Physical fitness, training volume, and self-determined motivation in soldiers during a peacekeeping mission

PURPOSE: The goal was to register physical training volume and to measure changes in physical fitness in soldiers during a peacekeeping mission. The relationship between these factors and motivation for physical training was also investigated. METHODS: Physical training volume was registered and maximal oxygen uptake, 3-km run time, sit-ups, push-ups, and chin-ups were tested before and after 1 year of service for 71 Norwegian soldiers in the international Kosovo Force. Self-determined motivation was measured at the end of the service. RESULTS: Physical training volume was 117 +/- 77 minutes/week. The average maximal oxygen uptake decreased by 2.5 +/- 0.8% (p < 0.01). Intrinsic motivation positively predicted physical training volume (p < 0.01). CONCLUSIONS: A large variation in training volume was found, and only one-third of the soldiers improved physical fitness and maintained body weight. Fostering intrinsic motivation toward physical training is key to increasing training volume. However, obligatory training could ensure a minimum of physical training among the soldiers who were least motivated for physical training.     

Secular trends in adiposity in Norwegian 9-year-olds from 1999-2000 to 2005

Background  

Due to the negative health consequences of childhood obesity monitoring trends in body mass and adiposity is essential. The purpose of this study was to describe secular trends in the prevalence of overweight and obesity among 9-year-old children, and to study changes in adiposity and fat distribution by investigating changes in waist circumference (WC) and skinfold thicknesses.     

Targeted cancer therapy with a novel low-dose rate alpha-emitting radioimmunoconjugate

Alpha-emitting radionuclides are highly cytotoxic and are of considerable interest in the treatment of cancer. A particularly interesting approach is in radioimmunotherapy. However, alpha-emitting antibody conjugates have been difficult to exploit clinically due to the short half-life of the radionuclides, low production capability, or limited source materials. We have developed a novel technology based on the low-dose rate alpha-particle-emitting nuclide (227)Th, exemplified here using the monoclonal antibody rituximab. In vitro, this radioimmunoconjugate killed lymphoma cells at Becquerel per milliliter (Bq/mL) levels. A single injection of (227)Th-rituximab induced complete tumor regression in up to 60% of nude mice bearing macroscopic (32-256 mm(3)) human B-lymphoma xenografts at Becquerel per gram (Bq/g) levels without apparent toxicity. Therapy with (227)Th-rituximab was significantly more effective than the control radioimmunoconjugate (227)Th-trastuzumab and the standard beta-emitting radioimmunoconjugate for CD20(+) lymphoma(90)Y-tiuxetan-ibritumomab. Thorium-227 based constructs may provide a novel approach for targeted therapy against a wide variety of cancers.     

Clinical assessment techniques for detecting ligament and membrane injuries in the upper cervical spine region--a comparison with MRI results

In this study we examined whether results from a clinical test of passive mobility of soft tissue structures in the upper cervical spine, corresponded with signs of physical injuries, as judged by magnetic resonance imaging (MRI). Results were based on examinations of 122 study participants, 92 with and 30 without a diagnosis of whiplash-associated disorder, type 2. The structures considered were the alar and the transverse ligaments, and the tectorial and the posterior atlanto-occipital membranes. Ordinary and weighted kappa coefficients were used as a measure of agreement, whereas McNemar's test was used for evaluating differences in rating. The clinical classification and the MRI examination both comprised four response categories (grades 0-3), with 0 representing a normal structure, and 3 indicating a structure with pronounced abnormality. In our sample, an abnormal clinical test reflected a hyper- rather than hypo-mobility. Considering all four-response categories, the kappa coefficient indicated moderate agreement (range 0.45-0.60) between the clinical and the MRI classification. The results for the membranes appeared somewhat better than for the ligaments. When there was disagreement, the classifications obtained by the clinical test were significantly lower than the MRI grading, but mainly within one grade difference. When combining grade 0-1 (normal) and 2-3 (abnormal), the agreement improved considerably (range 0.70-0.90). Although results from the clinical test seem to be slightly more conservative than the MRI assessment, we believe that a clinical test can serve as valuable clinical tool in the assessment of WAD patients. However, further validity- and reliability studies are needed.     

Magnetic resonance imaging of the knee in Norway 2002–2004 (national survey): rapid increase,older patients,large geographic differences

Background  

Magnetic resonance imaging (MRI) of the knee is the second most common MRI examination in Norway after head/brain MRI. Little has been published internationally on trends in the use of knee MRI after 1999. This study aimed to describe levels and trends in ambulant knee MRI utilisation in Norway 2002–2004 in relation to type of radiology service, geographic regions, number of MRI-scanners, patient age and gender, and type of referring health care provider.     

The Norwegian Multiple Sclerosis National Competence Centre and National Multiple Sclerosis registry – a resource for clinical practice and research

The Norwegian Multiple Sclerosis National Competence Centre was established at the Department of Neurology, Haukeland University Hospital, Bergen in 1996. Promotion of research, supervision and education of doctors and other health care professionals in Norway are the main responsibilities of the Centre. The centre has established national networks for MS care and research and has provided supervision and education of doctors and other health care professionals in Norway. Guidelines for diagnosis and treatment of MS have been established. The National Multiple Sclerosis Registry was established in 1998 and includes by January 2006 50–60% of all MS patients in Norway. Through a national collaboration, the registry aims for inclusion of a biobank unit for collection of cerebrospinal fluid and serum, DNA, and tissue samples.     

Association of low blood pressure with anxiety and depression: the Nord-Trøndelag Health Study

Background

Low blood pressure has mainly been regarded as ideal, but recent studies have indicated an association with depression in elderly people.

Objective

To investigate whether low blood pressure is associated with anxiety and depression in the general population.

Design

Cross‐sectional study.

Setting

Participants in the population‐based Nord‐Trøndelag Health Study (HUNT‐2, 1995–7), Norway.

Participants

60 799 men and women aged 20–89 years filled in the Hospital Anxiety and Depression Scale as part of a general health study. Systolic and diastolic blood pressure was classified in age‐stratified and sex‐stratified centile groups.

Main results

Compared with participants with systolic blood pressure within the 41–60 centile (reference) group, the odds ratio for anxiety was 1.31 (95% confidence intervals (CI) 1.16 to 1.49), for depression 1.22 (95% CI 1.03 to 1.46), and for comorbid anxiety and depression 1.44 (95% CI 1.24 to 1.68) in the group with ⩽5 centile systolic blood pressure. Slightly weaker associations were found of low diastolic blood pressure with anxiety and depression. These associations were similar across sex and age groups. Physical impairment, smoking and angina pectoris influenced the associations only marginally, whereas stroke, myocardial infarction, use of drugs for hypertension, body mass index and several other covariates had no influence.

Conclusions

This study represents epidemiological evidence for an association of low blood pressure with anxiety and depression, which is not caused by cardiovascular disease.The global burden of hypertension as a leading risk factor for cardiovascular and kidney disease, and for mortality,¹ has overshadowed possible health problems associated with chronic low blood pressure. Through decades, medicine has viewed hypotension as an ideal blood pressure level,² and as an example of a non‐disease.³ Earlier, however, low blood pressure was associated with neurasthenic symptoms such as tiredness, weakness, dizziness and headache,⁴ and with sleep disturbances, anxiety and depression.⁵ Although chronic low blood pressure can still be used in some continental European countries to explain a variety of constitutional symptoms, the prevailing attitude in English‐speaking countries has been that low blood pressure does not produce symptoms.^5,6Psychosomatic research on blood pressure has mainly focused on hypertension.^7,8,9 Several studies have indicated an association between hypertension and psychological factors. However, the psychometric properties of the scales used have often been less well established,⁹ and most previous studies have not explored the lower range of blood pressure. By contrast, some studies have indicated that low blood pressure is associated with various somatic and psychological symptoms.^5,10,11,12 Four of six geriatric studies, using standardised screening inventories for depression, found an association between low blood pressure and depression,^6,13,14,15 one study found no association,¹⁶ whereas a recent study found an association between hypertension and depression.¹⁷ However, the design and findings in some of the studies have been contested.¹⁸ In the absence of a commonly accepted definition of low blood pressure, various boundaries have been used. Four geriatric studies defined blood pressure <120/75 mm Hg as hypotensive, 120–139/75–84 mm Hg as normal and ⩾140/85 mm Hg as hypertensive.^6,13,15,16As most previous studies have limitations, and as their results are inconsistent, we wanted to examine the association of blood pressure with anxiety and depression in the general population using a standardised screening inventory. Our large sample size and broad age range gave an opportunity to explore both tails of the blood pressure distribution, and to control for body weight, cigarette smoking, cardiovascular disease and other relevant covariates.     

Benefit efficient statistical distributions on patient lists

In this paper, we consider statistical distributions of different types of patients on the patient lists of doctors. In our framework different types of patients have different preferences regarding their preferred choice of doctor. Assuming that the system is benefit efficient in the sense that distributions with larger total utility have higher probability, we can construct unique probability measures describing the statistical distribution of the different types of patients.