Heimsfaraldur inflúensu : ekki spurning hvort heldur hvenær

Hægt er að lesa greinina í heild sinni með því að smella á hlekkinn View/OpenInflúensa er skráningarskyldur smitsjúkdómur skv. reglugerð og ber að tilkynna til sóttvarnalæknis fjölda tilfella mánaðarlega á 1. og 2. skeiði milli heimssótta. Þegar komið er á viðvörunarskeið, 3. stig, verður sjúkdómur, sem orsakast af nýjum stofni veirunnar, tilkynningaskyldur og ber læknum að tilkynna ný tilfelli með persónugreinanlegum upplýsingum til sóttvarnalæknis án tafar

Lyfjaiðnaðurinn og þróunarlönd : mistök og möguleikar

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn Skoða/Opna(view/open)Lyfjafyrirtæki hafa hagsmuna að gæta í þróunarlöndum og íbúar þar hafa væntingar til lyfjafyrirtækja. Aðgangur að lyfjum og heilbrigðistækni sem henta aðstæðum er ein mikilvægasta forsenda þess að stemma stigu við aðkallandi heilsufarslegum vandamálum þróunarríkja. Samskipti lyfjaiðnaðarins við þróunarlönd eru margvísleg og á ýmsum sviðum. Hér er gefið yfirlit um þessi samskipti sem fela í sér margvíslega möguleika til uppbyggingar í auknu samstarfi fyrirtækja og fagmanna á sviði heilbrigðisþjónustu í fátækum ríkjum

Hreinar hendur hindra smit : handhreinsun í heilbrigðisþjónustu

Neðst á síðunni er að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenSamtökin World Alliance for Patient Safety starfa á vegum Alþjóðaheilbrigðismálastofnunarinnar (WHO) og er breski landlæknirinn, sir Liam Donaldson, formaður þeirra. Samtökin stýra fjölþjóðlegu verkefni sem lýtur að því að efla öryggi í heilbrigðisþjónustunni, m.a. með því að vinna gegn sýkingum, og hefur verkefnið verið kallað á íslensku Hreinlæti og örugg heilbrigðisþjónusta haldast í hendur (Clean care is safer care). Sir Liam heimsótti Ísland fyrir skömmu til kynningar á verkefninu og við það tækifæri undirritaði Siv Friðleifsdóttir, heilbrigðis- og tryggingamálaráðherra, samkomulag um að Ísland taki þátt í verkefninu og yfirlýsingu um að Ísland takist á hendur skuldbindingar til að vinna að fækkun sýkinga innan heilbrigðisþjónustunnar. Um 40 aðrar þjóðir hafa undirritað sams konar yfirlýsingu

Selvmord og sosial integrasjon i vår tid. En kvantitativ studie av selvmordstilbøyelighet i Norge

Selvmordsraten er fremdeles høy i Norge, selv med velferdsstat og gode støtteordninger. I denne oppgaven undersøkes selvmord i forhold til sosial integrasjon i Norge i dag, ved hjelp av aggregerte data på kommunenivå og tidligere forskning. I tillegg vil Durkheims bidrag fra tidlig 1900-tall være til nytte for å undersøke selvmord mellom kommuner i forhold til sosial integrasjon og modernitetsbevegelsen. Derfor vil fire kategorier for sosial integrasjon studeres gjennom familie, religion, økonomi og arbeidsliv. Videre vil jeg også rette søkelyset mot kjønn, da menn leder selvmordsstatistikken betydelig. Min problemstilling er følgende: “Hvilken betydning har sosial integrasjon for selvmordstilbøyeligheten i vår tid?” For å svare på problemstillingen presenteres tre forskningsspørsmål: Forskningsspørsmålene blir dermed som følger: 1. På hvilken måte har faktorene familie, religion, økonomi og arbeidsliv betydning for selvmordstilbøyelighet? 2. Ser vi kjønnsforskjeller når det gjelder forholdet mellom sosial integrasjon og selvmordstilbøyelighet? 3. Hvordan kan Durkheims teorier om selvmord bidra til å forklare dette fenomenet i dag? Materialet i studien ble samlet inn fra Statistisk sentralbyrå og folkehelseinstituttet, som tilsvarer aggregerte data på kommunenivå. Datamaterialet ble analysert gjennom SPSS, både deskriptiv statistikk og univariat regresjonsanalyser. De statistiske resultatene viser at den sosiale integrasjonen har endret seg, blant annet hvor familieinstitusjonen har endret form der ekteskapet påvirker i større grad fremfor barn i husholdningene, når det gjelder selvmordstilbøyelighet. Videre viser funn at det økonomiske aspektet spiller en større rolle i forhold til arbeidsliv og religion har en moderat effekt. Durkheims begrep om anomi og egoisme kan på flere måter vises i det moderne samfunnet, likevel har Durkheim flere påstander som ikke stemmer overens med våre funn når det gjelder sosial integrasjon

The prevalence of sicca symptoms in Iceland

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjectives: Sjoegren' syndrome is one of the most common inflammatory systemic rheumatic disorders. The syndrome is characterised by tiredness, pain problems and mucosal dryness. The goal of this study is to elucidate the prevalence of sicca symptoms in the Icelandic population and to calculate the preliminary prevalence value for Sjoegren' syndrome in Iceland. Material and methods: Random sample was retrieved from two age groups; 40-49 and 70-75 years Icelandic inhabitants of Reykjavík and Akureyri. Questionnaire with 14 questions of the most common symptoms of Sjoegren' syndrome was mailed to those sampled. A small sample was evaluated by Schirmer-I test, tear film break up time (BUT) and Rose Bengal score for keratoconjunctivitis sicca (KCS) and unstimulated salivary flow rate was performed. Results: The questionnaire was sent to 621 subjects, 300 male and 321 female. The response rate was 74%. Of those 20.3% had subjective symptoms of dry eyes and 12.0% of dry mouth according to the six questions used in the European classification criteria (EEC). The prevalence of both was higher in females (p<0.05). Of the 23 subjects who reported sicca symptoms, fatigue and pain problems; 26% had abnormal Shirmer-I test, 13% had abnormal BUT and 39% had abnormal salivary flow rate, two of those individuals fulfilled the EEC criteria for Sjoegren' syndrome (0.2%; 0-0.5%, 95% CI). None in the age and sex matched control group fulfilled the EEC criteria. Conclusion: The subjective symptoms of dry eye and dry mouth are common in Iceland, as are the three major symptoms of Sjoegren' syndrome. Standardised objective diagnostic criteria is necessary when the diagnosis of the syndrome is made.Inngangur: Heilkenni Sjögrens er samkvæmt erlendum rannsóknum einn af algengari fjölkerfasjúkdómum. Sjúkdómurinn einkennist af dagsþreytu, stoðkerfisverkjum og þurrkeinkennum frá slímhúðum. Algengi augn- og munnþurrks er ekki þekkt hér á landi né algengi heilkennis Sjögrens. Markmið rannsóknarinnar var að kanna algengi helstu einkenna heilkennis Sjögrens og finna líklegar algengistölur fyrir sjúkdóminn hérlendis. Efniviður og aðferðir: Handahófskennt úrtak var fengið úr tveimur aldurshópum; 40-49 ára og 70-75 ára Íslendingum, búsettum á höfuðborgarsvæðinu og á Akureyri. Notast var við spurningakver með 14 spurningum um algengustu einkenni heilkennis Sjögrens. Völdu úrtaki samkvæmt svarmynstri var boðið til skoðunar með Schirmer-I prófi, mælingu á tárafilmurofstíma og Rose Bengal litun fyrir glæru- og tárabólgu. Ennfremur var gerð munnvatnsrennslismæling í hvíld. Niðurstöður: Í úrtakinu var 621 einstaklingur, 300 karlar og 321 kona. Skilatíðni spurningakversins var 74%. Alls höfðu 20% þátttakenda einhver einkenni augnþurrks og 12% höfðu munnþurrk, hvort tveggja var marktækt algengara hjá konum (p<0,05). Tuttugu og þrír einstaklingar (3%) kvörtuðu um öll þrjú aðaleinkenni heilkennis Sjögrens og var þeim boðið til skoðunar. Af þeim mældust sex (26%) með óeðlilega táraframleiðslu og níu (39%) með óeðlilega lítið munnvatnsrennsli. Tvær konur uppfylltu greiningarskilmerkin um heilkenni Sjögrens eða 0,2% úrtaksins (0-0,5%; 95% öryggisbil). Í einkennalausa samanburðarhópnum höfðu sín hvor 17% hlutlæg einkenni augn- eða munnþurrks og ein kona hafði hvort tveggja. Ályktun: Niðurstöður sýna að einkenni augn- og munnþurrks eru algeng hér á landi, sem og þrjú aðaleinkenni heilkennis Sjögrens. Því er nauðsynlegt að styðjast við ströng greiningarskilmerki þegar staðfesta skal sjúkdómsgreininguna heilkenni Sjögrens. Til að hægt sé að fullyrða um algengi heilkennis Sjögrens á Íslandi verður þó að gera ítarlegri ónæmisfræðilegar rannsóknir með stærri skoðunarhóp

Trends in parent- and teacher-rated emotional, conduct and ADHD problems and their impact in prepubertal children in Great Britain: 1999-2008

Background Evidence from Western countries indicates marked increases in diagnosis and treatment of childhood psychiatric disorders in recent years. These could reflect changes in prevalence of mental health problems, changes in their impact or increased clinical recognition and help‐seeking. Epidemiological cross‐cohort comparisons are required to test possible changes in prevalence, but are lacking for pre‐adolescent children in Great Britain. Methods Parent and teacher Strength and Difficulties Questionnaire (SDQ) ratings were used to compare rates of emotional, conduct and hyperactivity problems in 7‐year‐old children across three nationally representative British samples assessed in 1999 (n = 1033), 2004 (n = 648) and 2008 (n = 13 857). The SDQ impact supplement was used to assess associated distress, social, and educational impairment. Stratified analyses examined trends by gender and socio‐economic group. Results There was a decline in mean problem scores and a fall in the percentages scoring in the ‘abnormal’ range for all symptom types across the period of study. This decline was observed for all demographic groups, for parent and teacher reports, and was more marked for boys than girls. Both parent‐ and teacher‐rated impact scores differed across the three cohorts for boys. Teacher‐rated impact scores differed across cohorts for girls. Conclusions The first decade of the 21st Century saw a reduction in perceived levels of emotional and behaviour problems in pre‐adolescent children in Great Britain. The threshold at which mental health problems have an impact on children's distress and classroom learning has changed over time. Continued monitoring of child mental health remains a priority

Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)

BackgroundPreterm infants are especially vulnerable to pain. The intensive treatment often necessary for their survival unfortunately includes many painful interventions and procedures. Untreated pain can lead to both short- and long-term negative effects. The challenge of accurately detecting pain has been cited as a major reason for lack of pain management in these non-verbal patients. The Premature Infant Pain Profile (PIPP) is one of the most extensively validated measures for assessing procedural pain in premature infants. A revised version, PIPP-R, was recently published and is reported to be more user-friendly and precise than the original version. The aims of the study were to develop translated versions of the PIPP-R in Finnish, Icelandic, Norwegian, and Swedish languages, and to establish their content validity through a cultural adaptation process using cognitive interviews.MethodsPIPP-R was translated using the recommendations from the International Society for Pharmacoeconomics and Outcomes Research and enhanced with cognitive interviews. The respondent nurse was given a copy of the translated, national version of the measure and used this together with a text describing the infant in the film to assess the pain of an infant in a short film. During the assessment the nurse was asked to verbalize her thought process (thinking aloud) and upon completion the interviewer administered probing questions (verbal probing) from a structured interview guide. The interviews were recorded, transcribed, and analyzed using a structured matrix approach.ResultsThe systematic approach resulted in translated and culturally adapted versions of PIPP-R in the Finnish, Icelandic, Norwegian and Swedish languages. During the cultural adaptation process several problems were discovered regarding how the respondent understood and utilized the measure. The problems were either measure problems or other problems. Measure problems were solved by a change in the translated versions of the measure, while for other problems different solutions such as education or training were suggested.ConclusionsThis study have resulted in translations of the PIPP-R that have content validity, high degree of clinical utility and displayed beginning equivalence with each other and the original version of the measure.</p

Modular and coordinated expression of immune system regulatory and signaling components in the developing and adult nervous system

During development, the nervous system (NS) is assembled and sculpted through a concerted series of neurodevelopmental events orchestrated by a complex genetic programme. While neural-specific gene expression plays a critical part in this process, in recent years, a number of immune-related signaling and regulatory components have also been shown to play key physiological roles in the developing and adult NS. While the involvement of individual immune-related signaling components in neural functions may reflect their ubiquitous character, it may also reflect a much wider, as yet undescribed, genetic network of immune–related molecules acting as an intrinsic component of the neural-specific regulatory machinery that ultimately shapes the NS. In order to gain insights into the scale and wider functional organization of immune-related genetic networks in the NS, we examined the large scale pattern of expression of these genes in the brain. Our results show a highly significant correlated expression and transcriptional clustering among immune-related genes in the developing and adult brain, and this correlation was the highest in the brain when compared to muscle, liver, kidney and endothelial cells. We experimentally tested the regulatory clustering of immune system (IS) genes by using microarray expression profiling in cultures of dissociated neurons stimulated with the pro-inflammatory cytokine TNF-alpha, and found a highly significant enrichment of immune system-related genes among the resulting differentially expressed genes. Our findings strongly suggest a coherent recruitment of entire immune-related genetic regulatory modules by the neural-specific genetic programme that shapes the NS

Cultural adaptation and harmonization of four Nordic translations of the revised Premature Infant Pain Profile (PIPP-R)

Publisher's version (útgefin grein)Background: Preterm infants are especially vulnerable to pain. The intensive treatment often necessary for their survival unfortunately includes many painful interventions and procedures. Untreated pain can lead to both shortand long-term negative effects. The challenge of accurately detecting pain has been cited as a major reason for lack of pain management in these non-verbal patients. The Premature Infant Pain Profile (PIPP) is one of the most extensively validated measures for assessing procedural pain in premature infants. A revised version, PIPP-R, was recently published and is reported to be more user-friendly and precise than the original version. The aims of the study were to develop translated versions of the PIPP-R in Finnish, Icelandic, Norwegian, and Swedish languages, and to establish their content validity through a cultural adaptation process using cognitive interviews. Methods: PIPP-R was translated using the recommendations from the International Society for Pharmacoeconomics and Outcomes Research and enhanced with cognitive interviews. The respondent nurse was given a copy of the translated, national version of the measure and used this together with a text describing the infant in the film to assess the pain of an infant in a short film. During the assessment the nurse was asked to verbalize her thought process (thinking aloud) and upon completion the interviewer administered probing questions (verbal probing) from a structured interview guide. The interviews were recorded, transcribed, and analyzed using a structured matrix approach. Results: The systematic approach resulted in translated and culturally adapted versions of PIPP-R in the Finnish, Icelandic, Norwegian and Swedish languages. During the cultural adaptation process several problems were discovered regarding how the respondent understood and utilized the measure. The problems were either measure problems or other problems. Measure problems were solved by a change in the translated versions of the measure, while for other problems different solutions such as education or training were suggested. Conclusions: This study have resulted in translations of the PIPP-R that have content validity, high degree of clinical utility and displayed beginning equivalence with each other and the original version of the measure.Not applicable.Peer Reviewe

Zika virus causes persistent infection in porcine conceptuses and may impair health in offspring

Outcomes of Zika virus (ZIKV) infection in pregnant women vary from the birth of asymptomatic offspring to abnormal development and severe brain lesions in fetuses and infants. There are concerns that offspring affected in utero and born without apparent symptoms may develop mental illnesses. Therefore, animal models are important to test interventions against in utero infection and health sequelae in symptomatic and likely more widespread asymptomatic offspring. To partially reproduce in utero infection in humans, we directly inoculated selected porcine conceptuses with ZIKV. Inoculation resulted in rapid trans-fetal infections, persistent infection in conceptuses, molecular pathology in fetal brains, fetal antibody and type I interferon responses. Offspring infected in utero showed ZIKV in their fetal membranes collected after birth. Some in utero affected piglets were small, depressed, had undersized brains, and showed seizures. Some piglets showed potentially increased activity. Our data suggest that porcine model of persistent in utero ZIKV infection has a strong potential for translational research and can be used to test therapeutic interventions in vivo