Comparative study of the vibrational optical activity techniques in structure elucidation : the case of galantamine

The absolute configuration of the alkaloid galantamine was studied using a range of solution-state techniques; nuclear magnetic resonance (NMR), vibrational circular dichroism (VCD), and Raman optical activity (ROA). While the combined use of NMR and VCD does provide a fast, high-resolution methodology for determining the absolute configuration of galantamine, both techniques were needed in concert to achieve this goal. ROA, on the other hand, proved to be sensitive enough to assign the full absolute configuration without relying on other techniques. In both cases, statistical validation was applied to aid the determination of absolute configuration. In the case of galantamine, ROA combined with statistical validation is shown to be a powerful stand-alone tool for absolute configuration determination

Turning on the tap: the benefits of using 'real-life' vignettes in qualitative research interviews

The use of vignettes that are based upon fictionalised accounts is well-established in contemporary social science. Vignettes have been used in a variety of ways to contribute to studies with both a quantitative and a qualitative orientation. This paper reflects on two recent qualitative studies which have made innovative use of ‘real-life’ vignettes. In each case, the paper describes some of the unanticipated and overlapping benefits that accrued from their incorporation into the research design and reflects on the advantages that ‘real-life’ vignettes might bring to future research. Drawing on two different research projects, the paper highlights the further potential contribution of ‘real-life’ vignettes to the repertoire of research methods currently available to social scientists

Quality of life and well-being of carers of people with dementia: are there differences between working and nonworking carers? Results from the IDEAL program

The aim of this study was to identify the differences in quality of life (QoL) and well-being between working and nonworking dementia carers and the relative contribution of psychological characteristics, caregiving experience, and social support. Multiple regressions modeled the contribution of working status, caregiver experiences, and psychological and social resources to carer QoL (EQ-5D) and well-being (WHO-5). After controlling for age, gender, carer–dyad relationship, and severity of dementia, working status contributed significant variance to EQ-5D (2%) but not to WHO-5 scores. Independent of working status, higher self-esteem and reduced stress contributed to variance in both models. Self-efficacy, social support, and positive perceptions of caregiving additionally contributed to higher WHO-5 scores. Working status associated with higher EQ-5D QoL; this may reflect the sustained sense of independence associated with supported work opportunities for carers. Outside of working status, the findings support the importance of psychological and social factors as targets to improved mental health for dementia carers

Exploring aspects of significance when arranging dog visits to home-dwelling patients: An action research approach

Municipalities have been encouraged to collaborate with volunteers to facilitate social and cultural activities for patients. Dog visits have been primarily arranged as a group activity in nursing homes. The aim of the present study was to pilot a dog visit program for home-dwelling patients delivered through a collaboration between nurses and volunteers, and to explore aspects of significance when arranging such visits. The project used an action research approach. The action was the implementation of regular dog visits to home-dwelling patients for 6 months, through collaboration between nurses and volunteers. The empirical investigation included respective focus group interviews with nurses and volunteers. Transcribed data were analyzed thematically. Standards for Reporting Qualitative Research guidelines were followed. Influence of motivation, vulnerable relationships, and the perception that various factors contributed to a ‘comprehensive puzzle’ were aspects of significance when arranging dog visits to home-dwelling patients. One crucial factor in the conduction of the dog visits was having coordinators for both the nurses and volunteers. Future dog visits should emphasize thorough mapping of patients and equipages, and appropriate information flow through collaboration between coordinators for nurses and volunteers.publishedVersionPaid open acces

Anal incontinence after vaginal delivery or cesarean section.

INTRODUCTION: Uncertainties remain as to whether cesarean section is protective for short and long term development of anal incontinence. Our aim was to explore whether women who had only delivered vaginally were at greater risk of anal incontinence compared to nulliparous women and women who had undergone caesarean sections only. MATERIAL AND METHODS: Background information, medical history and data on anal incontinence (defined as fecal or flatus incontinence weekly or more) reported by women participating in a large population-based health survey in Norway (HUNT 3) during the period October 2006-June 2008, was collected and linked to data from the Medical Birth Registry of Norway. Anal incontinence prevalence was calculated and multivariable logistic regression analyses were applied. RESULTS: Mean age amongst the 12.567 women was 49.9 years. Age and educational level were similar in women with caesarean sections only and those with vaginal delivery and obstetric anal sphincter injuries (OASIS). Nulliparas and women with vaginal delivery and no OASIS were older and had higher educational achievements. One in four women with OASIS reported anal incontinence compared to one in six amongst the other women(p<.001). Age, educational level, diarrhea, constipation, birthweight and OASIS increased the risk of anal incontinence in all women. Parity was associated with anal incontinence in parous women only. No differences were found for fecal urgency. CONCLUSIONS: Women with vaginal deliveries complicated by OASIS were at increased risk of anal incontinence. However, no increased risk of anal incontinence was found in nulliparous women or women with cesarean sections only or vaginal deliveries not complicated by OASIS

Best mulig behandling med antiepileptika for den enkelte pasient!

Hensikt «Best mulig behandling med antiepileptika for den enkelte pasient!» er et avgjørende mål for behandling av pasienter med epilepsi, men også for stadig nye pasientgrupper som bruker antiepileptika. Hensikten med artikkelen er å gi en oppdatert oversikt over metoder og anvendelse av klinisk farmakologi for antiepileptika, med fokus på populasjons- og pasientaspekter. Materiale og metoder Artikkelen er basert på erfaring og et utvalg av litteratur fra forfatternes forskningsbakgrunn. Resultater Det er fokusert på to tilnærminger for å studere klinisk farmakologi av antiepileptika. Endring i bruk av antiepileptika ved epilepsi og andre indikasjoner (smerte og psykiatri), polyterapi og psykiatrisk komorbiditet kan undersøkes ved farmakoepidemiologiske studier, for eksempel ved bruk av Reseptregisteret. Slike studier kan være til hjelp også i behandling av den enkelte pasient. Farmakokinetisk variabilitet hos enkeltpasienter og i spesielle pasientgrupper som barn, gravide og eldre kan studeres ved bruk av data fra terapeutisk legemiddelmonitorering. Dermed kan dosen bedre tilpasses individuelt for optimalisering av behandlingen. Utfordringer inkluderer aldersrelaterte endringer i farmakokinetikk, interaksjoner, farmakogenetisk variasjon, stor bivirkningsbelastning og varierende etterlevelse. Konklusjon Kunnskap om bruk og oppfølging av antiepileptika i hele populasjonen og i spesielle pasientgrupper er viktig for å oppnå en best mulig behandling for den enkelte pasient

Direct observation of substitutional Ga after ion implantation in Ge by means of extended x-ray absorption fine structure

We present an experimental lattice location study of Ga atoms in Ge after ion implantation at elevated temperature (250°C). Using extended x-rayabsorption fine structure (EXAFS) experiments and a dedicated sample preparation method, we have studied the lattice location of Ga atoms in Ge with a concentration ranging from 0.5 at. % down to 0.005 at. %. At Ga concentrations ≤0.05 at.%, all Ga dopants are substitutional directly after ion implantation, without the need for post-implantation thermal annealing. At higher Ga concentrations, a reduction in the EXAFS amplitude is observed, indicating that a fraction of the Ga atoms is located in a defective environment. The local strain induced by the Ga atoms in the Ge matrix is independent of the Ga concentration and extends only to the first nearest neighbor Ge shell, where a 1% contraction in bond length has been measured, in agreement with density functional theory calculations.We acknowledge the support from the Research Foundation Flanders, the epi-team from imec, the KU Leuven GOA 09/06 project, the IUAP program P6/42 and the Australian Research Council. S.C. acknowledges support from OCAS NV by an OCAS-endowed chair at Ghent University

Changes in mental health services and suicide mortality in Norway: an ecological study

<p>Abstract</p> <p>Background</p> <p>Mental disorders are strongly associated with excess suicide risk, and successful treatment might prevent suicide. Since 1990, and particularly after 1998, there has been a substantial increase in mental health service resources in Norway. This study aimed to investigate whether these changes have had an impact on suicide mortality.</p> <p>Methods</p> <p>We used Poisson regression analyses to assess the effect of changes in five mental health services variables on suicide mortality in five Norwegian health regions during the period 1990-2006. These variables included: number of man-labour years by all personnel, number of discharges, number of outpatient consultations, number of inpatient days, and number of hospital beds. Adjustments were made for sales of alcohol, sales of antidepressants, education, and unemployment.</p> <p>Results</p> <p>In the period 1990-2006, we observed a total of 9480 suicides and the total suicide rate declined by 26%. None of the mental health services variables were significantly associated with female or male suicide mortality in the adjusted analyses (p > 0.05). Sales of antidepressants (adjusted Incidence Rate Ratio = 0.98; 95% CI = 0.97-1.00) and sales of alcohol (adjusted IRR = 1.41; 95% CI = 1.18-1.72) were significantly associated with female suicide mortality; education (adjusted IRR = 0.86; 95% CI = 0.79-0.94) and unemployment (adjusted IRR = 0.91; 95% CI = 0.85-0.97) were significantly associated with male suicide mortality.</p> <p>Conclusions</p> <p>The adjusted analyses in the present study indicate that increased resources in Norwegian mental health services in the period 1990-2006 were statistically unrelated to suicide mortality.</p

Suicidal behaviour : An epidemiological study of suicide and attempted suicide in relation to mental health services

Psychiatric disorders and a history of suicide attempts are the best known risk factors for suicide. Thus, major changes in mental health services and interventions aimed at patients who have attempted suicide might affect the risk of subsequent suicide attempts and suicide. The overall aim of the present thesis was to evaluate the impact of health services on suicidal behaviour, and thereby gain new knowledge relevant for preventing suicidal behaviour. The thesis consists of three papers. Paper I was designed as a prospective cohort study. We investigated whether individuals admitted to inpatient psychiatric care after a suicide attempt had shorter length of stays in the period 1996-2006 than individuals admitted in the former period 1984-1995. We also considered whether length of stays and time period in which the patients received treatment were related to the risk of subsequent suicide attempts and/or suicide. Individuals hospitalised in the period 1996-2006 had significantly shorter stays than individuals hospitalised in the former period (log rank P 0.05). Considering that shortened length of stays might increase the likelihood of incomplete recovery, and thereby increased risk of subsequent suicidal behaviour, our interpretation of the results were that shortened length of stays was compensated by improved mental health services, in particular through the major extension of outpatient services. Paper II was designed as an ecological study. We examined whether increased resources in specialist mental health services in the period 1990-2006 were inversely associated with female and male suicide mortality in five Norwegian health regions. None of the variables that measured mental health service resources (number of man-labour years by all personnel, number of discharges, number of outpatient consultations, number of inpatient days and number of hospital beds) were associated with female or male suicide mortality (adjusted P > 0.05). Paper III was designed as a prospective cohort study. The aim was to explore whether a chain of care intervention aimed at individuals who have attempted suicide was effective in preventing subsequent suicide attempts and suicide. In general, a chain of care intervention means the establishment of an integrated health care system which aims to improve quality of care. We compared the risk of subsequent suicidal behaviour among patients who received a community based chain of care intervention in addition ’to treatment as usual’ with patients who only received ’treatment as usual’. We observed no significant differences between the two groups in the risk of a repeated suicide attempt; not within six months (adjusted OR = 1.08; 95% CI = 0.66-1.74), 12 months (adjusted OR = 0.86; 95% CI = 0.57-1.30) or five years of follow-up (adjusted RR = 0.90; 95 % CI = 0.67-1.22). Nor did we observe significant differences in the risk of committing suicide (adjusted RR = 0.85; 95% CI = 0.46-1.57). Intervention was not assigned to patients for whom the standard aftercare was already deemed sufficient. Thus, we interpreted the results to indicate that this intervention was at least able to render, in terms of outcomes, patients judged to be needier and those judged to be less needy, as indistinguishable