The "Romsås in Motion" community intervention: program exposure and psychosocial mediated relationships to change in stages of change in physical activity

<p>Abstract</p> <p>Background</p> <p>Conducting process evaluations of health promoting interventions, and measuring the effectiveness of specific intervention components, may help in the understanding of program failure or success. The purposes of the present study were to examine adults' exposure to and involvement in specific components of a three year long pseudo-experimental community-based physical activity intervention, and to examine the relationship between such exposure and participation and changes in stages of change in physical activity and psychosocial mediators.</p> <p>Methods</p> <p>1497 persons in the intervention group attended the baseline survey in 2000 (50.6%) and 1204 (80.4 of baseline attendees) provided data on the outcome variables of the present study. In 2003, 1089 were still living in the area, and were re-invited to follow-up assessments. Current analyses are based on the 603 persons (mean age 49 ± 10 years) who provided baseline and follow-up data for the current purposes (56.6% follow-up rate). Process data, stages of change in physical activity, and potential psychosocial mediators of change in physical activity were assessed by questionnaires. The theory-based intervention was composed of communication, physical activity, environmental and participatory components. Data were analysed using frequency and descriptive statistics, Chi-square and t-tests, and regression analyses.</p> <p>Results</p> <p>Exposure and participation rates in the various intervention components varied greatly (1.5–92.7%). Participation in walking groups and aerobic exercise groups, as well as having seen the "Walk the stairs"-poster were significantly and positively related to change in stages of change in physical activity (β = .12, p = .011; β = .211, p < .001; β = .105, p = .014, respectively). Additionally, having used the walk path was significantly and positively related to change in stages in women (β = .209, p = .001) but not in men (β = -.011, p = .879), and in Western people (β = .149, p = .003) but not in non-Westerners (β = -.293, p = .092). Observed significant relations were partly mediated by positive changes in psychosocial factors as social support from friends, perceived control, and physical activity identity.</p> <p>Conclusion</p> <p>Findings revealed that particular intervention components, such as participation in physical activity groups, were more strongly related to forward transition in stages of change in physical activity than others. These findings together with results indicating that such transitions were mediated by specific psychosocial influences may improve theory and help to prioritize among specific intervention components in future programs.</p

The Motivations of Pilgrimage Walking the St.Olav Way in Norway

Walking pilgrimages are experiencing a revival, while at the same time a change of character in light of our changing times. Pilgrimage walking is increasingly taking on non-religious dimensions, related to a person’s self and health as seen on long-distance walking pilgrimages such as the Camino routes to Santiago. Long-range walking pilgrimages seem to offer a promise and space for ‘personal fixing’ / ‘self-healing’, thus attracting people with a variety of motives. This article is based on an empirical study consisting of qualitative open-ended questionnaires with 53 respondents from 13 countries. It aims to shed light on the motives, expectations and hopes that make people walk the less known and studied Norwegian St. Olav Way and what motivational trends prevail there, compared to others pilgrimage routes such as the more popular Camino de Santiago de Compostela and Japanese Shikoku Henro trail. Motivational categories were generated through an inductive thematic analysis of their answers and explanations were sought, drawing on existing literature as well as meaning-making and motivational theories. Results indicate that religious motives were not predominant in people’s quest with the journey. Instead, contemplation, health, social / solitary, pilgrimage walking / repeating, and nature motives stood out as the most significant, followed by less mentioned motives such as historical / cultural / travel interests, spiritual / religious reasons, a more present / simple / slow life, and life celebrations / crossroads / transitions. These findings challenge popular assumptions about why people undertake long-term walking pilgrimages. Further research is needed given the emerging trend to seek long-distance pilgrimage walking for self-discovery / development / therapy. This is largely uncovered ground in health care / science, despite the fact that pilgrimages have, throughout time, been sought for betterment and wellbeing

An integrated 4249 marker FISH/RH map of the canine genome

BACKGROUND: The 156 breeds of dog recognized by the American Kennel Club offer a unique opportunity to map genes important in genetic variation. Each breed features a defining constellation of morphological and behavioral traits, often generated by deliberate crossing of closely related individuals, leading to a high rate of genetic disease in many breeds. Understanding the genetic basis of both phenotypic variation and disease susceptibility in the dog provides new ways in which to dissect the genetics of human health and biology. RESULTS: To facilitate both genetic mapping and cloning efforts, we have constructed an integrated canine genome map that is both dense and accurate. The resulting resource encompasses 4249 markers, and was constructed using the RHDF5000-2 whole genome radiation hybrid panel. The radiation hybrid (RH) map features a density of one marker every 900 Kb and contains 1760 bacterial artificial chromosome clones (BACs) localized to 1423 unique positions, 851 of which have also been mapped by fluorescence in situ hybridization (FISH). The two data sets show excellent concordance. Excluding the Y chromosome, the map features an RH/FISH mapped BAC every 3.5 Mb and an RH mapped BAC-end, on average, every 2 Mb. For 2233 markers, the orthologous human genes have been established, allowing the identification of 79 conserved segments (CS) between the dog and human genomes, dramatically extending the length of most previously described CS. CONCLUSIONS: These results provide a necessary resource for the canine genome mapping community to undertake positional cloning experiments and provide new insights into the comparative canine-human genome maps

Genetic risk and a primary role for cell-mediated immune mechanisms in multiple sclerosis.

Multiple sclerosis is a common disease of the central nervous system in which the interplay between inflammatory and neurodegenerative processes typically results in intermittent neurological disturbance followed by progressive accumulation of disability. Epidemiological studies have shown that genetic factors are primarily responsible for the substantially increased frequency of the disease seen in the relatives of affected individuals, and systematic attempts to identify linkage in multiplex families have confirmed that variation within the major histocompatibility complex (MHC) exerts the greatest individual effect on risk. Modestly powered genome-wide association studies (GWAS) have enabled more than 20 additional risk loci to be identified and have shown that multiple variants exerting modest individual effects have a key role in disease susceptibility. Most of the genetic architecture underlying susceptibility to the disease remains to be defined and is anticipated to require the analysis of sample sizes that are beyond the numbers currently available to individual research groups. In a collaborative GWAS involving 9,772 cases of European descent collected by 23 research groups working in 15 different countries, we have replicated almost all of the previously suggested associations and identified at least a further 29 novel susceptibility loci. Within the MHC we have refined the identity of the HLA-DRB1 risk alleles and confirmed that variation in the HLA-A gene underlies the independent protective effect attributable to the class I region. Immunologically relevant genes are significantly overrepresented among those mapping close to the identified loci and particularly implicate T-helper-cell differentiation in the pathogenesis of multiple sclerosis

IFT81, encoding an IFT-B core protein, as a very rare cause of a ciliopathy phenotype

Background: Bidirectional intraflagellar transport (IFT) consists of two major protein complexes, IFT-A and IFT-B. In contrast to the IFT-B complex, all components of IFT-A have recently been linked to human ciliopathies when defective. We therefore hypothesised that mutations in additional IFT-B encoding genes can be found in patients with multisystemic ciliopathies. Methods: We screened 1628 individuals with reno-ocular ciliopathies by targeted next-generation sequencing of ciliary candidate genes, including all IFT-B encoding genes. Results: Consequently, we identified a homozygous mutation in IFT81 affecting an obligatory donor splice site in an individual with nephronophthisis and polydactyly. Further, we detected a loss-of-stop mutation with extension of the deduced protein by 10 amino acids in an individual with neuronal ceroid lipofuscinosis-1. This proband presented with retinal dystrophy and brain lesions including cerebellar atrophy, a phenotype to which the IFT81 variant might contribute. Cultured fibroblasts of this latter affected individual showed a significant decrease in ciliated cell abundance compared with controls and increased expression of the transcription factor GLI2 suggesting deranged sonic hedgehog signalling. Conclusions: This work describes identification of mutations of IFT81 in individuals with symptoms consistent with the clinical spectrum of ciliopathies. It might represent the rare case of a core IFT-B complex protein found associated with human disease. Our data further suggest that defects in the IFT-B core are an exceedingly rare finding, probably due to its indispensable role for ciliary assembly in development

Psychosynthesis: A Foundational Bridge Between Psychology and Spirituality

Pastoral psychologists have long tried to establish a working model that encompasses the seemingly conflicting disciplines of science and religion. Psychosynthesis, a transpersonal psychology and therapeutic approach, offers such a model of the human personality, in which the psychological and spiritual perspectives can converge. This article explores psychosynthesis psychology and therapy as a theoretical framework for pastoral psychology. Although psychosynthesis psychotherapy relies on an array of techniques, it fundamentally works with the clients’ will while emphasizing, exploring, and cultivating their relationships on all levels—intrapersonal, interpersonal, and with the Higher Self. In addition to the subconscious, psychosynthesis includes a higher psychological plane, called the superconscious, from which our higher ethical, aesthetic, scientific, and spiritual values are derived. This article begins by introducing psychosynthesis concepts and techniques. It then provides qualitative findings showing that psychosynthesis counseling helped to awaken spirituality in three out of eleven clients who had formerly identified themselves as atheists. In addition, testimonies are included that show that psychosynthesis counseling also helped all eleven clients to attain personal growth. Finally, the counselor describes her experience of psychosynthesis as a Christian in the therapeutic setting. The framework of psychosynthesis psychology and its techniques are viable methodologies for anyone searching to incorporate spiritual growth into a psychological working mode

PATJ Low Frequency Variants Are Associated with Worse Ischemic Stroke Functional Outcome: A Genome-Wide Meta-Analysis

RATIONALE: Ischemic stroke is among the leading causes of adult disability. Part of the variability in functional outcome after stroke has been attributed to genetic factors but no locus has been consistently associated with stroke outcome. OBJECTIVE: Our aim was to identify genetic loci influencing the recovery process using accurate phenotyping to produce the largest GWAS (genome-wide association study) in ischemic stroke recovery to date. METHODS AND RESULTS: A 12-cohort, 2-phase (discovery-replication and joint) meta-analysis of GWAS included anterior-territory and previously independent ischemic stroke cases. Functional outcome was recorded using 3-month modified Rankin Scale. Analyses were adjusted for confounders such as discharge National Institutes of Health Stroke Scale. A gene-based burden test was performed. The discovery phase (n=1225) was followed by open (n=2482) and stringent joint-analyses (n=1791). Those cohorts with modified Rankin Scale recorded at time points other than 3-month or incomplete data on previous functional status were excluded in the stringent analyses. Novel variants in PATJ (Pals1-associated tight junction) gene were associated with worse functional outcome at 3-month after stroke. The top variant was rs76221407 (G allele, β=0.40, P=1.70×10-9). CONCLUSIONS: Our results identify a set of common variants in PATJ gene associated with 3-month functional outcome at genome-wide significance level. Future studies should examine the role of PATJ in stroke recovery and consider stringent phenotyping to enrich the information captured to unveil additional stroke outcome loci

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

Samarbeid og kompetanseutveksling mellom sykehus og kommune : evaluering av prosjektet "Ambulant team"

Rapporten er en evaluering av prosjektet ”Ambulant team” som innbefattet ambulerende virksomhet fra Geriatrisk seksjon ved Sykehuset i Vestfold og ut i Horten, Nøtterøy og Sandefjord kommuner i forbindelse med hjemsending av pasienter. Hovedmålene med inneværende undersøkelse har vært å evaluere effekten av den ambulerende virksomheten på samhandlingen og kompetanseutvekslingen behandlingsnivåene imellom, samt å ta stilling til prosjektets videre- og overføringsverdi

Evaluering av Nærmiljøprosjektet i Vestfold fylke

I perioden 2016-2018 var Vestfold fylkeskommune og seks Vestfoldkommuner med i Nærmiljøprosjektet sammen med 7 andre fylker og 34 andre kommuner. Kommunene fra Vestfold var Færder, Horten, Larvik, Sandefjord, Tjøme og Tønsberg. Nærmiljøprosjektet ble initiert av Helsedirektoratet og var en del av et nasjonalt strategisk arbeid for styrket lokalt folkehelsearbeid og et ledd i implementeringen av folkehelseloven. Hovedmålet med prosjektet var å styrke kommunene i utviklingen av helsefremmende nærmiljøer og lokalsamfunn basert på gjennomføring av ulike innbyggermedvirkningsmetoder. Hensikten var å innhente kvalitativ lokalkunnskap fra innbyggerne som skulle inngå i kunnskaps- og beslutningsgrunnlaget i kommunale folkehelseoversikter og planer. Universitetet i Sørøst-Norge fikk oppdraget med ha en «følge-med-rolle» og å evaluere prosjektet i Vestfold. Evalueringen er basert på kvalitative data innhentet gjennom spørreskjemaer som ble besvart av deltakerne i medvirkningsprosessene og prosjektmedarbeiderne i kommunene og fylkeskommunen. I tillegg er evalueringen basert på diverse tilgjengelige dokumenter, deltakelse på prosjektledermøter, deltakelse på nasjonale og regionale samlinger og seminarer, samt samtaler med prosjektmedarbeiderne. Resultatene viser at prosjektkommunene iverksatte mange ulike aktiviteter og prosesser. Flere forskjellige medvirknings- og datainnsamlingsmetoder ble utprøvd både i form av kartlegging og dialogbaserte medvirkningsprosesser. Det lyktes å rekruttere bredt i alle aldersgrupper og fra mange ulike målgrupper, selv om det i noen tilfeller var mangler i rekrutteringsprosessene som resulterte i lav deltakelse. Både i rekrutteringsarbeidet og i etterkant av gjennomførte medvirkningsmetoder framstår informasjon til deltakere og innbyggere som essensielt. I rekrutteringen danner informasjonen selve grunnlaget for deltakelse, og i etterkant har informasjon om anvendelse av resultatene betydning for demokratisk deltakelse og myndiggjøring. Ved å bidra med innspill og å være med å bestemme opplevde deltakerne seg betydningsfulle og uttrykte at medvirkningsprosessene var demokrati i praksis. Prosjektkommunene fikk gjennom medvirkningsprosessene et bredt kvalitativt kunnskapsgrunnlag som ble integrert i folkehelseoversikter og planer. Resultatene fra medvirkningsmetodene ga også grunnlag for å iverksette umiddelbare tiltak. Prosjektmedarbeiderne arbeidet systematisk og langsiktig med integrering av den kvalitative kunnskapen i folkehelseoversikter og planer, men graden av integrering i ulike planer og plannivåer varierte i de ulike kommunene. Resultatene viser tydelig at Nærmiljøprosjektet styrket kommunenes kvalitative kunnskapsgrunnlag og utgjorde et viktig supplement til eksisterende kvantitativ kunnskap. Evalueringen viser videre at aktivitetene i Nærmiljøprosjektet stimulerte det tverrsektorielle samarbeidet innad i kommunene og la et godt grunnlag for å styrke kommunenes langsiktige og systematiske nærmiljøutviklingsarbeid. Det framkom at samarbeidet med kommunenes planavdelinger var viktig i alle faser av prosjektet, men særlig i forhold til integrering av resultatene fra medvirkningsprosessene i planutviklingsarbeidet. Planleggere ble inspirert av og så nytteverdien av innbyggermedvirkning og ga uttrykk for at de ønsket å implementere dette i planutviklingsarbeidet og i sine rutiner. Underveis i prosjektperioden utfylte Vestfold fylkeskommune sin rolle som kompetansebygger og bidro med viktige og systematiske kompetansehevende tiltak, samt veiledning og støtte for prosjektmedarbeiderne og kommunene. Fylkeskommunen bidro i stor grad til at prosjektmedarbeiderne og kommunene kunne gjennomføre Nærmiljøprosjektet på en velfungerende måte. Resultatene viser at medvirkningsarbeidet er viktig for å fremme befolkningens helse – gjennom tiltak og planer basert på et styrket kunnskapsgrunnlag og gjennom helsefremmende og bemyndigende prosesser både på individ- og samfunnsnivå. Resultatene gir også grunn til å tro at medvirkningsprosesser bidrar til å styrke fellesskapsfølelse og tilhørighet i nærmiljøer og lokalsamfunn