Helsebibliotekets Research Archive
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Meldesentralen – oppsummeringsrapport 2001–2007
No full textNORSK SAMMENDRAG: Frå 2001 til 2007 blei det registrert 13 136 meldingar om uønskte hendingar i spesialisthelsetenesta. Éi av ti meldingar (10 prosent) gjeld unaturleg dødsfall.\ud
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Desse meldingane har verksemder i spesialisthelsetenesta sendt til Helsetilsynet i fylket etter § 3–3 i spesialisthelsetenestelova. Denne meldeplikta blir utløyst når det blir ytt helsehjelp og det skjer hendingar som har ført til, eller kunne ha ført til, betydeleg skade på ein pasient. \ud
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I denne perioden er det stor variasjon i meldefrekvensen, målt etter talet på meldingar per 10 000 døgnopphald, både mellom dei regionale helseføretaka (RHF) og mellom helseføretaka (HF).\ud
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Helse Sør-Øst RHF har den høgste meldefrekvensen. Sykehuset Østfold HF, Sykehuset Asker og Bærum HF og Blefjell sykehus HF er dei tre helseføretaka med dei høgste meldefrekvensane.\ud
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5 prosent av alle meldingane gjeld hendingar som er knytte til fødslar.\ud
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27 prosent av alle meldingane gjeld hendingar som har med lækjemiddel å gjere.\ud
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17 prosent av alle meldingane gjeld hendingar som har skjedd i samband med psykiatrisk behandling.\ud
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17 prosent av alle meldingane gjeld hendingar som har skjedd i samband med fall.\ud
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Funna tyder på at institusjonane i spesialisthelsetenesta oppfyller meldeplikta i svært ulik grad. Statens helsetilsyn er av den oppfatning at dei helseinstitusjonane som melder flest uønskte hendingar, ikkje nødvendigvis er dei institusjonane der det faktisk skjer flest hendingar, men at mange meldingar kan vere eit uttrykk for ein god meldekultur og eit kvalitetsarbeid som fungerer.SUMMARY IN ENGLISH: During the period 2001 to 2007, 13 136 reports of adverse events in specialized health services were registered in MedEvent (the Reporting System for Adverse Events in Specialized Health Services). Such events involve a duty to report to the Norwegian Board of Health Supervision in the counties, in accordance with the Specialized Health Services Act, section 3-3.\ud
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About half of the events (52 per cent) were reports of events that could have led to serious injury to patients, and one-third (36 per cent) were reports of serious injury. One out of ten (10 %)were reports of unnatural death.\ud
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During this period, there is large variation in the frequency of reporting,measured as the number of reports per10 000 days of stay in hospital. This variation is seen both for the regional health authorities and for the health trusts.\ud
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Southern and Eastern Norway Regional Health Authority has the highes tfrequency of reporting. The health trusts with the highest frequency of reporting are: Sykehuset Østfold HF, Sykehuset Asker og Bærum HF, and Blefjell sykehus HF.\ud
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Five per cent of all reports of adverse events from 2001 to 2007 were related to childbirth.\ud
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Twenty-seven per cent of all reports were related to the use of medication.\ud
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The proportion of reports of adverse events that had occurred in mental health services was 17 per cent.\ud
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Seventeen per cent of all reports were related to falls.\ud
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The results indicate that there is great variation in the extent to which hospitals fulfil their duty to report adverse events. The Norwegian Board of Health Supervision believes that the hospitals with the highest reporting frequency are not necessarily the hospitals where the most events occur. A high frequency of reporting may reflect a positive reporting culture and that work with improving the quality of services is functioning well
Rusmiddelbruk blant unge voksne, 21-30 år. Resultater fra spørreskjemaundersøkelser 1998, 2002 og 2006
No full textNORSK SAMMENDRAG: Rapporten bygger på spørreskjemaundersøkelser om bruk av rusmidler og tobakk blant unge voksne mellom 21 og 30 år. SIRUS har foretatt slike undersøkelser i 1998, 2002 og 2006, og ett utvalg med personer fra hele landet og ett utvalg fra Oslo er blitt spurt. SIRUS-forskerne Marte Ødegård Lund, Astrid Skretting og Karl Erik Lund står bak rapporten.\ud
Røyking ned, snus opp\ud
Det har vært bortimot en halvering av andelen unge dagligrøykere fra 29 prosent i 1998 til 17 prosent i 2006. Andelen av-og-til røykere ligger stabilt på ca. 12 prosent. Men blant menn har andelen som snuser daglig blitt mer enn fordoblet i perioden, fra 7 til 17 prosent.\ud
Økning i alkoholbruk\ud
Årlig alkoholbruk i aldersgruppen har økt fra et gjennomsnitt på 4,5 liter ren alkohol i 1998 til 5,3 liter i 2006. I Oslo drikker de unge voksne over en liter mer enn i landet som helhet. Menn drikker omtrent dobbelt så mye som kvinner i samme aldersgruppe. Alkoholforbruket synker med økende alder, men stiger med økende inntekt.\ud
Økt bruk av hasj og kokain\ud
På landsbasis har andelen som har brukt hasj noen gang økt fra 22 prosent i 1998 til 34 prosent i 2006. I Oslo har det vært en økning fra 35 prosent til 47 prosent i samme periode. Andelen som har brukt hasj siste seks måneder har økt fra 7 til 10 prosent i Norge og fra 12 til 15 prosent i Oslo.\ud
Det har vært en tredobling i andelen som har brukt kokain noen gang fra 3 prosent i 1998 til 9 prosent i 2006. Andelen som har brukt amfetamin har økt fra 5 til 10 prosent i samme periode. I Oslo har økningen i kokainbruken vært fra 7 prosent til 14 prosent. Økningen har særlig skjedd blant menn, og blant menn fra 21 til 30 år i Oslo hadde 8 prosent brukt kokain fem ganger eller mer i 2006.\ud
Det finnes ingen belegg for påstanden om at kokain er et stoff for de spesielt velstående eller ressurssterke. Inntektene blant dem som bruker kokain skiller seg ikke ut fra resten av utvalget, mens utdanningsnivået er lavere enn gjennomsnittet.ENGLISH ABSTRACT: SIRUS has conducted surveys of young adults aged 21–20 on drug and alcohol use in 1998, 2002 and 2006. Using the same procedure as the annual surveys of adolescents, each of these young adult surveys operates with two samples, one of people officially resident in Oslo, the other of people resident in Norway, including Oslo.\ud
In 2006, only half as many respondents in the 21–30 age-group were smokers relative to 1998 (17 per cent in 2006 and 29 per cent in 1998). The percentage of occasional smokers has remained stable (at around 12 per cent). Daily smokers smoke as many cigarettes as before. The proportion of daily smokers in the Oslo sample tumbled from 27 per cent in 1998 to 14 per cent in 2006. The proportion of occasional smokers has been stable here too (around 15 per cent). In contrast, fewer respondents in the Oslo sample smoke more than ten cigarettes daily. The differences in smoking habits between the sexes are minor or non-existent. Education level appears to have a strong effect on smoking behaviour, as increasing education correlates with less likelihood of being a smoker and, inversely, low education predicts a higher likelihood of being a smoker.\ud
Wide differences prevail, however, between the sexes in use of snus. The chances of a male respondent taking snus daily doubled between 1998 and 2006 (from 7 to 17 per cent). Ten per cent of male respondents in the Oslo sample used snus daily in 1998, 16 per cent in 2006. 1–2 per cent of both female samples in both years (1998 and 2006) took snus daily. Individuals with a history of snus use irrespective of frequency etc. were more likely to have quit smoking.\ud
Estimates of the national annual alcohol consumption rate of young adults averaged at 4.5 litres pure alcohol in 1998 and 5.3 litres in 2006. Oslo residents aged 21–30 drink at least one litre more on average than the national average. Males aged 21–30 drink about twice as much as females in the same age-group. Alcohol consumption rates fall with increasing age (21-30 years), but rise with increasing income. The rate of self-reported episodes of binge drinking is relatively stable. About 80 per cent of both samples report obvious sensations of drunkenness in the past six months. Males prefer beer and liquor, females tend to drink wine more frequently. The rate of illicit alcohol consumption (privately distilled and smuggled alcohol) fell sharply between 1998 and 2006.\ud
There was a rise between 1998 and 2006 in the percentage of respondents aged 21–30 reporting having used cannabis at some point both in the national and Oslo samples. The percentage in the national sample was 22 in 1998, 30 per cent in 2002 and 34 per cent in 2006. For the Oslo sample, 35 per cent said in 1998 that they had some personal experience of cannabis use. By 2002 the percentage had grown to 41 and by 2006 to 47 per cent. The national average of respondents reporting use of cannabis in the past six months was 10 per cent in both 2002 and in 2006. For Oslo, the figure was 15 per cent in both years. Male respondents are more likely to use cannabis. Cannabis is more readily available. It sees that cannabis users are more likely to be unemployed, not involved in a training/education programme and belong to a low income bracket.\ud
For the other types of drug the highest increase was in the use of cocaine and amphetamine. The number of respondents in the national sample that reported using cocaine at some point rose from 3 per cent in 1998 to 9 per cent in 2006, while for those reporting amphetamine use at some point grew from 5 per cent in 1998 to 10 in 2006. For the Oslo sample, 7 per cent said in 1998 they had used cocaine at some point, rising to 14 per cent in 2006. Respondents reporting the use at some point of amphetamine grew from 10 per cent in 1998 to 13 per cent in 2006
The estrogen hypothesis of schizophrenia implicates glucose metabolism: association study in three independent samples.
No full textBACKGROUND: Schizophrenia is a highly heritable complex psychiatric disorder with an underlying pathophysiology that is still not well understood. Metaanalyses of schizophrenia linkage studies indicate numerous but rather large disease-associated genomic regions, whereas accumulating gene- and protein expression studies have indicated an equally large set of candidate genes that only partially overlap linkage genes. A thorough assessment, beyond the resolution of current GWA studies, of the disease risk conferred by the numerous schizophrenia candidate genes is a daunting and presently not feasible task. We undertook these challenges by using an established clinical paradigm, the estrogen hypothesis of schizophrenia, as the criterion to select candidates among the numerous genes experimentally implicated in schizophrenia. Bioinformatic tools were used to build and priorities the signaling networks implicated by the candidate genes resulting from the estrogen selection. We identified ten candidate genes using this approach that are all active in glucose metabolism and particularly in the glycolysis. Thus, we tested the hypothesis that variants of the glycolytic genes are associated with schizophrenia or at least with gender-associated aspects of the illness. RESULTS: We genotyped 185 SNPs in three independent case-control samples of Scandinavian origin (a total of 765 patients and 1274 control subjects). Variants of the mitogen-activated protein kinase 14 gene (MAPK14) and the phosphoenolpyruvate carboxykinase 1 (PCK1) and fructose-1,6-biphosphatase (FBP1) were nominal significantly associated with schizophrenia, and several haplotypes within enolase 2 gene (ENO2) consist of the same SNP allele having elevated risk of schizophrenia. Importantly, we find no evidence of stratification due to nationality or gender. CONCLUSION: Several gene variants in the Glycolysis were associated with schizophrenia in three independent samples. However, the findings are weak and not resistant to correction for multiple testing, which may indicate that they are either spurious or may relate to a particular subtype or aspect of the illness
Evidence-informed health policy 3 - Interviews with the directors of organizations that support the use of research evidence.
No full textABSTRACT: BACKGROUND: Only a small number of previous efforts to describe the experiences of organizations that produce clinical practice guidelines (CPGs), undertake health technology assessments (HTAs), or directly support the use of research evidence in developing health policy (i.e., government support units, or GSUs) have relied on interviews and then only with HTA agencies. Interviews offer the potential for capturing experiences in great depth, particularly the experiences of organizations that may be under-represented in surveys. METHODS: We purposively sampled organizations from among those who completed a questionnaire in the first phase of our three-phase study, developed and piloted a semi-structured interview guide, and conducted the interviews by telephone, audio-taped them, and took notes simultaneously. Binary or categorical responses to more structured questions were counted when possible. Themes were identified from among responses to semi-structured questions using a constant comparative method of analysis. Illustrative quotations were identified to supplement the narrative description of the themes. RESULTS: We interviewed the director (or his or her nominee) in 25 organizations, of which 12 were GSUs. Using rigorous methods that are systematic and transparent (sometimes shortened to 'being evidence-based') was the most commonly cited strength among all organizations. GSUs more consistently described their close links with policymakers as a strength, whereas organizations producing CPGs, HTAs, or both had conflicting viewpoints about such close links. With few exceptions, all types of organizations tended to focus largely on weaknesses in implementation, rather than strengths. The advice offered to those trying to establish similar organizations include: 1) collaborate with other organizations; 2) establish strong links with policymakers and stakeholders; 3) be independent and manage conflicts of interest; 4) build capacity; 5) use good methods and be transparent; 6) start small and address important questions; and 7) be attentive to implementation considerations. The advice offered to the World Health Organization (WHO) and other international organizations and networks was to foster collaborations across organizations. CONCLUSION: The findings from our interview study, the most broadly based of its kind, extend to both CPG-producing organizations and GSUs the applicability of the messages arising from previous interview studies of HTA agencies, such as to collaborate with other organizations and to be attentive to implementation considerations. Our interview study also provides a rich description of organizations supporting the use of research evidence, which can be drawn upon by those establishing or leading similar organizations in LMICs
Three-year follow-up of physical activity in Norwegian youth from two ethnic groups: associations with socio-demographic factors.
No full textBACKGROUND: More research on factors associated with physical activity and the decline in participation during adolescence is needed. In this paper, we investigate the levels, change, and stability of physical activity during the late teens among ethnic Norwegians and ethnic minorities, and we examine the associations between physical activity and socio-demographic factors. METHODS: The baseline (T1) of this longitudinal study included 10th graders who participated in the youth part of the Oslo Health Study, which was carried out in schools in 2000-2001. The follow-up (T2) in 2003-2004 was conducted partly at school and partly by mail. A total of 2489 (1112 boys and 1377 girls) participated both at baseline and at follow-up. Physical activity level was measured by a question on weekly hours of physical activity outside of school. Socio-demographic variables were collected by questionnaire and from data obtained from Statistics Norway. Analysis of variance was used to study the level of and changes (T1 to T2) in physical activity, and the associations between physical activity and socio-demographic factors. Stability in physical activity was defined as the percentage of students reporting the same physical activity both times. RESULTS: Boys were more active than girls at age 15 and 18 years, independent of ethnic background. Among girls, ethnic Norwegians were more active than ethnic minorities. Hours per week spent on physical activity declined in all groups during the follow-up period. Few associations were found between physical activity and socio-demographic factors in both cross-sectional and longitudinal data. Among the ethnic minority girls, 65% reported being physically active 0-2 hours per week at baseline, and 82% of these girls reported the same level at follow up. CONCLUSION: The association between physical activity and ethnicity at age 15 years remained the same during the follow-up. Few associations were found between physical activity and socio-demographic variables. A large proportion of ethnic minority girls reported a persistently low physical activity level, and this low participation rate may need special attention
Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up.
No full textBACKGROUND: Obesity is one of the most important risk factors for osteoarthritis (OA) in knee(s). However, the relationship between obesity and OA in hand(s) and hip(s) remains controversial and needs further investigation. The purpose of this study was to investigate the impact of obesity on incident osteoarthritis (OA) in hip, knee, and hand in a general population followed in 10 years. METHODS: A total of 1854 people aged 24-76 years in 1994 participated in a Norwegian study on musculoskeletal pain in both 1994 and 2004. Participants with OA or rheumatoid arthritis in 1994 and those above 74 years in 1994 were excluded, leaving n = 1675 for the analyses. The main outcome measure was OA diagnosis at follow-up based on self-report. Obesity was defined by a body mass index (BMI) of 30 and above. RESULTS: At 10-years follow-up the incidence rates were 5.8% (CI 4.3-7.3) for hip OA, 7.3% (CI 5.7-9.0) for knee OA, and 5.6% (CI 4.2-7.1) for hand OA. When adjusting for age, gender, work status and leisure time activities, a high BMI (> 30) was significantly associated with knee OA (OR 2.81; 95%CI 1.32-5.96), and a dose-response relationship was found for this association. Obesity was also significantly associated with hand OA (OR 2.59; 1.08-6.19), but not with hip OA (OR 1.11; 0.41-2.97). There was no statistically significant interaction effect between BMI and gender, age or any of the other confounding variables. CONCLUSION: A high BMI was significantly associated with knee OA and hand OA, but not with hip OA
Meldesentralen – årsrapport 2006
No full textNORSK SAMMENDRAG:\ud
I Meldesentralen er det i perioden 2003 til 2006 registrert ca 2000 meldinger hvert år. Disse meldingene har spesialisthelsetjenesten sendt til Helsetilsynet i fylket i henhold til spesialisthelsetjenesteloven § 3-3. Denne meldeplikten utløses når det under ytelse av helsehjelp, skjer hendelser som har medført eller kunne ha medført betydelig skade på pasient.\ud
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Antall registrerte meldinger i 2006 var 1855. \ud
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Over halvparten av meldingene registrert i 2006 (51 prosent) gjelder forhold som kunne ha ført til betydelig personskade, og en tredjedel (33 prosent) gjelder betydelig personskade.\ud
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Meldinger som omhandler hendelser i forbindelse med fødsel utgjør fem prosent av alle meldingene. \ud
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Andelen meldinger fra psykiatri har vært nokså stabilt fra 2001 til 2006 – mellom 16 og 19 prosent. Meldinger om selvmord og selvmordsforsøk utgjør seks prosent av alle meldingene.\ud
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Meldinger om legemiddelfeil registrert i 2006 utgjør 27 prosent av alle -meldingene. \ud
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Andelen pasienter som er informert om skaden de har vært utsatt for og om Norsk Pasientskadeerstatning (NPE) viser en gradvis økning. Det er imidlertid fortsatt for mange pasienter som har vært utsatt for hendelser og som ikke informeres verken om hendelsen eller om NPE. Så her er det fortsatt et potensial for forbedring.SUMMARY IN ENGLISH:\ud
During the period 2003 to 2006, about 2 000 reports of adverse events have been registered each year in Medevent (the Reporting System for Adverse Events in Specialized Health Services). Such events involve a duty to report to the Norwegian Board of Health Supervision in the counties, in accordance with the Specialized Health Services Act, section 3-3. The number of reports registered in 2006 was 1 855. \ud
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About half of the events registered in 2006 (51 per cent) were reports of events that could have led to serious injury to patients, and one-third (33 per cent) were reports of serious injury. \ud
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Five per cent of all reports of adverse events from 2001 to 2006 were related to childbirth. \ud
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The proportion of reports of adverse events that had occurred in mental health services has been fairly stable from 2001 to 2006 – between 16-19 per cent. Six per cent of all reports were related to suicide and attempted suicide. \ud
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Twenty-seven per cent of reports registered in 2006 were related to the use of medication. \ud
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The proportion of patients who were informed about the adverse event, and about the Norwegian System of Compensation for Injuries to Patients (NPE), shows a gradual increase. \ud
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However, there are still many patients who are not informed about the event or about NPE. There is potential for improvement in this area
Conducting a meta-ethnography of qualitative literature: lessons learnt.
No full textBACKGROUND: Qualitative synthesis has become more commonplace in recent years. Meta-ethnography is one of several methods for synthesising qualitative research and is being used increasingly within health care research. However, many aspects of the steps in the process remain ill-defined. DISCUSSION: We utilized the seven stages of the synthesis process to synthesise qualitative research on adherence to tuberculosis treatment. In this paper we discuss the methodological and practical challenges faced; of particular note are the methods used in our synthesis, the additional steps that we found useful in clarifying the process, and the key methodological challenges encountered in implementing the meta-ethnographic approach.The challenges included shaping an appropriate question for the synthesis; identifying relevant studies; assessing the quality of the studies; and synthesising findings across a very large number of primary studies from different contexts and research traditions. We offer suggestions that may assist in undertaking meta-ethnographies in the future. SUMMARY: Meta-ethnography is a useful method for synthesising qualitative research and for developing models that interpret findings across multiple studies. Despite its growing use in health research, further research is needed to address the wide range of methodological and epistemological questions raised by the approach
Bruk av laser og sterke optiske kilder til medisinske og kosmetiske formål
No full textStrålevernet har foretatt spørreundersøkelser og tilsyn med bruk av optisk stråling i medisinsk og\ud
kosmetisk behandling. Undersøkelsen viser at mer enn halvparten av virksomhetene har avvik fra\ud
strålevernforskriften, særlig i forhold til kompetanse og sikkerhet ved bruk av laser.Medical and cosmetic treatment with optical radiation has been assayed by questionnaires and\ud
inspection of different types of clinics. The results indicate lack of competent personnel and/or\ud
insuffi cient laser safety in half of the undertakings investigate
Autism spectrum traits in children and adolescents with obsessive-compulsive disorder (OCD).
No full textOBJECTIVE: Assess the prevalence of autistic traits (AST) in pediatric obsessive-compulsive disorder (OCD) and relate them to OCD co-morbidity and compare them with published normative data. METHODS: Pediatric patients with obsessive-compulsive disorder (n=109) according to the DSM-IV were studied using parent ratings of the Autistic Symptom/Syndrome Questionnaire to assess AST symptoms as a continuous rather than categorical trait. The KSADS, a semi-structured psychiatric interview, was used for the psychiatric diagnostic evaluation. Also, the Children's Yale-Brown Obsessive-Compulsive Scale was used to assess OCD severity and other clinical features. RESULTS: AST was common among our patients. Symptom scores were highest in cases with co-morbid Autistic Spectrum Disorders, but cases with other co-morbidities as tics/Tourette and attention/behavioral disorders also scored higher. All sub-groups, including OCD without these co-morbidities scored higher than the Swedish normative group. Using ANOVA, co-morbid ASD and tics/Tourette (plus a term for gender by tic interaction indicating that girls with tics scored high, otherwise low) and pathological doubt contributed (R2=.41) to the AST-traits, while OCD severity and co-morbid anxiety- and depressive disorders did not. CONCLUSION: AST traits are prevalent in OCD and seem to be intricately associated with the co-morbidities as well as the OCD syndrome itself. The findings might have implication for our nosological understanding of OCD which currently is discussed