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PubMed2002

2000-based national population projections for the United Kingdom and its constituent countries.

The 2000-based national population projections, carried out by the Government Actuary at the request of the Registrars General, show the population of the United Kingdom rising from 59.8 million in 2000 to nearly 65 million by 2025. Longer-term projections suggest the population will peak at nearly 66 million around 2040 and then gradually start to fall. The population will become gradually older with the median age expected to rise from 37.4 years in 2000 to 42.4 years by 2025. In 2000, there were 1.3 million (12 per cent) more children aged under 16, than people of state pensionable age. However, by 2007, the population of state pensionable age is projected to exceed the number of children.

Adolescent↗
PubMed2004

2002-based national population projections for the United Kingdom and constituent countries.

The 2002-based national population projections, carried out by the Government Actuary in consultation with the Registrars General, show the population of the United Kingdom rising from 59.2 million in 2002 to nearly 65 million by 2031. Longer-term projections suggest the population will peak around 2050 at over 65 million and then gradually start to fall. The population will become gradually older with the median age expected to rise from 38.2 years in 2002 to 43.3 years by 2031. In 2002, there were around 850 thousand (8 per cent) more children aged under 16, than people of state pensionable age. However, from 2007, the population of pensionable age is projected to exceed the number of children.

Adolescent↗
PubMed2001

Investigation of the mechanism of domain closure in citrate synthase by molecular dynamics simulation.

Six, 2 ns molecular dynamics simulations have been performed on the homodimeric enzyme citrate synthase. In three, both monomers were started from the open, unliganded X-ray conformation. In the remaining three, both monomers started from a closed, liganded X-ray conformation, with the ligands removed. Projecting the motion from the simulations onto the experimental domain motion revealed that the free-energy profile is rather flat around the open conformation, with steep sides. The most closed conformations correspond to hinge-bending angles of 12-14 compared to the 20 degrees that occurs upon the binding of oxaloacetate. It is also found that the open, unliganded X-ray conformation is situated at the edge of the steep rise in free energy, although conformations that are about 5 degrees more open were sampled. A rigid-body essential dynamics analysis of the combined open trajectories has shown that domain motions in the direction of the closed X-ray conformation are compatible with the natural domain motion of the unliganded protein, which has just two main degrees of freedom. The simulations starting from the closed conformation suggest a free-energy profile with a small barrier in going from the closed to open conformation. A combined essential dynamics and hinge-bending analysis of a trajectory that spontaneously converts from the closed to open state shows an almost exact correspondence to the experimental transition that occurs upon ligand binding. The simulations support the conclusion from an earlier analysis of the experimental transition that the beta-hairpin acts as a mechanical hinge by attaching the small domain to the large domain through a conserved main-chain hydrogen bond and salt-bridges, and allowing rotation to occur via its two flexible termini. The results point to a mechanism of domain closure in citrate synthase that has analogy to the process of closing a door.

Citrate (si)-Synthase↗
PubMed1989

Healthy eating starts at school.

The healthy eating programme targeted at children attending Montagu Primary School is described. The project was placed first in the professional category of the 1987 Domestos Health Education Awards.

Child↗
PubMedDate not supplied

[Results of a screening project for congenital hypothyroidism in 4 years of experience].

A screening program for congenital hypothyroidism has been starting in Siena since November, 1977 with the Guthrie's test for PKU. According to the recommendations of the Committee of the European Thyroid Association the program were performed on capillary blood samples collected between the fourth and sixth days after birth on an adsorbent paper. The screening began with the measurement of T4 RIA (up to May, 1980), and T4 and TSH RIA (from may, 1980, to december, 1981). At december, 1981, 23.693 newborns have been screened. The recall rate was 2,5% up to may, 1980, and 0,11% from may, 1980 to december, 1981. Ten newborns with congenital hypothyroidism have been detected; the incidence is one in 2.400 live births. There were no cases of transient hypothyroidism and no cases of TBG deficiency. All patients are treated before the age of one month. The diagnosis is confirmed in seven cases at one year of life after stopterapy for one month. Our program confirm the high incidence of congenital hypothyroidism. Clinical control, based on physical and psychomotor development testing in seven patients treated confirmed that all infants are normal.

Congenital Hypothyroidism↗
PubMed2001

Effect of dexamethasone therapy on pulmonary function in chronic lung disease: a comparison of disease types.

BACKGROUND: In the present study, we investigated the effect of dexamethasone (DEX) therapy on extubation and pulmonary function in patients with chronic lung disease (CLD) who required long-term mechanical ventilation. In addition, we compared the effects of DEX therapy among CLD types. METHODS: Twenty-two CLD patients who were ventilator dependent for 28 days or longer received DEX therapy for the purposes of extubation. A tapering dose of DEX, starting from 0.5 mg/kg per day, was administered for 7 days. Pulmonary function was measured at initiation of administration and 4 days after initiation. We evaluated static respiratory system compliance (Crs) and static respiratory system resistance (Rrs) adjusted by bodyweight. Chronic lung disease types were categorized according to the classification of the Ministry of Health and Welfare Research Project. We compared the effect of DEX therapy among CLD types. RESULTS: Dexamethasone therapy was started at a mean (+/-SD) 45 =/- 11 days after birth and 32.1 +/- 1.3 weeks of postconceptional age in infants with a mean bodyweight of 939 +/- 153 g. After DEX therapy, extubation was successful in all 22 patients. Following DEX administration, Crs was significantly increased from 0.69 +/- 0.13 to 1.17 +/- 0.21 mL/cm H2O per kg. In contrast, Rrs did not show any clear changes. Comparing CLD types, no difference was observed for Crs and Rrs in each disease type. CONCLUSIONS: Dexamethasone was administered to CLD patients requiring long-term mechanical ventilation for the purposes of extubation and extubation was successful in all patients. It was found that Crs was increased in all patients following DEX, regardless of CLD type. The increase in Crs following DEX administration may have been related to successful extubation.

Anti-Inflammatory Agents↗
PubMed2003

[Research training for all physicians--also outside university hospitals. Evaluation of a course in basic research methods].

INTRODUCTION: General practitioners are often interested in doing research but are hampered by lack of time and research training. Interpreting the results of others can also be difficult. For this reason a course in basic research methods for GPs was started in Sweden in 1989. It was originally aimed at GPs but was later extended to hospital physicians as well. The course is given regionally and at present is held in six different locations in southern Sweden as well as in Hillerød, Denmark. The aim of this study is to evaluate the course as part of a research project to recommend changes to the courses in accordance with the course evaluations. MATERIALS AND METHODS: The course consists of theory (lectures/seminars six hours a month) and practice (project work) over a period of 18 months. Questionnaires were mailed to the 112 physicians who, starting in 1997 and 1999, completed the course. Eighty-five percent responded to the questionnaire, which asked if the course goals were relevant and if they thought they had achieved them. RESULTS: The most frequent reasons given for attending the course were a desire to learn how to read scientific articles critically and how to carry out one's own research projects. Two thirds of the participants thought that the theoretical lectures and project work had supplemented each other well. Most of the participants thought that the goals were very relevant but fewer--between 57% and 77%--felt those goals had been achieved. DISCUSSION: The course provides important empirical information with regard to future specialist training in Denmark. The plan is for all physicians to have research training--amounting to a total of 60 days--with lectures in research methodology and tutored research projects. The Danish College of General Practitioners has planned research training in accordance with the experience from these courses.

Adult↗
PubMedDate not supplied

[Tables of Moses: nursing research project].

UNLABELLED: A review of literature and in others realities of our country has been done to verify the existence of welfare procedure in stomatherapy. It has been pointed out that the behaviours are not supported by evidence and that the given performances are not measurable. It borns the idea to start a nursing research finalized to define care standards procedures supported by evidence. MATERIALS AND METHOD: Once the project group is formed with nurses, ET nurses and surgeons, the research is structured in the following points: predisposition of nursing protocols; predisposition of evaluation tools for each protocol; experimentation of the tools with 150 national investigators specifically trained; gathering, elaboration and interpretation of the data; on 13.172 forms picked up, 2.034 has been regularly fulfilled; distribution of the knowledge through a text, the associative magazine, presentation at courses and associative congresses; Research development: the critic results analysis has permitted to recognize areas on which continue the research. CONCLUSION: Data confirms the validity of specifics check-lists and protocols even if the research says the achievement of care standards results through codified performances, to disadvantage of a case-control way for example.

Adolescent↗
PubMed1991

The Nordic Expert Group, an inter-Nordic project for assessment of occupational risks.

Risk management and risk control within the occupational environment are individual national issues in the Nordic countries. Within the area of occupational exposure limit setting there is, however, some collaboration. As an internordic project the Nordic Expert Group for Documentation of Occupational Exposure Limits was started in 1977, in order to develop scientific criteria documents. The documents are used by the five national regulatory authorities as a common scientific basis for setting national occupational exposure limits. In risk management in the Nordic countries the Nordic Expert Group deals with the scientific issues and the regulatory authorities deal with the transscientific issues, taking economical aspects and technological feasibility into account. The setting of occupational exposure limits is thus an administrative (or political) concern and the limit values are norms rather than limits between hazardous and nonhazardous concentrations. The work by the Nordic Expert Group exemplifies the fact that the scientific part of risk management can be preferentially performed on an international basis.

Carcinogens↗
PubMed1993

A dosimetric quality audit of photon beams by the Belgian Hospital Physicist Association.

Since 1987, a dosimetric standardization process has been started by the Belgian Hospital Physicist Association (BHPA). As part of this project, on-site visits were performed by a voluntary team, by request of the local physicist. They included mechanical checks on treatment machines and simulators and a dosimetric intercomparison of photon beams, following the EORTC methodology. Until now 16 centres have participated. Dose measurements were performed in order to evaluate the uniformity in dosimetry after the adoption by the BHPA members of the Nederlandse Commissie voor Stralingsdosimetrie (NCS) code of practice for photon beams. Doses were measured with an ionization chamber in water under NCS reference conditions and under other conditions in 13 cobalt beams and 24 high energy X-ray beams from 4 to 25 MV. Under reference conditions, the mean ratio of measured to stated dose is 0.999 (+/- 0.010) and 1.006 (+/- 0.23) for cobalt and X-ray beams, respectively, with a difference between the extreme values (delta) of 0.042 for cobalt beams and 0.084 for X-ray beams. In other conditions, the spread is a little larger for all beams. The results are comparable, but with a smaller dispersion, with those of other national and international similar dose intercomparisons and show the importance of applying a common protocol. The results of mechanical checks show some large deviations in digital displays and indicate the need for a systematic mechanical and beam alignment quality assurance programme.

Belgium↗
PubMed1996

Acute myocardial infarction in Estonia: first results from the Tallinn AMI Register.

The acute myocardial infarction (AMI) register of Tallinn, the capital of Estonia, started in 1990. The register follows methodology recommended by the WHO MONICA Project for the registration of coronary events. By standardizing its procedures with the FINMONICA AMI register, the Tallinn AMI register aims at producing data comparable with those of the centers participating in the WHO MONICA Project. This article presents incidence, attack rates, and mortality rates of AMI in Estonia during the first year of registration in Estonians and non-Estonians (mostly Russians) of the study area. The total number of registered AMI events was 493 among men and 117 among women. The age-standardized mortality from AMI (per 100,000 population) was 249 (95% confidence interval, 201-297) in Estonian men and 234 (189-279) in non-Estonian men. In women the corresponding rates were 35 (20-50) and 39 (23-55), respectively. The incidence and attack rate of AMI were not different in Estonians and non-Estonians. The incidence of AMI seems to be relatively high in international comparison. The registration period of our study is thus far rather short, but it is the first investigation of the incidence of AMI in Estonia based on standardized data collection procedures. This study provides a basis for the development of surveillance of cardiovascular disease in Estonia.

Adult↗
PubMed2004

Characterisation of reversed-phase liquid-chromatographic columns by chromatographic tests comparing column classification based on chromatographic parameters and column performance for the separation of acetylsalicylic acid and related compounds.

Selection of RP-LC columns with suitable selectivity for a given analysis is difficult. For example, the European Pharmacopoeia (Ph. Eur.) and other official compendia for drug analysis only give a general description of the stationary phase in the operating procedure of a liquid chromatographic method. The need for a general test method to characterise RP-LC columns has been rising since the 1970s. A project to define a chromatographic procedure characterising RP-LC columns was started earlier. A procedure to measure test parameters was introduced and a classification of the columns, based on a minimal number of parameters, was obtained. This paper focuses on correlating the column classification with the selectivity obtained for a real separation. The separation of acetylsalicylic acid (aspirin) and related compounds was performed according to the Ph. Eur. monograph on the stationary phases previously characterised chromatographically. It was examined whether the classes of columns, determined using test parameter results, contain either suitable or unsuitable supports for the aspirin separation. The system suitability test prescribed by the Ph. Eur. in order to distinguish between suitable or unsuitable columns for this separation was also evaluated.

Aspirin↗
PubMed1999

Bone tissue response to biodegradable polymers used for intra medullary fracture fixation: a long-term in vivo study in sheep femora.

Since the degradability of the synthetic polymers used for fracture fixation is still unclear, a research project with biodegradable interlocking nails with a longterm implantation period has been started. In 21 female sheep a complete mid-shaft osteotomy of the left femur was performed to mimic a fracture of the femoral shaft. For the fixation, an intramedullary stainless-steel interlocking nail, a PLA rod or a PLA/PGA rod was used. After 30 months of implantation the histological results of these three materials were examined. In contrast to most reports the degradation rate of both polymers was much lower than the suggested ultimate period of two years. Even the tissue response was more pronounced than expected and this reaction can imply certain risks for repulsion. One can conclude that the volume quantity of polymeric implant in the bony tissue must be reduced if possible to avoid severe foreign body responses. The immunologic responses and the clinical consequences need more studies. The degradation behavior of the polymer is still not under control.

Animals↗
PubMed2001

[Role and modalities of insulin treatment in type 2 diabetics].

INTRODUCTION: The natural history of type 2 diabetes mellitus is characterized by an inescapable and gradual worsening of a decrease in insulin secretion. Thus after several years of progress, less than half of type 2 diabetic patients have good glycemic control. This explains the increase in insulin prescription to type 2 diabetic patients in France in recent years. This work's objective is to take into account recent publication data to clarify the status of and adjustments in insulin therapy. CURRENT KNOWLEDGE AND KEY POINTS: The benefit of insulin treatment-mediated glycemic control optimization on microvascular complications is now proven. However, there is still controversy concerning macrovascular complications. Hypoglycemic risk in type 2 diabetic patients is limited and the main problem with insulin treatment is weight gain. Following failure with treatment by tablets, the most suitable treatment in terms of metabolic improvement, weight gain limitation and treatment adhesion is to add an intermediate insulin injection at bedtime. The next step remains several injections a day, with metformine addition if possible. FUTURE PROSPECTS AND PROJECTS: Therapeutic treatment in type 2 diabetes mellitus may become an earlier start of insulin therapy to preserve the remaining pancreatic insulin reserve. The role of brief and long-lasting insulin analogues, as well as inhaled insulin, which will soon be available, should be specified.

Clinical Protocols↗
PubMed1998

Developing curriculum in nursing informatics in Europe.

The NIGHTINGALE Project (NIGHTINGALE Project: HC1109 DGXIII Contract and Technical Annex, European Commission, December 1995) which started on the 1st of January, 1996, after the approval of the European Commission, has a 36 month duration. It is essential in planning and implementing a strategy in training the nursing profession in using and applying healthcare information systems. NIGHTINGALE contributes towards the appropriate use of the developed telematics infrastructure across Europe by educating and training nurses in a harmonious way across Europe in the upcoming field of nursing informatics. NIGHTINGALE develops courseware material based on the curriculum development process using multimedia technologies. Computer based training software packages in nursing informatics will be the basis of the training material and the corresponding courses. CD-ROM based training and reference material will also be provided in the courses whereas the traditional booklets, teaching material and textbooks can also play an adequate role in training. NIGHTINGALE will disseminate all information and courseware material freely to all interested parties through the publications of the proceedings of the conferences, through the establishment of the world wide web (WWW) server in nursing informatics for Europe (http://www.dn.uoa.gr/nightingale), which will become a depository of nursing information knowledge across Europe as well as a dissemination node of nursing informatics throughout the European members states for the benefit and welfare of the European citizen.

CD-ROM↗
PubMed2004

Irradiation after surgically induced brain injury in the rat: timing in relation to severity of radiation damage.

The aim of this study was to evaluate how timing of irradiation after brain surgery in rats relates to overall extent of brain radiation damage. Extent of injury was determined according to lipid peroxidation (malondialdehyde; MDA) levels in brain tissue. Thirty female rats were randomly assigned to five equal groups (Groups A-E). Four groups underwent trephination and scalpel hemisection of right frontal lobe. Rats in Groups B and D received 25 Gy cranial irradiation in a LINAC system at 10 and 20 days after surgery, respectively. Twenty-four hours later they were killed and their right frontal lobes were removed for lipid peroxidation determination. Groups A and C were not irradiated; these groups were killed and had their frontal lobes removed on day 11 and day 21 post-surgery, respectively. The remaining six animals (Group E, sham surgery) underwent trephination only, and were killed and had their frontal lobes removed 24 h later. There was a significant difference between the mean MDA levels in the control group and Group D, and between the levels in Group B and Group D (P < 0.05 for both). The difference between the mean for Group A and the mean for Group B was even more significant (P < 0.01). The most striking differences were between the control group and Group B, and between Group B and Group C (P < 0.001 for both). The data from this rat model suggest that, in humans, starting radiotherapy early (1-2 weeks) after debulking of a brain tumor may result in significantly higher levels of tissue damage than if the radiation is started 3 weeks or more postoperatively. Further experimental research is needed to project these findings in rats to human subjects.

Animals↗
PubMed2006

[Professional nursing--development and contents of a definition].

This definition of professional nursing was developed at the Institute of Nursing Science, University of Basel, in collaboration with the group of experts from the project "Future of Swiss Medicine" of the Swiss Academy of Medical Sciences. Starting points were existing definitions and a list of desirable contents. Using Grounded Theory approaches, potential contents were analysed and a first draft was written. Through several feedback rounds, this draft was refined to the definition that is presented here. Professional nursing is defined in two core sentences. As regards content, it relates to promoting and maintaining health, preventing health problems, and assisting people in treating illnesses and in dealing with consequences of illnesses and their therapies. The goal is to achieve the best possible results of treatments and care as well as the best possible quality of life in all phases of life until death for the people cared for. Eight additional paragraphs describe to whom professional nursing is directed, the tasks it includes, its essential basics, who delivers it, how it is put into practice, and its context. The definition has a scientific background and incorporates international perspectives and developments. An addendum outlines further thoughts regarding interprofessional collaboration in health care, focal points of nursing education, and future directions of professional nursing. It calls for an optimal collaboration among the different professional groups to reach the best possible outcomes for people with (potential) health problems. Trends in society and health care, especially the growing numbers of old and chronically ill people, will increase the need for professional care. It is necessary to develop new systems and models of care that meet population needs and have a lasting effect. Nursing education must take these future changes into consideration.

Clinical Competence↗
PubMed2006

An efficient tandem affinity purification procedure for interaction proteomics in mammalian cells.

Tandem affinity purification (TAP) is a generic two-step affinity purification protocol that enables the isolation of protein complexes under close-to-physiological conditions for subsequent analysis by mass spectrometry. Although TAP was instrumental in elucidating the yeast cellular machinery, in mammalian cells the method suffers from a low overall yield. We designed several dual-affinity tags optimized for use in mammalian cells and compared the efficiency of each tag to the conventional TAP tag. A tag based on protein G and the streptavidin-binding peptide (GS-TAP) resulted in a tenfold increase in protein-complex yield and improved the specificity of the procedure. This allows purification of protein complexes that were hitherto not amenable to TAP and use of less starting material, leading to higher success rates and enabling systematic interaction proteomics projects. Using the well-characterized Ku70-Ku80 protein complex as an example, we identified both core elements as well as new candidate effectors.

Affinity Labels↗