Closure of patent foramen ovale for secondary prevention of cerebrovascular events

Stroke is the most debilitating cardiovascular event. It has a variety of causes that may be present simultaneously. In young or otherwise healthy people a patent foramen ovale (PFO) is increasingly searched for. In stroke of the elderly atherosclerosis and atrial fi brillation are in the foreground but the PFO should not be ignored. The risk of a PFO related stroke over time is controversial and so is its prevention by PFO closure. Percutaneous PFO closure is a minimally invasive procedure which can be performed with high success and low morbidity. We review the rationale for PFO closure for secondary prevention of embolic events

IT-baserad hemvård av djur med hjärtfel

Studiens målsättning var att utvärdera om ett internetbaserat system kan användas för att förbättra vården av hjärtsjuka hundar och katter. Detta med huvudsyfte att på ett tidigare stadium kunna upptäcka en hälsoförsämring samt visa om eftersträvad effekt uppnås vid behandling och medicinering av hjärtsvikt. Hjärtsjuka hundar och katter är vanligt förekommande patienter bland våra smådjur och hanteringen av dessa är en utmaning för veterinärer. Denna patientgrupp är ofta hemma långa perioder mellan återbesöken och akuta veterinärbesök på grund av uppkomst av hjärtsvikt är vanligt förekommande. Systemet som användes i studien fick namnet PetHeart och bygger på att djurägare i hemmamiljö, mäter och via en webbportal rapporterar in parametrar som kan förändras i samband med progrediering av hjärtsjukdom. Dessutom har djurägarna via webbportalen besvarat hälsorelaterade frågor om sitt djur och en dialogfunktion har möjliggjort kommunikation med vårdgivaren. Inrapporterad data avlästes dagligen av vårdgivaren och vid misstanke om en försämring utifrån inrapporterad data kontaktades djurägaren. Till skillnad mot på veterinärsidan där mycket lite inom området verkar vara gjort har flera studier på humansidan demonstrerat genomförbarheten och fördelarna med användandet av eHälso-lösningar som en del i uppföljningen av kroniskt hjärtsjuka patienter. Patienter som hemifrån regelbundet rapporterar in objektiva parametrar såväl som subjektiva hälsosymptom, vilka sedan granskas av vårdpersonal, har visats ha ett lägre antal sjukhusinskrivningar, sjukhusbesök och en högre livskvalitet jämfört med kontrollpatienter. Vi har under studieperioden följt totalt 26 hundar och katter, varav 17 hjärtsjuka djur och 9 friska kontroller. Vid sju olika tillfällen har vi utifrån inrapporterad data kunnat misstänka en försämring av hälsotillståndet, vilket föranlett till kontakt med djurägaren. Djurägarna var positiva till systemet i den enkät som skickades ut och flera djurägare uppgav att det var lätt att komma i kontakt med veterinär och att systemet skapade en ökad trygghet. Alla djurägare till de hjärtsjuka patienterna som besvarade enkäten uppgav att de skulle kunna tänka sig att fortsätta använda systemet. Resultaten från studien tyder på att PetHeart kan vara ett bra komplement vid vården av hjärtsjuka hundar och katter. Fler och större studier för att ytterligare undersöka och belysa fördelarna med den här typen av uppföljning behövs.The purpose of this study was to evaluate whether an internet-based system can be used to improve the care of dogs and cats with heart disease. The aim is to detect health impairment at an earlier stage, and demonstrate whether the desired effect is achieved in the treatment and medication of heart failure. Dogs and cats suffering from heart disease are common patients among small animals and their management is a challenge for veterinarians. This group of patients often stays at home for long periods between re-visits, and emergency visits due to the onset of heart failure are common. The system used in this study is named PetHeart. It is based on the pet owners themselves, who measure and report parameters that change in the progression of heart disease, via a web portal. In addition, pet owners answer health-related questions about their animals via the web portal, and have the possibility of communicating with the veterinarian via a dialogue function. Reported data was read daily by the caregiver, who could contact the pet owner if the reported data led to a suspicion of a deterioration in the health of the patient. This is a new concept for veterinarians, as little research has been done in this area. In contrast research in human medical care demonstrates the feasibility and benefits of the use of eHealth solutions as part of the monitoring of chronically ill heart patients. In these studies, human patients report objective parameters as well as subjective health symptoms from home on a regular basis which is then examined by the medical staff. This system has been shown to have a lower number of hospitalizations, hospital visits and a higher quality of life compared with control patients. In this study we have followed a total of 26 dogs and cats, including 17 animals with heart disease and 9 healthy controls. On seven different occasions, we have suspected a deterioration of health based on data reported, which led to contact with the animal owner. Pet owners answered a questionnaire in which they stated that they were in favor of the system as it was easy to get in touch with the veterinarian, and the system created greater security. All pet owners to animals with heart disease who responded to the survey said they would be willing to continue using the system. This study shows promising results, and suggests that PetHeart could be a great addition for the care of dogs and cats with heart disease in the future. More and larger studies to further investigate the advantages of this type of monitoring are needed

Spolmaskangrepp är ett ökande problem hos värphöns

This literature review summarizes available data on infection with the parasitic roundworm, Ascaridia galli, as a cause of disease in poultry, including the consequences of a conversion to alternative production systems. Ascaridia galli has a direct life cycle with resistant eggs that survive and are easily spread in the environment, especially in systems with bedding materials where the faecal contact is high. The infection is usually subclinical but depending on the infection dose, the symptoms range from weight loss and diarrhea to mortality. Factors such as the feed composition and genetic variation among different hybrids clearly affect the establishment rate of the infection. Ascaridia galli will probably become an increasing problem, with a shift from the traditional battery cages to alternative systems where the risk of re-infection is high. There is an increasing need for intensified research in this area to maintain a low infection pressure and thereby avoid the associated clinical and economic problems

Cornelia Maier-Gutheil / Kira Nierobisch: Beratungswissen für die Erwachsenenbildung. Reihe: Studientexte für Erwachsenenbildung. Bielefeld: W. Bertelsmann 2015 (136 S.) [Rezension]

Rezension von: Cornelia Maier-Gutheil / Kira Nierobisch: Beratungswissen für die Erwachsenenbildung. Reihe: Studientexte für Erwachsenenbildung. Bielefeld: W. Bertelsmann 2015 (136 S.; ISBN 978-3-7639-5652-4; 19,90 EUR)

From policy to return. A study of the National Police Immigration Service implementation of the Norwegian Parliaments return policy.

Dybdebasert master, 120 studiepoeng.Politiets utlendingsenhet (PU) har ansvaret for selve uttransporteringen av utlendinger som oppholder seg ulovlig i Norge. Denne oppgaven studerer Politiets utlendingsenhet sin implementering av Stortingets returpolitikk. Problemstillingen er todelt: Hvordan implementerer Politiets utlendingsenhet Stortingets returpolitikk? Hvorfor blir produksjonsmålet på antallet som returneres så dominerende for virksomheten? Oppgaven har fulgt politikkens «reise» fra det brede asylforliket som ble inngått på Stortinget høsten 2015, og gjennom forvaltningen. Asylforliket blir til politiske vedtak i Statsbudsjettet og iverksettingen fortsetter gjennom styring fra Justis- og beredskapsdepartementet og Politidirektoratet, til politikken treffer ledelsen i PU, og politidistriktene. Oppgaven har først en analyse av de mest sentrale offentlige dokumentene som setter rammene for iverksettingen. Deretter har fire sentrale iverksettere blitt intervjuet med utgangspunkt i hvilke forhold som styrker eller eventuelt svekker implementeringsprosessen. Analysene kobles fortløpende opp mot aktuell implementeringsteori som er presentert i oppgavens teoridel. Oppgaven drøfter samtidig aktuelle problemstillinger rundt mål- og resultatstyring, med bakgrunn i relevant organisasjonsteori. Formålet er ikke å kritisere styringsformen da kritikken rundt dette og New Public Management er godt kjent. Utgangspunktet er å finne svar på hvordan politikken implementeres og hvorfor måltallet er dominerende.Engelsk sammendrag (abstract) The National Police Immigration Service (PU) is responsible for the actual return of foreigners who are illegally in Norway. This thesis studies PU's implementation of the the Norwegian parliament's return policies. The problem is twofold: How does the PU implement the Norwegian parliament's return policies? Why is the set target number for returns so dominating when it comes to how PU conduct their job? The thesis has followed the policy's "journey" from the asylum settlement, that was agreed upon in the Norwegian parliament in the fall of 2015, and through the administration. The asylum settlement becomes policy in the national budget, and the implementation continues through directives from the Ministry of Justice and Public Security and the Police Directorate, until the policies reaches the management of the PU and the police districts. The thesis starts with an analysis of the most important government documents that set the framework for the implementation. Then, four key initiators have been interviewed, based on what conditions strengthen -- or possibly weaken -- the implementation process. The analyses are linked continuously to the current implementation theory, presented in the theoretical part of the thesis. The thesis also discusses current issues regarding goal and performance management, based on relevant organizational theory. The purpose is not to criticize the governance, as the criticism related to this and New Public Management is well known. The basis for this thesis is to find answers to how the policy is implemented and why the target number is dominant

Secondary stroke prevention: patent foramen ovale, aortic plaque, and carotid stenosis

Stroke is the most debilitating cardiovascular event. It has a variety of causes that may be present simultaneously. In young or otherwise healthy people, the search for a patent foramen ovale (PFO) has become standard. In stroke of the elderly, atherosclerosis and atrial fibrillation are in the foreground but the PFO should not be ignored. The risk of a PFO-related stroke over time is controversial and so is its prevention by device closure. The association of proximal aortic plaques in arteries subtending the brain and stroke is considered strong, ignoring that it is as putative as that of the PFO. Statins can prevent progression of such plaques. Antiplatelet agents in asymptomatic and surgical endarterectomy in symptomatic patients or highly ulcerated lesions are the treatment of choice. Stenting with protection devices was shown competitive in selected patient

Natural variability in hard bottom communities and possible drivers assessed by a time-series study in the SW Baltic Sea: know the noise to detect the change

In order to detect shifts in community structure and function associated with global change, the natural background fluctuation in these traits must be known. In a 6 yr study we characterized the composition of young benthic communities at 7 sites along the 300 km coast of the Kiel and Lübeck bights in the German Baltic Sea and we quantified their interannual variability of taxonomic and functional composition. Along the salinity gradient from NW to SE, the relative abundance of primary producers decreased while that of heterotrophs increased. Along the same gradient, annual productivity tended to increase. Taxonomic and functional richness were higher in Kiel Bight as compared to Lübeck Bight. With increasing species richness functional group richness showed saturation indicating an increasing functional redundancy in species rich communities. While taxonomic fluctuations between years were substantial, functionality of the communities seem preserved in most cases. Environmental conditions potentially driving these fluctuations are winter temperatures and current regimes. We tentatively define a confidence range of natural variability in taxonomic and functional composition a departure from which might help identifying an ongoing regime shift driven by global change. In addition, we propose to use RELATE, a statistical procedure in the PRIMER (Plymouth Routines in Multivariate Ecological Research) package to distinguish directional shifts in time ("signal") from natural temporal fluctuations ("noise"