Improvements in staff competency levels will be more important in the future, as a result of the forecasted increase in the percentage of the population who will suffer from dementia and reside in nursing homes.

BackgroundNormal aging involves a decline in cognitive function that has been shown to correlate with volumetric change in the hippocampus, and with genetic variability in the APOE-gene. In the present study we utilize 3D MR imaging, genetic analysis and assessment of verbal memory function to investigate relationships between these factors in a sample of 170 healthy volunteers (age range 46–77 years).MethodsBrain morphometric analysis was performed with the automated segmentation work-flow implemented in FreeSurfer. Genetic analysis of the APOE genotype was determined with polymerase chain reaction (PCR) on DNA from whole-blood. All individuals were subjected to extensive neuropsychological testing, including the California Verbal Learning Test-II (CVLT). To obtain robust and easily interpretable relationships between explanatory variables and verbal memory function we applied the recent method of conditional inference trees in addition to scatterplot matrices and simple pairwise linear least-squares regression analysis.ResultsAPOE genotype had no significant impact on the CVLT results (scores on long delay free recall, CVLT-LD) or the ICV-normalized hippocampal volumes. Hippocampal volumes were found to decrease with age and a right-larger-than-left hippocampal asymmetry was also found. These findings are in accordance with previous studies. CVLT-LD score was shown to correlate with hippocampal volume. Multivariate conditional inference analysis showed that gender and left hippocampal volume largely dominated predictive values for CVLT-LD scores in our sample. Left hippocampal volume dominated predictive values for females but not for males. APOE genotype did not alter the model significantly, and age was only partly influencing the results.ConclusionGender and left hippocampal volumes are main predictors for verbal memory function in normal aging. APOE genotype did not affect the results in any part of our analysis.

Purpose: To investigate the T2 decay in prostate tissue for multiexponentiality and to assess how the biexponential model relates to established T2W contrast. Materials and Methods:A 32-echo spin-echo sequence was performed on 16 volunteers. Six single-voxel decay curves were sampled from each prostate. Prediction accuracies were assessed by jackknifing for the mono-, bi-, and triexponential models. The differences were evaluated by cross-validated analysis of variance (CVANOVA). Multiple linear regression was performed to assess the relation between parameters in the biexponential model and the contrast in T2W images.Results: Mono-, bi-, and triexponential models were preferred in 8 (10%), 72 (86%), and 4 (5%) cases, respectively. The biexponential short T2 was 64 msec (range 43 to 92 msec) and the long T2 was 490 msec (range 161 to 1319 msec). The fitted signal fraction, f, of the long T2 component was 27% (range 3% to 80%). The adjusted R 2 was 75.1% for the full regression model and decreased by 0.9%, 1.3%, and 39.2% when short T2, long T2, and f were removed from the model, respectively. Conclusion:Prostatic T2 decay was, in general, biexponential. The differences between the T2 components were large enough for accurate quantification. The T2W image contrast was primarily predicted by the biexponential signal fractions.

Hospital admissions from nursing homes have not previously been investigated in Norway. During 12 months all hospital admissions (acute and elective) from 32 nursing homes in Bergen were recorded via the Norwegian ambulance register. The principal diagnosis made during the stay, length of stay, and the ward were sourced from the hospital's data register and data were merged. Altogether 1,311 hospital admissions were recorded during the 12 months. Admissions from nursing homes made up 6.1% of the total number of admissions to medical wards, while for surgical wards they made up 3.8%. Infections, fractures, cardiovascular and gastri-related diagnoses represented the most frequent admission diagnoses. Infections accounted for 25.0% of admissions, including 51.0% pneumonias. Of all the admissions, fractures were the cause in 10.2%. Of all fractures, hip fractures represented 71.7. The admission rate increased as the proportion of short-term beds increased, and at nursing homes with short-term beds, admissions increased with increasing physician coverage. Potential reductions in hospitalizations for infections from nursing homes may play a role to reduce pressure on medical departments as may fracture prevention. Solely increasing physician coverage in nursing homes will probably not reduce the number of hospitalizations.

MRU has the potential to replace traditional diagnostic methods which use ionising radiation in paediatric patients. Further studies are needed before definite conclusions can be drawn.

No abstract

Summaryobjectives To evaluate the recent WHO's ultrasonographic diagnostic staging system of schistosomal periportal thickening/fibrosis and to assess intra/inter-observer variation associated with its use.methods Local standard of portal branch wall thickness (PBWT) for height was established using 150 healthy subjects. Intra and inter-observer variation in image pattern identification and PBWT measurements were assessed in 94 and 35 subjects, respectively, with differing stages of periportal thickening fibrosis. WHO's diagnostic criteria were evaluated in 2451 community members (1277 males, 1174 females; mean age 18.8 years) with an overall Schistosoma mansoni prevalence estimate of 65.9%.results There were no significant inter/intra-observer variations in image pattern identification and PBWT measurements. Based on Ethiopian PBWT-for-height standard, 128/2451 (5.2%) had insipient, 46/2451 (1.9%) had possible/probable and 112/2451 (4.6%) had definite/advanced periportal thickening/fibrosis. Comparable figures were obtained using the Senegalese PBWT-for-height standard and there was good agreement between Ethiopian and Senegalese healthy control-based diagnostic criteria in classifying the 286 subjects into stages of periportal thickening/fibrosis (j ¼ 0.87, P < 0.001).conclusions With further improvement, the WHO's ultrasonographic diagnostic criteria can be used in health institutions and community surveys. Image pattern based assessment is simple and more reproducible than PBWT based assessment of periportal thickening/fibrosis. The latter is, however, more useful in clarifying the status of an individual with doubtful image pattern, and in monitoring posttreatment outcome of periportal thickening/fibrosis. Considering the comparability of PBWT-for-height standards, setting one international standard of PBWT-for-height is more practical than developing local standards for each endemic area.

No abstract