Transcatheter Aortic Valve Implantation in the Elderly: Who to Refer?

In recent years, experience with transcatheter aortic valve implantation has led to improved outcomes in elderly patients with severe aortic stenosis (AS) who may not have previously been considered for intervention. These patients are often frail with significant comorbid conditions.     

Social factors of sickness absences and ways of coping: a qualitative study of men and women with mental and musculoskeletal diagnoses,Norway

The rate of sickness absence is a serious problem in Norway and Scandinavia as a whole. Musculoskeletal problems are a heterogeneous category, covering a spectrum from a broken back and diffuse muscle pains. Mental diagnoses constitute generally about 25–30% of the total number of the long-term sickness absences. It is thus important to document scientifically how and why participation in nature–culture–health (NaCuHeal) activities may prove beneficial for individuals with long-term illnesses. The purpose of our project is to focus on and to discuss how social factors influence sickness absence. There were two aims of this study: (a) to explore and reveal the absentees' own experiences and perceptions of sickness absence in daily life and (b) to explore and reveal the absentees' own perceptions and experiences of various coping strategies while being on sickness absence. Qualitative method through a pragmatic synthesis of elements of ethnography and grounded theory were used. The sample from the county of Oppland, Norway (n = 30), had a mental or a musculoskeletal diagnosis in accordance with the ICPC-2 medical classification system. In this study, men and women understand and interpret their health situation differently; most men in this sample have become ill due to work-related factors, and for women it seems to be the combined impact of domestic responsibilities and job strain, the so-called double exposure. Health-promoting nature and culture activities refuel their energy levels, which in turn help them to sustain their social network. A combination of various social activities seemed also to be beneficial as long as these activities could be personally chosen within their own time and space. This notion highlights the importance of a lay perspective on the illness experience and its connections to coping strategies. Combined with discussion of sickness absence as a phenomenon, we believe that our findings can contribute to a wider understanding of sickness absence, the complexity behind the outbreak of long-term illnesses and ways of coping in everyday life. This research may add important knowledge and insight, hence increase awareness and understanding of NaCuHeal benefits among health personnel and rehabilitation.     

The psychological sequelae of thermal injury on children and adolescents: Part 1

The psychological effects of thermal injury and children and their mothers were investigated in a three-part study; Part 1 is concerned with group comparisons regarding the psychological effects of thermal injury on children; Part 2 with aspects of the thermally injured group and Part 3 with psychological effects on their mothers. A total of 44 thermally injured (aged 11–16 years) injured 3–14 years previously, were matched according to age, sex, burn percentage and site of injury. In-depth interviewing and questionnaire responses on measures of psychological disturbance indicated that thermally injured children were differentiated in terms of psychopathology from matched Fracture Controls and Normal Controls. Such differences embraced many aspects of social and recreational functioning, and group differences emphasised depression, anxiety (particularly situational anxiety) and anti-social disorder as being particularly prominent in the thermally injured group. Therapeutic approaches are briefly discussed.     

Cost-effectiveness of tobacco control policies in Vietnam: the case of personal smoking cessation support

Aims To examine the cost‐effectiveness of personal smoking cessation support in Vietnam. Design, setting and participants We followed‐up the population aged 15 years and over in 2006 to model the costs and health gains associated with five interventions: physician brief advice; nicotine replacement therapy (patch and gum); bupropion; and varenicline. Threshold analysis was undertaken to determine the price levels of pharmaceuticals for the interventions to be cost‐effective. A multi‐state life table model was constructed such that the interventions affect the smoking cessation behaviour of the age cohorts, and the resulting smoking prevalence defines their health outcomes. A health‐care perspective was employed. Measurements Cost‐effectiveness is measured in 2006 Vietnamese Dong (VND) per disability‐adjusted life year (DALY) averted. We adopted the World Health Organization thresholds of being ‘cost‐effective’ if less than three times gross domestic product (GDP) per capita (VND 34 600 000) and ‘very cost‐effective’ if less than GDP per capita (VND 11 500 000). Findings The cost‐effectiveness result of physician brief advice was VND 1 742 000 per DALY averted (international dollars 543), which was ‘very cost‐effective’. Varenicline dominated bupropion and nicotine‐replacement therapies, although it did not fall within the range of being ‘cost‐effective’ under different scenarios. The threshold analysis revealed that prices of pharmaceuticals must be substantially lower than the levels from other countries if pharmacological therapies are to be cost‐effective in Vietnam. Conclusions Physician brief advice is a cost‐effective intervention and should be included in the priority list of tobacco control policy in Vietnam. Pharmacological therapies are not cost‐effective, and so they are not recommended in Vietnam at this time unless pharmaceuticals could be produced locally at substantially lower costs in the future.     

The generation of theta rhythm in hippocampal formation maintained in vitro

The most spectacular example of oscillations and synchrony which appear in the brain is the rhythmic slow activity (theta) of the limbic cortex. Theta rhythm is the best synchronized electroencephalographic activity that can be recorded from the mammalian brain. Hippocampal formation is considered to be the main structure involved in the generation of this activity. Although detailed studies of the physiology and pharmacology of theta‐band oscillations have been carried out since the early 1950s, the first demonstration of atropine‐sensitive theta rhythm, recorded in completely deafferented hippocampal slices of a rat, was performed in the second half of the 1980s. Since the discovery of cholinergically induced in vitro theta rhythm recorded from hippocampal formation slices, the central mechanisms underlying theta generation have been successfully studied in in vitro conditions. Most of these experiments were focused on the basic question regarding the similarities between the cholinergically induced theta activity and theta rhythm examined in vivo. The results of numerous in vitro experiments strongly suggest that cholinergically induced theta rhythm recorded in hippocampal slices is a useful analogue of theta observed in intact animals, and could be helpful in searching for the mechanisms of oscillations and synchrony in the central nervous system neuronal networks. The objective of the present review is to discuss the main results of experiments concerning theta oscillations recorded in in vitro conditions. It is our intent to provide, on the basis of these results, the characteristics of essential mechanisms underlying the generation of atropine‐sensitive in vitro theta.     

The Effects of Therapeutic Horseback Riding Program on Motor Skills in Children with Autism Spectrum Disorder

Therapeutic horseback riding (THR) as an animal-assisted intervention is one of the innovative approaches emerging in the treatment for children with autism spectrum disorder (ASD). The current study was designed to investigate the effects of a 12-week, twice a week THR program on motor skills in sixty-eight children with ASD aged 5–10 years old. All participants selected met the DSM-V criteria for ASD, and a total of fifty-three participants completed the study. A randomized controlled trial design was utilized for the study. Data was collected via a pre-THR test, interim-THR test, and post-THR test to investigate the possible changes in motor skills throughout the 12-week THR program. Results showed that the THR program significantly improved overall motor skills across time points (p < 0.05) and sub-skills of run, gallop and two-hand catch (as compared to the control group, p < 0.05). In conclusion, the THR program may be an effective option for improving motor skills in children with ASD and further investigation with a longer period of intervention is warranted.     

Orientation and exploratory behavior and anxiety of CBA mice with anosmia induced by N-trimethylindole (skatole)

The behavior of CBA mice in the hole-board test and elevated plus maze was studied after intraperitoneal injection of skatole leading to destruction of the epithelium in the main olfactory system. Locomotor and exploratory activity and degree of anxieties were low in intact mice. Anosmia was accompanied by an increase in orientation and exploratory activities and degree of anxiety. __________ Translated from Byulleten’ Eksperimental’noi Biologii i Meditsiny, Vol. 143, No. 1, pp. 4–7, January, 2007     

早期康复对脑卒中患者功能活动能力的影响

采用FIM量表对68例急性脑卒中患者功能活动能力进行临床对照研究。两组患者在病后3月时的功能活动能力均有不同程度的改善，但康复组优于对照组（P＜0．001），在恢复独立功能活动者中，康复组16例（47．06％），对照组4例（11．76％）。研究结果表明，早期康复干预有助于脑卒中患者独立功能活动能力的恢复；患者在病后1月内，FIM评定为72．25±20．96分考，经早期康复治疗有可能达到功能活动独立。