A systematic review of capnography for sedation

We included six trials with 2524 participants. Capnography reduced hypoxaemic episodes, relative risk (95% CI) 0.71 (0.56-0.91), but the quality of evidence was poor due to high risks of performance bias and detection bias and substantial statistical heterogeneity. The reduction in hypoxaemic episodes was statistically homogeneous in the subgroup of three trials of 1823 adults sedated for colonoscopy, relative risk (95% CI) 0.59 (0.48-0.73), although the risks of performance and detection biases were high. There was no evidence that capnography affected other outcomes, including assisted ventilation, relative risk (95% CI) 0.58 (0.26-1.27), p = 0.17.

The story of my family : The German-Jewish family of Hermann Nelki /

History of the Nelki and Russo families in Berlin; concentrates mainly on first half of the 20th century; most members of the family were physicians; persecution in Nazi period; emigration to England; attached is the story of Eva Edith Ehrlich who survived the war years in Berlin in hiding.

When time ran out : Coming of age in the Third Reich 1925-1982

Memoir based on diaries kept by sculptor Zeller as a boy; Nazi periods in Berlin; primary and secondary school; pogrom (November 1938); emigration to England via Holland; visit to Berlin in 1982

The File Marked "Rita". Selections from the Letters of Herbert Mueller and Rita Klein (1939-1945) 1939-1946

Exchange of letters between Herbert Mueller and Rita Klein after Mueller's emigration to England in 1939; Rita Klein's attempt to obtain divorce; suicide attempt by her husband Leo Klein; correspondence through intermediaries after outbreak of World War II; notice of Rita Klein's deportation to Auschwitz; (translation from original German)

Das Tagebuch von Ilse Jacob 1940-1944 1940-1944

Diary of Ilse Jacob, born in Berlin in 1924. Emigrated on children's transport to England in 1940, later followed by her brother Hans. He was interned on the Isle of Man and later sent to Canada. At first Ilse Jacob was housed by the Jewish immigrant community, then got a position of bookkeeper in a store owned by a British Jew. Finally she was accepted by the ATS where she was trained as a cook for the military service. Eventually she passed the entry exams for the university.

Manch Gespenst steht sinnend. 1938-1945

Manuscript of an autobiographical novel, recounting the author’s experiences under Nazi rule in Austria after the occupation of 1938, particularly his imprisonment in Dachau concentration camp and his subsequent emigration to England.

Lucien Wolf and David Mowshowitch papers, [ca. 1869-1959]

Correspondence, reports, minutes, manuscripts, and clippings relating to the activities of Wolf, Mowshowitch, and the Joint Foreign Committee, as well as to the political situation of Jews in various countries and to the Paris Peace Conference. Papers of Lucien Wolf include his diary, lectures on English-German relations and English-Russian relations; bibliography of Wolf's works on Jewish themes; clippings of Wolf's articles; congratulations on his seventieth birthday; article on his last interview with Chamberlain; and correspondence with parents, 1869-1882, A. Abrahams, 1914-1925, Chief Rabbi Dr. J.H. Hertz, 1892-1923, Clara Melchior, 1913-1929, Jacob Schiff, 1910, Maxim Vinawer, 1917, Mark Wischnitzer, 1926-1928, Lord Robert Cecil, 1916-1919, Lord Rothschild, 1906, Cyrus Adler, Count J. Bernstorff, Szymon Ashkenazy, Solomon Dingol, Louis Marshall, Claude G. Montefiore, Sir Edward Sassoon, Jacob Schiff, Lord William Selborne, Nakhum Sokolow, Oscar Straus, Chaim Weizmann, the American Jewish Congress, 1916-1923, Hilfsverein der Deutschen Juden, 1913, and Jewish Historical Society of England.

Franks family papers, 1711-1821, [1965-1968].

Contains business correspondence, accounts and documents relating to Jacob Franks of New York, his two sons, Moses and David, a nephew, Isaac, and a John Franks of Halifax, possibly a member of the family.

Oath of allegiance to George II by Jews in American colonies

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Elevated circulating sclerostin concentrations in individuals with high bone mass, with and without LRP5 mutations

CONTEXT: The role and importance of circulating sclerostin is poorly understood. High bone mass (HBM) caused by activating LRP5 mutations has been reported to be associated with increased plasma sclerostin concentrations; whether the same applies to HBM due to other causes is unknown. OBJECTIVE: Our objective was to determine circulating sclerostin concentrations in HBM. DESIGN AND PARTICIPANTS: In this case-control study, 406 HBM index cases were identified by screening dual-energy x-ray absorptiometry (DXA) databases from 4 United Kingdom centers (n = 219 088), excluding significant osteoarthritis/artifact. Controls comprised unaffected relatives and spouses. MAIN MEASURES: Plasma sclerostin; lumbar spine L1, total hip, and total body DXA; and radial and tibial peripheral quantitative computed tomography (subgroup only) were evaluated. RESULTS: Sclerostin concentrations were significantly higher in both LRP5 HBM and non-LRP5 HBM cases compared with controls: mean (SD) 130.1 (61.7) and 88.0 (39.3) vs 66.4 (32.3) pmol/L (both P < .001, which persisted after adjustment for a priori confounders). In combined adjusted analyses of cases and controls, sclerostin concentrations were positively related to all bone parameters found to be increased in HBM cases (ie, L1, total hip, and total body DXA bone mineral density and radial/tibial cortical area, cortical bone mineral density, and trabecular density). Although these relationships were broadly equivalent in HBM cases and controls, there was some evidence that associations between sclerostin and trabecular phenotypes were stronger in HBM cases, particularly for radial trabecular density (interaction P < .01). CONCLUSIONS: Circulating plasma sclerostin concentrations are increased in both LRP5 and non-LRP5 HBM compared with controls. In addition to the general positive relationship between sclerostin and DXA/peripheral quantitative computed tomography parameters, genetic factors predisposing to HBM may contribute to increased sclerostin levels.

Humanitaarisuuden varjossa : Poliittiset tekijät lastensiirroissa Ruotsiin sotiemme aikana ja niiden jälkeen

The evacuation of Finnish children to Sweden during WW II has often been called a small migration . Historical research on this subject is scarce, considering the great number of children involved. The present research has applied, apart from the traditional archive research, the framework of history-culture developed by Rüsen in order to have an all-inclusive approach to the impact of this historical event. The framework has three dimensions: political, aesthetic and cognitive. The collective memory of war children has also been discussed. The research looks for political factors involved in the evacuations during the Winter War and the Continuation War and the post-war period. The approach is wider than a purely humanitarian one. Political factors have had an impact in both Finland and Sweden, beginning from the decision-making process and ending with the discussion of the unexpected consequences of the evacuations in the Finnish Parliament in 1950. The Winter War (30.11.1939 13.3.1940) witnessed the first child transports. These were also the model for future decision making. The transports were begun on the initiative of Swedes Maja Sandler, the wife of the resigned minister of foreign affairs Rickard Sandler, and Hanna Rydh-Munck af Rosenschöld , but this activity was soon accepted by the Swedish government because the humanitarian help in the form of child transports lightened the political burden of Prime Minister Hansson, who was not willing to help Finland militarily. It was help that Finland never asked for and it was rejected at the beginning. The negative response of Minister Juho Koivisto was not taken very seriously. The political forces in Finland supporting child transports were stronger than those rejecting them. The major politicians in support belonged to Finland´s Swedish minority. In addition, close to 1 000 Finnish children remained in Sweden after the Winter War. No analysis was made of the reasons why these children did not return home. A committee set up to help Finland and Norway was established in Sweden in 1941. Its chairman was Torsten Nothin, an influential Swedish politician. In December 1941 he appealed to the Swedish government to provide help to Finnish children under the authority of The International Red Cross. This plea had no results. The delivery of great amounts of food to Finland, which was now at war with Great Britain, had automatically caused reactions among the allies against the Swedish imports through Gothenburg. This included the import of oil, which was essential for the Swedish navy and air force. Oil was later used successfully to force a reduction in commerce between Sweden and Finland. The contradiction between Sweden´s essential political interests and humanitarian help was solved in a way that did not harm the country´s vital political interests. Instead of delivering help to Finland, Finnish children were transported to Sweden through the organisations that had already been created. At the beginning of the Continuation War (25.6.1941 27.4.1945) negative opinion regarding child transports re-emerged in Finland. Karl-August Fagerholm implemented the transports in September 1941. In 1942, members of the conservative parties in the Finnish Parliament expressed their fear of losing the children to the Swedes. They suggested that Finland should withdraw from the inter-Nordic agreement, according to which the adoptions were approved by the court of the country where the child resided. This initiative failed. Paavo Virkkunen, an influential member of the conservative party Kokoomus in Finland, favoured the so-called good-father system, where help was delivered to Finland in the form of money and goods. Virkkunen was concerned about the consequences of a long stay in a Swedish family. The risk of losing the children was clear. The extreme conservative party (IKL, the Patriotic Movement of the Finnish People) wanted to alienate Finland from Sweden and bring Finland closer to Germany. Von Blücher, the German ambassador to Finland, had in his report to Berlin, mentioned the political consequences of the child transports. Among other things, they would bring Finland and Sweden closer to each other. He had also paid attention to the Nordic political orientation in Finland. He did not question or criticize the child transports. His main interest was to increase German political influence in Finland, and the Nordic political orientation was an obstacle. Fagerholm was politically ill-favoured by the Germans, because he had a strong Nordic political disposition and had criticised Germany´s activities in Norway. The criticism of child transports was at the same time criticism of Fagerholm. The official censorship organ of the Finnish government (VTL) denied the criticism of child transports in January 1942. The reasons were political. Statements made by members of the Finnish Parliament were also censored, because it was thought that they would offend the Swedes. In addition, the censorship organ used child transports as a means of active propaganda aimed at improving the relations between the two countries. The Finnish Parliament was informed in 1948 that about 15 000 Finnish children still remained in Sweden. These children would stay there permanently. In 1950 the members of the Agrarian Party in Finland stated that Finland should actively strive to get the children back. The party on the left (SKDL, the Democratic Movement of Finnish People) also focused on the unexpected consequences of the child transports. The Social Democrats, and largely Fagerholm, had been the main force in Finland behind the child transports. Members of the SKDL, controlled by Finland´s Communist Party, stated that the war time authorities were responsible for this war loss. Many of the Finnish parents could not get their children back despite repeated requests. The discussion of the problem became political, for example von Born, a member of the Swedish minority party RKP, related this problem to foreign policy by stating that the request to repatriate the Finnish children would have negative political consequences for the relations between Finland and Sweden. He emphasized expressing feelings of gratitude to the Swedes. After the war a new foreign policy was established by Prime Minister (1944 1946) and later President (1946 1956) Juho Kusti Paasikivi. The main cornerstone of this policy was to establish good relations with the Soviet Union. The other, often forgotten, cornerstone was to simultaneously establish good relations with other Nordic countries, especially Sweden, as a counterbalance. The unexpected results of the child evacuation, a Swedish initiative, had violated the good relations with Sweden. The motives of the Democratic Movement of Finnish People were much the same as those of the Patriotic Movement of Finnish People. Only the ideology was different. The Nordic political orientation was an obstacle to both parties. The position of the Democratic Movement of Finnish People was much better than that of the Patriotic Movement of Finnish People, because now one could clearly see the unexpected results, which included human tragedy for the many families who could not be re-united with their children despite their repeated requests. The Swedes questioned the figure given to the Finnish Parliament regarding the number of children permanently remaining in Sweden. This research agrees with the Swedes. In a calculation based on Swedish population registers, the number of these children is about 7 100. The reliability of this figure is increased by the fact that the child allowance programme began in Sweden in 1948. The prerequisite to have this allowance was that the child be in the Swedish population register. It was not necessary for the child to have Swedish nationality. The Finnish Parliament had false information about the number of Finnish children who remained in Sweden in 1942 and in 1950. There was no parliamentary control in Finland regarding child transports, because the decision was made by one cabinet member and speeches by MPs in the Finnish Parliament were censored, like all criticism regarding child transports to Sweden. In Great Britain parliamentary control worked better throughout the whole war, because the speeches regarding evacuation were not censored. At the beginning of the war certain members of the British Labour Party and the Welsh Nationalists were particularly outspoken about the scheme. Fagerholm does not discuss to any great extent the child transports in his memoirs. He does not evaluate the process and results as a whole. This research provides some possibilities for an evaluation of this sort. The Swedish medical reports give a clear picture of the physical condition of the Finnish children when arriving in Sweden. The transports actually revealed how bad the situation of the poorest children was. According to Titmuss, similar observations were made in Great Britain during the British evacuations. The child transports saved the lives of approximately 2 900 children. Most of these children were removed to Sweden to receive treatment for illnesses, but many among the healthy children were undernourished and some suffered from the effects of tuberculosis. The medical inspection in Finland was not thorough. If you compare the figure of 2 900 children saved and returned with the figure of about 7 100 children who remained permanently in Sweden, you may draw the conclusion that Finland as a country failed to benefit from the child transports, and that the whole operation was a political mistake with far-reaching consequenses. The basic goal of the operation was to save lives and have all the children return to Finland after the war. The difficulties with the repatriation of the children were mainly psychological. The level of child psychology in Finland at that time was low. One may question the report by Professor Martti Kaila regarding the adaptation of children to their families back in Finland. Anna Freud´s warnings concerning the difficulties that arise when child evacuees return are also valid in Finland. Freud viewed the emotional life of children in a way different from Kaila: the physical survival of a small child forces her to create strong emotional ties to the person who is looking after her. This, a characteristic of all small children, occurred with the Finnish children too, and it was something the political decision makers in Finland could not see during and after the war. It is a characteristic of all little children. Yet, such experiences were already evident during the Winter War. The best possible solution had been to limit the child transports only to children in need of medical treatment. Children from large and poor families had been helped by organising meals and by buying food from Denmark with Swedish money. Assisting Finland by all possible means should have been the basic goal of Fagerholm in September 1941, when the offer of child transports came from Sweden. Fagerholm felt gratitude towards the Swedes. The risks became clear to him only in 1943. The war children are today a rather scattered and diffuse group of people. Emotionally, part of these children remained in Sweden after the war. There is no clear collective memory, only individual memories; the collective memory of the war children has partly been shaped later through the activities of the war child associations. The main difference between the children evacuated in Finland (for example from Karelia to safer areas with their families) and the war children, who were sent abroad, is that the war children lack a shared story and experience with their families. They were outsiders . The whole matter is sensitive to many of such mothers and discussing the subject has often been avoided in families. The war-time censorship has continued in families through silence and avoidance and Finnish politicians and Finnish families had to face each other on this issue after the war. The lack of all-inclusive historical research has also prevented the formation of a collective awareness among war children returned to Finland or those remaining permanently abroad.. Knowledge of historical facts will help war-children by providing an opportunity to create an all-inclusive approach to the past. Personal experiences should be regarded as part of a large historical entity shadowed by war and where many political factors were at work in both Finland and Sweden. This means strengthening of the cognitive dimension discussed in Rüsen´s all-inclusive historical approach.

Bridging East and West : The Establishment of the International Institute for Applied Systems Analysis (IIASA) in the United States Foreign Policy of Bridge Building, 1964-1972.

The dissertation examines the foreign policies of the United States through the prism of science and technology. In the focal point of scrutiny is the policy establishing the International Institute for Applied Systems Analysis (IIASA) and the development of the multilateral part of bridge building in American foreign policy during the 1960s and early 1970s. After a long and arduous negotiation process, the institute was finally established by twelve national member organizations from the following countries: Bulgaria, Canada, Czechoslovakia, Federal Republic of Germany (FRG), France, German Democratic Republic (GDR), Great Britain, Italy, Japan, Poland, Soviet Union and United States; a few years later Sweden, Finland and the Netherlands also joined. It is said that the goal of the institute was to bring together researchers from East and West to solve pertinent problems caused by the modernization process experienced in industrialized world. It originates from President Lyndon B. Johnson s bridge building policies that were launched in 1964, and was set in a well-contested and crowded domain of other international organizations of environmental and social planning. Since the distinct need for yet another organization was not evident, the process of negotiations in this multinational environment enlightens the foreign policy ambitions of the United States on the road to the Cold War détente. The study places this project within its political era, and juxtaposes it with other international organizations, especially that of the OECD, ECE and NATO. Conventionally, Lyndon Johnson s bridge building policies have been seen as a means to normalize its international relations bilaterally with different East European countries, and the multilateral dimension of the policy has been ignored. This is why IIASA s establishment process in this multilateral environment brings forth new information on US foreign policy goals, the means to achieve these goals, as well as its relations to other advanced industrialized societies before the time of détente, during the 1960s and early 1970s. Furthermore, the substance of the institute applied systems analysis illuminates the differences between European and American methodological thinking in social planning. Systems analysis is closely associated with (American) science and technology policies of the 1960s, especially in its military administrative applications, thus analysis within the foreign policy environment of the United States proved particularly fruitful. In the 1960s the institutional structures of European continent with faltering, and the growing tendencies of integration were in flux. One example of this was the long, drawn-out process of British membership in the EEC, another is de Gaulle s withdrawal from NATO s military-political cooperation. On the other hand, however, economic cooperation in Europe between East and West, and especially with the Soviet Union was expanding rapidly. This American initiative to form a new institutional actor has to be seen in that structural context, showing that bridge building was needed not only to the East, but also to the West. The narrative amounts to an analysis of how the United States managed both cooperation and conflict in its hegemonic aspirations in the emerging modern world, and how it used its special relationship with the United Kingdom to achieve its goals. The research is based on the archives of the United States, Great Britain, Sweden, Finland, and IIASA. The primary sources have been complemented with both contemporary and present day research literature, periodicals, and interviews.

Pilottitutkimus apteekkien yksilöllisestä tupakoinninvieroituspalvelusta

Apteekkien yksilöllinen tupakoinninvieroituspalvelu on tupakoinnin lopettamiseen motivoituneille asiakkaille tarkoitettu maksullinen erikoispalvelu, joka sisältää 4–6 tapaamista vieroitusohjaajana toimivan farmaseutin tai proviisorin kanssa. Palvelu sisältää asiakkaalle räätälöityä neuvontaa, henkilökohtaisen vieroitussuunnitelman sekä seurantajakson. Apteekkien yksilöllinen tupakoinninvieroituspalvelu perustuu Isossa-Britanniassa kehitettyyn palvelumalliin, ja sitä on tarjottu suomalaisissa apteekeissa vuodesta 2006. Tämä pro gradu -tutkielma käsittelee apteekkien yksilöllisen tupakoinninvieroituspalvelun pilottitutkimusta, joka toteutettiin Suomen Apteekkariliiton ja Helsingin yliopiston farmasian tiedekunnan sosiaalifarmasian osaston yhteistyönä ja se kuului osana Hengitysliitto Heli ry:n koordinoimaa tupakasta vieroituksen hankekokonaisuutta. Tässä pro gradu -tutkielmassa tarkastellaan pilottitutkimuksessa saadun asiakasaineiston avulla apteekkien yksilöllisen tupakoinninvieroituspalvelumallin toimivuutta, asiakkaiden kokemuksia palvelusta, asiakkaiden onnistumista tupaakoinnin lopettamisessa sekä asiakkaiden kyvykkyyden tunteen kehittymistä palvelun aikana. Tässä interventiotutkimuksessa oli mukana 14 apteekkia, jotka rekrytoivat yhteensä 36 palveluasiakasta. Ennen asiakkaiden rekrytointia apteekit perehdytettiin palvelun tarjoamiseen. Apteekit tiedottivat pilottitutkimuksesta paikallisen terveydenhuollon lääkäreitä ja muita terveydenhuollon ammattilaisia, jotka voivat ohjata asiakkaita palveluun. Sosiaali- ja terveysministeriön pilottitutkimukselle myöntämä rahoitus mahdollisti asiantuntijapalkkion maksamisen apteekeille ja palvelun tarjoamisen asiakkaille ilmaiseksi tai pientä omakustannusosuutta vastaan. Asiakkaiden tupakoimattomana pysymistä sekä kokemuksia tupakoinninvieroituspalvelusta kartoitettiin kyselylomakkeilla, jotka asiakkaat saivat täytettäväkseen palvelun alussa sekä noin 3 kuukauden kohdalla palvelun alkamisesta. Asiakkaiden taustatiedot kerättiin ensimmäisen tapaamisen yhteydessä erillisille taustatietolomakkeille ja palvelun aikana tehtyjä huomioita niille tarkoitetuille kaavakkeille. Ensimmäisen kyselylomakkeen palauttaneista 28 henkilöstä 20 ja toisen kyselylomakkeen palauttaneista 17 henkilöstä 13 oli pysynyt tupakoimattomana (55,6 % ja 36,1 % kaikista asiakkaista). Kaikki tupakoinnin lopettaneet käyttivät jotakin tupakasta vieroituslääkettä. Tupakoinnin lopettaneilla asiakkailla kyvykkyyden tunne oli keskimääräistä parempi sekä palvelun alussa että koko palvelun ajan. Asiakkaat pitivät palvelua tarpeellisena ja apteekin vieroitusohjaajalta saatua tukea tärkeänä. Asiakkaat kokivat myös palvelun saamisen apteekista tärkeäksi. Noin 32 % ensimmäiseen kyselyyn vastanneista ja 41 % toiseen kyselyyn vastanneista oli valmis maksamaan palvelusta. Heidän ilmoittamansa maksuvalmius oli keskimäärin noin 45 euroa (10–100 euroa). Muusta terveydenhuollosta lähetettiin palveluun vain vähän tai ei lainkaan asiakkaita. Tästä syystä apteekit rekrytoivat asiakkaita myös ilman kontaktia muuhun terveydenhuoltoon. Palvelun 36 asiakkaasta noin 36 % oli pysynyt tupakoimattomana 3 kuukauden kohdalla. Verrokkiryhmä jouduttiin jättämään tutkimuksesta pois verrokkihenkilöiden rekrytoinnin epäonnistuttua. Tulos on kuitenkin vertailukelpoinen kansainvälisiin tutkimuksiin, joissa on saatu vastaavanlaisia tuloksia. Apteekkien yksilöllisestä tupakoinninvieroituspalvelusta saattaa olla hyötyä tupakoinnin lopettamisessa siihen motivoituneille henkilöille ja erityisesti henkilöille, jotka käyttävät lisäksi tupakasta vieroituslääkettä. Asiakkaat kokivat palvelun tärkeäksi ja tarpeelliseksi, mutta heikko maksuvalmius asettaa haasteita palvelun tarjoamiselle apteekeissa. Yhteistyömallia muun terveydenhuollon kanssa tulisi kehittää.