Sexual Dysfunction in Urogynaecology

__abstract__ This thesis is dedicated to enhance understanding of sexual dysfunction in the field of urogynaecology, focussing on the prevalence of sexual problems in urogynaecology clinics, the clinical attention of the urogynaecologist to female sexual dyfunction, the impact of POP, SUI and pelvic floor surgery on the sexual functioning of the female patient, as well as the impact on the sexual functioning of her partner

Organic and conventional public food procurement for youth in Norway

In Norway, public procurement of food to youth is not well developed in comparison to many other European and Scandinavian countries. School meals are only offered in very few primary schools, and the common school meal is a packed lunch (sandwiches) brought from home, consumed in the class room. Subscription schemes for milk were introduced around 1970, and for fruit around 1995. Organic milk and fruit is offered only in some regions. Since 2007, fruit is served without payment in all schools with a lower secondary level (class 8-10 or 1-10). This effort was introduced as a first step to develop a free school meal in all public schools, which is a goal of one of the political parties in the current government. As in many other European countries, free school meals were offered (especially to poor children) in schools in the larger Norwegian cities around 1900. However, these meals were criticised for being unhealthy, and replaced by whole grain bread, milk and vegetables around 1930. Increasing private wealth, and increased demand for investments in school buildings, books etc changed the public priority and free school meals disappeared in Oslo around 1960. Today, there is not a general agreement about the optimal school meal composition, and whether or not the meals should be funded by the public. However, the increasing length of the school day and unsatisfactory scores of Norwegian pupils in international comparison tests (e.g. PISA) makes the school meal sector highly relevant in the public debate. Three cases that will be studied in a research project about public organic food procurement for youth are briefly described: The municipality of Trondheim, Øya music festival in Oslo and the Air Force Academy. (Increased) serving of organic food is an important aim in all these cases, and young people are an important target group. The report is produced within the project “innovative Public Organic food Procurement for Youth”, iPOPY, and will be updated and revised during the project period (2007-2010)

Predictive properties and therapeutical use of gasotransmitters:A renal perspective

In this thesis, we explored the predictive properties of gasotransmitters on graft survival and all-cause mortality in renal transplant recipients. To provide further evidence for the involvement of gasotransmitters in renal and cardiovascular damage we tested their therapeutical potential in experimental models of hypertension-induced disease. To validate our assumptions, clinical observational studies in renal transplant recipients were performed in which we measured the end-metabolites of gasotransmitters and their systemic biochemical reactions in order to gain better insight into the associations of H2S, NO, their metabolites and inhibitors, with renal and cardiovascular risk parameters. To substantiate the clinical findings, we performed experimental intervention studies, whereby exogenously administered H2S metabolites, sulfide containing salts, and inhibitors of H2S producing enzymes were administered in hypertensive models of renal and cardiac disease. We conclude that the gasotransmitters NO, H2S and also CO are involved in diverse (patho)physiological processes in the kidney and that therapeutical intervention with these gaseous molecules might have therapeutic potential in the protection against morbidity and mortality of patients with hypertension-induced kidney disease or after renal transplantation

Evaluatie aanvullende en collectieve verzekeringen 2008

In dit rapport wordt verslag gedaan van een onderzoek naar de mogelijke gevolgen van aanvullende en collectieve verzekeringen voor risicoselectie en verzekerdenmobiliteit in de basisverzekering. De analyse heeft betrekking op het jaar 2008. Tevens worden de ontwikkelingen in 2008 vergeleken met de bevindingen van voorafgaande evaluatiestudies over eerdere jaren. Het onderzoek is uitgevoerd in opdracht van de Nederlandse Patiënten Consumenten Federatie (NPCF)

Evaluatie aanvullende en collectieve ziektekostenverzekeringen 2009

Voorwoord In dit rapport wordt verslag gedaan van een onderzoek naar de mogelijke gevolgen van aanvullende en collectieve verzekeringen voor risicoselectie en verzekerdenmobiliteit in de basisverzekering. De analyse heeft betrekking op het jaar 2009. Tevens worden de ontwikkelingen in 2009 vergeleken met de bevindingen van evaluatiestudies over eerdere jaren. Het onderzoek is uitgevoerd in opdracht van de Nederlandse Patiënten Consumenten Federatie (NPCF). De auteurs danken prof. dr. W.P.M.M. van de Ven voor zijn waardevolle commentaar op een eerdere versie van dit rapport. Tevens danken zij drs. P.J. Schout van de NPCF voor haar inzet voor de totstandkoming van dit onderzoeksproject en haar betrokkenheid en commentaar

iPOPY – innovative Public Organic food Procurement for Youth. School meals – and more!

One of eight pilot projects in the European CORE Organic programme, innovative Public Organic food Procurement for Youth, (iPOPY) will study efficient ways of implementing organic food in public serving outlets for young people (2007-10). By analysing practical cases of school meal systems and other food serving outlets for youth, we will identify hindrances and promoting factors in the participating countries (Denmark, Finland, Italy and Norway). Policies, supply chains, certification systems, the young consumers’ perception and participation, and health effects of implementation of organic policies and menus are focussed in iPOPY. The main aim is to suggest efficient policies and comprehensive strategies to increase the consumption of organic food among young consumers in a public setting, and fostering sustainable nutrition. Interdisciplinary project tools under development will be presented along with the first project results, which will be available by June 2008

THE COMPLETE STORY: A POPULATION‐ BASED PERSPECTIVE ON SCHOOL PERFORMANCE AND EDUCATIONAL TESTING

All children born in Manitoba in 1984 were tracked for 18 years to assess their grade‐ 12 performance on a provincial examination according to a student’s socio‐economic status. The proportion of youths in families receiving social assistance judged to have passed their language arts exam dropped from 80 per cent to 12 per cent, depending on whether one counts only those in the cohort who took the test on time in 2002 or all youths born in 1984 who should have taken the test in 2002. Getting better data on performance and doing something about the discrepancies should become a Canadian priority. Key words: educational opportunity, exam performance, socio‐economic status, testing, longitudinal studies Tous les enfants nés au Manitoba en 1984 ont été suivis sur une période de 18 ans en vue d’évaluer leur rendement en 12e année lors d’un examen provincial, tenant compte de leur statut socioéconomique. La proportion de jeunes issus des familles recevant de l’aide sociale et considérés comme ayant réussi leur examen au plan des compétences linguistiques passe de 80 % à 12 %, selon que l’on compte seulement ceux qui, dans la cohorte, ont subi l’examen à temps en 2002 ou tous les jeunes nés en 1984 qui auraient dû subir l’examen. En matière d’égalité des chances, la performance du système scolaire actuel au Canada laisse à désirer. Mots clés: possibilités éducatives, résultats d’examen, statut socioéconomique, analyse longitudinale.

Vereseerumi D-vitamiini sisaldus raseduse teisel kolmandikul mõjutab rasedustulemust ja ema tervist

Taust. D-vitamiin mõjutab rohkem kui 200 geeni ekspressiooni, mistõttu on see vitamiin oluline paljudes füsioloogilistes protsessides. Inimene vajab D-vitamiini kogu elu vältel, ent kriitilise tähtsusega on see raseduse ajal. Rasedad naised ja nende vastsündinud moodustavad hüpo-D-vitaminoosi riskirühma ning D-vitamiini puudulikkusest on saanud ülemaailmne probleem.Eesmärk. Analüüsida Eesti naiste rasedusaegset vereseerumi D-vitamiini sisaldust, seda määravaid tegureid ning hinnata D-vitamiini vähese sisalduse mõju ema ning lapse tervisele.Meetodid. Analüüsiti TÜ Kliinikumi naistekliiniku tervete rasedate (n = 118) anamnestilisi ning kliinilisi andmeid raseduse II trimestril ja sünnitusjärgsel perioodil ning andmeid nende vastsündinute loost. Vereseerumi D-vitamiini sisaldus määrati kemoluminestsents- immuunmeetodil. Andmete analüüsiks kasutati lineaarset ja logistilist regressioonanalüüsi ning kohandamist seoseid mõjutavatele teguritele.Tulemused. Eesti rasedate D-vitamiini sisaldus seerumis oli keskmiselt 55,0 ± 22,8 nmol/l, jäädes 79,7%-l (95% uv 71,1–86,3) uuritavatest alla referentsväärtuse (75 nmol/l) ning 17,8%-l (95% uv 11,6–26,1) esines D-vitamiini puudulikkus (≤ 30 nmol/l). D-vitamiini väärtused vereseerumis sõltusid kalendrikuust ja naise raseduseelsest kehamassiindeksist. Rasedusaegne D-vitamiini vähene sisaldus oli seotud suurema rasedusaegse kaaluiibega, vajadusega sekkuda sünnitusse, makrosoomse lapse sünniga, lapse kehvema Apgarihindega, lapse sünnijärgse kohanemisraskusega ning ema rasedusjärgse arteriaalse vererõhu kätevahelise erinevusega üle 10 mm Hg.Järeldused. D-vitamiini väike sisaldus on Eesti rasedate naiste hulgas sage ning selle peamisteks riskiteguriteks on raseduse kandmine vähese päikeseintensiivsusega kalendrikuudel ning raseduseelne rasvumine. D-vitamiini väike sisaldus mõjutab ebasoodsalt raseduse kulgu ning ema ja lapse tervisenäitajaid. Eestis suvekuudel talletatud D-vitamiini varud ei ole talviseks perioodiks piisavad. Lähtudes sellest, soovitame määrata vereseerumi D-vitamiini sisaldust hüpo-D-vitaminoosi riskirühmal ehk rasedatel naistel ning vajaduse korral seda toidulisanditena juurde manustada. Kirjanduse andmetele tuginedes näeme vajadust suurendada D-vitamiini profülaktilist doosi päevas 70–80 IU/kg