Helsebibliotekets Research Archive
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Pasienters erfaringer med døgnenheter ved somatiske sykehus - Institusjonsresultater for nasjonal undersøkelse i 2006
No full textCognitive performance among the elderly and dietary fish intake: the Hordaland Health Study.
No full textBACKGROUND: Increasing evidence suggests that cognitive impairment and dementia in older subjects might be influenced by a diet including seafood. OBJECTIVE: The objective was to examine the cross-sectional relation between intake of different amounts of various seafood (fish and fish products) and cognitive performance. DESIGN: The subjects (n = 2031 subjects; 55% women), aged 70-74 y, were recruited from the general population in Western Norway and underwent cognitive testing. A cognitive test battery included the Kendrick Object Learning Test, Trail Making Test (part A), modified versions of the Digit Symbol Test, Block Design, Mini-Mental State Examination, and Controlled Oral Word Association Test. Poor cognitive performance was defined as a score in the highest decile for the Trail Making Test and in the lowest decile for all other tests. RESULTS: Subjects whose mean daily intake of fish and fish products was >/=10 g/d (n = 1951) had significantly better mean test scores and a lower prevalence of poor cognitive performance than did those whose intake was <10 g/d (n = 80). The associations between total intake of seafood and cognition were strongly dose-dependent; the maximum effect was observed at an intake of approximately 75 g/d. Most cognitive functions were influenced by fish intake. The effect was more pronounced for nonprocessed lean fish and fatty fish. CONCLUSIONS: In the elderly, a diet high in fish and fish products is associated with better cognitive performance in a dose-dependent manner
Stråledose til screena kvinner i Mammografiprogrammet i 2005 og 2006
No full textRadiografane rapporterer inn eksponeringsdata for om lag 50 kvinner i året til Statens strålevern.\ud
På grunnlag av rapporterte data frå alle laboratorium som er med i Mammografi programmet er\ud
det rekna ut gjennomsnittleg absorbert brystkjerteldose til dei screena kvinnene.The radiographers report exposure data for approximately 50 women annually to the Norwegian\ud
Radiation Protection Authority. Based on reported data from all laboratories involved in the\ud
Norwegian Breast Cancer Screening Program average glandular dose (AGD) to the screened\ud
women has been calculated
Upgrading the regulatory framework of the Russian Federation for the safe decommissioning and disposal of radioisotope thermoelectric generators
No full textFormålet med dette samarbeidsprosjektet var å oppgradere eksisterende regelverk i Russland for\ud
sikker dekommisjonering og lagring av RTGs, med fokus på følgende områder: myndighetskrav\ud
og regelverk; trusselvurdering for lisensiering; overvåking og kontroll av strålevern og sikkerhet;\ud
beredskap og fysisk sikring og EIA for transport og lagring av RTG.The overall objective of the collaborative project was to upgrade the existing regulatory\ud
framework of the Russian Federation for the safe decommissioning and disposal of RTGs, with a\ud
focus on the priority areas: regulatory requirements and regulations; threat/hazard assessment\ud
needed in the licensing of the activity and authorisations (permits) for employees of the operating\ud
organisations; supervision over the radiological safety; supervision over emergency preparedness;\ud
physical protection in RTG decommissioning; and environmental impact assessment review for\ud
RTG dismantling, transportation, temporary storage and disposal
Educational outreach to general practitioners reduces children's asthma symptoms: a cluster randomised controlled trial.
No full textABSTRACT: BACKGROUND: Childhood asthma is common in Cape Town, a province of South Africa, but is underdiagnosed by general practitioners. Medications are often prescribed inappropriately, and care is episodic. The objective of this study is to assess the impact of educational outreach to general practitioners on asthma symptoms of children in their practice. METHODS: This is a cluster randomised trial with general practices as the unit of intervention, randomisation, and analysis. The setting is Mitchells Plain (population 300,000), a dormitory town near Cape Town. Solo general practitioners, without nurse support, operate from storefront practices. Caregiver-reported symptom data were collected for 318 eligible children (2 to 17 years) with moderate to severe asthma, who were attending general practitioners in Mitchells Plain. One year post-intervention follow-up data were collected for 271 (85%) of these children in all 43 practices.Practices randomised to intervention (21) received two 30-minute educational outreach visits by a trained pharmacist who left materials describing key interventions to improve asthma care. Intervention and control practices received the national childhood asthma guideline. Asthma severity was measured in a parent-completed survey administered through schools using a symptom frequency and severity scale. We compared intervention and control group children on the change in score from pre-to one-year post-intervention. RESULTS: Symptom scores declined an additional 0.84 points in the intervention vs. control group (on a nine-point scale. p = 0.03). For every 12 children with asthma exposed to a doctor allocated to the intervention, one extra child will have substantially reduced symptoms. CONCLUSION: Educational outreach was accepted by general practitioners and was effective. It could be applied to other health care quality problems in this setting
Education, sense of mastery and mental health: results from a nation wide health monitoring study in Norway.
No full textBACKGROUND: Earlier studies have shown that people with low level of education have increased rates of mental health problems. The aim of the present study is to investigate the association between level of education and psychological distress, and to explore to which extent the association is mediated by sense of mastery, and social variables like social support, negative life events, household income, employment and marital status. METHODS: The data for the study were obtained from the Level of Living Survey conducted by Statistics Norway in 2002. Data on psychological distress and psychosocial variables were gathered by a self-administered questionnaire, whereas socio-demographic data were based on register statistics. Psychological distress was measured by Hopkins Symptom Checklist 25 items. RESULTS: There was a significant association between low level of education and psychological distress in both genders, the association being strongest in women aged 55-67 years. Low level of education was also significantly associated with low sense of mastery, low social support, many negative life events (only in men), low household income and unemployment,. Sense of mastery emerged as a strong mediating variable between level of education and psychological distress, whereas the other variables played a minor role when adjusting for sense of mastery. CONCLUSION: Low sense of mastery seems to account for much of the association between low educational level and psychological distress, and should be an important target in mental health promotion for groups with low level of education
Patient adherence to tuberculosis treatment: a systematic review of qualitative research.
No full textBACKGROUND: Tuberculosis (TB) is a major contributor to the global burden of disease and has received considerable attention in recent years, particularly in low- and middle-income countries where it is closely associated with HIV/AIDS. Poor adherence to treatment is common despite various interventions aimed at improving treatment completion. Lack of a comprehensive and holistic understanding of barriers to and facilitators of, treatment adherence is currently a major obstacle to finding effective solutions. The aim of this systematic review of qualitative studies was to understand the factors considered important by patients, caregivers and health care providers in contributing to TB medication adherence. METHODS AND FINDINGS: We searched 19 electronic databases (1966-February 2005) for qualitative studies on patients', caregivers', or health care providers' perceptions of adherence to preventive or curative TB treatment with the free text terms "Tuberculosis AND (adherence OR compliance OR concordance)". We supplemented our search with citation searches and by consulting experts. For included studies, study quality was assessed using a predetermined checklist and data were extracted independently onto a standard form. We then followed Noblit and Hare's method of meta-ethnography to synthesize the findings, using both reciprocal translation and line-of-argument synthesis. We screened 7,814 citations and selected 44 articles that met the prespecified inclusion criteria. The synthesis offers an overview of qualitative evidence derived from these multiple international studies. We identified eight major themes across the studies: organisation of treatment and care; interpretations of illness and wellness; the financial burden of treatment; knowledge, attitudes, and beliefs about treatment; law and immigration; personal characteristics and adherence behaviour; side effects; and family, community, and household support. Our interpretation of the themes across all studies produced a line-of-argument synthesis describing how four major factors interact to affect adherence to TB treatment: structural factors, including poverty and gender discrimination; the social context; health service factors; and personal factors. The findings of this study are limited by the quality and foci of the included studies. CONCLUSIONS: Adherence to the long course of TB treatment is a complex, dynamic phenomenon with a wide range of factors impacting on treatment-taking behaviour. Patients' adherence to their medication regimens was influenced by the interaction of a number of these factors. The findings of our review could help inform the development of patient-centred interventions and of interventions to address structural barriers to treatment adherence
Klager på økonomisk stønad. En analyse av fylkesmennenes klagesaksbehandling etter kapittel 5 i sosialtjenesteloven for årene 1995-2005.
No full textNORSK SAMMENDRAG: Gruppe for inkluderende velferd ved Høgskolen i Oslo har på oppdrag fra Statens helsetilsyn foretatt en analyse av det materialet fylkesmennene årlig har rapportert til sentrale myndigheter om klagesaksbehandlingen etter sosialtjenesteloven. Rapporten omfatter klagesaker etter kapittel 5, som er saker om økonomisk stønad. Slike saker utgjør årlig omtrent 5000, som er 3/4 av det totale antallet klagesaker etter sosialtjenesteloven. Hovedtyngden av disse sakene omhandler klager på kommunenes utmåling av stønad til livsopphold. Kommunene har stor frihet til å utmåle stønaden, forutsatt at den ligger på et forsvarlig nivå. I 2001 ble det gitt statlige veiledende retningslinjer for utmåling av stønad til livsopphold. \ud
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I denne rapporten er fylkesmennenes behandling av klagesakene om økonomisk stønad gjennomgått. Da materialet spenner over perioden 1995-2005 gir det et bilde av fylkesmennenes behandling av klagesakene både forut for og etter at de statlige veiledende retningslinjene ble gitt. Materialet er vurdert i lys av fylkesmennenes rolle som rettssikkerhetsinstans og inneholder en analyse av antallet behandlede klagesaker, utfallet av behandlingen, begrunnelser for utfall, og behandlingstiden. Det er foretatt sammenligninger mellom fylkesmennenes behandling, og materialet er relatert til antallet mottakere av økonomisk stønad. \ud
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Da klageavgjørelsene har stor betydning for enkeltmenneskers rettssikkerhet og livssituasjon, ønsker Helsetilsynet å arbeide for en god og lik klagebehandling. Helsetilsynet ønsker også gjennom klagesakene å få økt kunnskap om tjenestene og tjenestemottakernes situasjon. Denne rapporten gir kunnskap om klagesaksbehandlingen, og vil være av interesse for personer og instanser som arbeider spesielt med oppgaver etter sosialtjenesteloven. Dessuten vil den være aktuell også for andre som arbeider med rettssikkerhetsspørsmål.SUMMARY IN ENGLISH: The Group for Inclusive Welfare at Oslo University College carried out an analysis of the material that the Offices of the County Governors have reported annually to the central authorities, about complaints pursuant to the Social Services Act. The report deals with complaints pursuant to Chapter 5 in the Act, which are cases about financial support. Each year, there are about 500 of these cases, which represent about three quarters of the total number of complaints pursuant to the Social Services Act. Most of these cases are about financial support provided by the municipalities to enable people to support themselves. The municipalities have a wide margin of freedom when providing this type of financial support, on the condition that the support is at an appropriate level. In 2001 official guidelines for determining the level of financial support to enable people to support themselves were published.\ud
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This report contains an analysis of the way complaints about financial support are dealt with by the Offices of the County Governors. The material covers the period 1995-2005, so provides a picture of the situation both before and after the official guidelines were available. The material has been evaluated in the light of the role of the Offices of the County Governors as a body that has the role of ensuring legal safeguards. It contains an analysis of the number of cases dealt with, the result, the reasons for the result, and the length of time taken to deal with the complaint. The material from the different Offices of the County Governors is compared, and the number of complaints is seen in relation to the number of clients who receive financial report.\ud
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Since the decision taken about a complaint has great importance for the legal safeguards of individuals and their life situation, the Norwegian Board of Health Supervision wishes to ensure that complaints are dealt with in a way that is appropriate and fair. This report provides knowledge about the way in which complaints are dealt with, and is of interest for people who work specifically with tasks related to the Social Services Act, and for the relevant organizations. It is also of interest for other people who work with the issue of legal safeguards
Tilsyn med risikoperspektiv
No full textRisiko kan beskrives fra ulike perspektiver. Det er ikke gitt at den forståelsen av risiko som er vanlig innenfor medisinsk arbeid, uten videre lar seg overføre til tilsyn med medisinske virksomheter. I tilsynsarbeidet må man legge vekt på risiko knyttet til arbeidsprosessene, ikke bare det risikobildet man får ved å se på resultatene. Risiko må også veies opp mot andre verdier som står på spill. Statens helsetilsyn har i prioriteringen av sin tilsynsvirksomhet lagt stor vekt på risiko i form av sannsynlighet for og konsekvens av svikt, i tillegg til avveininger av forhold knyttet til rettssikkerhet og menneskers evne til å ivareta egne interesser
HPV DNA-test for livmorhalskreft
No full textLivmorhalskreft er den tredje vanligste kreftformen blant kvinner på verdensbasis og utgjør ca. 10 prosent av all kreft hos kvinner. Livmorhalskreft er primært et resultat av vedvarende infeksjon med høyrisikotyper av humant papillomavirus (HPV). Over 95 prosent av dem som har livmorhalskreft er HPV- positive. Forstadier til livmorhalskreft oppdages ved analyse av celleprøver (cytologi), men siden HPV er så sterkt assosiert med kreftformen, har testing for HPV vært foreslått til å velge ut pasienter for videre diagnose av mulige forstadier til livmorhalskreft eller kreft i tidlig stadium. Sosial- og helsedirektoratet har derfor bedt Kunnskapssenteret om å vurdere HPV DNA-testers testegenskaper, det vil si hvilken evne de har til å skille godt mellom friske og syke. Notatet belyser HPV DNA-testers diagnostiske egenskaper sammenliknet med cytologi til å diagnostisere forstadier til livmorhalskreft.\ud
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Metode\ud
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Det ble søkt i HTA- og Cochrane-databasene etter systematiske oversikter som har vurdert HPV DNA-testing ved masseundersøkelser (screening) for livmorhalskreft, og resultater fra disse oversiktene er oppsummert.\ud
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Hovedfunn\ud
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HPV DNA-testing er mer sensitiv, men mindre spesifikk enn cytologi både ved primær- og sekundærscreening