European neonatal intensive care nursing research priorities: an e-Delphi study.

OBJECTIVE: This study aimed to identify and prioritise neonatal intensive care nursing research topics across Europe using an e-Delphi technique. DESIGN: An e-Delphi technique with three questionnaire rounds was performed. Qualitative responses of round one were analysed by content analysis and research statements were generated to be ranged on importance on a scale of 1-6 (not important to most important). SETTING: Neonatal intensive care units (NICUs) in 17 European countries. POPULATION: NICU clinical nurses, managers, educators and researchers (n=75). INTERVENTION: None. MAIN OUTCOME MEASURES: A list of 43 research statements in eight domains. RESULTS: The six highest ranking statements (≥5.0 mean score) were related to prevention and reduction of pain (mean 5.49; SD 1.07), medication errors (mean 5.20; SD 1.13), end-of-life care (mean 5.05; SD 1.18), needs of parents and family (mean 5.04; SD 1.23), implementing evidence into nursing practice (mean 5.02; SD 1.03), and pain assessment (mean 5.02; SD 1.11). The research domains were prioritised and ranked: (1) pain and stress; (2) family centred care; (3) clinical nursing care practices; (4) quality and safety; (5) ethics; (6) respiratory and ventilation; (7) infection and inflammation; and (8) professional issues in neonatal intensive care nursing. CONCLUSIONS: The results of this study might support developing a nursing research strategy for the nursing section of the European Society of Paediatric and Neonatal Intensive Care. In addition, this may promote more European researcher collaboratives for neonatal nursing research

Leren van de buren (samenvatting). Beleid publieke gezondheid internationaal bezien: roken, alcohol, overgewicht, depressie, gezondheidsachterstand, jeugd, screening

English summary of report 270051010 A full English translation is available in report 270626001Nederland kan veel leren van het gezondheidsbeleid in andere landen. De overheid doet er goed aan gezondheidsproblemen vaker aan te pakken met een nationale strategie of actieplan. Ervaring uit het buitenland leert dat een dergelijk nationaal actieplan bijdraagt aan een systematischer beleid en minder versnippering van maatregelen. Dit concludeert het RIVM op basis van het internationaal vergelijkend rapport Leren van de buren. Het rapport is 9 juli 2007 aangeboden aan minister Klink van VWS. Het RIVM concludeerde vorig jaar dat Nederland op gebied van gezondheid niet langer bij beste Europese landen hoort.* Zo blijft Nederland achter met de daling van het aantal rokers en drinken Nederlandse jongeren vaker alcohol dan hun Europese leeftijdsgenoten. Het ontmoedigingsbeleid voor tabak en alcohol blijkt niet streng vergeleken met veel andere landen. Ook met de bestrijding van bijvoorbeeld depressies en gezondheidsachterstanden bij bevolkingsgroepen ontbreekt in Nederland een integrale aanpak. Het RIVM heeft het Nederlandse gezondheidsbeleid op roken, alcohol, overgewicht, gezondheidsachterstanden, depressie, jeugd en screening, vergeleken met dat van andere Europese landen. Hieruit blijkt dat veel maatregelen effectiever en meer in samenhang kunnen gebeuren. Zo heffen Duitsland, Zwitserland, Frankrijk en Denemarken extra belasting op breezers om jongeren te ontmoedigen alcohol te drinken. In sommige landen is een pakje sigaretten twee keer zo duur als in Nederland. Schotland, Finland en Australie bevorderen de psychische gezondheid met programma's op school en werk. Marktkrachten en andere -internationale- invloeden bemoeilijken soms de weg naar goed beleid, maar kunnen ook kansen bieden. Het RIVM adviseert de Nederlandse overheid om op basis van de buitenlandse ervaring haalbare doelen en effectieve maatregelen te vinden voor een meer integraal gezondheidsbeleid in Nederland. * Volksgezondheid Toekomst Verkenningen, RIVM juni 2006.The Netherlands does not make sufficient use of national strategies or action plans in tackling its public health problems. Our neighbours teach us that a comprehensive national strategy can contribute to the creation of a more systematic body of policy and less fragmented preventive measures. This is the conclusion reached by the RIVM in an international comparative report 'Learning from our neighbours; Cross-national inspiration for Dutch public health policies'. The Report was presented to Ab Klink, the Minister of Health, Welfare and Sports on July 9th 2007. Last year, the RIVM concluded that Dutch public health lags behind leading European nations.* The percentage of smokers hasn't decreased as fast as in other countries and Dutch young people drink alcohol more often than their European peers. The alcohol and tobacco control policies in place in the Netherlands are not as strict as those in other countries. Prevention of depression and reducing health inequalities miss a coherent strategy. Learning from our neighbours outlines existing policies on smoking, alcohol, overweight, depression, health inequalities, youth and screening throughout the world. For example Germany, Switzerland, France and Denmark levy extra taxes on breezers to discourage young people to drink alcohol. In some countries a package of cigarettes is two times as expensive as in the Netherlands. Scotland, Finland and Australia promote mental health through programmes at school and work. Market forces and other -international- influences sometimes interfere with good policy-making, but they also offer opportunities. To ensure a more coherent body of health policy, the RIVM recommends that Dutch public authorities make use of the lessons from our neighbours to set realistic goals and effective measures

Leren van de buren : Beleid publieke gezondheid internationaal bezien: roken, alcohol, overgewicht, depressie, gezondheidsachterstanden, jeugd, screening

English translation of RIVM report 270051010 RIVM report 270262002 is a summary of this reportNederland kan veel leren van het gezondheidsbeleid in andere landen. De overheid doet er goed aan gezondheidsproblemen vaker aan te pakken met een nationale strategie of actieplan. Ervaring uit het buitenland leert dat een dergelijk nationaal actieplan bijdraagt aan een systematischer beleid en minder versnippering van maatregelen. Dit concludeert het RIVM op basis van het internationaal vergelijkend rapport Leren van de buren. Het rapport is 9 juli 2007 aangeboden aan minister Klink van VWS. Het RIVM concludeerde vorig jaar dat Nederland op gebied van gezondheid niet langer bij beste Europese landen hoort.* Zo blijft Nederland achter met de daling van het aantal rokers en drinken Nederlandse jongeren vaker alcohol dan hun Europese leeftijdsgenoten. Het ontmoedigingsbeleid voor tabak en alcohol blijkt niet streng vergeleken met veel andere landen. Ook met de bestrijding van bijvoorbeeld depressies en gezondheidsachterstanden bij bevolkingsgroepen ontbreekt in Nederland een integrale aanpak. Het RIVM heeft het Nederlandse gezondheidsbeleid op roken, alcohol, overgewicht, gezondheidsachterstanden, depressie, jeugd en screening, vergeleken met dat van andere Europese landen. Hieruit blijkt dat veel maatregelen effectiever en meer in samenhang kunnen gebeuren. Zo heffen Duitsland, Zwitserland, Frankrijk en Denemarken extra belasting op breezers om jongeren te ontmoedigen alcohol te drinken. In sommige landen is een pakje sigaretten twee keer zo duur als in Nederland. Schotland, Finland en Australie bevorderen de psychische gezondheid met programma's op school en werk. Marktkrachten en andere -internationale- invloeden bemoeilijken soms de weg naar goed beleid, maar kunnen ook kansen bieden. Het RIVM adviseert de Nederlandse overheid om op basis van de buitenlandse ervaring haalbare doelen en effectieve maatregelen te vinden voor een meer integraal gezondheidsbeleid in Nederland. * Volksgezondheid Toekomst Verkenningen, RIVM juni 2006.The Netherlands does not make sufficient use of national strategies or action plans in tackling its public health problems. Our neighbours teach us that a comprehensive national strategy can contribute to the creation of a more systematic body of policy and less fragmented preventive measures. This is the conclusion reached by the RIVM in an international comparative report 'Learning from our neighbours; Cross-national inspiration for Dutch public health policies'. The Report was presented to Ab Klink, the Minister of Health, Welfare and Sports on July 9th 2007. Last year, the RIVM concluded that Dutch public health lags behind leading European nations.* The percentage of smokers hasn't decreased as fast as in other countries and Dutch young people drink alcohol more often than their European peers. The alcohol and tobacco control policies in place in the Netherlands are not as strict as those in other countries. Prevention of depression and reducing health inequalities miss a coherent strategy. Learning from our neighbours outlines existing policies on smoking, alcohol, overweight, depression, health inequalities, youth and screening throughout the world. For example Germany, Switzerland, France and Denmark levy extra taxes on breezers to discourage young people to drink alcohol. In some countries a package of cigarettes is two times as expensive as in the Netherlands. Scotland, Finland and Australia promote mental health through programmes at school and work. Market forces and other -international- influences sometimes interfere with good policy-making, but they also offer opportunities. To ensure a more coherent body of health policy, the RIVM recommends that Dutch public authorities make use of the lessons from our neighbours to set realistic goals and effective measures

Activity of the EBNA1 promoter associated with lytic replication (Fp) in Epstein-Barr virus associated disorders

Background/Aims - In Epstein-Barr virus (EBV) positive cell lines that are stably infected, three different promoters are known to direct the transcription of EBV nuclear antigen 1 (EBNA1). These are located in the BamHI-C, BamHI-Q, and BamHI-F regions of the viral genome (Cp, Qp, and Fp, respectively). Fp is activated upon induction of the viral lytic cycle. The aim of this study was to investigate the activity of Fp in EBV associated diseases. Methods - Using reverse transcriptase polymerase chain reaction, a qualitative analysis of EBNA1 promoter usage in various EBV associated diseases was performed. Results - Fp driven transcription was detected in the context of primary infection and/or lytic replication; at least a portion of the Fp driven transcripts encoded EBNA1. Qp driven EBNA1 transcripts were detected in most samples across the range of disorders tested. Cp driven EBNA1 transcripts were detected in the context of immune suppression and in samples containing EBV positive (nonneoplastic) lymphoid cells. Conclusions - These results confirm the previously proposed housekeeping function of the Qp promoter.published_or_final_versio

The Familial Clustering of Age at Menarche in Extended Twin Families

The timing of puberty is complex, possibly involving many genetic factors that may interact with environmental influences. Familial resemblance for age at menarche was studied in a sample of 4,995 female twins, 1,296 sisters, 2,946 mothers and 635 female spouses of male twins. They had indicated their age at menarche as part of a larger longitudinal survey. We assessed assortative mating for age at menarche, gene–environment interaction effects and estimated the heritability of individual differences in pubertal timing. There was significant evidence of gene–environment interaction, accounting for 1.5% of the variance. There was no indication of consistent mate assortment on age at menarche. Individual differences in age at menarche are highly heritable, with additive genetic factors explaining at least 70% of the true variation. An additional 1.5% of the variation can be explained by a genotype–environment interaction effect where environmental factors are more important in individuals genetically predisposed for late menarche

Black Hole Deconstruction

A D4-D0 black hole can be deconstructed into a bound state of D0 branes with a D6-anti-D6 pair containing worldvolume fluxes. The exact spacetime solution is known and resembles a D0 accretion disk surrounding a D6-anti-D6 core. We find a scaling limit in which the disk and core drop inside an AdS_2 throat. Crossing this AdS_2 throat and the D0 accretion disk into the core, we find a second scaling region describing the D6-anti-D6 pair. It is shown that the M-theory lift of this region is AdS_3 x S^2. Surprisingly, time translations in the far asymptotic region reduce to global, rather than Poincare, time translations in this core AdS_3. We further find that the quantum mechanical ground state degeneracy reproduces the Bekenstein-Hawking entropy-area law.Comment: 11 page

How to develop a program to increase influenza vaccine uptake among workers in health care settings?

Background: Apart from direct protection and reduced productivity loss during epidemics, the main reason to immunize healthcare workers (HCWs) against influenza is to provide indirect protection of frail patients through reduced transmission in healthcare settings. Because the vaccine uptake among HCWs remains far below the health objectives, systematic programs are needed to take full advantage of such vaccination. In an earlier report, we showed a mean 9% increase of vaccine uptake among HCWs in nursing homes that implemented a systematic program compared with control homes, with higher rates in those homes that implemented more program elements. Here, we report in detail the process of the development of the implementation program to enable researchers and practitioners to develop intervention programs tailored to their setting. Methods: We applied the intervention mapping (IM) method to develop a theory-and evidence-based intervention program to change vaccination behaviour among HCWs in nursing homes. Results: After a comprehensive needs assessment, we were able to specify proximal program objectives and selected methods and strategies for inducing behavioural change. By consensus, we decided on planning of three main program components, i.e., an outreach visit to all nursing homes, plenary information meetings, and the appointment of a program coordinator - preferably a physician - in each home. Finally, we planned program adoption, implementation, and evaluation. Conclusion: The IM methodology resulted in a systematic, comprehensive, and transparent procedure of program development. A potentially effective intervention program to change influenza vaccination behaviour among HCWs was developed, and its impact was assessed in a clustered randomised controlled trial