http://hera.helsebiblioteket.no/hera HeRA captures, stores, indexes, preserves, and distributes digital research material. Search the Channel search http://hera.helsebiblioteket.no/hera/simple-search http://hdl.handle.net/10143/93682 Title: A framework for mandatory impact evaluation to ensure well informed public policy decisions.<br/><br/>Authors: Oxman, Andrew David; Bjørndal, Arild; Becerra-Posada, Francisco; Gibson, Mark; Block, Miguel Angel Gonzalez; Haines, Andy; Hamid, Maimunah; Odom, Carmen Hooker; Lei, Haichao; Levin, Ben; Lipsey, Mark W; Littell, Julia H; Mshinda, Hassan; Ongolo-Zogo, Pierre; Pang, Tikki; Sewankambo, Nelson; Songane, Francisco; Soydan, Haluk; Torgerson, Carole; Weisburd, David; Whitworth, Judith; Wibulpolprasert, Suwit http://hdl.handle.net/10143/93161 Title: Expression patterns of Neil3 during embryonic brain development and neoplasia.<br/><br/>Authors: Hildrestrand, Gunn A; Neurauter, Christine G; Diep, Dzung B; Castellanos, Cesilie G; Krauss, Stefan; Bjørås, Magnar; Luna, Luisa<br/><br/>Abstract: BACKGROUND: The base excision repair pathway is responsible for repairing small DNA base lesions caused by endogenous and exogenous damaging agents. Repair is initiated by DNA glycosylases that recognize and remove the lesions. NEIL3 is one of 11 mammalian DNA glycosylases identified to date and it was discovered on the basis of sequence homology to the E. coli Fpg and Nei glycosylases. Difficulties in purifying the protein have limited its biochemical characterization and in contrast to the other glycosylases, its function remains unclear. RESULTS: In this study we describe the expression pattern of Neil3 during mouse embryonic development with special focus on brain development. We have also looked at the expression of NEIL3 in several normal and tumor tissues. Quantitative real-time PCR and in situ hybridization revealed that Neil3 was highly expressed at embryonic days 12-13, when neurogenesis starts. The expression decreased during development and in the adult brain,Neil3 could not be detected in any of the brain areas examined by quantitative real-time PCR. During embryogenesis and in newborn mice specific expression was observed in areas known to harbour neural stem and progenitor cells such as the subventricular zone and the dentate gyrus. Finally, NEIL3 expression was higher in tumors compared to normal tissues, except for testis and pancreas. CONCLUSION: Our findings indicate that mammalian NEIL3 is specifically expressed in brain areas where neurogenesis takes place during development and that its expression is tightly regulated both temporally and spatially. In addition, NEIL3 seems to be upregulated in tumor tissues compared to normal tissues. Altogether, mammalian NEIL3 seems to be highly expressed in cells with high proliferative potential. http://hdl.handle.net/10143/93136 Title: Methylation detection oligonucleotide microarray analysis: a high-resolution method for detection of CpG island methylation.<br/><br/>Authors: Kamalakaran, Sitharthan; Kendall, Jude; Zhao, Xiaoyue; Tang, Chunlao; Khan, Sohail; Ravi, Kandasamy; Auletta, Theresa; Riggs, Michael; Wang, Yun; Helland, Aslaug; Naume, Bjørn; Dimitrova, Nevenka; Børresen-Dale, Anne-Lise; Hicks, Jim; Lucito, Robert<br/><br/>Abstract: Methylation of CpG islands associated with genes can affect the expression of the proximal gene, and methylation of non-associated CpG islands correlates to genomic instability. This epigenetic modification has been shown to be important in many pathologies, from development and disease to cancer. We report the development of a novel high-resolution microarray that detects the methylation status of over 25,000 CpG islands in the human genome. Experiments were performed to demonstrate low system noise in the methodology and that the array probes have a high signal to noise ratio. Methylation measurements between different cell lines were validated demonstrating the accuracy of measurement. We then identified alterations in CpG islands, both those associated with gene promoters, as well as non-promoter-associated islands in a set of breast and ovarian tumors. We demonstrate that this methodology accurately identifies methylation profiles in cancer and in principle it can differentiate any CpG methylation alterations and can be adapted to analyze other species. http://hdl.handle.net/10143/93013 Title: Three-year follow-up of physical activity in Norwegian youth from two ethnic groups: associations with socio-demographic factors.<br/><br/>Authors: Sagatun, Ase; Kolle, Elin; Anderssen, Sigmund A; Thoresen, Magne; Søgaard, Anne Johanne<br/><br/>Abstract: BACKGROUND: More research on factors associated with physical activity and the decline in participation during adolescence is needed. In this paper, we investigate the levels, change, and stability of physical activity during the late teens among ethnic Norwegians and ethnic minorities, and we examine the associations between physical activity and socio-demographic factors. METHODS: The baseline (T1) of this longitudinal study included 10th graders who participated in the youth part of the Oslo Health Study, which was carried out in schools in 2000-2001. The follow-up (T2) in 2003-2004 was conducted partly at school and partly by mail. A total of 2489 (1112 boys and 1377 girls) participated both at baseline and at follow-up. Physical activity level was measured by a question on weekly hours of physical activity outside of school. Socio-demographic variables were collected by questionnaire and from data obtained from Statistics Norway. Analysis of variance was used to study the level of and changes (T1 to T2) in physical activity, and the associations between physical activity and socio-demographic factors. Stability in physical activity was defined as the percentage of students reporting the same physical activity both times. RESULTS: Boys were more active than girls at age 15 and 18 years, independent of ethnic background. Among girls, ethnic Norwegians were more active than ethnic minorities. Hours per week spent on physical activity declined in all groups during the follow-up period. Few associations were found between physical activity and socio-demographic factors in both cross-sectional and longitudinal data. Among the ethnic minority girls, 65% reported being physically active 0-2 hours per week at baseline, and 82% of these girls reported the same level at follow up. CONCLUSION: The association between physical activity and ethnicity at age 15 years remained the same during the follow-up. Few associations were found between physical activity and socio-demographic variables. A large proportion of ethnic minority girls reported a persistently low physical activity level, and this low participation rate may need special attention. http://hdl.handle.net/10143/92213 Title: Tannhelsetjenesten – med særlig blikk på offentlige tannhelsetjenester til prioriterte grupper<br/><br/>Abstract: NORSK SAMMENDRAG: Som en del av det overordnede faglige tilsyn med helsetjenesten har Statens helsetilsyn tidligere utredet området tannhelsetjenester. Vi har hatt et særlig fokus på omfanget av den offentlige tannhelsetjenesten til de gruppene som tannhelsetjenesteloven stiller krav om at fylkeskommunen skal prioritere. Statens helsetilsyn har tidligere gitt ut tre rapporter om tannhelsetjenesten i Norge. Rapportene viste betydelige fylkesvise forskjeller i tannhelsetjenestetilbudet, som ga grunn til bekymring for at prioriterte grupper i flere fylker ikke fikk det tilbudet de har krav på. Denne rapporten presenterer bakgrunnsdata på følgende områder:- Områdeovervåkning – tannhelsestatistikk Oppsummering av tilsynserfaring – planlagte tilsyn - Oppsummering av tilsynserfaring – tilsynssaker og rettighetsklager - Gjennomgang av forvaltningsrapporter om tannhelsetjenesten.; SUMMARY IN ENGLISH: As part of general supervision of health services, the Norwegian Board of Health Supervision has previously investigated dental services. In particular we have investigated dental services for groups in the population that are defined as priority groups in the Dental Health Services Act.Previously, the Norwegian Board of Health Supervision has published three reports on dental services in Norway. We identified large differences in supply of dental services in differentcounties. We were concerned that not all people in the priority groups are offered the dental services they are entitled to.This report presents background data in the following areas:- statistics about dental services - experience gained from supervision of dental services – planned supervision - experience gained from supervision of dental services – cases of complaint about dental personnel and rights for dental services - summary of reports evaluating public dental services http://hdl.handle.net/10143/91914 Title: Self-Monitoring of Blood Glucose in Type 1 Diabetes Patients with Insufficient Metabolic Control: Focused Self-Monitoring of Blood Glucose Intervention Can Lower Glycated Hemoglobin A1C.<br/><br/>Authors: Skeie, Svein; Kristensen, Gunn B B; Carlsen, Siri; Sandberg, Sverre<br/><br/>Abstract: OBJECTIVE: Little attention has been given and few studies have been published focusing on how to optimize self-monitoring of blood glucose (SMBG) use to monitor daily therapy for persons with type 1 diabetes mellitus. This study was designed to evaluate the effect on glycated hemoglobin (A1C) of a structured intervention focused on SMBG in type 1 diabetes patients with insufficient metabolic control (A1C >/= 8%) using a randomized clinical trial design. METHOD: One hundred fifty-nine outpatients with type 1 diabetes on multiple injection therapy with insulin and A1C >/=8% were recruited and randomized to one group receiving a focused, structured 9-month SMBG intervention (n = 59) and another group receiving regular care based on guidelines (n = 64). RESULTS: Glycated hemoglobin values (mean % +/- standard deviation) at study start was similar: 8.65 +/- 0.10 in the intervention group and 8.61 +/- 0.09 in the control group. The two groups were comparable (age, gender, body mass index, complication rate, and treatment modality) at study start and had mean diabetes duration and SMBG experience of 19 and 20 years, respectively. At study end, there was decrease in A1C in the intervention group (p < .05), and the A1C was 0.6% lower compared with the control group (p < .05). No increase in the number of minor or major hypoglycemia episodes was observed in the intervention group during the study period. CONCLUSIONS: A simple, structured, focused SMBG intervention improved metabolic control in patients with longstanding diabetes type 1 and A1C >/= 8%. The intervention was based on general recommendations, realistic in format, and can be applied in a regular outpatient setting. http://hdl.handle.net/10143/91148 Title: Experience of unpleasant sensations in the mouth after injection of saline from prefilled syringes.<br/><br/>Authors: Kongsgaard, Ulf E; Andersen, Anders; Oien, Marina; Oswald, Inger-Ann Y; Bruun, Laila I<br/><br/>Abstract: BACKGROUND: Nurses at The Norwegian Radium Hospital have reported that some patients notice an unpleasant smell or taste in accordance with flushing of intravenous lines with commercially available prefilled syringes. We have conducted a study in healthy volunteers to investigate the occurrence, consistency and intensity of this phenomenon. METHODS: A randomised, blinded, crossover study comparing commercial available prefilled saline 9 mg/ml syringes to saline 9 mg/ml for injection in polyethylene package was performed in 10 healthy volunteers. The volunteers were given intravenous injections of varying volume and speed. Data were analysed using descriptive statistics, and also Wilcoxon Signed Rank Test to compare groups. RESULTS: After intravenous injection, 2 of 15 recordings demonstrated any sensation of smell or taste after injection of saline from polyethylene package, while 14 of 15 recordings noted a sensation after injection of saline from prefilled syringes. The intensity of the unpleasant sensation was rated significantly higher after injection of saline from prefilled syringes compared to saline from polyethylene (p = 0.001). CONCLUSIONS: Injection of saline from prefilled syringes in healthy volunteers resulted in an experience of bad taste or smell. It is important that nurses and health workers are aware of the phenomenon as described in this article in order to choose the preferred product for a given patient. http://hdl.handle.net/10143/90234 Title: Nære pårørende av alkoholmisbrukere. Hvor mange er de og hvordan berøres de?<br/><br/>Authors: Rossow, Ingeborg; Moan, Inger Synnøve; Natvig, Henrik<br/><br/>Abstract: NORSK SAMMENDRAG: Mellom 50 000 og 150 000 barn og mellom 50 000 og 100 000 ektefeller/partnere bor sammen med personer med et risikofylt alkoholkonsum i Norge. Mer enn 130 000 har i løpet av livet opplevd ulike negative konsekvenser av foreldres eller partners alkoholproblemer.Da det ikke er noen klare skiller mellom alkoholmisbrukere og andre alkoholbrukere, ville det være misvisende å lage et enkelt anslag over antall barn og partnere som berøres. Det er derfor angitt intervaller som antyder i hvilket størrelsesområde antallet trolig befinner seg.For første gangBeregningene i rapporten er gjort på grunnlag av en intervjuundersøkelse blant vel 2000 voksne og en spørreskjemaundersøkelse blant vel 20 000 ungdommer. Det er første gang det er gjort beregninger i Norge av hvor mange nære pårørende det er til alkoholmisbrukere og hvilke negative konsekvenser de opplever.Negative konsekvenserDe negative konsekvensene varierer både i type, varighet og alvorlighetsgrad. Blant de mulige konsekvensene som er undersøkt i denne studien, er sjikane, vold og trusler om vold, seksuelle overgrep og uønsket seksuell tilnærming og hærverk.Psykososiale problemerBlant ungdom øker andelen med ulike psykososiale problemer som å bli utsatt for vold, dårlig mental helse og dårlige foreldrerelasjoner, med hyppigheten av å se foreldrene beruset. Ungdom som så foreldrene beruset flere ganger i uka, hadde 3 – 5 ganger høyere risiko for å få slike problemer sammenlignet med annen ungdom. Likevel er det et flertall som ikke rapporterer denne typen problemer, selv blant dem som ofte opplever at foreldrene er beruset.Forsømt forskningsområdeAlkoholbrukets konsekvenser for nære pårørende er et forsømt forskningsområde. Gjennomgangen av forskningslitteraturen viser at det åpenbart er behov for mer forskning om norske forhold. Det er også viktig å bidra til den internasjonale kunnskapen om dette feltet.; ENGLISH SUMMARY: Alcohol accounts for the largest fraction of substance related problems, both with respect to the number substance abusers and with respect to the extent of health and social consequences of substance use. The aim of the report was twofold: (i) to estimate the number of children and partners who live with an alcohol abuser, and (ii) to examine negative consequences that they experience. This is the first attempt to examine these issues using Norwegian data.We used two available data sets for the analyses; one interview survey conducted among more than 2000 adults and a school based survey conducted among more than 20 000 adolescents. An important concern of this report has been to show that there are no clear distinctions between those who abuse alcohol or people with a hazardous drinking pattern and other alcohol consumers. Moreover, children and partners of heavy drinkers may experience negative consequences that will probably vary with respect to type of consequences as well as degree of severity. Such consequences can probably be attributed to a larger group of alcohol consumers than the small group of the most heavy drinkers.Our estimates showed that we may assume that there are some 50 000 – 150 000 children and some 50 000 – 100 000 partners living with persons who have a hazardous alcohol consumption. There are more than 130 000 persons who, during their adulthood, have experienced certain types of consequences (harassment, violent threats, unwanted sexual contact, vandalism, and sexual abuse) due to parents’ or partners’ heavy drinking. Among adolescents, psychosocial problems such as violence, mental health problems and poor parental relations, were found to increase with frequency of exposure to parental alcohol intoxication. However, even among those who often have seen their parents intoxicated, the majority did not report having experienced any of these problems.A review of the research literature showed that this is a neglected area of research. It is clearly a need not only for further research on Norwegian conditions in this area, but also important to contribute to the international scientific literature on this topic. http://hdl.handle.net/10143/87660 Title: Understanding the implementation of complex interventions in health care: the normalization process model.<br/><br/>Authors: May, Carl; Finch, Tracy; Mair, Frances; Ballini, Luciana; Dowrick, Christopher; Eccles, Martin; Gask, Linda; MacFarlane, Anne; Murray, Elizabeth; Rapley, Tim; Rogers, Anne; Treweek, Shaun; Wallace, Paul; Anderson, George; Burns, Jo; Heaven, Ben<br/><br/>Abstract: BACKGROUND: The Normalization Process Model is a theoretical model that assists in explaining the processes by which complex interventions become routinely embedded in health care practice. It offers a framework for process evaluation and also for comparative studies of complex interventions. It focuses on the factors that promote or inhibit the routine embedding of complex interventions in health care practice. METHODS: A formal theory structure is used to define the model, and its internal causal relations and mechanisms. The model is broken down to show that it is consistent and adequate in generating accurate description, systematic explanation, and the production of rational knowledge claims about the workability and integration of complex interventions. RESULTS: The model explains the normalization of complex interventions by reference to four factors demonstrated to promote or inhibit the operationalization and embedding of complex interventions (interactional workability, relational integration, skill-set workability, and contextual integration). CONCLUSION: The model is consistent and adequate. Repeated calls for theoretically sound process evaluations in randomized controlled trials of complex interventions, and policy-makers who call for a proper understanding of implementation processes, emphasize the value of conceptual tools like the Normalization Process Model. http://hdl.handle.net/10143/86633 Title: High Prevalence of Orthostatic Hypotension in Mild Dementia.<br/><br/>Authors: Sonnesyn, Hogne; Nilsen, Dennis W; Rongve, Arvid; Nore, Sabine; Ballard, Clive; Tysnes, Ole B; Aarsland, Dag<br/><br/>Abstract: Background/Aims: Orthostatic hypotension (OH) and QTc prolongation have potentially important prognostic and therapeutic consequences but have rarely been studied in patients with mild dementia. Methods: Patients with mild dementia were diagnosed according to consensus criteria after comprehensive standardized assessment. OH and QTc were assessed using standardized criteria. Results: OH was significantly more common in the dementia than in the control group, and systolic drop was higher in those with dementia with Lewy bodies. There were no significant differences in QTc values between dementia and control subjects. Conclusion: OH occurs even in patients with mild dementia, in particular in dementia with Lewy bodies. QTc was not prolonged in patients with mild dementia compared with normal controls.