Implementation of recommended trauma system criteria in south-eastern Norway: a cross-sectional hospital survey

<p>Abstract</p> <p>Background</p> <p>Formalized trauma systems have shown beneficial effects on patient survival and have harvested great recognition among health care professionals. In spite of this, the implementation of trauma systems is challenging and often met with resistance.</p> <p>Recommendations for a national trauma system in Norway were published in 2007. We wanted to assess the level of implementation of these recommendations.</p> <p>Methods</p> <p>A survey of all acute care hospitals that receive severely injured patients in the south-eastern health region of Norway was conducted. A structured questionnaire based on the 2007 national recommendations was used in a telephone interview of hospital trauma personnel between January 17 and 21, 2011. Seventeen trauma system criteria were identified from the recommendations.</p> <p>Results</p> <p>Nineteen hospitals were included in the study and these received more than 2000 trauma patients annually via their trauma teams. Out of the 17 criteria that had been identified, the hospitals fulfilled a median of 12 criteria. Neither the size of the hospitals nor the distance between the hospitals and the regional trauma centre affected the level of trauma resources available. The hospitals scored lowest on the criteria for transfer of patients to higher level of care and on the training requirements for members of the trauma teams.</p> <p>Conclusion</p> <p>Our study identifies a major shortcoming in the efforts of regionalizing trauma in our region. The findings indicate that training of personnel and protocols for inter-hospital transfer are the major deficiencies from the national trauma system recommendations. Resources for training of personnel partaking in trauma teams and development of inter-hospital transfer agreements should receive immediate attention.</p

Pastoral Herding Strategies and Governmental Management Objectives: Predation Compensation as a Risk Buffering Strategy in the Saami Reindeer Husbandry

Previously it has been found that an important risk buffering strategy in the Saami reindeer husbandry in Norway is the accumulation of large herds of reindeer as this increases long-term household viability. Nevertheless, few studies have investigated how official policies, such as economic compensation for livestock losses, can influence pastoral strategies. This study investigated the effect of received predation compensation on individual husbandry units’ future herd size. The main finding in this study is that predation compensation had a positive effect on husbandry units’ future herd size. The effect of predation compensation, however, was nonlinear in some years, indicating that predation compensation had a positive effect on future herd size only up to a certain threshold whereby adding additional predation compensation had little effect on future herd size. More importantly, the effect of predation compensation was positive after controlling for reindeer density, indicating that for a given reindeer density husbandry units receiving more predation compensation performed better (measured as the size of future herds) compared to husbandry units receiving less compensation

Housing system and herd size interactions in Norwegian dairy herds; associations with performance and disease incidence

<p>Abstract</p> <p>Background</p> <p>According to the Norwegian animal welfare regulations, it has been forbidden to build new tie-stall barns since the end of 2004. Previous studies have shown that cow performance and health differ between housing systems. The interaction between housing system and herd size with respect to performance and disease incidence has not been evaluated.</p> <p>Methods</p> <p>Cow performance and health in 620 herds housed in free-stall barns were compared with in 192 herds housed in tie-stall barns based on a mail survey and data from the Norwegian Dairy Herd Recording and Cattle Health Systems. The housing systems herds were comparable with respect to herd size (15-55 cows). Associations between performance/disease incidence and housing system, herd size and year of building the cow barn were tested in general linear models, and values for fixed herd size of 20 and 50 cows were calculated. On the individual cow level mixed models were run to test the effect of among others housing system and herd size on test-day milk yield, and to evaluate lactation curves in different parities. All cows were of the Norwegian Red Breed.</p> <p>Results</p> <p>Average milk production per cow-year was 134 kg lower in free-stall herd than in tie-stall herds, but in the range 27-45 cows there was no significant difference in yields between the herd categories. In herds with less than 27 cows there were increasingly lower yields in free-stalls, particularly in first parity, whereas the yields were increasingly higher in free-stalls with more than 45 cows.</p> <p>In free-stalls fertility was better, calving interval shorter, and the incidence rate of teat injuries, ketosis, indigestions, anoestrus and cystic ovaries was lower than in tie-stalls. All of these factors were more favourable in estimated 50-cow herds as compared to 20-cow herds. In the larger herd category, bulk milk somatic cell counts were higher, and the incidence rate of mastitis (all cases) and all diseases was lower.</p> <p>Conclusion</p> <p>This study has shown that there is an interaction between housing system and herd size, and that performance and health is not universally better in small free-stalls than in tie-stalls.</p

The QUIET Instrument

The Q/U Imaging ExperimenT (QUIET) is designed to measure polarization in the Cosmic Microwave Background, targeting the imprint of inflationary gravitational waves at large angular scales (~ 1 degree). Between 2008 October and 2010 December, two independent receiver arrays were deployed sequentially on a 1.4 m side-fed Dragonian telescope. The polarimeters which form the focal planes use a highly compact design based on High Electron Mobility Transistors (HEMTs) that provides simultaneous measurements of the Stokes parameters Q, U, and I in a single module. The 17-element Q-band polarimeter array, with a central frequency of 43.1 GHz, has the best sensitivity (69 uK sqrt(s)) and the lowest instrumental systematic errors ever achieved in this band, contributing to the tensor-to-scalar ratio at r < 0.1. The 84-element W-band polarimeter array has a sensitivity of 87 uK sqrt(s) at a central frequency of 94.5 GHz. It has the lowest systematic errors to date, contributing at r < 0.01. The two arrays together cover multipoles in the range l= 25-975. These are the largest HEMT-based arrays deployed to date. This article describes the design, calibration, performance of, and sources of systematic error for the instrument

First Season QUIET Observations: Measurements of CMB Polarization Power Spectra at 43 GHz in the Multipole Range 25 <= ell <= 475

The Q/U Imaging ExperimenT (QUIET) employs coherent receivers at 43GHz and 95GHz, operating on the Chajnantor plateau in the Atacama Desert in Chile, to measure the anisotropy in the polarization of the CMB. QUIET primarily targets the B modes from primordial gravitational waves. The combination of these frequencies gives sensitivity to foreground contributions from diffuse Galactic synchrotron radiation. Between 2008 October and 2010 December, >10,000hours of data were collected, first with the 19-element 43GHz array (3458hours) and then with the 90-element 95GHz array. Each array observes the same four fields, selected for low foregrounds, together covering ~1000deg^2. This paper reports initial results from the 43GHz receiver which has an array sensitivity to CMB fluctuations of 69uK sqrt(s). The data were extensively studied with a large suite of null tests before the power spectra, determined with two independent pipelines, were examined. Analysis choices, including data selection, were modified until the null tests passed. Cross correlating maps with different telescope pointings is used to eliminate a bias. This paper reports the EE, BB and EB power spectra in the multipole range ell=25-475. With the exception of the lowest multipole bin for one of the fields, where a polarized foreground, consistent with Galactic synchrotron radiation, is detected with 3sigma significance, the E-mode spectrum is consistent with the LCDM model, confirming the only previous detection of the first acoustic peak. The B-mode spectrum is consistent with zero, leading to a measurement of the tensor-to-scalar ratio of r=0.35+1.06-0.87. The combination of a new time-stream double-demodulation technique, Mizuguchi-Dragone optics, natural sky rotation, and frequent boresight rotation leads to the lowest level of systematic contamination in the B-mode power so far reported, below the level of r=0.1Comment: 19 pages, 14 figures, higher quality figures are available at http://quiet.uchicago.edu/results/index.html; Fixed a typo and corrected statistical error values used as a reference in Figure 14, showing our systematic uncertainties (unchanged) vs. multipole; Revision to ApJ accepted version, this paper should be cited as "QUIET Collaboration et al. (2011)

Vurderinger vedrørende utslipp av suspendert stoff fra Rekefjord Stone

Prosjektleder Hilde C. TrannumRekefjord Stone har utslipp av suspenderte partikler til resipienten i Rekefjorden. Effekter av slike partikler på fisk, skalldyr og bunnmiljøet i fjorden er vurdert. Vurderingen er basert på data fra to feltinnsamlinger, analyser av partikler i vannmassene og bunnsediment sammenholdt med eksisterende kunnskap fra litteraturen. Partikler fra pukkverket ble observert både i vannmassene og på bunnen. Partikkelanalysen viste dominans av avlange partikler i alle prøvene. Selv om slike partikler i utgangspunktet kan medføre skade, var partikkelmengdene såpass lave at sannsynligheten for negativ effekt på fisk og skalldyr er ansett å være liten.Rekefjord Stone ASpublishedVersio

Educational attainment, health outcomes and mortality: a within-sibship Mendelian randomization study

BACKGROUND: Previous Mendelian randomization (MR) studies using population samples (population MR) have provided evidence for beneficial effects of educational attainment on health outcomes in adulthood. However, estimates from these studies may have been susceptible to bias from population stratification, assortative mating and indirect genetic effects due to unadjusted parental genotypes. MR using genetic association estimates derived from within-sibship models (within-sibship MR) can avoid these potential biases because genetic differences between siblings are due to random segregation at meiosis. METHODS: Applying both population and within-sibship MR, we estimated the effects of genetic liability to educational attainment on body mass index (BMI), cigarette smoking, systolic blood pressure (SBP) and all-cause mortality. MR analyses used individual-level data on 72 932 siblings from UK Biobank and the Norwegian HUNT study, and summary-level data from a within-sibship Genome-wide Association Study including >140 000 individuals. RESULTS: Both population and within-sibship MR estimates provided evidence that educational attainment decreased BMI, cigarette smoking and SBP. Genetic variant-outcome associations attenuated in the within-sibship model, but genetic variant-educational attainment associations also attenuated to a similar extent. Thus, within-sibship and population MR estimates were largely consistent. The within-sibship MR estimate of education on mortality was imprecise but consistent with a putative effect. CONCLUSIONS: These results provide evidence of beneficial individual-level effects of education (or liability to education) on adulthood health, independently of potential demographic and family-level confounders