<p>In 1995 and 2000 a total of 29 886 non surgical ED visits at Uppsala University Hospital were registered. Presenting complaint, admittance to a ward, length of stay, in-hospital mortality, discharge diagnoses, 30-day and long-term mortality were registered. The presenting complaints were sorted into 33 presenting complaint groups (PCGs). </p><p>For different PCGs there was different in-hospital fatality rate. Compared to the largest PCG, chest pain, the gender and age adjusted OR was 2.12 (95% CI 1.01 – 4.44) for the miscellaneous complaint group and 2.04 (95 % CI 1.35 – 3.08) for the stroke–like symptom group. Within a given PCG the in-hospital mortality could vary depending on discharge diagnoses. By relating PCG and long term mortality to the expected mortality in the population, the Standardized Mortality Ratio (SMR) could be calculated. The SMR was found to be highest in seizure 2.62 (95 % CI 2.13 – 3.22), intoxication 2.51 (95% CI 2.11-2.98) and symptoms of asthma 1.8 (1.65 – 2.06). For the same discharge diagnoses the long term mortality could differ considerably depending on PCG at ED arrival (p<0.001). </p><p>Between 1995 and 2000 there was a 30 % increase in ED visits at the non surgical ED. PCGs representing lesser severe conditions had increased. Demographic changes could account for 45 % of the increment and the remaining increase could be ascribed to change in visiting pattern. </p><p>In the 2000 cohort 41.0 % of all visits were performed by re-visitors. The number of revisits and five-year mortality had an inversed u-shaped relationship were patients with three re-visits within the same year had an increased mortality compared to patients with more or less visits. </p><p>Conclusion: It is possible to define presenting complaint groups (PCGs) that are robust and consistent over time and useful as a tool for epidemiological studies in the ED.</p>

Identifying the sites and mechanisms involved in haematopoietic stem cells (HSCs) during development would improve our understanding of how to induce HSCs from alternative sources like embryonic stem cells, while offering insight into pathways involved in HSC-related diseases such as leukaemia. Adult-type HSC, or long-term reconstituting HSCs (LTR-HSCs), are widely defined as cells capable of reconstituting the entire haematopoietic system of a lethally irradiated adult recipient. The first LTR-HSCs emerge and expand in the aorta-gonad-mesonephros (AGM) region of the mid-gestation mouse embryo. Recently, the development of a novel reaggregate culture system has provided a valuable tool to identify key cell populations involved in LTR-HSC development. This system allows the mechanical dissociation of the E11.5 AGM region prior to culture whilst maintaining its ability to autonomously expand LTR-HSCs. Here, I show that reaggregate LTR-HSCs are CD45+Sca1+c-kit+CD31med and that IL-3, SCF, and Flt3l are required in order to achieve an optimal 150 fold LTR-HSC expansion. I also characterise the pattern of Runx1 expression in the adult and E11.5 AGM region of our novel Runx1EGFP reporter mouse and identify a population of EGFP+CD45-VE-cadherin- cells in the E11.5 AGM region that disappears during reaggregate culture. Finally, using the E11.5 AGM reaggregate culture, I show that while uro-genital ridges are potentially required for optimal LTR-HSC expansion, most LTR-HSCs are derived from the dorsal aorta (Ao) region, and that the dorsal aspect of the dorsal aorta (AoD) can contribute to the reaggregate LTR-HSCs compartment.

To preserve multi-centennial length variability in annual tree-ring chronologies, the Regional Curve Standardization (RCS) method calculates anomalies from a regionally common, non-climatic age-trend function. The influence of various factors on the estimation of the regional curve (RC) and resulting RCS- chronology is discussed. These factors are: the method of calculating anomalies from the age-trend function, estimation of the true pith offset, the number of series used, species composition, and site characteristics. By applying RCS to a collection of millennium-length tree-ring data sets, the potential and limitations of the RCS method are investigated. RCS is found to be reasonably robust with respect to tested factors, suggesting the method is a suitable tool for preserving low-frequency variance in long tree-ring chronologies.

No description available.

No description available.

The primary aim was to compare the effectiveness of smoking cessation interventions of different intensities in a clinical dental and a telephone setting in Sweden. Methods: A total of 300 smokers were randomized to High or Low Intensity Treatment (HIT or LIT) at the Public Dental Service, County Council of Västmanland. Effectiveness (abstinence rate) was measured after 1yr (paper I) and 5-8yrs (paper III). A cost-effectiveness analysis was conducted, based on intervention costs, number of abstinent participants after 1yr, and a Markov modelling of future costs and health (in QALYs) consequences (paper II). In paper IV, 586 callers to the Swedish National Tobacco Quitline (SNTQ) were randomized to high-intensity proactive or low-intensity reactive service, and effectiveness was measured after 1 yr. Effectiveness measures were self-reported point prevalence, 6-month continuous abstinence, and sustained abstinence. Results: Absolute quit rates were 7% higher with HIT than with LIT on all measures and increased by 8% from 1yr to 5-8yrs. Point prevalence was 23% vs. 16% (p=.11) after 1yr and 31% vs. 24% (p=.16) after 5-8yrs. Six-month continuous abstinence was 18% vs. 9% (p =.02) after 1yr and 26% vs.19% (p=.18) after 5-8yrs. Sustained abstinence was 12% vs. 5% (p =.03) after 5-8yrs. Nicotine dependence was a strong predictor for abstinence at 1yr and achieved abstinence at 1yr was a strong predictor for abstinence at long-term follow-up. The cost-effectiveness analysis showed that both HIT and LIT were cost-effective, and LIT was even cost-saving compared with doing nothing. HIT was more costly and more effective than LIT, and the cost of each extra QALY gained by HIT was 100,000SEK, which is considered very cost-effective in Sweden. Proactice and reactive services were equally effective at the SNTQ. Point prevalence was 27% and 6-month continuous abstinence was 21% after 1yr. Being smoke-free at baseline was the strongest predictor for abstinence at 1yr. Conclusion: Support at high as well as low intensity in a clinical dental setting in Sweden and at the SNTQ was effective in achieving smoking cessation. Both high- and low-intensity interventions were very cost-effective in a clinical dental setting.

Darbe nagrinėjama priklausomų nuo psichoaktyviųjų medžiagų asmenų gyvenimo kokybė: psichologinė gerovė (pozityvios gerovės pojūtis, savikontrolė, bendrasis sveikatingumas, gyvybingumas, nerimas, depresiška nuotaika), kasdienio gyvenimo fizinė sveikata, psichologinis kūno įvaizdis ir išvaizda, socialiniai ir asmeniniai santykiai, aplinka ir materialiniai ištekliai. Tyrimo tikslas - atlikti priklausomų nuo psichoaktyviųjų medžiagų asmenų, baigusių Lietuvos priklausomybės ligų reabilitacijos centrų ilgalaikes programas, gyvenimo kokybės analizę. Naudotos metodikos: Psichologinės gerovės klausimynas, Pasaulio sveikatos organizacijos Gyvenimo kokybės klausimynas (WHOQOL-BREF). Tyrime dalyvavo 86 ilgalaikę PRP (priklausomybių reabilitacinę programą) baigę asmenys: 68 vyrai ir 17 moterų bei 1 nenurodęs savo lyties asmuo, kurių amžius yra nuo nuo 19 iki 51 metų. Duomenų analizė parodė, kad PRP programą baigusių asmenų, palyginus su reabilitacijos bendruomenėje besigydančiais asmenimis, gyvenimo kokybė yra labiau pozityvi: a) jų geresnė psichologinė gerovė – jie jaučia mažiau nerimo, depresiškos nuotaikos; jaučia turintys daugiau savikontrolės, gyvybingumo; jų yra didesnis pozityvios gerovės pojūtis bei bendrasis sveikatingumas; b) jie savo gyvenimo kokybės visumą bei sveikatos būklę suvokia kaip geresnes; c) jie geriau vertina kasdieninio gyvenimo fizinę sveikatą, socialinius ir asmeninius santykius, aplinką ir materialinius išteklius. PRP programą baigusių asmenų gyvenimo kokybė... [toliau žr. visą tekstą] / The thesis analyses the quality of life of the people with addictive disorders. The quality of life includes their psychological well-being (positive sensation of well-being, self-control, general health, viability, anxiety, and depressed mood), everyday physical health, psychological body image and appearance, social and personal relationships, physical environment and financial resources. The goal of this study was to perform the analysis of the quality of life of the people who have finished long-term addiction rehabilitation programmes in Lithuanian therapeutic communities. The following instruments were used: Psychological General Well-being Schedule, WHO Quality of Life Questionnaire (WHOQOL-BREF). 86 residents of therapeutic communities who have finished a long term ARP (the Addiction Rehabilitation Programme), i.e. 68 men and 17 women and 1 person of an unidentified gender with age ranging from 19 to 51 participated in this study. The data analysis showed that the quality of life of the people who have finished the ARP programme compared to the patients in the same rehabilitation is more positive: a) their psychological well-being is better - they feel less anxiety, depressed mood; they feel more self-control, vitality; they have a greater sensation of positive well-being and general health; b) they perceive their whole quality of life and health status as better; c) they have a better assessment of their everyday physical health, social and personal relationships... [to full text]

The purpose of this study is to learn about the professional development practices of physiotherapists working in long-term care homes in Ontario. A survey was created based on relevant literature and piloted for this study. The survey included both quantitative and open-ended questions. 44 Physiotherapist responded, which represents approximately 10% of physiotherapists working in long-term care in Ontario. The results indicate that physiotherapists are isolated from their physiotherapist peers and lack access to communities of practice, professional socialisation, professional culture and social regulation. Although physiotherapists’ interactions with interprofessional teams added breadth to their knowledge, these interactions did not enhance their profession-specific skills. Many physiotherapists are seeking professional community and social supports in healthcare settings outside of the long-term care context. The implications of this study are that physiotherapists, their professional associations, and their college must understand the importance of professional socialization in learning, and ensure that physiotherapists working in long-term care have access to and seek such social support. Physiotherapy service providers in long-term care should provide mentoring, support and opportunities for social learning for their clinicians. Finally, long-term care homes and the Ministry of Health and Long-term care need to ensure that policies provide a better definition of the role of physiotherapists in long-term care.

The aims of this thesis were (1) to learn about the identities of the molecules involved in the maintenance of long-term potentiation (LTP), and (2) to develop and test a behavioural paradigm capable of elucidating the interaction between these molecular processes and the persistence of long-term memories. By improving the stability of field recordings in in vitro electrophysiology, it was possible to investigate the molecular processes that determine the long-term changes in synaptic efficacy. In these experiments, the interactions between two convergent inputs onto the same neuronal population in the CA1 region of the hippocampus were monitored for over ten hours. Analytically powerful three-pathway protocols using sequential strong and weak tetanization in varying orders, and test stimulation over long periods of time after LTP-induction, enabled a pharmacological dissociation of potentially distinct roles of the calmodulin kinase (CaMK) pathways in LTP. This places constraints on the mechanisms by which synaptic potentiation, and possibly memories, become stabilized. The experiments show that tag setting is blocked by the CaMK inhibitor KN-93 that, at low concentration primarily blocks CaMKII, whereas a CaMKK inhibitor, STO-609, selectively limits the synthesis or the availability of plasticity related proteins (PRPs). To test whether memories can be subject to modulation by independent experiences, behavioural studies tested the possibility of lengthening the persistence of a relatively weak memory by pairing its induction with an event capable of inducing the synthesis of the required PRPs. Corticosterone-dependent stressful events like a cold swim proved to interfere and weaken spatial memories. On the other hand, the exploration of a novel environment succeeded in rescuing the decay of a weak memory. The effect of the exploration of the novel environment was dependent on NMDA and dopamine receptor activation, as well as protein synthesis. These results are discussed in relation to the synaptic tagging and capture hypothesis and a novel model of the neuronal mechanisms underlying synaptic plasticity is developed from them.

This thesis proposes four novel techniques to solve the problem of growing energy consumption requirements in cellular communication networks. The first and second part of this work propose a novel energy efficient scheduling mechanism and two new bandwidth management techniques, while the third part provides an algorithm to actively manage the power state of base stations (BSs) so that energy consumption is minimized throughout the day while users suffer a minimal loss in achieved data rate performance within the system. The proposed energy efficient score based scheduler (EESBS) is based on the already existing principle of score based resource allocation. Resource blocks (RBs) are given scores based on their energy efficiency for every user and then their allocation is decided based on a comparison between the scores of the different users on each RB. Two additional techniques are introduced that allow the scheduler to manage the user’s bandwidth footprint or in other words the number of RBs allocated. The first one, bandwidth expansion mode (BEM), allows users to expand their bandwidth footprint while retaining their overall transmission data rate. This allows the system to save energy due to the fact that data rate scales linearly with bandwidth and only logarithmically with transmission power. The second technique, time compression mode (TCoM), is targeted at users whose energy consumption is dominated by signalling overhead transmissions. If the assumption is made that the overhead is proportional to the number of RBs allocated, then users who find themselves having low data rate demands can release some of their allocated RBs by using a higher order modulation on the remaining ones and thus reduce their overall energy expenditure. Moreover, a system that combines all of the aforementioned scheduling techniques is also discussed. Both theoretical and simulation results on the performance of the described systems are provided. The energy efficient hardware state control (EESC) algorithm works by first collecting statistical information about the loading of each BS during the day that is due to the particular mobility patterns of users. It then uses that information to allow the BSs to turn off for parts of the day when the expected load is low and they can offload their current users to nearby cell sites. Simplified theoretical, along with complete system computer simulation, results are included. All the algorithms presented are very straightforward to implement and are not computationally intensive. They provide significant energy consumption reductions at none to minimal cost in terms of experienced user data rate.