Search

Information about the contagiousness of new SARS-CoV-2 variants, including the alpha lineage, and how they spread in various locations is essential. Country-specific estimates are needed because local interventions influence transmissibility. We analysed contact tracing data from Oslo municipality, reported from January through February 2021, when the alpha lineage became predominant in Norway and estimated the relative transmissibility of the alpha lineage with the use of Poisson regression. Within households, we found an increase in the secondary attack rate by 60% (95% CI 20–114%) among cases infected with the alpha lineage compared to other variants; including all close contacts, the relative increase in the secondary attack rate was 24% (95% CI −6%−43%). There was a significantly higher risk of infecting household members in index cases aged 40–59 years who were infected with the alpha lineage; we found no association between transmission and household size. Overall, including all close contacts, we found that the reproduction number among cases with the alpha lineage was increased by 24% (95% CI 0%−52%), corresponding to an absolute increase of 0.19, compared to the group of index cases infected with other variants. Our study suggests that households are the primary locations for rapid transmission of the new lineage alpha. [ABSTRACT FROM AUTHOR]

A Structural Equations Modeling analysis of multiple groups often involves specification of cross-group parameter equality constraints. In this paper, we present a technique for estimating the differences and equalities in parameters between groups using L1-penalized estimation (also known as the Lasso). We present the general model formulation and provide an algorithm for estimating the parameters across a range of penalization levels and a procedure for determining the amount of penalization. We also provide two case studies, one with a model including only observed variables, and one with a model with latent variables. Further, we conduct a simulation study to investigate some properties of the method. [ABSTRACT FROM AUTHOR]

Objectives: The effect of vitamin D supplementation on the disease course of multiple sclerosis (MS) is not established. Neurofilament light chain (NFL) is a sensitive marker of axonal degeneration. The aim of this study was to establish whether high‐dose vitamin D supplementation reduces serum levels of NFL. Materials and Methods: We have performed a 96 weeks placebo‐controlled randomized study of weekly supplementation with 20 000 IU vitamin D3 in 71 patients with relapsing remitting MS (RRMS). Serum levels of NFL were measured at baseline, week 48 and week 96 with a single molecule (Simoa) assay in 69 of these patients. Results: Serum levels of 25‐hydroxyvitamin D more than doubled in the vitamin D group. Compared to placebo, vitamin D supplementation had no overall effect on the change in serum levels of NFL from baseline (P = 0.93 at week 48 and P = 0.56 at week 96). In the subgroup of patients not receiving disease‐modifying therapy, NFL decreased by 30.9% to week 48% and 32.6% to week 96 from baseline in the vitamin D group as compared to the placebo group (P = 0.06 for both time points). Conclusion: With a possible exception for patients not treated with disease‐modifying drugs, weekly supplementation with 20 000 IU vitamin D3 did not affect NFL levels in these RRMS patients. [ABSTRACT FROM AUTHOR]

Objective: In Norway, diagnoses from specialist health care visits, drug prescriptions, and causes of deaths are registered in compulsory health registers. We aimed to determine amyotrophic lateral sclerosis (ALS) prevalence from 2009 to 2015 by combining these registers. Methods: We validated the Norwegian Patient Registry (NPR) through hospital files, and linked it with the Norwegian Cause of Death Registry and the Norwegian Prescription Database. Poisson regression models were fitted for estimating gender ratios, time trends and possible interactions. Similar models were used for mortality data subtracted from the dataset. Results: Eleven percent of patients with at least one ALS-related entry in NPR did not have ALS. ALS prevalence could nevertheless be reliably estimated through ascertaining cases identified in two separate registers, or with at least two entries in NPR with first entry within four years prior to prevalence date. ALS prevalence remained stable, and was 7.6/100,000 (95% CI 6.9-8.4) at 31st December 2015. Mean male:female ratio was higher for prevalence (1.8; 95% CI 1.6-2.0) than for mortality (1.5; 95% CI 1.2-1.8) (p = 0.04). There were also significant regional differences in prevalence (p < 0.01) but not in mortality. Conclusions: Norwegian compulsory health registers provide reliable tools for ALS surveillance, and suggest gender and regional differences in survival after diagnosis. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate the implementation strategy used in the first-phase of implementation of the Illness Management and Recovery (IMR) programme, an intervention for adults with severe mental illnesses, in nine mental health service settings in Norway. Methods: A total of 9 clinical leaders, 31 clinicians, and 44 consumers at 9 service settings participated in the implementation of IMR. Implementation was conducted by an external team of researchers and an experienced trainer. Data were gathered on fidelity to the intervention and implementation strategy, feasibility, and consumer outcomes. Results: Although the majority of clinicians scored within the acceptable range of high intervention fidelity, their participation in the implementation strategy appeared to moderate anticipated future use of IMR. No service settings reached high intervention fidelity scores for organizational quality improvement after 12 months of implementation. IMR implementation seemed feasible, albeit with some challenges. Consumer outcomes indicated significant improvements in illness self-management, severity of problems, functioning, and hope. There were nonsignificant positive changes in symptoms and quality of life. Conclusions: The implementation strategy appeared adequate to build clinician competence over time, enabling clinicians to provide treatment that increased functioning and hope for consumers. Additional efficient strategies should be incorporated to facilitate organizational change and thus secure the sustainability of the implemented practice. Trial registration ClinicalTrials.gov NCT02077829. Registered 25 February 2014. [ABSTRACT FROM AUTHOR]

Objective: To determine the effectiveness of the Targeted Interdisciplinary Model for Evaluation and Treatment of Neuropsychiatric Symptoms (TIME) for treatment of moderate to severe agitation in people with dementia.Methods: In a single-blinded, cluster randomized controlled trial in 33 nursing homes (clusters) from 20 municipalities in Norway, 229 patients (104 patients in 17 nursing homes and 125 patients in 16 nursing homes) were randomized to an intervention or control group, respectively. The intervention group received TIME, and the control group received a brief education-only intervention. TIME is an interdisciplinary multicomponent intervention and consists of a comprehensive assessment of the patient with the goal to create and put into action a tailored treatment plan. The primary outcome was the between-group difference in change at the agitation/aggression item of the Neuropsychiatric Inventory Nursing Home version between baseline and 8 weeks. Secondary outcomes were the between-group difference in change at the agitation/aggression between baseline and 12 weeks in other neuropsychiatric symptoms, quality of life, and use of psychotropic and analgesic medications between baseline and 8 and 12 weeks.Results: A significant between-group difference in reduction of agitation at both 8 weeks (1.1; 95% confidence interval: 0.1-2.1; p = 0.03) and 12 weeks (1.6; 95% confidence interval: 0.6-2.7; p = 0.002) in favor of the TIME intervention was found.Conclusion: The implementation of TIME resulted in a significant reduction of agitation among nursing homes patients with dementia. These results should inform training programs for care staff in Norway and internationally. [ABSTRACT FROM AUTHOR]