Helsebibliotekets Research Archive
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Mayak health report. Dose assessments and health of riverside residents close to "Mayak" PA
No full textRapporten presenterer doseestimat for befolkningen langs elven Techa som har blitt utsatt for radioaktive utslipp fra Mayak Production Association (Mayak PA). I tillegg blir helseeffekter fra estimerte doser, samt utvikling i den valgte metoden for å beregne stråledoser, diskutert.This report presents dose estimates for specifi c populations along the Techa River which have been affected by radioactive discharges originating from activities at Mayak Production Association (Mayak PA). Likely health effects resulting from estimated doses are briefly discussed as well as recent developments in the chosen dose estimation methodology
Local and distant effects of isolated calf muscle lengthening in children with cerebral palsy and equinus gait.
No full textPURPOSE: The purpose was to assess the local and distant effects of isolated calf muscle lengthening in ambulant children with cerebral palsy. METHODS: The study included fifteen ambulant children with cerebral palsy (nine with diplegia and six with hemiplegia), average age 8.8 years, Gross Motor Function Classification System (GMFCS) level I and II. None of the children had previously undergone orthopaedic surgery, apart from one child who had tendo-achilles lengthening (TAL) nine years earlier. All the children underwent pre and post-operative clinical examination and three-dimensional gait analysis (gait analysis). Twenty calf muscle lengthenings were performed, ten TAL and ten gastrocnemius recessions (GR). RESULTS: Post-operative ankle kinematics showed significant improvements in all parameters. Ankle power during push-off increased, but only significantly after TAL. Only one limb (5%) was over-corrected. Four limbs (20%) were under-corrected and one of these limbs remained in mild equinus position in stance. There was one recurrent equinus (5%) during the follow-up period of three years (range: 13-55 months). Distant effects on joints and segments were more marked in diplegia than in hemiplegia. Ten of 17 kinematic parameters distant from the ankle joint improved significant post-operatively when the preoperative values were 1SD below or above the mean of the normal material. There was no significant deterioration in any of the measured parameters. CONCLUSION: The improvement in ankle kinematics and kinetics supported the experience of other studies. The distant effects, which have previously not been evaluated in three planes, showed improvement in several kinematic parameters indicating that additional surgery in selected patients could be abandoned or delayed
Three decades (1978-2008) of Advanced Trauma Life Support (ATLS) practice revised and evidence revisited.
No full textABSTRACT: The Advanced Trauma Life Support (ATLS) Program was developed to teach doctors one safe, reliable method to assess and initially manage the trauma patient. The ATLS principles represents an organized approach for evaluation and management of seriously injured patients and offers a foundation of common knowledge for all members of the trauma team. After 3 decades of teaching (1978-2008) of ATLS worldwide one should intuitively perceive that the evidence for the effect of ATLS teaching on the improved management of the injured patient be well established. This editorial addresses aspects of trauma education with needs for further development of better evidence of best practice
A piglet model for detection of hypoxic-ischemic brain injury with magnetic resonance imaging.
No full textBACKGROUND: Early detection of hypoxic-ischemic (HI) injury in the asphyxic newborn is important because present prognostic factors are inadequate. Furthermore, therapeutic interventions may have additional benefit if initiated in time. PURPOSE: To assess whether the use of a combined protocol including conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), and proton MR spectroscopy (MRS) could detect pathological findings in a piglet model 7 hours after HI. MATERIAL AND METHODS: Ten piglets were submitted to HI for 30 min followed by reoxygenation with 21% O2 for 7 hours. MRI at 1.5T was done prior to and 7 hours after the HI. Single-voxel proton MRS was performed, and apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were measured in the basal ganglia. MRS identified N-acetylaspartate (NAA), choline (Cho), creatine (Cr), and lactate (Lac). Histology and microtubule-associated protein 2 (MAP-2) staining was performed in the basal ganglia at the end of the experiment. RESULTS: Compared to baseline, ADC, NAA/Cho, and NAA/Cr were significantly reduced after 7 hours (P<0.001, P=0.01, and P=0.05, respectively) and FA values were increased (P<0.025). The ratios of Lac/Cho and Lac/NAA were significantly higher after 7 hours compared to baseline (P<0.001). Presence of necrosis correlated well with reduced ADC (R(S)=0.91) and presence of Lac (R(S)=0.80). Histology and MAP-2 staining showed more than 90% necrosis in eight piglets, 60% in one piglet, and no necrosis in one piglet. CONCLUSION: Diffusion MRI and proton MRS can detect HI injury in the piglet brain 7 hours after hypoxia. DWI and MRS can be used to give useful prognostic information. This piglet model may potentially be used to mimic clinical situations and is suitable for further research investigating HI injury
Radioactivity in the Marine Environment 2006. Results from the Norwegian National Monitoring Programme (RAME)
No full textThis report presents results of monitoring of radioactivity in seawater and biota collected along the Norwegian coast, the Norwegian Sea and the Skagerrak in 2006. An overview of discharges from Norwegian sources and data concerning the long-range transport of radionuclides from European nuclear facilities is included
The clinicopathological and prognostic impact of 14-3-3 sigma expression on vulvar squamous cell carcinomas.
No full textBACKGROUND: 14-3-3 sigma promotes G2/M cell cycle arrest by sequestering cyclin B1-CDC2 complex in cytoplasm. Down-regulation of 14-3-3sigma, which has been demonstrated in various carcinomas, may contribute to malignant transformation. However, the exact role of 14-3-3sigma in the pathogenesis of vulvar carcinoma is not fully characterized, and the prognostic impact of 14-3-3sigma protein expression is still unknown. METHODS: We investigated the 14-3-3sigma expression in a series of 302 vulvar squamous cell carcinomas using immunohistochemistry and its associations with clinicopathological factors and clinical outcome. RESULTS: In cytoplasm, nucleus and cytoplasm/nucleus of vulvar carcinomas high 14-3-3sigma protein expression was found in 72%, 59% and 75% of the carcinomas, respectively, and low levels in 28%, 41% and 25% of the cases, respectively. High level of 14-3-3sigma in cytoplasm, nucleus and cytoplasm/nucleus was significantly correlated to large tumor diameter (p = 0.001, p = 0.002 and p = 0.001, respectively) and deep invasion (p = 0.01, p = 0.001 and p = 0.007, respectively). Variations of 14-3-3sigma protein expression were not associated to disease-specific survival. CONCLUSION: Our results indicate that 14-3-3sigma may be involved in the development of a subset of vulvar squamous cell carcinomas by down-regulation of 14-3-3sigma protein. Neither cytoplasmic nor nuclear level of 14-3-3sigma expression was associated with prognosis
Evidence-Informed Health Policy: using research to make health systems healthier
No full textA review of organisations that support the use of research evidence in developing\ud
guidelines, technology assessments, and health policy.\ud
Prepared for the WHO Advisory Committee on Health Research.\ud
A Final Report and Video Documentary SeriesBackground: • Over the past two years there has been a great deal of international\ud
discussion about how to harness health research more effectively in order\ud
to achieve the United Nations’ Millennium Development Goals as well as other\ud
national health goals in low- and middle-income countries. • Our objective was\ud
to identify organisations around the world, and especially in low- and middleincome\ud
countries, that are in some way successful or innovative in supporting the\ud
use of research evidence in the development of clinical practice guidelines, health\ud
technology assessments, and health policy, and to describe their experiences.\ud
Key messages from the report: • The study presents seven main implications\ud
for those establishing or administering organisations to produce clinical practice\ud
guidelines or health technology assessments, or organisations to support the use\ud
of research evidence in developing health policy: • 1. Collaborate with other organisations\ud
• 2. Establish strong links with policymakers and involve stakeholders\ud
in the work • 3. Be independent and manage conflicts of interest among those involved\ud
in the work • 4. Build capacity among those working in the organisation • 5. Use good methods and be transparent in the work • 6. Start small, have a clear audience and scope, and address important questions • 7. Be attentive to implementation considerations even if implementation is not a remit. • The study presents four main implications for the World Health Organisation and other international organisations: • 1. Support collaborations\ud
among organisations • 2. Support local adaptation efforts • 3. Mobilize support\ud
• 4. Create knowledge-related global public goods, including methods and evidence\ud
syntheses. Client: The report is prepared for the WHO Advisory Committee\ud
on Health Research. • Links to a Video Documentary Series about the cases\ud
described in the study are found in the appendix, page 104
Depression and anxiety in relation to catechol-O-methyltransferase Val158Met genotype in the general population: the Nord-Trøndelag Health Study (HUNT).
No full textBACKGROUND: The catechol-O-methyltransferase (COMT) gene contains a functional polymorphism, Val158Met, which has been linked to anxiety and depression, but previous results are not conclusive. The aim of the present study was to examine the relationship between the Val158Met COMT gene polymorphism and anxiety and depression measured by the Hospital Anxiety and Depression Scale (HADS) in the general adult population. METHODS: In the Nord-Trøndelag Health Study (HUNT) the association between the Val158Met polymorphism and anxiety and depression was evaluated in a random sample of 5531 individuals. Two different cut off scores (> or = 8 and > or = 11) were used to identify cases with anxiety (HADS-A) and depression (HADS-D), whereas controls had HADS-A <8 and HADS-D <8. RESULTS: The COMT genotype distribution was similar between controls and individuals in the groups with anxiety and depression using cut-off scores of > or = 8. When utilizing the alternative cut-off score HADS-D > or = 11, Met/Met genotype and Met allele were less common among men with depression compared to the controls (genotype: p = 0.017, allele: p = 0.006). In the multivariate analysis, adjusting for age and heart disease, depression (HADS-D > or = 11) was less likely among men with the Met/Met genotype than among men with the Val/Val genotype (OR = 0.37, 95% CI = 0.18-0.76). CONCLUSION: In this population-based study, no clear association between the Val158Met polymorphism and depression and anxiety was revealed. The Met/Met genotype was less likely among men with depression defined as HADS-D > or = 11, but this may be an incidental finding
Service quality in hospital wards with different nursing organization: nurses' ratings.
No full textAim. This paper is a report of a study to assess: (1) the relations between nursing organization models in hospital wards and nurses' perception of the quality of patient care and dimensions of the practice environment, and (2) if these relations were modified by variations in local conditions at the ward level. Background. Previous literature is inconclusive concerning what model of nursing organization maximizes the quality of nursing services. Method. A cross-sectional survey was carried out in a representative sample of Norwegian hospital wards in 2005. Intra-ward organization models were classified as: (1) Team leader (n = 30), characterized by extensive responsibilities for team leaders, (2) Primary nurse (n = 18), with extensive responsibilities for named nurses, and (3) Hybrid (n = 37), (1) and (2) combined. We prepared multilevel regression models using scales describing quality of patient care, learning climate, job satisfaction, and relationships with physicians as dependent variables. As independent variables, we used variables representing local ward conditions. Results. Eighty-seven wards and 1137 nurses (55% response rate) provided complete data. The ward level proportion of variance ranged from 0.10 (job satisfaction) to 0.22 (relationships with physicians). The univariate effect of organization models on quality ratings was not statistically significant. Introducing local ward conditions led to a statistically significant effect of primary nurse organization on relationships with physicians, and to a substantial proportional reduction in ward level variance, ranging from 32% (quality of patient care) to 24% (learning climate). Conclusion. Caution is needed about using service quality arguments when considering the possible benefits and drawbacks of different organizational models