Who enrols and graduates from web-based pharmacy education - Experiences from Northern Sweden

Introduction: As a response to the shortage of prescriptionists in Northern Sweden, a web-based Bachelor of Science in Pharmacy program was introduced at Umeå University in 2003. This study explored who is likely to enrol and graduate from the web-based bachelor program and whether the program has addressed the shortage of prescriptionists in rural Northern Sweden. Methods: Data from three different sources were included in this study; the initial cohort including students admitted to the program in 2003 (survey), the entire cohort including all people admitted to the program between 2003 and 2014 (university\u27s admissions data) and the alumni cohort including graduates who participated in an alumni survey in 2015. Results: A typical student of the web-based pharmacy program is female, over 30 years of age, married or in a de-facto relationship and has children. Furthermore, the students graduating before 2009 were more likely to live in Northern Sweden compared to those graduating later. Discussion and conclusion: The results indicate that the introduction of a web-based bachelor of pharmacy program at Umeå University was to some extent able to address the shortage of prescriptionists in Northern Sweden. Web-based education may potentially help address the maldistribution of health professionals by providing flexible education opportunities

Butorfanol till get : farmakokinetik efter subkutan injektion

Today there are no analgesic drugs approved to be used in goats. Drugs approved for use in other species are consequently being used without knowing the pharmacokinetics of these drugs in goats. The purpose of this study was to investigate the pharmacokinetics of the opioid butorphanol when given subcutaneously in goats. Subcutaneous administration might extend the half-life compared to intravenous or intramuscular administration. Eight clinically healthy, non-pregnant 6 months old female goats were used. Butorphanol, 0.2 mg/kg, or saline was given subcutaneously with a crossover design. Blood samples were taken 10 min before and 5, 15, 30, 60, 120, 240, 360, 480, 660 and 1320 min after the injection. Plasma concentrations of butorphanol were analysed with a liquid chromatography–electrospray ionization–tandem mass spectroscopy and the limit of quantification was 0.5 ng butorphanol/ ml plasma. The results showed a terminal half-life of 78.6 ± 21.7 min. After 10 ± 5.3 min (Tmax) post administration mean and median Cmax was 199 ± 265.6 ng/ml and 56.1 ng/ml, repectively. Cmax varied between the different goats, with a range between 30.5 and 770 ng/ml. Plasma concentrations higher than 30 ng/ml were achieved in all of the goats within 15 min. The mean plasma concentration after 60 min was 20.2 ng/ml with a range between 9.3 – 42.3 ng/ml which is in accordance with analgesic plasma levels in other speices, assuming 0.2 mg/kg of butorphanol given subcutaneously would maintain analgesia in goats for about 30-60 min. If long term analgesia is required, the short half-life of butorphanol makes it less appropriate because of the short dose interval required. The wide range in plasma concentrations between different goats makes subcutaneously administration of butorphanol to goats inappropriate especially as the half-life did not increase in comparison with after intravenous or intramuscular administration. In our study, the goats showed behavioral changes such as agitation, chewing on the interior and increased bleating frequency. Studies that further investigate analgesic efficacy and behavioral changes in goats are needed

Use of CFSE staining of borreliae in studies on the interaction between borreliae and human neutrophils

BACKGROUND: Species of the tick-transmitted spirochete group Borrelia burgdorferi sensu lato (B. burgdorferi) cause Lyme borreliosis. Acute borrelial infection of the skin has unusual characteristics with only a mild local inflammatory response suggesting that the interaction between borreliae and the cells of the first-line defence might differ from that of other bacteria. It has been reported that human neutrophils phagocytose motile borreliae through an unconventional mechanism (tube phagocytosis) which is not observed with non-motile borreliae. Therefore, it would be of great interest to visualise the bacteria by a method not affecting motility and viability of borreliae to be able to study their interaction with the cells of the innate immunity. Carboxyfluorescein diacetate, succinimidyl ester (CFSE) labelling has been previously used for studying the adhesion of labelled bacteria to host cells and the uptake of labelled substrates by various cells using flow cytometry. RESULTS: In this study, CFSE was shown to efficiently stain different genospecies of B. burgdorferi without affecting bacterial viability or motility. Use of CFSE staining allowed subsequent quantification of borreliae associated with human neutrophils with flow cytometry and confocal microscopy. As a result, no difference in association between different borrelial genospecies (Borrelia burgdorferi sensu stricto, Borrelia afzelii, Borrelia garinii), or between borreliae and the pyogenic bacterium Streptococcus pyogenes, with neutrophils could be detected. Borrelial virulence, on the other hand, affected association with neutrophils, with significantly higher association of a non-virulent mutant B. burgdorferi sensu stricto strain compared to the parental virulent wild type strain. CONCLUSION: These results suggest that the flow cytometric assay using CFSE labelled borreliae is a valuable tool in the analysis of the interaction between borreliae and human neutrophils. The results also indicate a clear difference in the association with neutrophils between virulent and non-virulent borrelial strains

Vaihdevuosioireiden erotusdiagnostiikka

Vaihdevuosioireiden diagnosointi on yleensä helppoa, mutta vastaavia oireita esiintyy myös erilaisten sairauksien oireina. Tärkeimmät erotusdiagnostiikassa huomioitavat sairaudet ovat uniapnea ja kilpirauhasen toimintahäiriö. Jos oirekuvaan sisältyy vasomotorisia oireita, voidaan tyypillisessä vaihdevuosi-iässä esiintyviä vaihdevuosi­­oireiksi sopivia oireita pitää ensisijaisesti vaihdevuosiin liittyvinä, eikä erotusdiagnostisia lisätutkimuksia tarvita. Mikäli potilaan ikä tai oirekuva ovat epätyypilliset, korostuu huolellisen anamneesin ja potilaan tutkimisen merkitys.</p

COX-2 gene expression in colon cancer tissue related to regulating factors and promoter methylation status

<p>Abstract</p> <p>Background</p> <p>Increased cyclooxygenase activity promotes progression of colorectal cancer, but the mechanisms behind COX-2 induction remain elusive. This study was therefore aimed to define external cell signaling and transcription factors relating to high COX-2 expression in colon cancer tissue.</p> <p>Method</p> <p>Tumor and normal colon tissue were collected at primary curative operation in 48 unselected patients. COX-2 expression in tumor and normal colon tissue was quantified including microarray analyses on tumor mRNA accounting for high and low tumor COX-2 expression. Cross hybridization was performed between tumor and normal colon tissue. Methylation status of up-stream COX-2 promoter region was evaluated.</p> <p>Results</p> <p>Tumors with high COX-2 expression displayed large differences in gene expression compared to normal colon. Numerous genes with altered expression appeared in tumors of high COX-2 expression compared to tumors of low COX-2. COX-2 expression in normal colon was increased in patients with tumors of high COX-2 compared to normal colon from patients with tumors of low COX-2. IL1β, IL6 and iNOS transcripts were up-regulated among external cell signaling factors; nine transcription factors (ATF3, C/EBP, c-Fos, Fos-B, JDP2, JunB, c-Maf, NF-κB, TCF4) showed increased expression and 5 (AP-2, CBP, Elk-1, p53, PEA3) were decreased in tumors with high COX-2. The promoter region of COX-2 gene did not show consistent methylation in tumor or normal colon tissue.</p> <p>Conclusions</p> <p>Transcription and external cell signaling factors are altered as covariates to COX-2 expression in colon cancer tissue, but DNA methylation of the COX-2 promoter region was not a significant factor behind COX-2 expression in tumor and normal colon tissue.</p

Face and content validity and acceptability of the Swedish ICECAP-O capability measure: Cognitive interviews with 70-year-old persons

This study is part of a project that aims to culturally adapt the Investigating Choice Experiments for the Preferences of Older People-CAPability Index (ICECAP-O) for use in research and health and social care in Sweden. The objective was to evaluate face and content validity and acceptability. Eighteen 70-year-old community-dwelling persons participated in cognitive interviews. A standardized classification scheme was used to quantify any identified response problems, and a thematic analysis was applied to capture participants’ perceptions of included attributes and experiences of completing the measure. The results show that three participants (18%) had problems completing ICECAP-O, and that judged problems occurred for five (6%) of participants responses in the standardized classification scheme. Most participants perceived the attributes as understandable even though the meaning of Control brought some uncertainty. ICECAP-O seems to measure what it is supposed to measure, quality of life (QoL) with a capability approach, and acceptability is satisfactory. ICECAP- O has potential for becoming a valuable addition to the supply of QoL measures in research and health and social care in Sweden. However, we recommend further research on more diverse groups of older persons

International human rights frameworks in relation to national family reunification policy and administrative practice

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Organic matter composition and greenhouse gas production of thawing subsea permafrost in the Laptev Sea

Subsea permafrost represents a large carbon pool that might be or become a significant greenhouse gas source. Scarcity of observational data causes large uncertainties. We here use five 21-56 m long subsea permafrost cores from the Laptev Sea to constrain organic carbon (OC) storage and sources, degradation state and potential greenhouse gas production upon thaw. Grain sizes, optically-stimulated luminescence and biomarkers suggest deposition of aeolian silt and fluvial sand over 160 000 years, with dominant fluvial/alluvial deposition of forest- and tundra-derived organic matter. We estimate an annual thaw rate of 1.3 ± 0.6 kg OC m−2 in subsea permafrost in the area, nine-fold exceeding organic carbon thaw rates for terrestrial permafrost. During 20-month incubations, CH4 and CO2 production averaged 1.7 nmol and 2.4 µmol g−1 OC d−1, providing a baseline to assess the contribution of subsea permafrost to the high CH4 fluxes and strong ocean acidification observed in the region

Bestrophin-3 Expression in a Subpopulation of Astrocytes in the Neonatal Brain After Hypoxic-Ischemic Injury

Bestrophin-3, a potential candidate for a calcium-activated chloride channel, recently was suggested to have cell-protective functions. We studied the expression and alternative splicing of bestrophin-3 in neonatal mouse brain and after hypoxic-ischemic (HI) injury and in human neonatal brain samples. HI brain injury was induced in 9-day old mice by unilateral permanent common carotid artery occlusion in combination with exposure to 10% oxygen for 50 min. Endoplasmic reticulum stress was induced by thapsigargin treatment in primary culture of mouse brain astrocytes. We also investigated expression of bestrophin-3 protein in a sample of human neonatal brain tissue. Bestrophin-3 protein expression was detected with immunohistochemical methods and western blot; mRNA expression and splicing were analyzed by RT-PCR. HI induced a brain tissue infarct and a pronounced increase in the endoplasmic reticulum-associated marker CHOP. Three days after HI a population of astrocytes co-expressed bestrophin-3 and nestin in a penumbra-like area of the injured hemisphere. However, total levels of Bestrophin-3 protein in mouse cortex were reduced after injury. Mouse astrocytes in primary culture also expressed bestrophin-3 protein, the amount of which was reduced by endoplasmic reticulum stress. Bestrophin-3 protein was detected in astrocytes in the hippocampal region of the human neonatal brain which had patchy white matter gliosis and neuronal loss in the Sommer’s sector of the Ammon’s horn (CA1). Analysis of bestrophin-3 mRNA in mouse brain with and without injury showed the presence of two truncated spliced variants, but no full-length mRNA. Total amount of bestrophin-3 mRNA increased after HI, but showed only minor injury-related change. However, the splice variants of bestrophin-3 mRNA were differentially regulated after HI depending on the presence of tissue injury. Our results show that bestrophin-3 is expressed in neonatal mouse brain after injury and in the human neonatal brain with pathology. In mouse brain bestrophin-3 protein is upregulated in a specific astrocyte population after injury and is co-expressed with nestin. Splice variants of bestrophin-3 mRNA respond differently to HI, which might indicate their different roles in tissue injury