Hvordan kan legemiddelrelaterte problemer hos sykehjemsbeboere forebygges?

The sickest of the Norwegian elderly live in nursing homes. The high number of children born in the years after the Second World War are about to be defined as elderly, and the expected lifetime for the Norwegian population is still increasing. Thus there has lately been an increased focus from the media on drug related problems involving nursing home patients. Nursing home patients are predisposed to suffer from serious side effects from drug treatment because of their multimorbidity and reduced homeostatic capacity. The aim of this thesis is to give a description of how one can avoid drug related problems in nursing home patients. A systematic search for relevant literature was performed with the assistance of a medical librarian in January 2010. In addition the thesis is based on selected articles received from the tutor. The first main chapter of the thesis gives information about the complexity of drug treatment as regards this particular patient group whilst the second and largest chapter describes proposed changes to prevent drug related problems amongst nursing home patients. Not surprisingly the thesis emphasizes the need for an improved quality in the drug treatment of nursing home patients. The limited evidence base, the lack of systematic medication reviews and no statutory minimum standard for medical supervision in this patient group are only three of the many examples. Although it is hard to predict the future it seems that a lot of changes are at the point of being made both politically and ethically due to a raising awareness of the wide extent of this particular problem

Modelling secondary production in the Norwegian Sea with a fully coupled physical/primary production/individual-based Calanus finmarchicus model system

The copepod Calanus finmarchicus is the dominant species of the meso-zooplankton in the Norwegian Sea, and constitutes an important link between the phytoplankton and the higher trophic levels in the Norwegian Sea food chain. An individual-based model for C. finmarchicus, based on super-individuals and evolving traits for behaviour, stages, etc., is two-way coupled to the NORWegian ECOlogical Model system (NORWECOM). One year of modelled C. finmarchicus spatial distribution, production and biomass are found to represent observations reasonably well. High C. finmarchicus abundance is found along the Norwegian shelf-break in the early summer, while the overwintering population is found along the slope and in the deeper Norwegian Sea basins. The timing of the spring bloom is generally later than in the observations. Annual Norwegian Sea production is found to be 29 million tonnes of carbon and a production to biomass (P/B) ratio of 4.3 emerges. Sensitivity tests show that the modelling system is robust to initial values of behavioural traits and with regards to the number of super-individuals simulated given that this is above about 50,000 individuals. Experiments with the model system indicate that it provides a valuable tool for studies of ecosystem responses to causative forces such as prey density or overwintering population size. For example, introducing C. finmarchicus food limitations reduces the stock dramatically, but on the other hand, a reduced stock may rebuild in one year under normal conditions

A user's guide to NORVECOM V2.0. the norwegian ecological model system

A coupled 3 dimensional Physical-Chemical-Biological model system, NORWECOM, has been developed through cooperation between several Norwegian institutions. The physical module is based on the Princeton Ocean Model already well documented in several reports. This guide is an attempt to give an introduction to the Chemical-Biological module, and will hopefully help new users to understand the flow between and processes inside the various subroutines. The guide will concentrate on how the chemical-biological dynamics is formulated in the module. Why these formulations is preferred to others, is not a part of such a guide

Does operational oceanography address the needs of fisheries and applied environmental scientists?

Although many oceanographic data products are now considered operational, continued dialogue between data producers and their user communities is still needed. The fisheries and environmental science communities have often been criticized for their lack of multidisciplinarity, and it is not clear whether recent developments in operational oceanographic products are addressing these needs. The International Council for the Exploration of the Sea (ICES) Working Group on Operational Oceanographic products for Fisheries and Environment (WGOOFE) identified a potential mismatch between user requirements and the perception of requirements by the providers. Through a questionnaire (98 respondents), WGOOFE identified some of these issues. Although products of physical variables were in higher demand, several biological parameters scored in the top 10 rankings. Users placed specific focus on historic time series products with monthly or annual resolution and updating on similar time scales. A significant percentage requested access to numerical data rather than graphical output. While the outcomes of this survey challenge our views of operational oceanography, several initiatives are already attempting to close the gap between user requirements and products available

An investigation of factors identified at birth in relation to anxiety and depression in old age: the Hordaland Health Study (HUSK)

Background: Although life course influences have long been recognised in affective disorder, little is known about the influence of early life factors on late life anxiety and depression. The aim was to investigate the extent to which birth measures, maternal health and family circumstances were associated with symptoms of anxiety and depression in late life. Methods: A retrospective cohort study was constructed from a cross-sectional survey sample of community residents aged 72–74 years, 406 of whom had traceable birth records. Cases and controls for late life anxiety and depression were defined applying standard cut-offs to the Hospital Anxiety and Depression Scale. A range of measures and circumstances were extracted from birth records blind to survey data and compared in age- and gender-adjusted models. Results: There were no differences in any anthropometric measure in either case control comparison. Case-level anxiety and depression were both associated with significantly lower maternal age. Late-life anxiety was additionally associated with smaller maternal pelvic size and the mother’ s condition being rated as poor at birth/discharge. Late-life depression was associated with a lower status paternal occupation. Conclusions: There was no evidence for a substantial influence of early life size on late life affective disorder. However, there was some evidence in secondary analyses for an enduring influence of the family’s socioeconomic environment and maternal health

Midlife mental distress and risk for dementia up to 27 years later: the Nord-Trøndelag Health Study (HUNT) in linkage with a dementia registry in Norway.

Background Dementia is an increasing public health challenge, and the number of individuals affected is growing rapidly. Mental disorders and symptoms of mental distress have been reported to be risk factors for dementia. The aim of this study was to examine whether midlife mental distress is a predictor for onset of dementia later in life. Methods Using data from a large population-based study (The Nord-Trøndelag Health Study; HUNT1) linked to a dementia registry (The Health and Memory study; HMS) enabling a maximum 27 years of follow-up, we ascertained mental distress and subsequent dementia status for 30,902 individuals aged 30–60 years at baseline. In HUNT1, self-reported mental distress was assessed using the four-item Anxiety and Depression Index (ADI-4). Dementia status was ascertained from HMS, which included patient and caregiver history, cognitive testing and clinical and physical examinations from the hospitals and nursing homes serving the catchment area of HUNT1. In the main analysis, unadjusted and adjusted logistic regression models were computed for the prospective association between mental distress and dementia. In secondary analyses, two-way age and gender interactions with mental distress on later dementia were examined. Results A 50% increased odds for dementia among HUNT1-participants reporting mental distress was found (crude odds ratio (OR): 1.52; 95% CI 1.15–2.01), and a 35% increase in the fully adjusted model (OR 1.35; 95% CI 1.01-1.80). In secondary analyses, we found evidence for a two-way interaction with age on the association between mental distress and dementia (p = 0.030): the age- and gender adjusted OR was 2.44 (95% CI 1.18–5.05) in those aged 30–44 years at baseline, and 1.24 (0.91–1.69) in 45–60 year olds. Conclusions Our results indicate an association between midlife mental distress and increased risk of later dementia, an association that was stronger for distress measured in early compared to later midlife. Mental distress should be investigated further as a potentially modifiable risk factor for dementia

Decadal fluctuations in North Atlantic water inflow in the North Sea between 1958-2003: impacts on temperature and phytoplankton populations

The circulation of Atlantic water along the European continental slope, in particular the inflow into the North Sea, influences North Sea water characteristics with consequent changes in the environment affecting plankton community dynamics. The long-term effect of fluctuating oceanographic conditions on the North Sea pelagic ecosystem is assessed. It is shown that (i) there are similar regime shifts in the inflow through the northern North Sea and in Sea Surface Temperature, (ii) long-term phytoplankton trends are influenced by the inflow only in some North Sea regions, and (iii) the spatial variability in chemicophysical and biological parameters highlight the influence of smaller scale processes

Trajectories and stability of self-reported short sleep duration from adolescence to adulthood

The trajectories and stability of self-reported sleep duration recorded at ages 13, 15, and 23 years on reported sleep duration at age 30 years among 1105 students (55% male) who participated in the Norwegian Longitudinal Health and Behaviour Study were examined. Questionnaire data were used to obtain demographic and sleep variables. Dichotomised short sleep duration was based on normative values and set as ≤8.5 h (age 13 years), ≤8 h (age 15 years) and ≤7 h (ages 23 and 30 years). Results indicated a significant overall reduction in total sleep duration (h per night) across age groups. Sleep duration (continuous) at age 15 and 23 years (whole group) was moderately but positively correlated with sleep duration at age 30 years (P < 0.01). When split by sex, at age 15 years, this association was present among females only (P < 0.01); however, at age 23 years, this association was present in both male and females (both P < 0.001). Categorical short sleep at age 23 years (whole group) was associated with short sleep at age 30 years (unadjusted odds ratio = 3.67, 95% confidence interval 2.36-5.69). Following sex stratification, this effect was significant for both males (unadjusted odds ratio = 3.77, 95% confidence interval: 2.22-6.42) and females (unadjusted odds ratio = 2.71, 95% confidence interval: 1.46-5.04). No associations were noted for categorical short sleep at ages 13 or 15 years, and subsequent short sleep at 30 years. Habitual short sleep duration during middle adulthood is not sustained from the time of early adolescence. Rather, these trends appear to be formed during early adulthood

Detection of novel truncated forms of human serum amyloid A protein in human plasma

AbstractSerum amyloid A protein (SAA) is a human plasma protein that has been recognized as potential biomarker of multiple ailments including myocardial infarction, inflammatory disease and amyloiosis. Presented here is the application of a novel immunoassay technique, termed mass spectrometric immunoassay for the detection and identification of SAA present in human plasma. Results demonstrate the ability to readily detect known SAA isotypes, and to identify novel truncated forms of SAA, in the plasma of healthy individuals and those suffering from acute and chronic inflammation. The approach represents a rapid and sensitive means for the routine structural characterization of known SAA isotypes and the discovery of associated post-translational modifications

A Guide for Occupational Therapists: Utilizing Equine-assisted Therapy for Children in the Foster Care System Dealing with Trauma

In 2015, over three million children who were affected by trauma or abuse were reported to Child Protective Services (Papovich, 2019). “Children in the foster care system have often been exposed to traumatic experiences such as violence, illicit substances, and neglect” (Crabill & Hanson, 2018, p.8). Adverse childhood experiences (ACEs) can be similar to experiencing trauma; children, prior to entering the foster care system, often experience ACEs (Craig, 2020). Children in the foster care system face hardships such as being taken out of their homes, passing through multiple homes, in addition to other childhood traumas they experience prior to their time in the foster care system. In 2019, 46% of children in foster care lived in a nonrelative foster home, 32% in a relative foster home, and 4% in a group home (Children’s Bureau, 2020). Equine-assisted therapy is a service provided by occupational therapists, physical therapists, psychologists, and speech therapists to assist with neurological and sensory needs (Koca, 2015). “Equine-assisted therapy broadly refers to any type of therapy or treatment that includes equine interactions, activities, or treatment strategies, and the equine milieu” (Hallberg, 2018, p.30). Horses provide a way for children in foster care to engage in activities that foster children have decreased experience in. There are many ways equine-assisted therapy can provide services to different populations; one area that has limited research is equine-assisted therapy with occupational therapy and children in foster care who have faced trauma leading to mental health challenges