Search

• Acknowledging complexity through advanced knowledge synthesis, competence of the context, and broad and strong stakeholder involvement is crucial is crucial to manage task complexity. • Clear consensus-based criteria for selecting low-value imaging procedures are key. • Having a clear target group is important. • Stakeholder engagement is crucial to ascertain intervention relevance and compliance. • Active and well-motivated intervention collaborators is a necessary but not sufficient condition. • It is crucial to pay close attention to the mechanisms of low-value imaging and the barriers to reduce it. Substantial overuse of health care services is identified and intensified efforts are incited to reduce low-value services in general and in imaging in particular. To report crucial success factors for developing and implementing interventions to reduce specific low-value imaging examinations based on a case study in Norway. Mixed methods design including one systematic review, one scoping review, implementation science, qualitative interviews, content analysis of stakeholders' input, and stakeholder deliberations. The description and analysis of an intervention to reduce low-value imaging in Norway identifies six general success factors: 1) Acknowledging complexity: advanced knowledge synthesis, competence of the context, and broad and strong stakeholder involvement is crucial to manage de-implementation complexity. 2) Clear consensus-based criteria for selecting low-value imaging procedures are key. 3) Having a clear target group is critical. 4) Stakeholder engagement is essential to ascertain intervention relevance and compliance. 5) Active and well-motivated intervention collaborators is imperative. 6) Paying close attention to the mechanisms of low-value imaging and the barriers to reduce it is decisive. Reducing low-value imaging is crucial to increase the quality, safety, efficiency, and sustainability of the health services. Reducing low-value imaging is a complex task and paying attention to specific practical success factors is key. [Display omitted] [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Soluble urokinase-type plasminogen activator receptor (suPAR) is a novel inflammatory marker, associated with lifestyle diseases and mortality risk. No studies have investigated whether physical activity may reduce suPAR levels using a randomized controlled design.Design and Methods: suPAR and C-reactive protein (CRP) levels were determined in blood samples from a previous randomized controlled trial with Pakistani immigrants in Norway, 2008. The study included physically inactive men that were randomized to an intervention group (supervised group exercises) or a control group and followed for 5 months. A linear regression model was used and adjusted for age, inactivity level at baseline, and mean difference in CRP levels.Results: Overall, 80 and 53 participants were included in the intervention and control group, respectively. Obesity and smoking were associated with higher suPAR levels at baseline. The intervention group had a mean suPAR level of 2.65 (95% CI=2.48-2.78)ng/mL at baseline compared to 2.80 (95% CI=2.65-2.95)ng/mL at post-test, and thereby significantly increased suPAR levels after intervention (p=0.02). In the control group, mean suPAR level significantly increased from 2.93 (95% CI=2.68-3.16)ng/mL at baseline to 3.09 (95% CI=2.81-3.38)ng/mL at post-test (p=0.04). When comparing change from baseline to post-test in suPAR levels for the intervention group versus the control group, no significant change in the unadjusted model was found (β=-0.002, 95% CI=-0.219-0.215). Similar results were found for CRP levels.Conclusion: There was no change in suPAR levels after regular exercise compared to a control group implying that suPAR rather reflects underlying harmful inflammatory responses associated with disease development. [ABSTRACT FROM AUTHOR]