Helsebibliotekets Research Archive
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AIDS-related primary central nervous system lymphoma: a Norwegian national survey 1989-2003.
No full textBACKGROUND: Primary central nervous system lymphoma (PCNSL) is a frequent complication in acquired immunodeficiency syndrome (AIDS). The objective of this survey was to investigate incidence, clinical features, radiological findings, histologic diagnosis, treatment and outcome for all patients with histologically verified AIDS-related PCNSL diagnosed in Norway in 1989-2003. METHODS: We identified the patients by chart review of all cases recorded as PCNSL in The Norwegian Cancer Registry (by law recording all cases of cancer in Norway) and all cases recorded as AIDS-related PCNSL in the autopsy registry at a hospital having 67% autopsy rate and treating 59% of AIDS patients in Norway, from 1989 to 2003. Histologic material and radiological images were reviewed. We used person-time techniques to calculate incidence rates of PCNSL among AIDS patients based on recordings on AIDS at the Norwegian Surveillance System for Communicable Diseases (by law recording all cases of AIDS in Norway). RESULTS: Twenty-nine patients had histologically confirmed, newly diagnosed AIDS-related PCNSL in Norway from 1989-2003. Only 2 patients had this diagnosis established while alive. AIDS patients had 5.5% lifetime risk of PCNSL. Their absolute incidence rate of PCNSL per 100 person-years was 1.7 (95%CI: 1.1-2.4) and decreased during the consecutive 5-year periods from 3.6, to 2.5, and to 0.4 (p < 0.001). Median survival from initial symptom of PCNSL was 2.3 months, but one patient was still alive 4 years after completed radiotherapy. CONCLUSION: This is the first national survey to confirm decreasing incidence of AIDS-related PCNSL. Despite dismal survival in most patients, the possibility of long term survival should prompt more aggressive diagnostics in suspected PCNSL
Nødvendig tvang? - Ein gjennomgang av fylkesmennenes data om bruk av tvang og makt overfor mennesker med psykisk utviklingshemming for perioden 2000-2007
No full textSUMMARY IN ENGLISH: 4A, decisions, dispensations, local supervision, and coercion and restraint are concepts that are often used by professionals who provide or assess services for people with mental disabilities. This report illuminates these concepts and describes the extent and development of the use of measures of coercion and restraint during the period 2000-2007, with a focus on the differences between the counties.\ud
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In 1999, regulations were introduced to limit and manage the use of coercion and restraint for people with mental disabilities. At the same time, the Offices of the County Governors were allocated the task of registering data on the practice of the regulations, and at fi rst to report to the Ministry, later to the Norwegian Board of Health Supervision. A presentation and analysis of the data is given in this report. The data show that there has been an increase in the number of:\ud
decisions about measures to prevent injury in emergency situations \ud
decisions about planned measures to prevent injury in repeated emergency situations \ud
measures to meet clients’ basic needs \ud
dispensations from the requirement regarding the qualifi cations of staff.\ud
What is the significance of these increases? Has registration of the use of coercion and restraint increased, or has use of coercion and restraint increased? Are coercion and restraint used appropriately, or are they used to compensate for lack of competence? The data can be interpreted in different ways.\ud
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There are large differences between the counties. This may reflect differences in how often coercion and restraint are used. But inadequate and non-uniform registration make interpretation of the data difficult. The report presents no conclusions about what is correct practice. It is a source of information to stimulate debate about the registration system for data on the use of coercion and restraint. For the Norwegian Board of Health Supervisio
Floating nuclear power plants and associated technologies in the northern areas
No full textThis report briefly presents the history and development of floating nuclear power plants\ud
(FNPP), introducing and discussing potential future implications associated with FNPP’s in\ud
the northern areas
Kreftpasienters erfaringer med Akershus universitetssykehus. Resultater fra en pilotundersøkelse
No full textNasjonalt kunnskapssenter for helsetjenesten gjennomførte våren 2007 en spørreundersøkelse blant kreftpasienter ved Akershus universitetssykehus. Undersøkelsen var en pilotundersøkelse for den første nasjonale brukererfaringsundersøkelsen blant kreftpasienter i Norge, som er planlagt gjennomført høsten 2008. Undersøkelsen omfatter både poliklinikker/dagavdelinger og sengeposter. Vi presenterer i dette notatet resultatene fra pilotundersøkelsen.\ud
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Faktoranalyser viser at det er seks hovedområder for pasienterfaringer ved poliklinikker/dagavdelinger:\ud
- pleiepersonalet\ud
- legene\ud
- informasjon om smerter og bivirkninger\ud
- informasjon om sykdom og behandling\ud
- forhold som gjelder pårørende og privatliv\ud
- faglig dyktighet og kontinuitet\ud
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og fem hovedområder ved sengeposter:\ud
- pleiepersonalet\ud
- legene\ud
- informasjon\ud
- kommunikasjon\ud
- pårørende\ud
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Det er noe variasjon i resultatene på de ulike hovedområdene. Vi har beregnet skårer på de ulike hovedområdene på en skala fra 0 til 100 der 100 er best mulige resultat. Poliklinikkenes/dagavdelingenes skåre på hovedområdene varierer fra 56 (informasjon om smerter og bivirkninger) til 78 (pleiepersonalet). Sengepostenes skåre varierer fra 60 (informasjon) til 77 (forhold til pårørende).\ud
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De enkeltspørsmålene som pasientene ved poliklinikker/dagavdelinger gir best tilbakemeldinger på, omfatter pleiepersonalets omsorg, respekt og faglig dyktighet. Spørsmålet "Ble du møtt med høflighet og respekt av helsepersonalet?" er det som har fått størst andel svar i de to mest positive svarkategoriene (95 prosent). Blant spørsmålene som pasientene ved poliklinikker/dagavdelinger gir dårligst tilbakemeldinger på, finner vi spørsmål om informasjon, om virkninger og bivirkninger av behandling, organisatoriske forhold og informasjon om smerter og smertelindring. Spørsmålet "Fikk du tilstrekkelig informasjon om hvilke smerter du kunne forvente?" er det som har fått størst andel av de to mest negative svarkategoriene (37 prosent)".\ud
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Spørsmål som pasientene ved sengeposter gir gode tilbakemeldinger på, er legenes faglige dyktighet, om legene hadde oversikt over behandlingen, pleiepersonalets omsorg, helsepersonellets relasjon til pårørende, samt høflighet og respekt. De spørsmålene hvor størst andel har svart en av de to mest positive svarkategoriene (89 prosent) er "Ble du møtt med høflighet og respekt av helsepersonalet?", "Har du opplevd at helsepersonalet har holdt tilbake informasjon om din tilstand?" og "Mener du at du på noen måte har blitt feilbehandlet (etter det du selv kan bedømme)?" Blant spørsmålene som pasientene ved sengeposter gir dårligst tilbakemeldinger på, finner vi spørsmål som omhandler informasjon om smerter og bivirkninger, organisatoriske forhold og fysiske omgivelser. De spørsmålene hvor størst andel har svart en av de to mest negative svarkategoriene (hhv 36 og 35 prosent) er "Ble du tatt med på råd i spørsmål som handlet om din behandling?" og "Fikk du tilstrekkelig informasjon om hvilke smerter du kunne forvente?".\ud
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Det er en del variasjon i svarene på enkeltspørsmål som angår både poliklinikker/ dagavdelinger og sengeposter. Det spørsmålet hvor flest personer svarer "Ikke i det hele tatt" eller "I liten grad" (57 prosent), er "Fikk du informasjon om andre støtte tilbud på sykehuset som sosionom, prestetjeneste eller lignende?" Mer enn 40 prosent har svart "Ikke i det hele tatt" eller "I liten grad" på spørsmål om sykehuset samarbeider godt med hjemmetjenesten eller andre kommunale tilbud, informasjon om fremtidige plager og hva du selv kan gjøre ved forverringer. Det spørsmålet hvor flest svarer "I stor grad" eller "I svært stor grad" (69 prosent), er "Har du fått tilfredsstillende svar fra sykehuset på dine spørsmål?" Nesten like stor andel (68 prosent) svarer at de i stor eller svært stor grad er fornøyd med den skriftlige informasjonen de har fått. 60 prosent svarer at kontaktpersonene ved sykehuset i stor eller svært stor grad er lette å få tak i
Comparison of the Agilent, ROMA/NimbleGen and Illumina platforms for classification of copy number alterations in human breast tumors.
No full textBACKGROUND: Microarray Comparative Genomic Hybridization (array CGH) provides a means to examine DNA copy number aberrations. Various platforms, brands and underlying technologies are available, facing the user with many choices regarding platform sensitivity and number, localization, and density distribution of probes. RESULTS: We evaluate three different platforms presenting different nature and arrangement of the probes: The Agilent Human Genome CGH Microarray 44 k, the ROMA/NimbleGen Representational Oligonucleotide Microarray 82 k, and the Illumina Human-1 Genotyping 109 k BeadChip, with Agilent being gene oriented, ROMA/NimbleGen being genome oriented, and Illumina being genotyping oriented. We investigated copy number changes in 20 human breast tumor samples representing different gene expression subclasses, using a suite of graphical and statistical methods designed to work across platforms. Despite substantial differences in the composition and spatial distribution of probes, the comparison revealed high overall concordance. Notably however, some short amplifications and deletions of potential biological importance were not detected by all platforms. Both correlation and cluster analysis indicate a somewhat higher similarity between ROMA/NimbleGen and Illumina than between Agilent and the other two platforms. The programs developed for the analysis are available from http://www.ifi.uio.no/bioinf/Projects/. CONCLUSION: We conclude that platforms based on different technology principles reveal similar aberration patterns, although we observed some unique amplification or deletion peaks at various locations, only detected by one of the platforms. The correct platform choice for a particular study is dependent on whether the appointed research intention is gene, genome, or genotype oriented
Regulatory improvements related to the radiation and environmental protection during remediation of the nuclear legacy sites in North West Russia
No full textStrålevernsreguleringer, opprydning av kontaminerte områder, brukt kjernebrensel, radioaktivt\ud
avfall, kontrollert og beskyttelses soner, radiologisk overvåking, strålevern av personale,\ud
effektive stråledoser, beredskap.This report describes work carried in 2007 under the NRPA – Federal Medical-Biological\ud
Agency regulatory support program. It focuses on development of improved regulatory\ud
documents and supervision of remediation activities due to be carried out at Andreeva Bay and\ud
Gremikha in Northwest Russia. The work program for 2008 is also introduced
Personality characteristics determine health-related quality of life as an outcome indicator of geriatric inpatient rehabilitation
No full textBackground. The aim of the present study was to investigate the relationships between personality and quality of life during the course of geriatric rehabilitation, against the background of Cloninger's biosocial theory of personality. Methods. All consecutive patients of a geriatric rehabilitation clinic during one year were evaluated at admission and discharge (N=687) by means of the ‘‘Vienna List’’ (a newly developed questionnaire for the assessment of quality of life in patients with severe dementia), and two variants of the Temperament and Character Inventory. Results. Self-directedness showed the most general and highest impact on quality of life and successful rehabilitation. Conclusions. It is probable in old and very old individuals who are on their highest level of maturity that the character represents the most important regulatory system in the encounter with challenges of daily life, which necessitates rehabilitation
Prognostication after out-of-hospital cardiac arrest, a clinical survey.
No full textABSTRACT: BACKGROUND: Numerous parameters and tests have been proposed for outcome prediction in comatose out-of-hospital cardiac arrest survivors. We conducted a survey of clinical practice of prognostication after therapeutic hypothermia (TH) became common practice in Norway. METHODS: By telephone, we interviewed the consultants who were in charge of the 25 ICUs admitting cardiac patients using 6 structured questions regarding timing, tests used and medical specialties involved in prognostication, as well as the clinical importance of the different parameters used and the application of TH in these patients. RESULTS: Prognostication was conducted within 24-48 hours in the majority (72%) of the participating ICUs.The most commonly applied parameters and tests were a clinical neurological examination (100%), prehospital data (76%), CCT (56%) and EEG (52%). The parameters and tests considered to be of greatest importance for accurate prognostication were prehospital data (56%), neurological examination (52%), and EEG (20%).In 76% of the ICUs, a multidisciplinary approach to prognostication was applied, but only one ICU used a standardised protocol. Therapeutic hypothermia was in routine use in 80% of the surveyed ICUs. CONCLUSION: Despite the routine use of TH, outcome prediction was performed early and was mainly based on prehospital information, neurological examination and CCT and EEG evaluation. Somatosensory evoked potentials appear to be underused and underrated, while the importance of prehospital data, CCT and EEG to appear to be overrated as methods for making accurate predictions.More evidence-based protocols for prognostication in cardiac arrest survivors, as well as additional studies on the effect of TH on known prognostic parameters are needed
The Nordic back pain subpopulation program: predicting outcome among chiropractic patients in Finland.
No full textABSTRACT: BACKGROUND: In a previous Swedish study it was shown that it is possible to predict which chiropractic patients with persistent LBP will not report definite improvement early in the course of treatment, namely those with LBP for altogether at least 30 days in the past year, who had leg pain, and who did not report definite general improvement by the second treatment. The objectives of this study were to investigate if the predictive value of this set of variables could be reproduced among chiropractic patients in Finland, and if the model could be improved by adding some new potential predictor variables. METHODS: The study was a multi-centre prospective outcome study with internal control groups, carried out in private chiropractic practices in Finland. Chiropractors collected data at the 1st, 2nd and 4th visits using standardized questionnaires on new patients with LBP and/or radiating leg pain. Status at base-line was identified in relation to pain and disability, at the 2nd visit in relation to disability, and "definitely better" at the 4th visit in relation to a global assessment. The Swedish questionnaire was used including three new questions on general health, pain in other parts of the spine, and body mass index. RESULTS: The Swedish model was reproduced in this study sample. An alternative model including leg pain (yes/no), improvement at 2nd visit (yes/no) and BMI (underweight/normal/overweight or obese) was also identified with similar predictive values. Common throughout the testing of various models was that improvement at the 2nd visit had an odds ratio of approximately 5. Additional analyses revealed a dose-response in that 84% of those patients who fulfilled none of these (bad) criteria were classified as "definitely better" at the 4th visit, vs. 75%, 60% and 34% of those who fulfilled 1, 2 or all 3 of the criteria, respectively. CONCLUSION: When treating patients with LBP, at the first visits, the treatment strategy should be different for overweight/obese patients with leg pain as it should be for all patients who fail to improve by the 2nd visit. The number of predictors is also important