth outcomes and identify potential windows of vulnerability to exposure.

Design: Population-based prospective cohort study, the Generation R Study (2002-2006).