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Air transport of the sick newborn infant: audit from a sparsely populated county in Norway.

https://arctichealth.org/en/permalink/ahliterature57278
Source
Acta Paediatr. 1999 Jan;88(1):66-71
Publication Type
Article
Date
Jan-1999
Author
J. Holt
I. Fagerli
Author Affiliation
Department of Paediatrics, Nordland Central Hospital, Bodø, Norway.
Source
Acta Paediatr. 1999 Jan;88(1):66-71
Date
Jan-1999
Language
English
Publication Type
Article
Keywords
Air Ambulances - standards - utilization
Birth weight
Body temperature
Catchment Area (Health)
Female
Humans
Infant, Newborn
Male
Medical Audit
Norway
Retrospective Studies
Rural Health Services
Rural Population
Abstract
The aim of this study was to describe principal problems and to analyse transport times, stabilizing procedures, adverse events during transfer, outcome, effectiveness and the care of infants transferred by air from district general hospitals and maternity homes to a central hospital. Transfer times, equipment adverse events and clinical deterioration were recorded as they occurred. Data regarding clinical problems, diagnoses and outcome were collected retrospectively from hospital records. During the study period (1984-95) 275 infants (267 transports) were transferred by fixed-wing aircraft (233) or helicopter (34). Median time from request of transfer to arrival of the transport team (usually a neonatal nurse and a paediatrician) was 120 min, median stabilizing time 60 min. Ninety-six infants (35%) were intubated, 62 (22.5%) by the transport team. During 34 transports (12.7%), equipment-related adverse events occurred making six infants worse. Ten more infants deteriorated during transit. A significant correlation between birthweight and after-transfer temperature was recorded. After-transfer temperature for very low birthweight (
PubMed ID
10090551 View in PubMed
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Asthma and allergy in Russian and Norwegian schoolchildren: results from two questionnaire-based studies in the Kola Peninsula, Russia, and northern Norway.

https://arctichealth.org/en/permalink/ahliterature15502
Source
Allergy. 2001 Apr;56(4):344-8
Publication Type
Article
Date
Apr-2001
Author
A. Selnes
J O Odland
R. Bolle
J. Holt
L K Dotterud
E. Lund
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Allergy. 2001 Apr;56(4):344-8
Date
Apr-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Asthma - epidemiology
Child
Comparative Study
Confidence Intervals
Female
Humans
Hypersensitivity - epidemiology
Male
Norway - epidemiology
Prevalence
Questionnaires
Research Support, Non-U.S. Gov't
Risk
Russia - epidemiology
Abstract
BACKGROUND: Previous studies have shown that the prevalence of asthma and allergy in children is lower in Eastern than Western Europe. METHODS: We have compared the prevalence of asthma, respiratory symptoms, allergic rhinoconjunctivitis, and atopic dermatitis in schoolchildren aged 7-13 years in a questionnaire-based study conducted in the city of Nikel on the Kola Peninsula, Russia, in 1994 (n = 1143) and another conducted in northern Norway in 1995 (n = 8676). RESULTS: The prevalence of diagnosed asthma was 5.1% in Russian children and 8.6% in Norwegian children; RR =0.58 (95% CI: 0.44-0.76). The prevalence of all respiratory symptoms was higher in Russian children. The prevalence of allergic rhinoconjunctivitis was 16.9%, in Russian children and 22.1%, in Norwegian children: RR =0.74 (95% CI: 0.65-0.85). The prevalence of atopic dermatitis was 7.4% in Russian children and 19.7% in Norwegian children; RR=0.38 (95% CI: 0.31-0.46). CONCLUSIONS: We conclude that the prevalence of diagnosed asthma, allergic rhinoconjunctivitis, and atopic dermatitis was higher in Norwegian than Russian schoolchildren. The higher prevalence of respiratory symptoms in Russian children probably reflects a higher prevalence of undiagnosed, nonallergic asthma.
PubMed ID
11284804 View in PubMed
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Atopic diseases in Sami and Norse schoolchildren living in northern Norway.

https://arctichealth.org/en/permalink/ahliterature15627
Source
Pediatr Allergy Immunol. 1999 Aug;10(3):216-20
Publication Type
Article
Date
Aug-1999
Author
A. Selnes
R. Bolle
J. Holt
E. Lund
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway.
Source
Pediatr Allergy Immunol. 1999 Aug;10(3):216-20
Date
Aug-1999
Language
English
Publication Type
Article
Keywords
Adolescent
Asthma - epidemiology - ethnology
Child
Cross-Sectional Studies
Dermatitis, Atopic - epidemiology - ethnology
Ethnic Groups
Humans
Hypersensitivity, Immediate - epidemiology - ethnology
Norway - epidemiology - ethnology
Prevalence
Questionnaires
Rhinitis, Allergic, Perennial - epidemiology - ethnology
Risk factors
Abstract
Among children in the western world, atopic diseases are a major cause of morbidity. However, several prevalence studies have indicated that the frequency of these diseases displays both geographic and ethnic variations. In 1995, we conducted a questionnaire-based, cross-sectional survey in northern Norway. Atopic diseases among 8676 schoolchildren, aged 7-13 years, including 491 children with Sami ethnicity, were studied. The role of ethnicity (Sami/white Caucasian) was determined by comparing the reported atopic disease rate in each of the respective groups. In the areas under investigation (the cumulative incidence, the point prevalence of asthma and allergic rhinoconjunctivitis and the cumulative incidence of atopic dermatitis), the Sami children scored higher than the white Caucasian Norwegian children. The relative risks (RR) in Sami children were: current asthma RR = 2.01 [95% confidence interval (CI) 1.48-2.73]; current allergic rhinoconjunctivitis RR = 1.51 (95% CI 1.14-1.99); lifetime atopic dermatitis RR = 1.39 (95% CI 1.18-1.63). We thus conclude that there is an association between Sami ethnicity and asthma and allergy among schoolchildren in northern Norway.
PubMed ID
10565563 View in PubMed
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"Bystander" amplification of PBMC cytokine responses to seasonal allergen in polysensitized atopic children.

https://arctichealth.org/en/permalink/ahliterature31878
Source
Allergy. 2001 Nov;56(11):1042-8
Publication Type
Article
Date
Nov-2001
Author
A. Rudin
C. Macaubas
C. Wee
B J Holt
P D Slya
P G Holt
Author Affiliation
TVW Telethon Institute for Child Health Research, and Centre for Child Health Research, University of Western Australia, Perth, Australia.
Source
Allergy. 2001 Nov;56(11):1042-8
Date
Nov-2001
Language
English
Publication Type
Article
Keywords
Allergens - adverse effects - immunology
Animals
Antibody Specificity - immunology
Bystander Effect
Child
Child Welfare
Cohort Studies
Comparative Study
Cytokines - biosynthesis - immunology
Dust - adverse effects
Humans
Hypersensitivity, Immediate - etiology - immunology
Immunization
Immunoglobulin E - blood - immunology
Leukocytes, Mononuclear - immunology - metabolism
Lolium - adverse effects - immunology
Mites - immunology
Research Support, Non-U.S. Gov't
Seasons
Skin Tests
Sweden - epidemiology
Abstract
BACKGROUND: Atopic children show increased expression and production of the Th2-associated cytokines IL-4, IL-5, IL-13, and IL-9 from PBMCs after stimulation with allergen, but it has previously not been clearly determined whether the Th2-cytokine production is restricted to the inhalant allergen the child is sensitized to, and whether perennial or seasonal allergens induce different cytokine responses. Our purpose was to determine whether in vitro Th2 cytokine production is specific to the sensitizing allergen, and to compare the cytokine responses to a perennial and a seasonal allergen in monosensitized and polysensitized children. METHODS: Using semiquantitative RT-PCR, we analyzed the expression of the cytokines IL-4, IL-5, IL-13, IL-9, IL-10, and IFN-gamma after stimulation of PBMCs with house-dust-mite (HDM) or ryegrass allergen. The cells were sampled from groups of 6-year-old children sensitized to either HDM (n=20) or ryegrass (n=24), or to both allergens (n=20), as well as from a nonatopic group (n=20). RESULTS: After stimulation with HDM allergen, PBMCs from children sensitized only to HDM expressed increased mRNA levels of the Th2 cytokines, but not of IL-10 and IFN-gamma, whereas ryegrass stimulation did not result in increased cytokine expression. PBMCs from children sensitized to HDM and ryegrass expressed increased Th2 cytokines after stimulation with either of the two allergens. In contrast, PBMCs from children sensitized only to ryegrass did not express increased levels after stimulation with either of the allergens. CONCLUSIONS: The expression of Th2 cytokines after in vitro stimulation of PBMCs from atopic children is specific to the sensitizing allergen, indicating that atopic status per se does not affect the type of T-cell response. In addition, T cells specific to seasonal allergens circulate in the blood out of season only if the child is concomitantly sensitized to a perennial allergen.
PubMed ID
11703216 View in PubMed
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[Can deliveries at risk be selected at smaller delivery units?]

https://arctichealth.org/en/permalink/ahliterature64225
Source
Tidsskr Nor Laegeforen. 1998 Mar 20;118(8):1218-20
Publication Type
Article
Date
Mar-20-1998
Author
J. Holt
I N Vold
Author Affiliation
Barneavdelingen, Nordland Sentralsykehus, Bodø.
Source
Tidsskr Nor Laegeforen. 1998 Mar 20;118(8):1218-20
Date
Mar-20-1998
Language
Norwegian
Publication Type
Article
Keywords
Birthing Centers - standards - statistics & numerical data
Cesarean Section
Delivery Rooms - standards - statistics & numerical data
Delivery, Obstetric
English Abstract
Female
Humans
Norway
Obstetric Labor Complications - diagnosis - surgery - therapy
Parity
Pregnancy
Pregnancy, High-Risk
Puerperal Disorders - diagnosis
Vacuum Extraction, Obstetrical
Abstract
In order to explore the possibility of converting a delivery unit at a small hospital to a maternity home, we examined the medical records of those women who delivered by Caesarean section, forceps or vacuum extraction at Lofoten hospital during 1995. How many of these women might it have been necessary to transfer to an obstetrical department if Lofoten hospital had been a maternity home caring for low risk deliveries (primipara and multipara)? Out of a total of 271 deliveries (primiparas 98), 49 women delivered by Caesarean section (n = 35), forceps (n = 5) or vacuum extraction (n = 9). Using risk assessment, 22 women (45%) would have been selected for antenatal transfer, and 20 (41%) for intrapartum transport. For seven women no transfer would have been possible. These women would have delivered locally by vacuum extraction. Primipara versus multipara had a relative risk of 2.8 for Caesarean section or assisted vaginal delivery. It is estimated that 8-9% of the women would be selected prenatally for planned delivery at a hospital unit and that 7-8% would be transferred in labour if primiparas delivered at the maternity home. If primiparas were excluded, the proportions would be 41% and 1-2% respectively. In 1997 the delivery unit at Lofoten hospital was temporarily converted to a maternity home for a period of two years.
PubMed ID
9567699 View in PubMed
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Child births in a modified midwife managed unit: selection and transfer according to intended place of delivery.

https://arctichealth.org/en/permalink/ahliterature58675
Source
Acta Obstet Gynecol Scand. 2001 Mar;80(3):206-12
Publication Type
Article
Date
Mar-2001
Author
J. Holt
I N Vold
B. Backe
M V Johansen
P. Oian
Author Affiliation
Department of Pediatrics, Nordland Central Hospital, Bodø, Norway.
Source
Acta Obstet Gynecol Scand. 2001 Mar;80(3):206-12
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Adult
Birthing Centers - organization & administration - utilization
Delivery Rooms - utilization
Delivery, Obstetric - classification
Female
Hospitals, Rural
Humans
Midwifery
Norway
Obstetrics and Gynecology Department, Hospital - organization & administration - standards
Outcome Assessment (Health Care)
Patient Selection
Patient transfer
Perinatal Care - organization & administration
Pregnancy
Pregnancy outcome
Prospective Studies
Research Support, Non-U.S. Gov't
Abstract
BACKGROUND: As small obstetrical departments may not be able to give second-level perinatal care, the delivery unit at Lofoten hospital was for the years 1997-98 reorganized to a modified midwife managed unit. Women at low obstetrical risk were delivered at this unit and women at high risk were referred to the central hospital. We assessed the effectiveness of the risk selection. MATERIAL AND METHODS: The study was a prospective, pragmatic, population-based trial. Desired outcome was defined as a non-operative delivery at 35-42 weeks gestational age giving an infant not needing resuscitation. Intermediate outcomes: Operative deliveries, infants transferred to neonatal intensive care unit and infants diverging from normal. The intended place of delivery was ultimately decided at admittance to the midwife managed unit. RESULTS: Of the 628 women in study 435 (69.3%) gave birth at the midwife managed unit, 152 (24.2%) were selected to be delivered at the central hospital and 41 (6.5%) were transferred to the central hospital after admittance to the midwife managed unit. Desired outcome was recorded in 94% of the deliveries at the midwife managed unit as compared to 50.3% at the central hospital. Women who intended to be delivered at the midwife managed unit, needed fewer operative deliveries and relatively few infants were transferred to the neonatal intensive care unit or diverged from normal. CONCLUSIONS: As nearly 70% of the births occurred at the midwife managed unit and 94% of these deliveries had a desired outcome, this indicates an effective selection process. This model might be an alternative to centralization of births in sparsely population areas.
PubMed ID
11207485 View in PubMed
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[Children with birth weight 1500 g or under from Nordland in the period 1978-1989]

https://arctichealth.org/en/permalink/ahliterature33444
Source
Tidsskr Nor Laegeforen. 1999 Jan 20;119(2):189-93
Publication Type
Article
Date
Jan-20-1999

Comparative analysis of the outcomes of elective abdominal aortic aneurysm repair in England and Sweden.

https://arctichealth.org/en/permalink/ahliterature296652
Source
Br J Surg. 2018 04; 105(5):520-528
Publication Type
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Date
04-2018
Author
A Karthikesalingam
M J Grima
P J Holt
A Vidal-Diez
M M Thompson
A Wanhainen
M Bjorck
K Mani
Author Affiliation
St George's Vascular Institute, St George's University of London, London, UK.
Source
Br J Surg. 2018 04; 105(5):520-528
Date
04-2018
Language
English
Publication Type
Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Keywords
Age Factors
Aged
Aortic Aneurysm, Abdominal - mortality - surgery
Elective Surgical Procedures - methods
Endovascular Procedures - methods
England - epidemiology
Female
Follow-Up Studies
Hospital Mortality - trends
Humans
Male
Prognosis
Retrospective Studies
Risk factors
Sex Factors
Survival Rate - trends
Sweden - epidemiology
Time Factors
Treatment Outcome
Abstract
There is substantial international variation in mortality after abdominal aortic aneurysm (AAA) repair; many non-operative factors influence risk-adjusted outcomes. This study compared 90-day and 5-year mortality for patients undergoing elective AAA repair in England and Sweden.
Patients were identified from English Hospital Episode Statistics and the Swedish Vascular Registry between 2003 and 2012. Ninety-day mortality and 5-year survival were compared after adjustment for age and sex. Separate within-country analyses were performed to examine the impact of co-morbidity, hospital teaching status and hospital annual caseload.
The study included 36?249 patients who had AAA treatment in England, with a median age of 74 (i.q.r. 69-79) years, of whom 87·2 per cent were men. There were 7806 patients treated for AAA in Sweden, with a median of age 73 (68-78) years, of whom 82·9 per cent were men. Ninety-day mortality rates were poorer in England than in Sweden (5·0 versus 3·9 per cent respectively; P?
PubMed ID
29468657 View in PubMed
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Comparison of long-term mortality after ruptured abdominal aortic aneurysm in England and Sweden.

https://arctichealth.org/en/permalink/ahliterature273139
Source
Br J Surg. 2016 Feb;103(3):199-206
Publication Type
Article
Date
Feb-2016
Author
A. Karthikesalingam
A. Wanhainen
P J Holt
A. Vidal-Diez
J R W Brownrigg
I. Shpitser
M. Björck
M M Thompson
K. Mani
Source
Br J Surg. 2016 Feb;103(3):199-206
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal - mortality - surgery
Aortic Rupture - mortality - surgery
Endovascular Procedures - methods
England - epidemiology
Female
Follow-Up Studies
Hospital Mortality - trends
Humans
Male
Prognosis
Retrospective Studies
Sweden - epidemiology
Time Factors
Abstract
Concern has been raised regarding international discrepancies in perioperative mortality after repair of ruptured abdominal aortic aneurysm (rAAA). The variation in in-hospital mortality is difficult to interpret, owing to international differences in discharge strategies. This study compared 90-day and 5-year mortality in patients who had a rAAA in England and Sweden.
Patients undergoing rAAA repair were identified from English Hospital Episode Statistics and the Swedish Vascular Registry (Swedvasc) between 2003 and 2012. Ninety-day and 5-year mortality were compared after matching for age and sex. Within-country analyses examined the impact of co-morbidity, teaching hospital status or hospital annual caseload, adjusted with causal inference techniques.
Some 12 467 patients underwent rAAA repair in England, of whom 83.2 per cent were men; the median (i.q.r.) age was 75 (70-80) years. A total of 2829 Swedish patients underwent rAAA repair, of whom 81.3 per cent were men; their median (i.q.r.) age was 75 (69-80) years. The 90-day mortality rate was worse in England (44.0 per cent versus 33.4 per cent in Sweden; P
PubMed ID
26620854 View in PubMed
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Determinants of the geographical distribution of endemic giardiasis in Ontario, Canada: a spatial modelling approach.

https://arctichealth.org/en/permalink/ahliterature178030
Source
Epidemiol Infect. 2004 Oct;132(5):967-76
Publication Type
Article
Date
Oct-2004
Author
A. Odoi
S W Martin
P. Michel
J. Holt
D. Middleton
J. Wilson
Author Affiliation
Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada, N1G 2W1. aodoi@uoguelph.ca
Source
Epidemiol Infect. 2004 Oct;132(5):967-76
Date
Oct-2004
Language
English
Publication Type
Article
Keywords
Animals
Endemic Diseases
Geography
Giardia lamblia - isolation & purification
Giardiasis - epidemiology - etiology - prevention & control - transmission
Humans
Ontario - epidemiology
Population Surveillance
Water Microbiology
Water supply
Abstract
Giardiasis surveillance data as well as drinking water, socioeconomic and land-use data were used in spatial regression models to investigate determinants of the geographic distribution of endemic giardiasis in southern Ontario. Higher giardiasis rates were observed in areas using surface water [rate ratio (RR) 2.36, 95 % CI 1.38-4.05] and in rural areas (RR 1.79, 95 % CI 1.32-2.37). Lower rates were observed in areas using filtered water (RR 0.55, 95 % CI 0.42-0.94) and in those with high median income (RR 0.62, 95 % CI 0.42-0.92). Chlorination of drinking water, cattle density and intensity of manure application on farmland were not significant determinants. The study shows that waterborne transmission plays an important role in giardiasis distribution in southern Ontario and that well-collected routine surveillance data could be useful for investigation of disease determinants and identification of high-risk communities. This information is useful in guiding decisions on control strategies.
PubMed ID
15473161 View in PubMed
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25 records – page 1 of 3.