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Cross-sectional data show that post-traumatic stress disorder (PTSD) patients often have increased levels of circulating inflammatory markers. There is, however, still a paucity of longitudinal studies with long follow-up times on levels of cytokines in such patients. The current study assesses patients with and without PTSD diagnosis 1 year after discharge from inpatient treatment.
Patients in treatment for serious non-psychotic mental disorders were recruited at the beginning of their treatment stay at a psychiatric centre in Norway. Ninety patients submitted serum samples and filled out the Hopkins Symptom Checklist-90 Revised Global Severity Index (HSCL-90R GSI) questionnaire during their mainstay and at a follow-up stay 1 year after discharge. Of these patients, 33 were diagnosed with PTSD, 48 with anxiety, depression, or eating disorder, while 9 patients had missing data. The patients were diagnosed using the Mini-International Neuropsychiatric Interview (MINI).
At the follow-up stay (T3), PTSD patients had higher levels of GSI scores than non-PTSD patients (p = 0.048). These levels were unchanged from the year before (T2) in both groups. The levels of circulating cytokines/chemokine did not differ between the PTSD and non-PTSD patients at T3. At T2, however, the PTSD and non-PTSD groups exhibited different levels of interleukin 1β (IL-1β) (p = 0.053), IL-1RA (p = 0.042), and TNF-α (p = 0.037), with the PTSD patients having the higher levels.
Despite exhibiting different mental distress scores, the PTSD and non-PTSD patients did not differ regarding levels of circulating inflammatory markers at 1-year follow-up.
To describe associations between adolescents’ frequency of vegetable consumption, food parenting practices and socioemotional family characteristics, and to explore potential mediated relationships that may contribute to an understanding of the family processes involved.
Cross-sectional survey among adolescents aged 13–15 years.
A survey questionnaire including self-report measures on adolescents’ frequency of vegetable consumption, perceived food parenting practices (i.e. family dinner frequency, maternal/paternal healthy eating guidance (HEG), maternal/paternal social support for vegetable consumption) and socioemotional family characteristics (i.e. general family functioning and level of cohesion and conflict within the family) was distributed in a convenience sample of secondary school students.
Four hundred forty students from five secondary schools in eastern Norway completed the questionnaire.
Results from multiple linear regression analysis revealed positive and statistically significant associations between adolescents’ frequency of vegetable consumption, maternal HEG and family cohesion. A partial indirect (mediated) association between family cohesion and adolescents’ frequency of vegetable consumption, working through maternal HEG, was also found.
Results from the present study suggest that perceived family cohesion may influence adolescents’ frequency of vegetable consumption both directly and indirectly. However, there is a need for continued investigation of family-related factors influencing adolescent eating. In particular, the role of socioemotional family characteristics should be further scrutinised in future studies.
Globally, there is a growing interest in the role of universities and public research institutes in the alchemy of innovation, the emphasis being on how they can make more systematic efforts to unlock the commercial value of their research. While many of these feel it is imperative that their knowledge transfer activities work to recover costs, from my experience, revenue generation, in most cases, is not and in my view should not be the primary motivation. The reasons these institutes engage in knowledge transfer is to advance education and research; and at the same time it helps to ensure that public investment in research is impactful, that it contributes to broader socioeconomic development objectives. However, the going is tough, even in high-income countries and the entrepreneurial character of these institutes remains the subject of academic scrutiny. The chapter inspires a deeper understanding of this critical area by examining the evolving role of institutes in national innovation systems. It also examines the impact of legislative and policy initiatives that promote protection of inventions through patenting and their commercialization through licensing and startup formation.
Previous research has shown that Dutch pronominal gender is in a process of resemanticization: Highly individuated nouns are increasingly referred to with masculine and feminine pronouns, and lowly individuated ones with the neuter pronoun het/’t ‘it’, irrespective of the grammatical gender of the noun (Audring 2009). The process is commonly attributed to the loss of adnominal gender agreement, which is increasingly blurring distinctions between masculine and feminine nouns and, therefore, requires speakers to resort to semantic default strategies (De Vogelaer & De Sutter 2011). Several factors have been identified that influence the choice of semantic vis-à-vis lexical agreement, both linguistic and social. This article seeks to weigh the importance of both structural and social factors in pronominal gender agreement in Belgian Dutch, using the Belgian part of the Spoken Dutch Corpus. A multivariate statistical analysis reveals that most effects are structural, including noun semantics and the syntactic function of the antecedent and the pronoun, as well as the pragmatic status of the antecedent. The most important social factor is speech register. We argue that these effects support a psycholinguistic account in which resemanticization is seen as a change from below, caused by hampered lexical access to noun gender.
This paper concerns affective relations and unexpected interruptions as the planned expansion of an extractive open-pit mining site gathers momentum. The site is a mountain in Varanger, North Norway, criss-crossed by a sand-coloured meshwork of roads that are part of the current infrastructure of a quartzite quarry. Recently purchased by Chinese investors, the mining company Elkem plans a massive expansion of the operations, which will interrupt a wide range of practices and projects, including the migratory movement of reindeer, as well as their grazing patterns. Known as Giemaš amongst Sámi speakers, the mountain is also alluded to as a site of other powers, manifesting as unexpected accidents. In this article, I explore how the planned expansion evokes this contested site as more than a singular mountain, and how divergent epistemic formations interrupt the making of extractive resources in multiple ways.
In 2019, the Norwegian Institute for Public Health and Canadian Agency for Drugs and Technologies in Health (CADTH) received support from HTAi to produce a quarterly current awareness alert for the HTAi Disinvestment and Early Awareness Interest Group in collaboration with the HTAi Information Retrieval Interest Group. The alert focuses on methods and topical issues, and broader forecasts of potentially disruptive technologies that may be of interest to those involved in horizon scanning and disinvestment initiatives in health technology assessment (HTA).
Information specialists at both agencies developed search strategies for disinvestment and for horizon scanning in PubMed and Google. The template for the alert was based on an e-newsletter developed by the Information Retrieval Interest Group. Information specialists and researchers reviewed the monthly (PubMed) and weekly (Google) search results and selected potentially relevant publications. Additional sources were also identified through regular HTA and horizon scanning work.
Alerts are posted quarterly on the HTAi Interest Group website; members receive an email notice when new alerts are available. While the revised PubMed searches are identifying relevant information, Google alerts have been disappointing, and this search may need to be revised further or dropped. When the one-year pilot project ends, in Fall 2020, interest group members will be surveyed to see if the alerts were useful, and whether they have suggestions for improving them.
Collaborating on this alert service reduces duplication of effort between agencies, and makes new research in horizon scanning and disinvestment more accessible to colleagues in other agencies working in these areas.
Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroendocrine malignancy typically involving the skin. The majority of MCC involves the head/neck region and the extremities. Despite the aggressive nature of the disease, there have been several case studies that report spontaneous regression. We report a unique case of spontaneous regression of an MCC in a peculiar region in the anterior mediastinum with no cutaneous involvement.
A 50-year-old man who presented with a mobile low anterior neck mass, proven by biopsy, to be MCC. Subsequent PET/CT confirmed an FDG (Flurodeoxyglucose)-avid upper mediastinal mass. The mass gradually regressed over the course of 1 month subsequent to biopsy and was no longer palpable on exam or visible on subsequent CT scans. The patient was treated with intensity modulated radiation therapy with a total dose of 6,160 cGy in 28 fractions to the site of previously visible primary disease. At-risk nodal basins were also treated. On subsequent follow-up, the patient continued to have no clinical or radiographic signs of disease.
Spontaneous regression of an MCC is rare but has been reported mostly in the head/neck region following biopsy. It is unknown why spontaneous regression occurs. There is a possibility that biopsy may stimulate T-lymphocytes resulting in spontaneous regression.
This is the first case to our knowledge of spontaneous regression of an MCC in the anterior mediastinum with no cutaneous involvement. Most MCC are seen clinically due to skin changes with a majority of cases occurring in the head/neck region.
Psychotherapy research aims to investigate predictors and moderators of treatment outcome, but there are few consistent findings. This study aimed to investigate cytokines in patients undergoing treatment for anxiety disorders and whether the level of cytokines moderated the treatment outcome. Thirty-seven patients with comorbid and treatment-resistant anxiety disorders were investigated using multilevel modelling. Serum cytokine levels were measured three times: pretreatment, in the middle of treatment, and at the end of treatment. Anxiety and metacognitions were measured weekly throughout treatment by self-report. The levels of monocyte chemoattractant protein-1, tumour necrosis factor-alpha, and interleukin-1 receptor antagonist did not change during therapy or were not related to the level of anxiety. Metacognitive beliefs predicted anxiety, but the relationship between metacognitions and anxiety was not moderated by cytokines. Limitations of the study include that the patients were not fasting at blood sampling, and we did not assess body mass index, which may affect cytokine levels. The lack of significance for cytokines as a predictor or moderator may be due to a lack of power for testing moderation hypotheses, a problem associated with many psychotherapy studies. Cytokines did not predict the outcome in the treatment of comorbid anxiety disorders in our sample. Furthermore, cytokines did not moderate the relationship between metacognitions and anxiety.
Background: Catheter-associated urinary tract infections (CAUTIs) are among the most prevalent healthcare-associated infections (HAIs) globally, contributing to increased morbidity, prolonged hospital stays, and increased healthcare costs. Interventions that support prompt removal of the urinary catheter are evidence-based actions to effectively reduce CAUTI rates.1Objective: At the National Hospital of Tropical Disease (NHTD), catheter removal interventions in the intensive care unit (ICU) were implemented using quality improvement (QI) methodology to reduce CAUTI incidence and urinary catheter device utilization. Methods: Training was performed for ICU clinical staff with knowledge checks before and after the program. A bedside visual reminder of CAUTI risk and checklist to assess catheter need were implemented. Weekly compliance of provided visual reminders and checklists were measured using a simple audit tool. Device utilization ratios (DURs, ratios of device days to patient days), and CAUTI incidence rates (per 1,000 device days) were collected at baseline (July–September 2018) and quarterly thereafter until June 2019. Statistical significance was determined by an independent t test. Results: In the first quarter (October–December 2018), the CAUTI incidence rate decreased from 8.9 to 1.3 per 1,000 device days (P = .036). The ICU staff trained in CAUTI prevention, mean knowledge scores before and after training increased from 68% to 87%. The DUR decreased slightly from 0.59 to 0.55 after the first-quarter training then steadily increased in the following quarter (0.60; January–March 2019) and after the intervention (0.54; April–June 2019). CAUTI incidence rates also increased but were still lower than at baseline: 4.8 and 6.3 per 1,000 days of device use. Compliance of reminders was 51% during the first quarter, increased slightly in the second quarter 62%, then decreased to 40% during the last quarter. The nurses’ adherence to the daily checklist remained stable (>75%). Conclusions: This CAUTI prevention project was the first use of quality improvement methodology to implement change at NHTD. A trend decrease in CAUTI was observed, though a greater decrease occurred at the beginning of the intervention. Limited compliance of daily reminders is likely reflected in no statistically significant decrease in DUR. Possibly, this quality improvement project raised awareness among clinicians to improve general CAUTI prevention practices in the ICU without decreasing DUR. Given limited compliance with reminder and checklists, the intervention will be revised during the next PDSA cycle to improve adherence.
1Meddings J, Rogers MA, Krein SL, Fakih MG, Olmsted RN, Saint S. Reducing unnecessary urinary catheter use and other strategies to prevent catheter-associated urinary tract infection: an integrative review. BMJ Qual Saf 2014;23:277–289.
We examined associations of urine iodide excretion, proxy for iodine intake, with child development and growth.
This is a secondary analysis of a 1:1 cluster-randomised trial with a 6-month nutrition/stimulation/hygiene education intervention among mothers of children aged 6–8 months to improve child development and growth. Development was assessed using Bayley Scales of Infant and Toddler Development–III (BSID-III) and Ages and Stages Questionnaire (ASQ), whereas anthropometry was used to assess growth. Urine iodide concentration (UIC) and urine iodide/creatinine ratio (ICR) were measured.
The current study was conducted in southern Uganda.
We randomly selected 155 children from the 511 enrolled into the original trial and analysed data when they were aged 20–24 and 36 months.
Median UIC for both study groups at 20–24 and 36 months were similar (P > 0·05) and within the normal range of 100–199 µg/l (0·79–1·60 µmol/l), whereas the intervention group had significantly higher ICR at 20–24 months. The BSID-III cognitive score was positively associated (P = 0·028) with ICR at 20–24 months in the intervention group. The ASQ gross motor score was negatively associated (P = 0·020) with ICR at 20–24 months among the controls. ICR was not significantly associated with anthropometry in the two study groups at either time-point.
Following the intervention, a positive association was noted between ICR and child’s cognitive score at 20–24 months, whereas no positive association with ICR and growth was detected. Iodine sufficiency may be important for child’s cognitive development in this setting.
Introduction: 2018 data from the Canadian Medical Association website shows that of practicing emergency physicians country-wide, only 31% were female. While there are some studies that examine the number and proportion of Canadian female applicants applying to surgical specialties, there are very few studies that are specific to emergency medicine (EM), and none that are Canadian in scope. Given the changing gender ratio of graduating medical students in Canada, the primary objective of this study is to assess the mean proportion and trends in proportion of females who applied and matched to English-language Canadian EM programs including Canadian College of Family Physicians emergency medicine certificate (CCFP-EM) and Fellow of the Royal College of Physicians of Canada emergency medicine (FRCPC-EM), family medicine (CCFP) programs, and all specialties combined. Methods: A retrospective data analysis on residency match results from 2013-2019 inclusively was performed. Data was accessed through a freedom of information request from the Canadian resident matching service (CaRMS). The mean proportions and trends in the proportions of females applying and matching to CCFP-EM, FRCPC-EM, CCFP, and all specialties were computed. Cochrane-Armitage trend of test was used for analysis. Results: From 2013-2019, the mean (SD) percentage of females who applied and matched respectively were as follows: CCFP-EM [44.4 (3.5);46.0(4.5)]; FRCPC-EM [41.3(4.1);44.0 (4.5], CCFP [56.5(1.3);61.0(1.9)], all specialties [54.0(1.1);55.5(0.9)]. There was a significant increase in the proportion of female applying to the FRCPC-EM (p < 0.0001), CCFP (p = 0.0002), and all disciplines (p = 0.0013). There was no significant change in the proportion of females applying for the CCFP-EM program (p = 0.6435). Conclusion: Our study shows that there is an increasing trend in the percentage of female applicants in all programs except the CCFP-EM program, where it remained statistically the same over time. There was a consistent percentage of applied versus matched female applicants over time for both CCFP-EM and FRCPC-EM programs. However, the percentage of females applying or matching to both CCFP-EM and FRCPC-EM programs remained less than 50%. Further research could focus on evaluating reasons for program choice, in order to further increase the percentage of female medical students and residents applying and matching to both emergency medicine programs.
We have recently found an association between smoking and mental distress in a three year follow up study among Norwegian adolescents. Earlier studies have demonstrated that the serotonin transporter gene interact on the association between negative life events and depression.
The aim of this study is, in stratified analyses by sex, to investigate whether there is a similar interaction of the serotonin transporter genotype on the relationship between smoking and mental distress.
All 10th graders in Oslo in 2000 and 2001 (n=7343, 88%) filled in questionnaires during school classes. The 2001 cohort (n = 3811) constituted the baseline. Of the participants in the baseline study 2489 (65%) participated in the follow-up. The response rate was 58% in boys and 74% in girls. The Hopkin's Symptom Cecklist-10 was used to measure mental distress. At follow up almost all participants provided genetic material using a cyto-brush on the buccal mucosa. The tag SNPs were analysed with Taqman MGB.
There was a significant interaction effect between the different genotype alleles and smoking among girls (F=4.0, p=0.019), but not among boys (F=0.8, p=0.44). Girls that are smoking daily with the long gene allele variant had lower mental distress scores than those with the short allele variant. Those with the heterozygote variant had scores that were between those with the short and long variant.
There is an interaction effect for the serotonin transporter genotype among adolescent girls, but not in boys in the relationship between smoking and mental distress.
Cardiovascular disease (CVD) and depressive disorders are the most two harmful problems for human health in the 21st century. The relationships between the two diseases are complicated, yet the mechanisms are not clear so far. This study addressed this issue by clarifying shared and unique factors between metabolic syndrome (MS) and mild psychiatric disorder (MPD) using the 8-year follow-up Landseed cohort.
A total of 5712 community residents were followed-up and analyzed. The point prevalence rates of MS and MPD and their comorbidity rate were estimated by each wave. Three multiple logistic regression models, with each treating MS, MPD, and comorbid condition as dependent variable, were compared to identify the shared and unique factors. Variables specifically correlate with MS or MPD are defined as unique factors; whilst those correlated with both MS and MPD or with comorbid condition as shared factors.
The point prevalence rates of MS ranged 13.83-14.26%, MPD ranged 17.17-19.60%, and comorbidity rates 2.75-3.07% in three waves. Educational level and weekly exercise frequency are shared factors of MS and MPD. Moderate personal income is a unique protective factor for MS; and male and abstaining from alcohol use are unique protective factors for MPD.
A balanced life style is beneficial for both physical and psychological health. Specifically, there are no dose-response effects between weekly exercise frequency and MS or MPD. It is important for clinicians and health educators to educate community people to engage in exercise in a proper way to improve public health.
To support decision-makers considering adopting integrated pest management (IPM) cropping in Norway, we used stochastic efficiency analysis to compare the risk efficiency of IPM cropping and conventional cropping, using data from a long-term field experiment in southeastern Norway, along with data on recent prices, costs, and subsidies. Initial results were not definitive, so we applied stochastic efficiency with respect to a function, limiting the assumed risk aversion of farmers to a plausible range. We found that, for farmers who are risk-indifferent to moderately (hardly) risk averse, the conventional system was, compared to IPM, less (equally) preferred.