Helse Førde

BackgroundThe Norwegian Quality of Life Study (NQoLS) was established to inform public health policy by assessing self-reported health (SRH) and quality of life (QoL) outcomes across the general population, identifying factors that influence these outcomes, and highlighting vulnerable groups. In this study, we assessed the psychometric properties of the NQoLS measures and applied network analysis to explore the structural relationships among outcome variables.MethodsThe 2022 NQoLS is a cross-sectional study that included 15,148 adults from the general adult Norwegian population. No exclusion criteria were specified beyond the requirement that participants have a registered address, email, and/or phone number. The study assessed SRH and QoL through single- and multi-item measures across physical, psychological, and social domains. The psychometric evaluation included descriptive statistics, reliability testing, confirmatory factor analysis, and correlation analysis, followed by a network analysis to map how outcomes connect and cluster.ResultsMeasures generally demonstrated acceptable reliability and validity. Model fit for multi-item scales was generally adequate following minor modifications. Network analysis identified a central cluster, including the Satisfaction with life scale, Hopkins Symptom Checklist-5, and Satisfaction with psychological health. These indicators were highly connected and structurally central. In contrast, physical health variables, including Satisfaction with physical health, Pain and discomfort, and General health, were more weakly connected and positioned at the network periphery. The sensitivity analysis, stratified by language preference, yielded results consistent with those of the entire sample.ConclusionsThe NQoLS provides a foundation for mapping SRH and QoL. Most measures worked well, though a few could be fine-tuned for a better fit and sensitivity. Based on our assessment and the structure revealed by the network analysis, physical health appears to be relatively underrepresented in the current survey, suggesting a potential area for future enhancement.

PurposeThe purpose of this study is to analyse geographic variation in rates of patients and service utilisation for persons with substance use disorders (SUD) across Norwegian hospital catchment areas from 2017 to 2021, considering both outpatient and Inpatient care across substance use diagnosis.Method and materialThis registry-based study used data from the Norwegian Patient Registry and Statistics Norway, covering 58,889 unique patients and 121,495 patient-years. Adjusted for age and sex this material yields a national SUD treatment rate of 14.0 per 1,000 over five years, on average 5.8 per year with a declining annual rate from 6.1–5.5. Analyses included diagnoses related to alcohol, opioids, cannabis, and other substances, excluding tobacco and opioid maintenance treatment. Three variation measures—Extreme Quotient (EQ), Coefficient of Variation (CV), and Systematic Component of Variation (SCV)—were used to assess disparities.ResultsGeographic variation in SUD treatment rates ranged from 3.6 to 11.5 per 1,000 inhabitants reaching a threefold difference between areas (EQ = 3.1). We found that SCV values (8.7–23.5) and SCV 5–95 (5.7–14.5) for diagnose groups and service type consistently exceeded the threshold of high and extremely high variation. Procurement of private services increased capacity significantly but did not markedly reduce variation. Variation remained extremely high even when the highest and lowest rates were excluded (SCV 13.8, SCV5–95 11.3).ConclusionPatient rates in SUD treatment fell every year between 2017–2021 and the geographic variation was high to extremely high. Treatment of substance use disorders in Norway may require stronger regional governance to reduce unwarranted variation and ensure equitable access to treatment. Substantial reductions in variation can be achieved by i) redistributing capacity among catchment areas, ii) purchasing fewer and shorter Inpatient stays and iii) increasing outpatient treatment. In addition, such means could dramatically increase patient rates. There is a need for more consistent clinical practices and adjusted capacity for treating specific substance diagnoses.Supplementary informationThe online version contains supplementary material available at 10.1007/s43999-025-00084-y.

Deep learning-based segmentation has evolved to a powerful strategy for automatically annotating glomeruli in kidney biopsy images. However, since any artificial intelligence can make mistakes, strategies for identifying and correcting faulty annotations are often indispensable. Yet, how can such a validation be achieved without the laborious task of a pathologist manually checking every single image? To address this issue, the current project performed an extensive study on the use of shape analysis to automatically evaluate the glomerular annotations produced by deep-learning segmentation. Examining a large repertoire of shape descriptors on over 168000 glomerular predictions, the study found that morphometry could successfully highlight and distinguish between three different types of segmentation inconsistencies. In addition, using shape descriptors to rank segmentation annotations, it was possible to obtain a distinct enrichment of errors on the leading edge of the ranking, implying that pathologists would only have to inspect and correct the most suspicious fraction of all annotations. Ultimately, the study suggested a panel of three shape descriptors that enabled an efficient enrichment of all errors, respective or irrespective of error type. In summary, the work demonstrates the methodological aspects and benefits of shape analysis for evaluating glomerular segmentation results. We are convinced that, by applying such a strategy for detecting segmentation errors, it will be possible to approach a more time-efficient correction of deep learning-derived glomerular annotations.

ABSTRACTThe aim of this systematic literature review (SLR) of reviews was to update the evidence, established in a 2017 SLR, on the impact of obesity and weight loss by various interventions on health‐related quality of life (HRQoL). In total, eight SLRs and/or meta‐analyses published since 2017 were identified. The results consistently demonstrated a negative association between obesity and HRQoL, with some evidence suggesting poorer HRQoL in people with adverse metabolic profiles. In addition to substantial weight or body mass index reduction, metabolic and bariatric surgery (MBS) or endoscopic bariatric therapies resulted in significant and clinically relevant HRQoL improvements, with pronounced and persistent effects on the physical components in particular. HRQoL typically improved within 1–2 years after MBS and stabilised or deteriorated while remaining above baseline in subsequent years, likely due to weight regain. Evidence for the benefits of exercise interventions on HRQoL was inconclusive. Notably, no SLRs on anti‐obesity medications were identified, limiting conclusions on this emerging treatment area. This updated SLR expands on previous findings from the 2017 SLR, providing additional insights into underexplored areas, including the role of metabolic profiles in HRQoL and trends of HRQoL after MBS. Evidence synthesis remains challenging due to heterogeneity in HRQoL measurements used in this field.

Denne artikkelen undersøker sykepleieres opplevelse av hvordan krav og ressurser former deres arbeidshverdag og psykiske helse innen psykisk helsevern (PHV) og tverrfaglig spesialisert rusbehandling (TSB). Studien er basert på kvalitative intervjuer med seks sykepleiere med arbeidsforhold innen PHV og TSB. Studien viser at jobbkrav i form av høyt ansvar og mange samtidige arbeidsoppgaver, emosjonelle påkjenninger og organisatoriske utfordringer fører til frustrasjon, redusert motivasjon og slitenhet. Jobbressurser som et godt arbeidsmiljø og nærhet til ledelse kan moderere jobbkravene og bidra til mestring, mening og trygghet. Likevel viser studien at jobbkravene til sykepleiere i PHV og TSB langt overgår jobbressursene. Innsiktene fra studien kan benyttes til å forebygge arbeidsrelaterte psykiske helseplager og redusere frafallet av nødvendig helsepersonell.

In Denmark, the parathyroidectomy rate due to primary hyperparathyroidism has increased over the last decade. Primary hyperparathyroidism leads to a range of diffuse neuromuscular symptoms, bone loss and kidney stones. Tertiary hyperparathyroidism can develop in secondary hyperparathyroidism from chronic renal failure. The predominant definitive treatment for both primary and tertiary hyperparathyroidism is surgery, generally preceded by localization imaging and usually with intraoperative parathyroid hormone assessment. This publication summarizes in this review the updated management of these diseases.

Abstract Exclusive breastfeeding the first six months corrected age (CA) is recommended for premature infants with very low birthweight (< 1500 g) (VLBW). As an adequate micronutrient status is important for psychomotor development and growth, we have investigated whether this regime provide an adequate B vitamin status in premature infants with VLBW from term to 12 months CA.In consecutively recruited infants born premature with VLBW, levels of vitamin B12 (cobalamin), B6 (pyridoxal 5´-phosphate, PLP), B2 (riboflavin), folate, and the metabolic markers, total homocysteine (tHcy) and methylmalonic acid (MMA), were determined at term, 2, 6 and 12 months CA.One third of the infants were exclusively breastfed to 6 months CA, and these had lower cobalamin, PLP and riboflavin concentrations compared to formula fed infants, and 80% had tHcy concentrations ≥ 6.5 µmol/L indicative of cobalamin deficiency during the first 6 months of CA. Severe deficiency of one or more B vitamins was evident in 3–9% of the infants at each time point during the first 12 months of CA. Only a minority used multivitamin supplementation, and this was associated with higher PLP and riboflavin levels.Exclusive breastfeeding to 6 months CA, with inadequate multivitamin supplementation and no specific recommendation for introduction of solid food, is not providing an adequate B vitamin status in infants born premature with VLBW. Nutrition should be optimized and B vitamin status should be checked regularly during the first year of life in premature VLBW infants.

BackgroundIn recent decades, there has been a shift in many substance use disorder (SUD) treatment settings toward routine outcome monitoring via clinical feedback systems (ROM/CFS). This move toward frequent measurement throughout the treatment course raises new questions about which variables should be measured in the evolving treatment process. In particular, there seems to be a lack of knowledge concerning self-report measures’ ability to capture patients’ subjective experiences relevant for treatment outcome and process. This qualitative study explored patients’ perspectives and reasoning processes to investigate how feedback systems can be adapted to track progress in the treatment of SUDs.MethodsPatients (N = 13) in specialized SUD treatment were interviewed while they responded to items from a feedback system used for routine outcome monitoring in that treatment setting. The approach to data collection was inspired by cognitive interviewing and the analysis was based on a descriptive and interpretative approach.ResultsThe findings provide support for monitoring of several outcome variables, such as behavioral and experiential symptoms, as well as variables relevant to everyday functioning. However, we also found that several aspects related to the subjective experience of being in an ongoing process of change provided important context for the various outcome variables during treatment. The analysis resulted in three themes reflecting this duality and issues that appeared important to consider together when adapting clinical feedback systems to longitudinal monitoring in SUD treatment: 1) The necessity of capturing both preliminary outcomes and the attitude toward the ongoing process of change; 2) The necessity of capturing both the passive and the active role of the patient; and 3) The necessity of capturing both objective and subjective change constructs. Related to each theme we describe the participants’ different interpretations of specific items and how different item characteristics facilitated meaningful measurement or not.ConclusionsThe findings expand the knowledge base and strengthen the qualitative foundation for longitudinal monitoring of SUDs and have implications for how feedback measures should be designed. The study also provides knowledge about the process of change and highlights patient experiences that are worth paying attention to when tracking progress in treatment of SUDs.

The Spirit's Active Presence in the Eucharist: Reflections on the Pentecostal View of the Eucharist The Lord’s Supper has been central to the Christian church since its institution by Jesus Christ. Within Pentecostal tradition, it has predominantly been understood as a symbolic memorial meal. In recent decades, however, several theologians have questioned the coherence between this memorialist interpretation and broader Pentecostal theology and practice. This article explores a range of theological perspectives from recent scholarship and invites renewed reflection on the Pentecostal understanding of the Lord’s Supper. The aim is to contribute to a more integrated and theologically robust view of the Lord’s Supper within a Norwegian Pentecostal context. The article argues for a pneumatological real presence—affirming the active and tangible presence of the Holy Spirit in the Lord’s Supper—and suggests that a more sacramental approach is both compatible with and enriching to Pentecostal faith and practice.