Tobacco smoking, an independent determinant for unhealthy diet?: A cross-sectional study of Norwegian workers on platforms in the North Sea

The objective of the study was to examine whether male tobaccosmokers had a more unhealthy diet than non-smokers. Data onsmoking and other variables were collected by questionnaireinterviews and food intake by one 24 h recall. The setting was2 oll platforms. The participants were 310 healthy men workingon 2 platforms in the Norwegian sector of the North Sea. Themean ages were 37 and 39 years for non-smokers and smokers.The prevalence of smoking was 50.3%. Smoking decreased withincreasing level of education, but increased with degree ofurbanization. Smokers consumed less vegetables, fruit and fish,but more meat, soft drinks containing sugar and more coffeethan non-smokers. Smokers had a higher intake of fat and a lowerintake of carbohydrate, vitamins A, D and C and dietary fibre.Smoking was an independent predictor for increasing the consumptionof coffee and high intake of energy, energy from fat and cholesteroland a decreasing consumption of vegetables, fruit, energy fromcarbohydrates, dietary fibre and vitamins A and C. It is concludedthat smokers had a more unhealthy diet than non-smokers.     

Drug and Alcohol Education from a Distance: a good reason for collaboration

Education by distance learning is a rapidly growing industry. The main attraction for learners is the flexibility to study when and where they like. There are other significant advantages too; by taking the course to the student, equity of access to education is improved and educational choices are widened. Yet education at a distance does have important limitations; it can impose considerable demands and constraints on the educational process that are all too rarely addressed in the literature. This paper examines the challenges faced by institutions offering distance-based courses. Specifically, the authors share their separate experiences of producing distance learning programmesfor drug and alcohol workers. There are special complexities inherent in the design, delivery and operation of drugs courses by distance learning and these are examined. Parochial perspectives on drugs issues assume less relevance as the target group for distance learning courses widens notably to include learners in other geographical areas and in other countries. The authors begin to explore the case for seeking national, and even international, consensus on what drug and alcohol education programmes should comprise. Collaboration between the educational institutions could be an effective way of identifying quality standards in drugs education in general and could assist course organizers in avoiding unnecessary replication of effort. Further flexibility for students could also be introduced in the form of a national credit accumulation and transfer scheme. Faced with an even greater choice of educational products, learners should benefit too from collaboration and the assurance that the courses they purchase have been designed and tested to meet their educational needs.     

EMOTIONS AND EATING IN EVERYDAY LIFE: APPLICATION OF THE EXPERIENCE-SAMPLING METHOD

Previous research emphasized relationships between negative emotions and eating. This study explored associations of both positive and negative emotions with eating by experience-sampling in the natural environment. Eight healthy volunteers (6 female, 2 male) were beeped at random intervals, 10 times daily on 7 consecutive days. Upon each signal, participants rated their emotional state and indicated whether they had eaten during the previous 15 minutes. In total, 485 situations were sampled. Emotional states reported in these situations were classified by cluster analysis. In 145 situations subjects reported having eaten. Thirty-seven percent of eating bouts occurred in situations classified as emotionally positive; 30% occurred in situations classified as emotionally negative. Participants rated that eating influenced their emotional state to a higher degree in emotionally positive situations than in emotionally negative ones. Positive emotions may play a stronger role in the relationship between emotions and eating than has been generally acknowledged.     

Impact of Programmed Sensitivity Safety Factor on Atrial Sensing in Children

The relationship between the pacemaker sensitivity safety factor (PSSF) and atrial under- or oversensing as documented by 24-hour Holter monitoring was examined. Our study comprised 78 transvenous fixed atrial leads implanted between 1983–1995 in 71 children. Overall, 210 Holter reports identified 143 (68%) Holters with normal atrial sensing function, 31 (15%) with undersensing, 32 (15%) with oversensing, and 4 (2%) with both problems. From 161 Holter reports in which the PSSF was available, the incidence of undersensing at a PSSF of 2.0 (range 1.5–2.4) was 25% (14/57). There was a dramatic decline in undersensing when the PSSF was 3 (3%) compared to a FSSF < 3 (21 %) (P < 0.001). A PSSF cut-off point of 2.0 best predicted occurrence of undersensing with a sensitivity of 79% and a specificity of 67%. Other variable were also examined by multiple logistic regression analysis, but only PSSF remained highly associated with undersensing (odds ratio [OR] = 0.6, P = 0.03). In contrast, PSSF did not have a significant role in predicting oversensing, but presence of sick sinus syndrome (OR = 10.5) or unipolar lead (OR = 5.6) were significantly associated with oversensing (P = 0.0001). The majority of undersensing problems can be avoided by routinely allowing for at least a threefold or more programmed sensitivity margin. Other factors may increase the risk of oversensing, regardless of the PSSF.     

The quality and management of written information presented to women undergoing hysterectomy

• ? A study of a random sample of hospitals in England that provide information leaflets for women undergoing hysterectomy indicates a large variation in quality.
• ? In general, the findings reveal that written information for patients is given a relatively low priority.
• ? Production and dissemination of information for hysterectomy patients is somewhat ad hoc.
• ? It is not clear that any evaluation of the leaflets has been conducted to prove the efficacy of the available literature.
• ? While the majority of leaflets include information deemed essential by past hysterectomy patients, the presentation of the recovery process often implies no control for the patient, and conceives normality with a narrow perspective about what healthy behaviour means for women. The provision of a specific timetable for resumption of housework duties in 65% of the leaflets is a case in point.
• ? On the basis of the results of the survey, recommendations are made concerning the improvement of the standard of patient information leaflets.

     

Clinical Use of Permanent Pacemaker for Conversion of Intraatrial Reentry Tachycardia in Children

The use of the implanted atrial-based pacemaker to overdrive postsurgical intraatrial reentry tachycardia (IART) was evaluated in a large group of pediatric patients over a 14-year study period. The authors sought to determine the feasibility of this noninvasive technique in the management of this specialized population and to determine factors associated with successful conversion. They examined 128 manual overdrive attempts performed on 22 consecutive patients. There were 10 patients with post-Fontan repair, 7 with post-Mustard/Senning procedure, and 5 with miscellaneous lesion types. The number of IART episodes for overdrive pacing per patient ranged from 1 to 15. The first overdrive pacing attempt was successful in 63% (14/22) of the patients. The mean IART cycle length was 278 +/- 59 ms. The mean pacing rate for effective conversion of IART was 66 +/- 10% faster than the IART rate. By controlling for repeated measures for individual patients, three factors were found to be independently associated with a successful outcome: (1) lesion type other than Fontan surgery (P = 0.007), (2) lack of acceleration of IART with the overdrive attempt (P < 0.001), and (3) patient use of amiodarone with attempt (P = 0.005). There were three procedural complications: two inadvertent overdrive pacing episodes, and one episode of acceleration of IART cycle length and conduction resulting in need for cardioversion. Manual pacemaker overdrive conversion of IART is a useful adjunct in the management of postsurgical IART in the pediatric population and should be considered as an initial treatment option.     

Emergence of fluoroquinolone‐resistant clonal group A: clonal analysis of Norwegian and Russian E. coli isolates

Strand L, Jenkins A, Grude N, Allum A‐G, Mykland H‐C, Nowrouzian FL, Kristiansen B‐E. Emergence of fluoroquinolone‐resistant clonal group A: clonal analysis of Norwegian and Russian E. coli isolates. APMIS 2010; 118: 571–77. We describe a study of urinary tract and intestinal isolates of Escherichia coli from Norway and Russia using automated ribotyping, single nucleotide polymorphism analysis for clonal group A (CgA) supplemented with phylogrouping, virulence gene profiling and resistance profiling. CgA comprised 19% of the Norwegian UTI isolates from 2001. Two highly multiresistant fluoroquinolone‐resistant CgA isolates were found. Ribotypes clustered into four major and six minor groups (ribogroups). Fluoroquinolone‐resistant isolates and phylogroups A and B1 were associated with ribogroup ^RA. Ribogroup ^RB predominated among Russian UTI isolates and was predominantly phylogroup A and depleted in P‐fimbriae. Ribogroup ^RC predominated among Norwegian UTI isolates and was rich in virulence factors (S‐fimbriae, haemagglutinin and haemolysin) and predominantly phylogroup B2 and D. Ribogroup ^RG was associated with CgA and predominantly phylogroup D. Ribogroups ^RD, ^RE and ^RF had too few members for statistical analysis. The correlation between ribotype and phylogenetic group was not as strong as reported in other studies.     

Inpatient and long‐term outcomes of individuals admitted for weaning from mechanical ventilation at a specialized ventilation weaning unit

Background: Weaning from invasive mechanical ventilation (IMV) in specialized weaning units has been demonstrated to be safe and cost‐effective. Success rates and outcomes vary widely, probably relating to patient factors and unit expertise. Methods: An audit was undertaken of patients admitted for weaning from IMV at the Austin Hospital Ventilation Weaning Unit (VWU) between March 2002 and January 2008. Weaning success, complications and both in‐hospital and long‐term mortality were examined and regression analysis was undertaken to examine factors related to these outcomes. Results: Seventy‐eight patients were admitted to the VWU after a median of 27 days of IMV at their referring centre. Weaning success rate (ventilator free or nocturnal non‐invasive ventilation only) was 78.2% (n = 61). Inpatient mortality was 10.2% (n = 8) and serious complications were infrequent. Progressive neuromuscular disease (odds ratio 0.10) and sepsis during admission to the VWU (odds ratio 0.09) were predictive of weaning failure at discharge. Overall survival at 12 months following discharge from the VWU was 66.7% (n = 52) with most survivors residing in the community. Increasing age (hazard ratio 1.93), referral from rural or outer metropolitan centres (hazard ratio 3.57 and 2.37 respectively) and a diagnosis of chronic obstructive pulmonary disease were associated with increased long‐term mortality. Conclusion: High rates of weaning success with infrequent complications and low mortality were achieved in this specialized non‐intensive care unit‐based weaning unit. The VWU may provide a useful template for the development of similar units elsewhere.     

The ion exchange properties of human post-mortem caecal and colonic mucus: The effect of sodium butyrate

This study examined Na+/H+ ion exchange of caecal and colonic mucus. Two distinct Na+/H+ ion exchange populations of caecal mucus were identified, one group being a cation exchanger and the other an anion exchanger, suggesting that caecal mucus has ampholyte properties responsive to changing physical and chemical properties of luminal contents. Mucus from the colon was consistently an anionic exchanger--this may aid water and electrolyte absorption in the colon. When mucus was incubated with sodium butyrate, the Na+/H+ ion exchange properties of the mucus were decreased.