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Biochemical characterization of salmon pancreas disease virus.

Salmon pancreas disease virus (SPDV) has been shown to cause severe economic losses in farmed Atlantic salmon (Salmo salar) and has been reported to occur in Europe, Scandinavia and the United States. This paper describes the biochemical characterization of SPDV in terms of its RNA and protein composition. SPDV was purified by precipitation from infected Chinook salmon embryo (CHSE-214) cell-culture supernatant and sucrose density-gradient centrifugation. Fractions containing virus were identified by an immunodot blot assay using an SPDV-specific MAb. Two major proteins with molecular masses of approximately 55 and 50 kDa, putatively identified as the E1 and E2 alphavirus glycoproteins respectively, were detected when purified virus preparations were analysed by PAGE. Radiolabelling experiments indicated that SPDV infection of CHSE-214 cells did not shut-off host-cell protein synthesis, making attempts to identify virus-specific proteins unsuccessful. However, radioimmunoprecipitation assay (RIPA) experiments showed that two SPDV-specific MAbs reacted with a protein in the 50-55 kDa range. Northern blot hybridization with cloned cDNA probes indicated that infected cells contained RNA species of approximately 11.4 and 4 kb, which correspond to the genomic and subgenomic RNAs specified by SPDV. The results described are consistent with SPDV being characterized as an alphavirus.

Alphavirus↗

Natural genetic variation of freezing tolerance in Arabidopsis.

Low temperature is a primary determinant of plant growth and survival. Using accessions of Arabidopsis (Arabidopsis thaliana) originating from Scandinavia to the Cape Verde Islands, we show that freezing tolerance of natural accessions correlates with habitat winter temperatures, identifying low temperature as an important selective pressure for Arabidopsis. Combined metabolite and transcript profiling show that during cold exposure, global changes of transcripts, but not of metabolites, correlate with the ability of Arabidopsis to cold acclimate. There are, however, metabolites and transcripts, including several transcription factors, that correlate with freezing tolerance, indicating regulatory pathways that may be of primary importance for this trait. These data identify that enhanced freezing tolerance is associated with the down-regulation of photosynthesis and hormonal responses and the induction of flavonoid metabolism, provide evidence for naturally increased nonacclimated freezing tolerance due to the constitutive activation of the C-repeat binding factors pathway, and identify candidate transcriptional regulators that correlate with freezing tolerance.

Acclimatization↗

How to manage the implementation of shared care: a discussion of the role of power, culture and structure in the development of shared care arrangements.

The Dutch health care sector has become familiar with innovation of care delivery in order to meet the changing demand of the steadily ageing population, in need of complex care. Innovations often concern the implementation of shared care models, implying collaboration and substitution of care. Whereas ageing is a European-wide phenomenon, the development of such new care arrangements can be observed not only in The Netherlands, but also in the UK, Scandinavia, Italy and other countries. In this article we discuss the implementation of shared care, with the help of three concepts: power, culture and structure. We discuss the role of these factors from the view that shared care can be considered as inter-professional working within a network context. The central question is how structure, culture and power can offer change managers a starting-point for improving their innovative capacity. To illuminate our discussion we make use of a number of event-descriptions from five Dutch shared care projects. Also, we give some practical recommendations for change managers.

Aged↗

From rat sexual behavior to schizophrenia: a tribute to Professor Emeritus Knut Larsson.

In July of 2002 Knut Larsson celebrated his 80th birthday. He could by then have looked back at a long and distingusihed career in the field of biological psychology. His research on sexual behavior had contributed to a basic understanding of many behavioral, endocrine and neural phenomena associated with or underlying sexual activity. Instead of looking back at his past achievements, Knut has preferred to look forward, constantly trying to find ways to stimulate interest in his own field and in biological psychology in general. This issue is a humble contribution to the noble end of enhancing the standing of biological psychology, particularly in Scandinavia. Foremost, however, it is a homage to a man of outstanding vision and intellectual integrity: Knut Larsson.

Animals↗

Female genital mutilation in the West: traditional circumcision versus genital cosmetic surgery.

This article intends to present the Scandinavian legislation on female genital mutilation and explore the implications of the laws. Juxtaposing trends of plastic genital surgery in the West with claims that female circumcision may be a practice generally abandoned in Scandinavia, we highlight the double morality inherent in current public discussions. Finally, we pose the question: Is the legal principle of equality before the law regarded when it comes to alterations of the female genitals?

Africa↗

Genetic basis of the K(0) phenotype in the Swedish population.

BACKGROUND: The absence of all Kell blood group antigens (K(0) phenotype) is very rare. K(0) persons, however, can produce clinically significant anti-Ku (K5) after transfusion and/or pregnancy and require K(0) blood for transfusion. Ten alleles giving rise to the K(0) phenotype have been reported: different populations were studied although none from Scandinavia. STUDY DESIGN AND METHODS: Three K(0) samples were identified by blood banks in Sweden (Uppsala, Umeå, and Linköping) during a 20-year period. Kell antigen typing was performed with standard serologic techniques by the respective blood banks and K(0) status was confirmed by the International Blood Group Reference Laboratory in Bristol, England. Polymerase chain reaction and DNA sequencing of the KEL coding region (exons 1-19) was performed on genomic DNA. RESULTS: The Uppsala K(0) was homozygous for a 1540C>T substitution in exon 13, leading to an immediate stop codon. The Umeå K(0) was homozygous for 1023delG in exon 8 that results in a frameshift and a premature stop codon in exon 9. In the Linköping K(0), a previously reported mutation g>a at +1 of intron 3 was found. CONCLUSION: Two novel and one previously reported null alleles at the KEL locus are described. The identified nonsense mutations abolish expression of the Kell glycoprotein and are thus responsible for the K(0) phenotype in these Swedish families.

Alleles↗

The impact of August Krogh on the insulin treatment of diabetes and our present status.

The influence of August Krogh on the introduction of insulin preparations in Scandinavia is mentioned, and his outstanding physiological background is outlined. Developments in preparation of insulin depending on the progress in protein-chemistry are summarized. The latest step in the purification of insulin extracted from pork pancreas now allows treatment of diabetics with protamine-pork-insulin without causing formation of insulin-antibodies in at least 90 per cent treated with insulin through several months. In only 3 out of 51 diabetics was it possible to demonstrate insulin-antibodies. This new step may be of great interest in two ways 1) it is now possible to make insulin-estimations in the plasma of insulin-treated cases and 2) it will be possible to find out whether elimination of insulin-antibody-formation will reduce the degree of vascular lesions in diabetics, such lesions being the greatest problem in clinical diabetes.

Diabetes Mellitus↗

Serum cholesterol and triglyceride concentrations of Finns and Finnish Lapps. II. Interpopulation comparisons and occurrence of hyperlipidemia.

Only small differences in serum cholesterol means and somewhat larger, but still modest differences in log(TG) means were observed, when seven Finnish population groups were compared. Semiurban and industrial groups had the highest triglyceride levels. Cholesterol levels tended to be lower in South Finland than in East or North Finland and lowest in semiurban population groups. Between 15-59 years of age, rural Finns of both sexes had higher and after this age lower cholesterol means than the Finns in the other population groups. The highest cholesterol levels below the age of 60 were observed in a rural population group in East Finland. The Finnish Lapps and the rural Finns had nearly identical serum lipid levels in spite of the differences in genetic background and way of life. The serum lipid concentration means were quite similar to those reported from the other Nordic countries, Denmark, Norway and Sweden. The differences between the populations of the Nordic countries are no larger than those observed between the Finnish population groups. However, no population in Scandinavia or elsewhere can confidently be said to have higher serum lipid levels than the Finns. The similarity of the lipid levels observed in different areas in Finland and in the larger Nordic area is remarkable in view of the large differences in the incidence of coronary heart disease and in mortality rates. It is conceivable that part of the variations in disease rates is attributable to differences in the prevalence of hyperlipidemias, although the present study does not prove this hypothesis. Such differences could occur in spite of similarities in the lipid concentration means. Prevalences of hyperlipidemias in Finland are given.

Adolescent↗

Prevalence of raised Yersinia enterocolitica antibody titre in unselected, adult populations in Denmark during 12 years.

Yersinia enterocolitica biotype 4, serotype 0:3 is by far the most common human pathogenic Yersinia enterocolitica subtype in Scandinavia. It is extraordinarily immunologically specific, and an elevated antibody titre greater than or equal 80-160 is known to indicate acute infection. This titre was measured in five population surveys conducted in 1967-78, including 3278 examined adult men and women. The prevalence of titre elevation greater than or equal to was 1.0% in 1967. In 1978 it was significantly higher, 7.7%, and also the individual course of the titre in a ten-year longitudinal survey showed a significant increase in this prevalence, indicating an increasing incidence of infection. Significant sex and age differences were seen, women and younger subjects being more frequently affected than men and older subjects. The prevalence of elevated titre showed a seasonal variation with a maximum in the spring and autumn.

Adolescent↗

Reports from research centres--20. Alcohol research at the Hjellestad Clinic.

Treatment and research efforts at the Hjellestad Clinic are based on a biobehavioural model of the addictions. The treatment program encompasses life-style changes and relapse prevention, and extensive assessment for the purpose of the treatment choices. The clinic is treating nearly 1500 patients a year. Psychological and medical research projects have included experimental drinking studies, psychopharmacological and biomedical studies, treatment evaluations, studies of neuropsychological assessment, studies of personality subtypes, studies of violence related to alcohol and drugs, and investigations of women alcoholics. A new research laboratory houses an experimental bar, and state-of-the-art facilities for psychophysiological and neuropsychological testing. The Hjellestad Clinic is the only Norwegian centre for clinical and experimental research on the addictions from a psycho-physiological as well as behavioral and cognitive perspective. In addition, a national educational program offers theoretical and practical training for professionals and paraprofessionals in the addictions in co-operation with the University of Bergen. Training in the addictions and internships for psychology students at the University of Bergen is provided at the Clinic. The centre has established connections with centres in Scandinavia, England, Canada and the U.S., through visiting scholars and study trips. (The centre has an especially strong liaison with the Rutgers Center of Alcohol Studies.)

Alcoholism↗

Is it really more difficult to treat prepyloric ulcers?

Prepyloric and duodenal ulcers have some common characteristics: gastric acid secretion is increased and there is an association with blood group O. Many, therefore, have considered prepyloric ulcers to be a variety of duodenal ulcer disease. From an anatomical point of view, however, prepyloric ulcers are clearly gastric ulcers. After proximal selective vagotomy, the recurrence rate is very high, amounting to more than 30% in 5 years; this is significantly higher than the rate for duodenal ulcers. Better results are obtained in prepyloric ulcers, if vagotomy is combined with a drainage procedure. In recent years, some evidence, primarily from Scandinavia, has accumulated indicating that prepyloric ulcers are more resistant to treatment with histamine H2-receptor antagonists than duodenal ulcers or ulcers located in other parts of the stomach. In addition, the recurrence rate is particularly high in prepyloric ulcers. One must, however, consider that not only have all of these studies included relatively small numbers of patients, but also the prepyloric ulcer healing rates in other studies were similar to those observed for both duodenal ulcers and ulcers located elsewhere in the stomach. Prospective studies with large numbers of patients are, therefore, necessary before a clear-cut conclusion can be reached. There are several reasons why prepyloric ulcers could be more resistant to treatment. Impaired gastric emptying, duodeno-gastric reflux or chronic gastritis, especially in conjunction with Campylobacter pylori infection, must be considered. At present, one can only speculate on the validity of any of these hypotheses.

Anti-Ulcer Agents↗

Meta-analysis: colorectal and small bowel cancer risk in patients with Crohn's disease.

BACKGROUND: Crohn's disease is associated with small bowel cancer whilst risk of colorectal cancer is less clear. AIM: To ascertain the combined estimates of relative risk of these cancers in Crohn's disease. METHODS: MEDLINE was searched to identify relevant papers. Exploding references identified additional publications. When two papers reviewed the same cohort, the later study was used. RESULTS: Meta-analysis showed overall colorectal cancer relative risk in Crohn's disease as 2.5 (1.3-4.7), 4.5 (1.3-14.9) for patients with colonic disease and 1.1 (0.8-1.5) in ileal disease. Meta-regression showed reduction in relative risk over the past 30 years. Subgroup analysis showed Scandinavia had significantly lower colorectal cancer relative risk than the UK and North America. Cumulative risk analysis showed 10 years following diagnosis of Crohn's disease relative risk of colorectal cancer is 2.9% (1.5%-5.3%). Meta-analysis showed small bowel cancer relative risk in Crohn's disease is 33.2 (15.9-60.9). Small bowel cancer relative risk has not significantly reduced over the last 30 years. CONCLUSION: Relative risk of colorectal and small bowel cancers are significantly raised in Crohn's disease. Cumulative risk of colorectal cancer of 2.9% at 10 years suggests a potential benefit from routine screening. However, the value of screening requires rigorous appraisal.

Colitis↗

Airborne contact dermatitis from Compsoitae oleoresins simulating photodermatitis.

American ragweed (Ambrosia) dermatitis has an airborne pattern and is caused by lipid soluble oleoresins of pollens. A similar weed dermatitis has been described in India and Australia. The weeds involved were all of the Compositae family and contain sesquiterpene lactones with one common antigenic determinant. This study reports seven Danish patients treated for many years under the diagnosis of photodermatitis, who eventually proved to suffer from Compsoitae oleoresin dermatitis. Probably, Compsitae dermatitis is a world-wide disease, although aften misdiagnosed as has happened in Scandinavia.

Aged↗

Compliance with treatment and understanding of own disease in patients with severe and moderate haemophilia.

It is well known that teenagers with chronic diseases have problems complying with their treatment. The aim of this study was to evaluate the patient's knowledge of haemophilia and his compliance to prophylactic treatment, and the age at which the patient took over the responsibility for his disease and to create educational material for teenagers and adolescents. This was a prospective multicentre study performed in Hemophilia Treatment Centres in Scandinavia. A total of 108 of 134 patients, between 13 and 25 years completed the questionnaire, a response rate of 80%. Eighty-three patients had a severe form of haemophilia, 24 patients in moderate form and one patient did not know the severity of his disease. Seventy-eight patients were on prophylactic treatment. The median age for starting prophylactic treatment was 3.0 years and the median age for the patient performing venepuncture was 11.6 years. Sixty-seven of 78 patients knew that the best time to give prophylactic treatment was in the morning. Even though the patients were on prophylactic treatment, 47 of 78 patients took additional treatment before sports activities. At a mean age of 14.1 years the patient himself had the responsibility for his disease and treatment. In the cohort of 108 patients, 73 were aware of their haemophilia heredity. This study shows a rather high degree of knowledge of haemophilia and compliance with treatment among the patients but it is of great importance for the nurse to continuously improve the patient's compliance and keep him aware of the benefit of regular treatment for his future well being.

Adolescent↗

Self-help groups as mutual support: what do carers value?

The literature suggests that the United Kingdom, in common with Europe, North America, Canada and Scandinavia, has seen significant growth in single-issue self-help/mutual aid groups concerned with health and social care issues since the 1970s, but there is only ad hoc academic and policy interest in such groups in the United Kingdom. This article presents findings from a doctoral study with two self-help/mutual aid groups for carers in South-East England. The data are drawn from semistructured interviews with 15 active members which explored reasons for joining, benefits derived from membership, and perceived differences between support gained by membership and their relationship with professionals. Most group members had prior experience of voluntary work/activity, which influenced their decision to join, often prompted by a failure of the 'usual' support network of family/friends to cope or adjust to the carer's needs. Members reported personal gains of empathy, emotional information, experiential knowledge and practical information, based on a core value of reciprocity through peer support. It is this latter benefit that sets apart membership of self-help groups from groups supported by professionals who may not appreciate the scope and breadth of carers' responsibilities, or of the importance of their relationship with the person for whom they care. In this way, self-help groups offered additional, but not alternative, 'space' that enabled members to transcend their traditional role as a 'carer'. It is concluded that self-help/mutual aid groups, based on reciprocal peer support, offer a valuable type of resource in the community that is not replicable in professional-client relations. The findings have contemporary relevance given the raft of new policies which value the experiential knowledge built by both individual and collectives of carers.

Adaptation, Psychological↗

Unsuspected analgesic nephropathy in transitional cell carcinoma of the upper tract: a morphological study.

Analgesic nephropathy is known to have a high incidence in Australia where, following the experience in Scandinavia, reports have been published for some time recording the association between analgesic nephropathy and urothelial malignancies. The morbid anatomical features of analgesic nephropathy are now sufficiently well accepted to allow a retrospective study of unselected nephrectomies for transitional cell carcinoma of the renal pelvis and ureter, in order to assess the incidence of analgesic-type changes in this well defined group of malignancies. The records of a large general histopathology department between 1972-1978 were searched and 24 consecutive transitional cell carcinomas in these sites treated by nephrectomy were selected for study. Of these, 21 were suitable for assessment and on review were shown to comprise II cases with papillary changes acceptable as analgesic in type and five which were suggestive of early analgesic change. Of these 16, seven were female, only two were known analgesic abusers and five were recorded as consuming analgesics on a regular basis. These findings suggest that analgesics may play a significant role in the pathogenesis of urothelial malignancy in the general population.

Adult↗

Changes in endodontic status 1973-1993 among 35-year-olds in Oslo, Norway.

Epidemiological investigations from Scandinavia have documented high prevalence of apical periodontitis and inferior quality and results of endodontic treatment performed in general practice. The present investigation is part of a 20-year follow-up study on oral health in 35-year-old Oslo citizens focusing on endodontic conditions. The results indicate reduced prevalence of apical periodontitis and statistically significant improvement in endodontic status compared with results from a similar study performed in 1984.

Adult↗

Using narrative pedagogy: learning and practising interpretive thinking.

AIM: This paper reports a hermeneutic study undertaken to explicate students' experiences in educational courses in which teachers enact Narrative Pedagogy. BACKGROUND: International interest in developing and implementing discipline-specific pedagogies is becoming commonplace as teachers respond to the challenges of preparing students for contemporary practice. Lifeworld Pedagogy, developed in Scandinavia, and Narrative Pedagogy, developed in the United States of America, Canada and New Zealand, are two approaches developed from nursing research for nursing education that provide teachers with research-based alternatives to conventional pedagogy. Further research is needed, however, that addresses how new pedagogies are experienced in schools of nursing. METHOD: Teachers and students from 22 schools of nursing in the United States of America were interviewed over a 4-year period between 2002 and 2005. Using interpretive phenomenology as the philosophical background and Heideggerian hermeneutics as the method, accounts from 52 participants were analysed by a research team. FINDINGS: The theme Learning and Practising Interpretive Thinking reveals how reform is occurring in schools of nursing that use Narrative Pedagogy. It documents how Narrative Pedagogy helps students challenge their assumptions and think through and interpret situations they encounter from multiple perspectives. Findings suggest that by focusing teachers' and students' attention on thinking and interpreting as communal experiences, interpretive pedagogies such as Narrative Pedagogy engage teachers and students in pooling their wisdom, challenging their preconceptions, envisioning new possibilities for providing care and engaging with others to ensure patient-centred care and safety. CONCLUSION: By documenting students' experiences in courses in which Narrative Pedagogy is used, this study provides teachers with research-based evidence to guide their pedagogical decisions. It extends international efforts to develop discipline-specific pedagogies and offers a practical, student-centred approach teachers can use to enhance students' thinking.

Education, Nursing↗