KOMMUNALE TILTAK I HELSEFREMMENDE OG FOREBYGGENDE PSYKISK HELSEARBEID

Sammendrag Forfattere Studentnummer: 101696 & 101728 Bachelor i Friskliv og lokalt folkehelsearbeid, 2013-2016 Institutt for helsefag, Høyskolen Kristiania Tittel Kommunale tiltak i helsefremmende og forebyggende psykisk helsearbeid. Bakgrunn Mange kommuner i Norge oppgir at psykisk helse er et folkehelseproblem for befolkningen, men det er få tiltak iverksatt. Menneskers psykiske helsetilstand er en kombinasjon av samspillet mellom flere faktorer i samfunnet. På bakgrunn av dette, skal denne oppgaven redegjøre for tiltak innen flere samfunnssektorer som kan fremme innbyggernes psykiske helse og forebygge psykiske lidelser. Problemstilling Hvilke tiltak kan iverksettes kommunalt for å fremme innbyggernes psykiske helse og forebygge psykiske lidelser? Metode For å svare på problemstillingen var litteraturstudie det mest nærliggende studiedesignet. Oppgaven er basert på allerede eksisterende forskning, artikler og rapporter. Resultatene gir grunnlag for diskusjon, redegjørelse og en konklusjon rundt problemstillingen. Resultater, diskusjon og redegjørelse Resultatene er 8 utvalgte tiltak fordelt i samfunnssektorene: nærmiljø og bolig, familie, skole, arbeid, kultur og fritid og helse- omsorgs og sosialtjenester. Det er utfordrende å sammenligne eller fastslå hvilke tiltak som vil gi størst effekt. Tiltakene er ulike i form av kunnskapsbasert evidens og hvor mange som blir berørt av iverksettelse. Mangelen på kunnskapsbasert folkehelsearbeid skaper utfordringer for både oppgaven og ved kommunalt arbeid. Kommuner har forskjellige områder hvor utfordringene er størst. Dette vil variere på bakgrunn av eksempelvis ressurser, kompetanse, størrelse og geografi. Konklusjon Alle de omtalte tiltakene kan etter vår vurdering fungere som helsefremmende og forebyggende for psykiske plager og lidelser. Det er opp til hver enkelt kommune å kartlegge hvilke samfunnssektorer som trenger tiltak, for å best tilpasse befolknings behov

Ethnopharmacological uses of Erythrina senegalensis: a comparison of three areas in Mali, and a link between traditional knowledge and modern biological science

This paper describes ethnopharmacological knowledge on the uses of Erythrina senegalensis DC (Fabaceae) in traditional medicine in three different areas (Dioila, Kolokani and Koutiala) in Mali. Data were collected using interviews of traditional healers selected randomly. The main reported diseases for which E. senegalensis was used by the traditional healers were amenorrhea, malaria, jaundice, infections, abortion, wound, and body pain (chest pain, back pain, abdominal pain etc). The fidelity level (which estimates the agreement of traditional healers on the same area about a reported use of the plant) was calculated to compare the results from the three areas. Certain differences were noticed, the most striking was the fact that amenorrhea was the most reported disease in Dioila and Kolokani with 21% of agreement for both areas, while this use was not reported in Koutiala at all. Similarities existed between the three areas on the use of the plant against malaria and infections, although with different degree of agreement among the healers. We also report the results of a literature survey on compounds isolated from the plant and their biological activities. A comparison of these results with the ethnopharmacological information from Mali and other countries showed that some of the traditional indications in Mali are scientifically supported by the literature. For instance, the use of E. senegalensis against infectious diseases (bilharzias, schistosomiasis, pneumonia etc.) is sustained by several antibacterial and antifungal compounds isolated from different parts of the plant. The comparison also showed that pharmacologists have not fully investigated all the possible bioactivities that healers ascribe to this plant

Chromatographic immunoassays for Helicobacter pylori detection – are they reliable in Mali, West Africa?

Introduction: Gastrointestinal diseases are major reasons for morbidity in Mali. As Helicobacter pylori is known to play a major role in gastritis and gastric ulcer we wanted to find a simple method for detection. Methods: Twenty-nine volunteers with confirmed gastric ulcer by gastroscopy and 59 randomly selected volunteers were diagnosed by using the rapid serological test Clearview®H. Pylori . The ImmunoCard STAT!® HpSA®test was applied on stool from 65 volunteers seeking help for gastrointestinal related ailments. Results: A Helicobacter pylori prevalence of 21% was found among the individuals with confirmed gastric ulcer, 44% among the randomly selected volunteers and 14% in individuals with gastrointestinal related ailments. Conclusion: According to what is already known about the aetiology of gastric ailments and the prevalence of Helicobacter pylori in neighboring countries, the infection rates in our study appear strikingly low. This might indicate that Clearview® H. Pylori and ImmunoCard STAT!® HpSA® have low sensitivities in the populations studied. Strain variability of H. Pylori may be an explanation. The tests need to be properly evaluated in Mali before they can be relied upon as diagnostic tools.Pan African Medical Journal 2013; 14: 7

Polysaccharides from the South African medicinal plant Artemisia afra: Structure and activity studies

Artemisia afra (Jacq. Ex. Willd), is an indigenous plant in South Africa and other parts of the African continent, where it is used as traditional medicine mostly for respiratory conditions. The objective of this study was to investigate the structural features of the polysaccharides from the leaves of this plant, as well as the biological activities of the polysaccharide fractions against the complement assay. Leaves of Artemisia afra were extracted sequentially with organic solvents (dichloromethane and methanol), 50% aqueous ethanol, and water at 50 and 100 °C respectively. The polysaccharide extracts were fractionated by ion exchange chromatography and the resulting fractions were tested for biological activity against the complement fixation assay. Active fractions were further fractionated using gel filtration. Monosaccharide compositions and linkage analyses were determined for the relevant fractions. Polysaccharides were shown to be of the pectin type, and largely contain arabinogalactan, rhamnogalacturonan and homogalacturonan structural features. The presence of arabinogalactan type II features as suggested by methylation analysis was further confirmed by the ready precipitation of the relevant polysaccharides with the Yariv reagent. An unusual feature of some of these polysaccharides was the presence of relatively high levels of xylose as one of its monosaccharide constituents. Purified polysaccharide fractions were shown to possess higher biological activity than the selected standard in the complement assay. Digestion of these polysaccharides with an endo-polygalacturonase enzyme resulted in polymers with lower molecular weights as expected, but still with biological activity which exceeded that of the standard. Thus on the basis of these studies it may be suggested that immunomodulating properties probably contribute significantly to the health-promoting effects of this medicinal plant

Contemporary migration patterns in the prevalence of Helicobacter pylori infection: a systematic review

Background: A rapid growth in the number of international migrants over the past years has occurred with most traveling to more affluent settings. As Helicobacter pylori infects over half of the adult population and its prevalence is higher in developing countries, understanding the prevalence of infection in migrants can provide insight into future trends in the burden and management of infection. We aimed to describe the prevalence of H. pylori among migrants through a systematic literature review. Methods: We searched PubMed® from inception to September 2015 to identify studies reporting the prevalence of H. pylori in international migrants according to country of birth for first‐generation, and country of birth and parents' nationality for successive generations. Comparable data from origin and destination populations were obtained from the same studies or, when not present, from a previous systematic review on H. pylori worldwide. Results: A total of 28 eligible studies were identified with data for 29 origin and 12 destination countries. Two studies that evaluated refugees presented prevalences of infection higher than both the origin and destination countries. Otherwise, the prevalences among migrants were generally similar or below that of the origin and higher than the destination. Second‐ or more generation had lower prevalences compared to first‐generation migrants. Conclusions: Our study findings are consistent with what would be expected based on the prevalence of H. pylori worldwide. The results of this review show that migrants are particularly at risk of infection and help to identify gaps in the knowledge of migrants' prevalence of infection globally.This work was supported by “Fundo Europeu de Desenvolvimento Regional” (FEDER) funds through the “Programa Operacional Factores de Competitividade” (POFC) – COMPETE (FCOMP‐01‐0124‐FEDER‐021181) and by national funds through the “Fundação para a Ciência e a Tecnologia” (PTDC/SAU‐EPI/122460/2010) and the Epidemiology Research Unit – Institute of Public Health, University of Porto supported by the “Fundação para a Ciência e a Tecnologia” (UID/DTP/047507/2013). Individual grants attributed to SM (SFRH/BD/102585/2014), ARC (SFRH/BD/102181/2014), AF (PD/BD/105823/2014), and BP (SFRH/BPD/75918/2011 and SFRH/BPD/108751/2015) were supported by “Fundação para a Ciência e a Tecnologia.” The funders had no role in study design, data collection, decision to publish, or preparation of the manuscript

Bidder returns for Norwegian acquirers : a study on how deal- and firm-specific characteristics affect bidder returns for Norwegian acquirers of foreign and domestic companies

We examine the announcement returns for Norwegian acquirers of foreign and domestic targets between 1988 and 2014. This is done using panel data in a random effects model with stock return data from NHH’s Børsprosjektet, and transaction data from SDC’s mergers and acquisitions database. We are the first, to our knowledge, to use panel data regression analysis on bidder announcement returns. Analysing periods around acquisition announcements reveal that only the day of announcement yields significant abnormal returns, which is consistent with the efficient market hypothesis in semi-strong form. Furthermore, we find no significant abnormal returns for firms acquiring public targets, which supports the theory of an efficient market for corporate control. However, we find significant abnormal returns for firms acquiring private targets. The returns from acquiring private targets are greatest when stock is used as the method of payment, while using stock to acquire public targets yields the most negative returns. The acquirer’s acquisition experience, the absolute size of the acquirer, and the target being in a related industry all have negative effects on announcement returns. Furthermore, we model the effect of relative size on announcement returns as a cubic function. This reveals a negative relationship until the target is one fourth of the acquirer’s size, and a positive relationship beyond this point. Additionally, we are, to our knowledge, the first to account for the possibility of altered marked beta coefficients as a result of acquisitions, through the use of a step-beta approach.nhhma

Structures, and immunomodulating and anti-ulcer activities of polysaccharides from Malian medicinal plants

The main purpose of this thesis was to evaluate the potential of pectins from the Malian medicinal tree Cola cordifolia used in the treatment of gastric ulcer and wounds. This thesis is a small contribution to the ultimate goal of providing efficient none-toxic and inexpensive medicines for the Malian population. The Department of Traditional Medicine, our collaborating partner in Bamako, wants to promote the use of renewable plant parts to guarantee a sustainable supply of medicinal plants. The structures and biological activities of the bark and leaf pectins were therefore compared in order to make recommendation on plant part substitution as debarking can damage or even kill the tree. We found that the pectins from the bark and leaves are structurally related. However, the leaf pectins are more polydisperse and heterogeneous compared to the pectins found in bark. Pectins from the bark were generally more active in the complement fixation test and the macrophage assay. Comparing the 50°C water extracts from bark and leaf in an experimental anti-ulcer model showed comparable and dose dependent inhibition of ulcer formation. However, a clinical trial is needed to evaluate the efficacy of the plant parts. Powdered roots of Vernonia kotschyana are highly valued as the improved traditional medicine “Gastrosedal”. The anti-ulcer activity of the medicine has previously been attributed to the presence of saponins. In this thesis, the anti-ulcer potential of 50°C and 100°C water extracts depleted of saponins, but high in inulin, 98% and 83% respectively, were evaluated in an experimental mouse model. The tested dose corresponded to the recommended daily intake of “Gastrosedal” and this dose showed a good inhibition of ulcer formation. We therefore concluded that inulin can also be responsible important for the anti-ulcer activity of “Gastrosedal”. In Mali, gastric ailments are rather common and contribute highly to morbidity in the country. In a previous study, Helicobacter pylori was found to be present in 95% of Malian patients with gastric ulcer. For future investigations and clinical trials, it was of interest to find a reliable and simple method for H. pylori detection. One stool and one serological based immunochromatographic method were tested, and the results showed that the sensitivity of these tests is too low in the Malian population. The low sensitivity was probably due to strain variability, in addition to high use of anti-malaria drugs, which might eradicate or lower the bio-burden of H. pylori

DNS of acoustic Instabilities in low Emission Combustion Systems

In a state of the art gas turbine using Lean Pre-Mixed fuels one of the main challenges is efficient and reliable control of sound generated during combustion. Knowledge of sound generation in gas turbine combustion chambers has to be enhanced in order to develop a reliable model with predictive capabilites.In this thesis Direct Numerical Simulations of two dimensional laminar imploding circular flame fronts have been performed. One dimensional simulations of laminar opposing flame fronts have been performed to establish modeling conditions for the two dimensional simulations, evaluate the boundary influence on the simulations and provide comparable simulation results. In addition a pre-study for three dimensional simulation of an inwards burning sphere of fuel has been done. The motivation of this thesis is to enhance the knowledge related to generation of acoustic waves in the combustion chamber of a gas turbine.The S3D code (a parallel DNS code for solving reactive flows) was modified to include two dimensional circular imploding flame fronts. A thorough investigation to validate the boundary influence on the annihilation event is recommended. This is due to simulations which indicate that the boundary conditions may influence especially the pressure drop after time of impact.In two dimensions DNS have been performed at pressure 1atm for fuel equivalence ratios 0.3, 0.5, 0.8 and 1.5 with detailed chemistry representation. Care has been taken to ensure adequat resolution of the flame (a minimum of ten points over the flame). The results from the simulations were used to measure key parameters (as the pressure drop after impact, the laminar flame speed, etc.). The following trends were found for the two dimensional simulations with increasing fuel equivalence ratio (in the given range): The flame thickness, unburned and burned gas density decrease, while the fluid expansion velocity, laminar flame speed, propagation speed of the pressure wave, pressure difference before the flame fronts meet, pressure drop after impact and burned temperature increase. This coincides with the the trends in the one dimensional simulations, and is consistent with the given theory.The results were compared with analytical relations developed in the candidate's project work of fall 2012. It was found that the three relations gave a poor impression of the measured values.It is indicated that to fully understand the annihilation process a number of simulations have to be run. The propagation speed of the pressure wave, the fluid expansion velocity and the pressure drop after time of impact require special attention

Biologisk aktive polysakkarider fra Glinus oppositifulius (L.) Aug. DC : ethnopharmacological survey in Mali

Første del i denne oppgaven tar for seg struktur- og aktivitetsstudier av polysakkarider fra Glinus oppositifolius, hvor arbeidet er blitt utført på en slik måte at det er enkelt å sammenligne resultatene med tidligere utført arbeid på samme plante av Inngjerdingen (2007), hvor pektinfraksjonene GOA1 og GOA2 ble isolert. Andre del tar for seg en etnofarmakologisk studie utført i områdene rundt Dioila og Koutiala i Mali i mars/april 2007. Utgangspunktet for analyser av polysakkarider fra G. oppositifolius var et vann-ekstrakt isolert av Inngjerdingen. Dette materialet ble videre applisert på en ionebytterkolonne type DEAE Sepharose fast flow. Det var ikke mulig å dele pektinmaterialet i flere fraksjoner, derfor fulgte videre separering på en gelfiltreringskolonne type Sephacryl S-200. Dette resulterte i to sure fraksjoner, GA1 og GA2. Ettersom det kun ble detektert en topp etter ionebytter, hvor det i tidligere studier har blitt oppdaget to, gav dette en teori om fytokjemiske ulikheter i de forskjellige batchene av plantemateriale. Hovedfraksjonen GA1 ble så degradertmed endo-1,4alfa-D-polygalakturonase (pektinase). Etter degradering og separasjon på gelfiltreringskolonne type Bio–Gel P30 ble det isolert fire fraksjoner, GA1Fr1–4. Det ble tilsatt for lite enzym ved førstegangstilsetting av pektinase. GA1Fr1 og GA1Fr2 ble derfor degradert en gang til med samme enzym. I tillegg ble GA1Fr1 og GA1Fr2 ble degradert med alfa-arabinofuranosidase i kombinasjon med pektinase. Det ble utført strukturoppklaring ved hjelp av metanolyse og GC/MS. Resultater fra disse analysene indikerer en RG-I struktur med AG-II sidekjeder, og muligens også arabinan-sidekjeder. Alle fraksjonene ble testet med tanke på biologisk aktivitet i to assay. GA1Fr1 viste potent antikomplementær effekt og et potensial til å kunne stimulere makrofager. Det ikke funnet sub-akutte toksiske effekter in vivo etter oral administrering av pektinfraksjon GA, i konsentrasjon 200 mg/kg, over 21 dager. I den etnofarmakologiske studien beskrevet i del 2 ble totalt 54 healere intervjuet om fem forskjellige planter, Erythrina senegalensis, Opilia celtidifolia, Combretum glutinosum, Biophytum petersianum and Syzygium guineense. De fire førstnevnte plantene var svært godt kjent for healerene, hvor de hyppigst nevnte indikasjonsområder for var for de respektive plantene: Amenoré, innvoldsorm, gulsott/ malaria og malaria. Det ble utarbeidet en tabell på engelsk for alle resultatene vist i vedlegg A