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Summary: Meticillin-resistant Staphylococcus aureus (MRSA) is a major problem in hospitals worldwide. Hand hygiene is recognised as crucial in limiting the spread of MRSA but less is known about the role of MRSA reservoirs in the inanimate hospital environment. We evaluated the effect of hydrogen peroxide vapour diffused by Sterinis® against MRSA in two experimental hospital settings and in two field trials. Dipslides were used for MRSA detection and quantification before and after using the Sterinis disinfection process. In the first experimental hospital setting, four epidemic MRSA strains were placed at five locations and left for one week. All strains survived the week but not the disinfection process. In field trial one 14 upholstered chairs from a department with many MRSA positive patients were left for one month in a closed room prior to disinfection. MRSA was found on the upholstery of four of the 14 chairs. Three chairs became MRSA negative immediately after the disinfection, the fourth 24h later. The second field trial was in the private home of a MRSA positive family of four individuals. One location was found MRSA positive, remaining so after the Sterinis cycles. We found Sterinis to be effective against MRSA in the experimental hospital setting and upholstered chairs, but not in the private home of heavily colonised MRSA patients. [Copyright &y& Elsevier]

We used the Quality of Life Scale to assess quality of life among 107 Norwegians with chronic mental health problems (MHP) from the community health care system versus 1893 general population adults. The groups differed in quality of life, including broader life domains. Age and quality of life were more strongly positively correlated in the MHP group than in the general population. Mental symptoms (measured by the Symptom Checklist-90 Revised) and quality of life were strongly negatively correlated in the MHP group. Services for people with chronic MHP should focus on enhancing quality of life and on its role as an outcome variable. [ABSTRACT FROM AUTHOR]

Abstract: Background: Nonoperative management (NOM) is an accepted treatment of pediatric solid organ injuries and is typically successful. Blunt pancreatic trauma tends to require operative intervention more frequently. We sought to identify predictors of failure of NOM and compare the outcome of operative management against NOM. Methods: A retrospective analysis was performed from January 1993 to December 2002 of all children with blunt pancreatic injuries from the trauma registries of 7 designated level 1 pediatric trauma centers. Failure of NOM was defined as the need for intraabdominal operative intervention. Injuries were graded I to V, and ductal injury was defined as grades III to V. Parameters included mechanism of injury, injury severity score (ISS), organ grade, Glasgow Coma Scale score, and outcome. Data were analyzed by Fisher exact test and Mann-Whitney U test, with mean values ± SD and significance of P < .05. Results: Pancreatic injuries were present in 173 (9.2%) of 1823 patients. Of these, 43 (26.0% [43/173]) required an operation. Valid morbidity data was obtained in 118 of 173 patients. ISS was significantly higher in all patients treated operatively. Patients with an injury of grade III to V failed NOM more frequently than all patients with pancreatic injury (P =.0169). Length of stay was longer, and the incidence of pseudocysts, drainage procedures, and pancreatitis was higher in NOM patients, although not significant. Conclusions: Patients with pancreatic injuries had a NOM failure rate of 26.0%. ISS and injury grades III to V were predictors of NOM failure. Patients with pancreatic ductal injury require more aggressive management. [Copyright &y& Elsevier]

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This article examines the semantic structure of the Norwegian preposition mot 'towards, against', and suggests an analysis within cognitive semantics where it is argued that the various senses of this word are best accounted for in terms of a family resemblance category, with two interrelated image schemas, SOURCE-PATH-GOAL and FORCE DYNAMICS, as its basic senses. Other senses are treated as extensions, for the most part metaphorical, of these two basic senses. The study builds on a corpus of Norwegian texts from various genres. [ABSTRACT FROM AUTHOR]

In vitro tests of cellular immune responses, using lymphocyte transformation tests and rosette tests for T and B lymphocytes, were studied in a cross-section analysis of a total of fifty-five patients in six groups (non-pregnant, 2-3 months pregnant, 4-5 months pregnant, 6-7 months pregnant, at parturition and 3 months after parturition). No pregnancy-related changes were found in the numbers of T, B or null cells, nor changes in PHA, PWM or MLC responses, hut a significant reversible depression of the PPD response was found in the second half of pregnancy. [ABSTRACT FROM AUTHOR]

A longitudinal investigation of the mixed lymphocyte culture (MLC) response during pregnancy between mother and father, between mother and child, and between the mother and an indifferent lymphocyte pool has been carried out, using starting values before pregnancy and a cryobiological freezing system that allows in vitro playback of the immunological course of pregnancy. Lymphocyte and serum samples from twenty-two pregnant women taken before and during pregnancy, at delivery, and after delivery were used. The study shows that the mother reacts during the course of pregnancy with an increasing MLC response to the father, which is replaced at delivery by a decrease in response and a subsequent increase after delivery. It is also shown that the mother reacts to the child in a similar manner at about half the level of reaction to the father. The mother also reacts similarly to a pool of indifferent lymphocytes. The MLC reactions mentioned are affected by both non-pregnant and pregnant serum, leading to a moderation of the MLC reaction in relation to that carried out in neutral AH serum. In addition, there seems to be cooperation between cellular and humoral factors, since the MLC reaction to the child carried out in relevant autologous serum seems to show a decreasing response during the course of pregnancy, in accordance with increasing tolerance of the fetal allograft. [ABSTRACT FROM AUTHOR]

In a longitudinal analysis of immunological changes in normal human pregnancy, twenty-two pregnant women were studied, with blood samples taken before pregnancy, during its course, at delivery, and 3–5 months after delivery. The blood samples were frozen successively, using a cryobiological freezing system, and were stored until the whole longitudinal series was obtained. The collected material for a longitudinal series was then thawed and tested in one seance. Lymphocyte transformation tests were performed with stimulation with the mitogens phytohaemagglutinin (PHA), pokeweed mitogen (PWM), concanavalin A (Con A) and the specific antigens tuberculin purified protein derivative (PPD), Candida albicans (CA), Staphylococcus aureus (SA) and streptokinase/streptodornase (SK/SD). No changes were found in PHA or in PWM responses, whereas there were significant changes in the Con A response, with lowest values in the middle of pregnancy. PPD, CA, SA and SK/SD responses all reached lowest values towards the end of pregnancy, with increases subsequently, after delivery. These findings seem to show that T suppressor function is increased and B-lymphocyte function decreases during the course of pregnancy. [ABSTRACT FROM AUTHOR]

Immunological relationships in pregnancy were investigated in a longitudinal study of twenty-two pregnant women, whose blood samples were taken before pregnancy, during pregnancy, at delivery, and 3–5 months after delivery. Blood samples were also taken from the fathers and the infants, both at birth and after 3–5 months. All the samples were frozen by means of a cryobiological freezing system, and when a whole longitudinal series had been collected, the material was thawed and tested in a single seance. T and B lymphocytes were studied with rosette tests (E and HEAC rosettes). T and B lymphocytes were found not to change during the course of pregnancy. It is thus concluded that the mother's tolerance of a fetus with a dissimilar tissue type is not exercised via changes in the total count of T and B lymphocytes, although there may well be changes in their subpopulations, with the hypothesis that T-suppressor function increases and B-lymphocyte function decreases. [ABSTRACT FROM AUTHOR]

Instantaneous cross sectional flow velocity profiles from early mitral flow in 10 healthy men were constructed by time interpolation of the velocity data from each point in sequentially delayed two dimensional digital Doppler ultrasound maps. This interpolation allows correction of the artificially produced skewness of velocities across the flow sector caused by the time taken to scan the flow sector for velocity recording of pulsatile blood flow. These results suggested that early mitral flow studied in an apical four chamber view is variably skewed both at the leaflet tips and at the annulus. The maximum flow velocity overestimated the cross sectional mean velocity at the same time by a factor of 1.2-2.2. Also the maximum time velocity integral overestimated the cross sectional mean time velocity integral to the same extent. This cross sectional skew must be taken into account when calculation of blood flow is based on recordings with pulsed wave Doppler ultrasound from a single sample volume. [ABSTRACT FROM PUBLISHER]

. A case is reported of a hydatidiform mole accompanied by a serious degree of toxaemia and severe disturbances in the function of the thyroid gland in a 20-year-old primigravida, who was admitted to the department in the 20th week of pregnancy. Clinically the patient showed severe toxaemia with gross oedema, congestion of the lungs, hypertension to approximately 200/ 130 mm Hg and proteinuria of 4.4 g/1000 ml, but no signs of thyrotoxicosis. The toxaemia disappeared within 14 days after treatment by evacuation, blood transfusion, albumin infusion, digitalization, diuretics and antihypertensive agents. Eight hours after removal of the mole an extremely high PBI (24.2 μg/100 ml) and a low serum cholesterol (97 mg/100 ml) were found. Both of these values returned to normal within the course of 14 days. Triiodothyronine uptake on Sephadex G 25 (T3 test) was found to be 101% and fell simultaneously with the changes in the other values to 48%. I131 uptake in the thyroid gland showed increased values 3 weeks after the operation but was normal again 5 weeks later. The values for the thyroid function tests which were found are compared with similar values reported in literature and it is concluded that the changes must be due to the usual effects on thyroid function of a normal pregnancy plus an extra factor, which must be produced by the molar tissue, and which must either be TSH or some other thyroid stimulator. It is recommended that in future TSH activity be determined in plasma and molar tissue in patients with hydatidiform mole and that various thyroid parameters be studied with regard to their possible diagnostic value in cases of hydatidiform mole. [ABSTRACT FROM AUTHOR]

Abstract Background Western governments have initiated reforms to improve the quality of care for nursing home residents. Most of these reforms encompass the use of regulations and national quality indicators. In the Norwegian context, these regulations comprise two pages of text that are easy to read and understand. They focus particularly on residents’ rights to plan their day-to-day life in nursing homes. However, the research literature indicates that the implementation of the new regulations, particularly if they aim to change nursing practice, is extremely challenging. The aim of this study was to further explore and describe nursing practice to gain a deeper understanding of why it is so hard to implement the new regulations. Methods For this qualitative study, an ethnographic design was chosen to explore and describe nursing practice. Fieldwork was conducted in two nursing homes. In total, 45 nurses and nursing aides were included in participant observation, and 10 were interviewed at the end of the field study. Results Findings indicate that the staff knew little about the new quality regulations, and that the quality of their work was guided by other factors rooted in their nursing practice. Further analyses revealed that the staff appeared to be committed to daily routines and also that they always seemed to know what to do. Having routines and always knowing what to do mutually strengthen and enhance each other, and together they form a powerful force that makes daily nursing care a taken-for-granted activity. Conclusion New regulations are challenging to implement because nursing practices are so strongly embedded. Improving practice requires systematic and deeply rooted practical change in everyday action and thinking.