Advice on assistance and protection from the Scientific Advisory Board of the Organisation for the Prohibition of Chemical Weapons : Part 2. On preventing and treating health effects from acute, prolonged, and repeated nerve agent exposure, and the identification of medical countermeasures able to reduce or eliminate the longer term health effects of nerve agents

The Scientific Advisory Board (SAB) of the Organisation for the Prohibition of Chemical Weapons (OPCW) has provided advice in relation to the Chemical Weapons Convention on assistance and protection. We present the SAB’s response to a request from the OPCW Director-General in 2014 for information on the best practices for preventing and treating the health effects from acute, prolonged, and repeated organophosphorus nerve agent (NA) exposure. The report summarises pre- and post-exposure treatments, and developments in decontaminants and adsorbing materials, that at the time of the advice, were available for NAs. The updated information provided could assist medics and emergency responders unfamiliar with treatment and decontamination options related to exposure to NAs. The SAB recommended that developments in research on medical countermeasures and decontaminants for NAs should be monitored by the OPCW, and used in assistance and protection training courses and workshops organised through its capacity building programmes.Peer reviewe

Advice from the Scientific Advisory Board of the Organisation for the Prohibition of Chemical Weapons on riot control agents in connection to the Chemical Weapons Convention

Compounds that cause powerful sensory irritation to humans were reviewed by the Scientific Advisory Board (SAB) of the Organisation for the Prohibition of Chemical Weapons (OPCW) in response to requests in 2014 and 2017 by the OPCW Director-General to advise which riot control agents (RCAs) might be subject to declaration under the Chemical Weapons Convention (the Convention). The chemical and toxicological properties of 60 chemicals identified from a survey by the OPCW of RCAs that had been researched or were available for purchase, and additional chemicals recognised by the SAB as having potential RCA applications, were considered. Only 17 of the 60 chemicals met the definition of a RCA under the Convention. These findings were provided to the States Parties of the Convention to inform the implementation of obligations pertaining to RCAs under this international chemical disarmament and non-proliferation treaty.Peer reviewe

Femurvinkler i hoften og korrelasjon med genu varum/valgum : Er det korrelasjon mellom anteversjonsvinkel, collum-diafysevinkel og Q-vinkel på femur?

Bakgrunn: Flere medisinske og anatomiske kilder sier at femurs anteversjonsvinkel og collum-diafysevinkel er korrelert med Q-vinkelen i kneleddet, der økning i disse vil gi større Q-vinkel. Det virker ikke som det foreligger noen vitenskapelig evidens for disse påstandene. Materiale og metode: Det ble foretatt målinger av Q-vinkel, collum-diafysevinkel, anteversjonsvinkel og femurlengde på 250 femora. Knoklene ble hentet fra ”De Schreinerske samlinger” ved Antropologisk seksjon, Institutt for medisinske basalfag ved Universitetet i Oslo. Målingene ble foretatt med goniometer og osteometrisk målebrett. Korrelasjoner ble regnet ut ved hjelp av regresjonsanalyse. Resultater: Enkel regresjonsanalyse, med collum-diafysevinkel som uavhengig variabel, viser en lineær sammenheng med Q-vinkelen, der én grads økning av collum-diafysevinkelen gir 0,054 graders reduksjon av Q-vinkelen (p=0,018). Én grads økning av anteversjonsvinkelen gir 0,047 graders økning av Q-vinkelen (p<0,01). Én centimeters økning av femurlengden med 0,139 graders reduksjon av Q-vinkelen (p<0,01). Ved multippel regresjon med både collum-diafysevinkel, anteversjonsvinkel og femurlengde som uavhengige variabler, mister collum-diafysevinkelen sin statistiske signifikans. R2 er da 0,085. Fortolkning: Collum-diafysevinkelen har ved enkel regresjon en negativ korrelasjon med Q-vinkelen, noe som strider mot tidligere påstander om denne korrelasjonen. De ulike variablenes innvirkning på Q-vinkelen er uansett meget liten. Eksempelvis vil en økning i collum-diafysevinkelen fra 125° til 135° bare redusere Q-vinkelen med ca. 0,5°. Collum-diafysevinkel, anteversjonsvinkel og femurlengde til sammen beskriver kun 8,5 prosent av Q-vinkelens variasjon. Det er åpenbart andre faktorer som innvirker på Q-vinkelen i mye større grad, så man bør antakelig moderere, om ikke fjerne, læresetninger som omtaler disse korrelasjonene som innlysende og omfattende

Innføring av Ottawa-kriterier ved Oslo Legevakt

SAMMENDRAG Bakgrunn/emne: Akutte ankelskader er en hyppig tilstand på legevakt, og ved Oslo Legevakt tas det røntgenbilder av så godt som alle som kommer inn med ankelskade. Denne oppgaven vil se på om man kan redusere antall ankelrøntgen ved Oslo Legevakt ved å innføre Ottawa-kriteriene, et enkelt sett med kliniske kriterier som indikerer hvorvidt det er behov for røntgen ved akutte ankelskader. Kunnskapsgrunnlag: En stor systematisk oversikt viser at Ottawa-kriteriene kan redusere andelen radiologiske undersøkelser ved akutte ankelskader med 30-40 prosent. Sensitiviteten er nesten 100 prosent, og spesifisiteten er ca. 40 prosent. Dette vil si at så godt som alle med brudd vil fanges opp, mens en del av pasientene som ikke har brudd fortsatt vil sendes til røntgen. Tiltak og kvalitetsindikator: Vi ønsker å innføre Ottawa-kriteriene ved Oslo Legevakt, og la disse kriteriene bestemme hvorvidt pasienter med akutt ankelskade skal til radiologisk undersøkelse. Målsettingen vår er en 30 prosents reduksjon i andelen røntgenundersøkelser ved akutte ankelskader i løpet av prosjektperioden. Vi har valgt å måle effekten av tiltaket med følgende indikator: Andel pasienter som oppsøker legevakten med ankeltraume hvor det blir tatt røntgen og hvor røntgen ikke viser brudd. Organisering/Ledelse: Vi ser for oss en prosjektperiode på ti uker. Det opprettes en prosjektgruppe bestående av leger, radiografer og administrativt ansatte for å innføre tiltaket. De fire første ukene brukes på baseline-registrering og planlegging. To uker brukes deretter på å informere legene ved legevakten om prosjektet og om Ottawa-kriteriene, i form av opplæring, mail og opphenging av plakater. De neste fire ukene skal Ottawa-kriteriene brukes i praksis, og indikatormålene registreres. Etter gjennomført prosjektperiode evalueres tiltaket, og det tas stilling til eventuell videre bruk av kriteriene. Det er viktig at tiltaket har klar forankring i ledelsen, og at legene får tett oppfølging av prosjektgruppen for å sikre at kriteriene faktisk blir tatt i bruk. Vurdering: Med bakgrunn i det sterke kunnskapsgrunnlaget vil vi anbefale Oslo Legevakt å innføre Ottawa-kriteriene. Ledelsen ønsker per i dag ikke å innføre tiltaket, og uten støtte herfra vurderer vi det slik at prosjektet vårt ikke vil la seg gjennomføre på det nåværende tidspunkt

School functioning and internalizing problems in young schoolchildren

Background Symptoms of anxiety and depression are common mental health problems in children and are often referred to as internalizing symptoms. Youth with such symptoms are at greater risk for poor academic achievement, school non-completion, and future mental health problems, all of which, lead to public health consequences and costs to society. The aim of the current study was to investigate associations between young school children’s internalizing symptoms and school functioning, as assessed separately by the teachers and the children. Methods This study is a cross-sectional study including children (N = 750. 58% girls) from the ages of 8–12 years with elevated levels of self-reported symptoms of anxiety (MASC-C) and/or depression (SMFQ). Teachers reported the academic achievement, school adaptation (TRF) and internalizing symptoms (BPM-T) of the children. Associations were analyzed using linear regression analyses. Results Both teacher-reported internalizing symptoms and children’s self-reported depressive symptoms were associated with poor academic achievement and school adaptation, while self-reported symptoms of anxiety were not. Symptoms of depression as assessed by the children were associated with teacher-rated internalizing symptoms, while self-reported symptoms of anxiety were not. Conclusion We found negative associations between school functioning and internalizing symptoms, as assessed by both the teachers and the children. The dual findings strengthen the validity of these relationships. Thus, prevention of depressive and anxiety symptoms in children may lead to positive changes in school domains such as academic achievement and school adaptation. We also identified a negative association between teacher-rated internalizing symptoms and children’s self-report of depressive symptoms, indicating that teachers may have difficulties recognizing children with these symptoms

School functioning and internalizing problems in young schoolchildren

Background - Symptoms of anxiety and depression are common mental health problems in children and are often referred to as internalizing symptoms. Youth with such symptoms are at greater risk for poor academic achievement, school non-completion, and future mental health problems, all of which, lead to public health consequences and costs to society. The aim of the current study was to investigate associations between young school children’s internalizing symptoms and school functioning, as assessed separately by the teachers and the children. Methods - This study is a cross-sectional study including children (N = 750. 58% girls) from the ages of 8–12 years with elevated levels of self-reported symptoms of anxiety (MASC-C) and/or depression (SMFQ). Teachers reported the academic achievement, school adaptation (TRF) and internalizing symptoms (BPM-T) of the children. Associations were analyzed using linear regression analyses. Results - Both teacher-reported internalizing symptoms and children’s self-reported depressive symptoms were associated with poor academic achievement and school adaptation, while self-reported symptoms of anxiety were not. Symptoms of depression as assessed by the children were associated with teacher-rated internalizing symptoms, while self-reported symptoms of anxiety were not. Conclusion - We found negative associations between school functioning and internalizing symptoms, as assessed by both the teachers and the children. The dual findings strengthen the validity of these relationships. Thus, prevention of depressive and anxiety symptoms in children may lead to positive changes in school domains such as academic achievement and school adaptation. We also identified a negative association between teacher-rated internalizing symptoms and children’s self-report of depressive symptoms, indicating that teachers may have difficulties recognizing children with these symptoms

Does the transdiagnostic EMOTION intervention improve emotion regulation skills in children?

Objectives Emotion regulation is thought to be an important transdiagnostic process across internalizing disorders in youth, and the regulation of emotions is believed to play a central role in both adaptive and maladaptive development. Several preventive interventions focus on improving children’s emotion regulation skills, but research regarding the outcomes of emotion regulation skills are scarce. Methods We therefore investigated whether a new transdiagnostic indicated prevention intervention for anxiety and depressive symptoms, the EMOTION program, improves emotion regulation skills as reported by parents of children aged 8–12 years. Data from a large national cluster randomized control trial (RCT) study, Coping Kids, performed in Norway were used, including data from 601 children and their parents. Results Using mixed models, we found a decrease in dysregulation of emotions (Δ  =  .06, CI  =  (0.00 to .11), p =  .040) and an increase in emotion regulation (Δ  =  .11, CI  =  (0.05 to .17) p  <  .001) in the intervention group compared to the control group. Conclusions The EMOTION intervention has a potential positive effect on children’s emotional regulation skills. One opportunity in transdiagnostic interventions lies in targeting common underlying processes in internalizing disorders and thereby reaching a larger proportion of the youth population than is possible with single-disorder approaches

A 12-month follow-up of a transdiagnostic indicated prevention of internalizing symptoms in school-aged children: The results from the EMOTION study.

Background - Anxious and depressive symptoms in youth are highly prevalent, are often comorbid and have a high rate of relapse. Preventive interventions are promising, but follow-up results are lacking. The transdiagnostic EMOTION program is an indicated preventive cognitive behavioral therapy (CBT) intervention targeting children aged 8–12 years. Methods - The present study investigates the 12 months follow-up effects of the EMOTION intervention in a cluster randomized controlled trial (RCT) with 795 children that included both child self-reports and parental reports. Results - Mixed model analyses showed a larger decrease of symptoms in the intervention group than in the control group for child self-reported anxious symptoms (The Multidimensional Anxiety Scale for Children (MASC) difference 4.56, CI 1.83 to 7.29, p = .001). Parental reports for both anxious (MASC difference 2.50, CI .26 to 4.74, p = .029) and depressive (The Mood and Feelings Questionnaire-short form (SMFQ) difference 1.55, CI .83 to 2.26, p ≤ .001) symptoms in children also showed a reduction. No statistically significant difference was found for child self-reported depressive symptoms (SMFQ difference .69, CI − .22 to 1.60, p = .139). Conclusion - The transdiagnostic EMOTION program has shown the potential for long-term reductions in symptoms of both anxiety and depression in school-aged children. However, results regarding depressive symptoms must be considered preliminary as only parental report indicated effect

Targeting Internalizing Symptoms in Children: What is the Impact on School Functioning?

Internalizing problems may be associated with poor academic performance and school absenteeism among youth. This study investigated the impact of the EMOTION: “Coping Kids” Managing Anxiety and Depression Program on academic achievement and school adaptation in children. Data were collected in a national cluster-randomized controlled trial at three time points in Norway. Children (N = 688, 8–12 years), who had elevated levels of anxiety or depressive symptoms from 36 schools participated. There were no significant differences between the intervention and control groups post-intervention or at 12-month follow-up regarding academic achievement and school adaptation. Likewise, no significant intervention effects were identified for school-related variables in the anxiety-only, depression-only, or combined (anxiety and depression) groups. The intervention did not have an impact on school functioning. Thus, focusing on school-related challenges and enhanced collaboration with teachers, possibly through a tailored version of the EMOTION program, could be an interesting adaptation of the intervention