The dipole moment of the spin density as a local indicator for phase transitions.

The intra-atomic magnetic dipole moment - frequently called ⟨Tz⟩ term - plays an important role in the determination of spin magnetic moments by x-ray absorption spectroscopy for systems with nonspherical spin density distributions. In this work, we present the dipole moment as a sensitive monitor to changes in the electronic structure in the vicinity of a phase transiton. In particular, we studied the dipole moment at the Fe(2+) and Fe(3+) sites of magnetite as an indicator for the Verwey transition by a combination of x-ray magnetic circular dichroism and density functional theory. Our experimental results prove that there exists a local change in the electronic structure at temperatures above the Verwey transition correlated to the known spin reorientation. Furthermore, it is shown that measurement of the dipole moment is a powerful tool to observe this transition in small magnetite nanoparticles for which it is usually screened by blocking effects in classical magnetometry.

Risk factors of post-operative urinary retention in hospitalised patients.

BACKGROUND: Post-operative urinary retention (POUR) is most accurately determined by using ultrasound to measure bladder volume. The aim of this study was to define the risk factors of POUR in the recovery room in hospitalised patients. METHODS: An ultrasound-determined bladder volume ≥400 ml at arrival in the recovery room was used to define POUR. Multivariate regression analysis was used to identify patient and system factors linked to POUR in 773 consecutive hospitalised patients who had undergone orthopaedic, abdominal, gynaecological or plastic surgery without an indwelling urinary catheter. RESULTS: We found the incidence of POUR to be 13%. The lack of pre-operative voiding, use of regional anaesthesia, anaesthesia time >2 h and emergency surgery were all independent risk factors for POUR. CONCLUSIONS: The detected incidence of POUR at arrival in the recovery room was rather high but had easily identifiable risk factors. We recommend pre-operative voiding whenever possible. Routine bladder scanning at arrival in the recovery room should be considered, especially after spinal anaesthesia, emergency surgery or when the anaesthesia time exceeds 2 h.

Repair and re-use of hearing instruments.

Norwegian hearing-impaired persons, since 1 May 1986, have been entitled to free hearing instruments (HI), and also to free repair of defective HIs. In order to reduce the community's expense, national regulation recommends that HIs not in use should be returned to a hearing centre for re-use. To achieve a further reduction of expense, the National Health Insurance (NHI) decided that from 1 January 1989, only persons under 18 years of age could have their HIs repaired free of charge. The NHI supposed that some users of HIs would be unwilling to pay for repair of defective instruments, and realized that this would lead to an increased number of defective HIs remaining among the users. A pilot study performed in 1990 supported this assumption. A further consequence of this change of regulation was that clients, entitled to free HIs, could not be given used instruments with or without reduced guarantee--when they had to pay for repair of the instruments themselves. Therefore, the NHI saved expense through user-paid repair of HIs, yet on the other hand had increased costs by buying new HIs instead of giving some of the clients used instruments. The aim of this investigation was to evaluate whether the NHI could pay for the repair of HIs and have these costs covered by savings from the re-use of HIs. During 1992, 1993 and 1994, the cost for repair of the 5150 HIs was 176,560 pounds. During the same period, 2105 HIs were re-used, representing a saving of 445,712 pounds. This repair/re-use system unburdens the users of HIs of expense, and in turn saves money for the community. For approximately 10% of all HIs sent for repair, the main problem was not that the instruments were defective.

Factors to consider when in-the-canal hearing instruments are used in aural rehabilitation.

The purpose of this investigation was to determine what subjective factors may influence the success of fitting in-the-canal hearing instruments (ITCs). Four different types of ITC were fitted to four matched groups of 20 experienced ITC users. In addition to the subjective experiences of the users, the results were checked using insertion gain (IG) measurements. The results indicate that too sharp sound quality from paper rustle, from running water and from use of kitchen utensils is a common problem that it is important to be aware of. The possibility of maximal venting is of special importance in order to avoid autophony. Feedback may be a problem, especially when maximal venting is necessary. However, for several models of ITC, feedback is, in reality, a minor problem. High cost of batteries may be a problem for persons with ITC using 10/230 batteries. IG measurements indicated that a gain of approximately 0.3 in relation to the hearing losses was preferred. It may be advantageous to choose a model of ITC that has extensive flexibility.

Assistive devices for hard-of-hearing persons--distribution system and costs.

A system to provide hearing-impaired persons with adequate assistive devices is described. Investigation of 100 persons' recommended devices in 1985 shows that the system functions reasonably well. To secure provision of adequate devices, a system must be established to take care of all practical tasks. The mean expense to supply a hearing-impaired person with the assistive devices needed was found to be 764 pounds. Supplying elderly hearing-impaired persons with assistive devices may enable them to stay at home longer. The cost of the required assistive devices for a hearing-impaired person is on average approximately the same as for 8 days' stay in a nursing home.

Hearing instruments for the elderly hearing impaired. A comparison of in-the-canal and behind-the-ear hearing instruments in first-time users.

The purpose of this investigation was to compare negative and positive experiences between two matched groups of elderly first-time users of hearing instruments (HI). One group had been supplied with behind-the-ear hearing instruments (BTE), the other with in-the-canal hearing instruments (ITC). There were 20 persons in each group. All were visited in their homes. Those who needed extra help were offered follow-up at the Hearing Centre. ITC were found to be superior to BTE as regards time-of-use, operational difficulties and undesirable sound experiences. ITC were also used in more difficult listening situations. Successful instruction and follow-up was more easily achieved with ITC users than with BTE users. ITC are recommended as the preferred instrument for elderly first-time HI users, at least for hearing losses not exceeding 60 dB PTA, provided the subject's dexterity and anatomical conditions permit fitting of ITC.

In-the-canal hearing instruments. Benefits and problems for inexperienced users given minimal instruction.

The number of in-the-canal hearing instruments (ITC) distributed annually in our region is increasing. The purpose of this investigation, which included 300 persons, was to evaluate the problems and benefits reported by ITC users who had received a minimum of counselling. Another aim was to decide which factors to concentrate on when teaching local health personnel how to assist hard-of-hearing equipped with ITC. The results showed that 38% had operational difficulties, 63% had experienced untoward sound reception. However, almost 90% reported positive experiences and the overall result for more than 80% was good. Operational difficulties resulted mainly from insufficient instruction. A moderate degree of instruction at the check-up was both essential and beneficial. Untoward sound experiences were caused mainly by inadequate venting and/or inaccurately adjusted instruments, faults that could be easily dealt with. It is therefore essential to teach local health service personnel that clients initially reporting problems in using their ITC can in most cases have their problems solved, mainly by simple instruction and/or an adjustment of the ITC. Only when these measures have failed should other types of hearing instruments (HI) be tried. Local health service personnel should therefore be instructed not to accept initial rejection of ITC merely because of the small size of the instrument until further instruction has been given, and not proved successful.

The use and benefits of assistive devices and systems for the hard-of-hearing.

Assistive devices and systems for the hard-of-hearing (ADs) have been used in varying degree in Norway since the early 1970s. The impression is that these devices offer excellent assistance in addition to hearing aids. This investigation included 100 persons who were recommended devices in 1985. Of these, 81 persons, mainly elderly with sensorineural hearing loss, were visited in their homes. Most of the devices were functioning well, and the users were satisfied. There was, however, a considerable need for supplementation. The need for a system to help the hard-of-hearing to acquire ADs is stressed. Domiciliary visiting by audiologically trained personnel some time after the installation of devices is also recommended.

Evaluation of flunisolide nasal solution in the symptomatic treatment of perennial rhinitis.

The effectiveness of a topical steroid, flunisolide, was evaluated in patients with perennial rhinitis. Thirty-four patients went through a double-blind cross-over study, comparing flunisolide 200 microgram per day with placebo. The symptoms were assessed over two treatment periods each of 4 weeks, with a 2 weeks' washout period in between. There was a statistically significant difference in favour of flunisolide. About half of the patients complained of mild initial irritation from both active drug and placebo.

Budesonide - a new steroid for intranasal use. A double-blind clinical comparison between budesonide and placebo in patients with seasonal allergic rhinitis.

Twenty-nine patients with seasonal rhinitis completed a double-blind study comparing budesonide nasal spray 200 micrograms b.i.d. with placebo. The patients were randomly assigned into two parallel groups. Symptoms were assessed over a treatment period of 3 weeks. There were statistically significant differences in favour of budesonide on all measurements. Side effects were mild and the incidence was low.

The effect of disodium cromoglycate in perennial allergic rhinitis. A controlled clinical study.

The clinical effect of disodium cromoglycate was compared with placebo in patients with perennial allergic rhinitis. The results of a double-blind cross-over trial in 17 patients suggest that insufflation with 10 mg disodium cromoglycate four times a day has no better effect than placebo. No significant differences between the side effect of disodium cromoglycate and placebo were noted.