Accessible health care: What is the future?

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkin

The short-and long term effect of multidisciplinary obesity treatment on body mass index and mental health

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnInngangur: Markmið rannsóknarinnar var að meta skammtíma- og langtímaárangur fjögurra vikna þverfaglegrar hópmeðferðar vegna offitu með eftirfylgd ásamt því að bera saman árangur þeirra sem fóru í hjáveituað- gerð og hinna sem ekki fóru í slíka aðgerð. Efniviður og aðferðir: Þátttakendur voru 100 sjúklingar sem frá árinu 2007 höfðu lokið fjögurra vikna offitumeðferð með allt að tveggja ára eftirfylgd á Fjórðungssjúkrahúsinu í Neskaupstað (FSN). Að meðferð lokinni fóru 28 sjúklingar í hjáveituaðgerð. Þyngd, þunglyndis- og kvíðaeinkenni auk lífsgæða voru mæld hjá þátttakendum fyrir og eftir meðferð, og síðan aftur með póstsendum spurningalistum í þversniðsgagnasöfnun sumarið 2012. Niðurstöður: Þátttakendur léttust marktækt auk þess sem andleg líðan og lífsgæði bötnuðu eftir offitumeðferð (miðgildi 1,85, líkamsþyngdarstuðull, LÞS stig), og hélst árangur til lengri tíma. Þremur árum eftir að meðferð lauk var þyngdartap ennþá marktækt hjá þeim sem ekki fóru í hjáveituaðgerð (miðgildi 2,13 LÞS stig), en breytingar á andlegri líðan og lífsgæðum voru hins vegar ekki lengur til staðar. Þeir sem fóru í hjáveituaðgerð léttust meira (miðgildi 13,12 LÞS stig) og náðu varanlegri árangri í lífsgæðum og þunglyndiseinkennum. Ályktun: Niðurstöður sýna að þverfagleg offitumeðferð er árangursrík leið til að draga úr offitu og bæta andlega líðan og lífsgæði til skamms tíma. Þegar veitt er eftirfylgdarmeðferð viðhelst árangurinn sem náðst hefur við að draga úr offitu allt að þremur árum eftir meðferð hjá öllum þátttakendum. Hjáveituhópurinn náði meiri árangri í að breyta holdafari sínu og sýndi varanlegri bata á þunglyndi og lífsgæðum. Þessar niðurstöður undirstrika mikilvægi þess að veita langtímameðferð til að stuðla að við- varandi árangri í glímunni við offitu.Introduction: The aim of this treatment study was to evaluate both short- and long-term effects of a multidisciplinary obesity treatment. Long-term outcomes of patients receiving gastric bypass surgery in addition to behavioral obesity treatment were compared with those who did not undergo surgery. Material and methods: The participants were 100 patients undergoing a four week inpatient obesity treatment at the Hospital in Neskaupsstaður (Fjórðungsjúkrahúsið í Neskaupstað (FSN). After treatment was completed, 28 of these patients underwent further treatment, receiving gastric bypass surgery. All patients were followed for two years after completing the four week treatment. Body mass index (BMI), quality of life and symptoms of depression and anxiety were measured for all participants before and after treatment, and again using mailed questionnaires in a cross-sectional data collection in the summer of 2012. Results: Participants achieved statistically significant weight loss (median 1,85 BMI points), improved their quality of life and mental health after four week obesity treatment, and long term results remained significant. Three years after the conclusion of treatment, statistically significant weight loss was still present for patients that had not undergone gastric bypass surgery (median 2.13 BMI points), but improvements in mental health and quality of life were no longer present among subjects who did not undergo surgery. Patients who underwent gastric bypass surgery achieved greater weight loss (median 13.12 BMI points) and longer lasting improvements in mental health and quality of life. Conclusion: Results show that the multidisciplinary obesity treatment is effective in reducing obesity and improving mental health and quality of life in the short term. With follow-up treatment, the weight loss is maintained for up to three years after treatment for all participants. The bypass surgery group lost more weight and showed more permanent improvements in mental health and quality of life. These results underline the necessity of providing long-term treatment in maintaining improvements when treating obesit

Treatment as Prevention for Hepatitis C (TraP Hep C) - a nationwide elimination programme in Iceland using direct-acting antiviral agents

Publisher's version (útgefin grein)A nationwide programme for the treatment of all patients infected with hepatitis C virus (HCV) was launched in Iceland in January 2016. By providing universal access to direct‐acting antiviral agents to the entire patient population, the two key aims of the project were to (i) offer a cure to patients and thus reduce the long‐term sequelae of chronic hepatitis C, and (ii) to reduce domestic incidence of HCV in the population by 80% prior to the WHO goal of HCV elimination by the year 2030. An important part of the programme is that vast majority of cases will be treated within 36 months from the launch of the project, during 2016–2018. Emphasis is placed on early case finding and treatment of patients at high risk for transmitting HCV, that is people who inject drugs (PWID), as well as patients with advanced liver disease. In addition to treatment scale‐up, the project also entails intensification of harm reduction efforts, improved access to diagnostic tests, as well as educational campaigns to curtail spread, facilitate early detection and improve linkage to care. With these efforts, Iceland is anticipated to achieve the WHO hepatitis C elimination goals well before 2030. This article describes the background and organization of this project. Clinical trial number: NCT02647879.Sigurdur Olafsson: Speaker's fee from Merck. Magnus Gottfredsson: Speaker's fee from Astellas and Gilead. MH and the Burnet Institute receive investigator‐initiated research funding from Gilead Sciences, AbbVie and BMS.Peer Reviewe

Binge Eating Scale: Analysis of the scale´s validity and clinical use

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadTilgangur rannsóknarinnar var að meta próffræðilega eiginleika Lotuofátskvarðans (e. Binge Eating Scale) og tengsl hans við aðrar klínískar breytur (depurðareinkenni og lotugræðgi). Lotuofátskvarðinn er 16 atriða sjálfsmatslisti ætlað að meta vanda tengdan átköstum og hefur verið notaður til að skima fyrir lotuofátsröskun hjá fólki sem glímir við offitu. Kvarðinn var lagður fyrir fimm hópa: þrjá hópa einstaklinga í offitumeðferð (n=53), einstaklinga með lotugræðgi (n=12) og samanburðarhóp (n=26). Niðurstöður sýndu að hlutfall lotuofátsröskunar meðal skjólstæðinga í offitumeðferð var 24,5%. Kvarðinn reyndist hafa góðan innri áreiðanleika og styðja niðurstöður réttmæti túlkunar á niðurstöðum kvarðans. Skimunareiginleikar Lotuofátskvarðans voru góðir (næmi 77% og sérhæfni 98%) og gefa vendigildi 24–25 besta samspil næmis og sérhæfni. Niðurstöður sýna að próffræðilegir eiginleikar Lotuofátskvarðans eru viðunandi. Getur kvarðinn því nýst í klínísku starfi hérlendis en mikilvægt er að hafa mælitæki með raunprófaða eiginleika til að meta einkenni lotuofátsröskunar hjá þeim sem eru í offitumeðferð svo að bæta megi meðferðarárangur.The aim of this study was to investigate the psychometric properties of the Icelandic translation of the Binge Eating Scale (BES) and its relation to depressive symptoms and bulimia. The BES is a sixteen-item questionnaire that assesses binge eating severity among obese persons. The BES was administered to individuals in obesity treatment (n=53), individuals with a diagnosis of bulimia nervosa (n=12) and kindergarten employees (n=26). The prevalence of binge eating indicative of binge eating disorder (BED) was 24.5% among individuals in obesity treatment. The results showed that using a scoring threshold of 24–25 sensitivity was 77% and specificity 98%. The scale has good internal consistency and reliability as well as a good construct-, convergent- and discriminant validity. The results of the study support the use of the Icelandic BES among individuals in obesity treatment

Binge Eating Scale: Analysis of the scale´s validity and clinical use

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadTilgangur rannsóknarinnar var að meta próffræðilega eiginleika Lotuofátskvarðans (e. Binge Eating Scale) og tengsl hans við aðrar klínískar breytur (depurðareinkenni og lotugræðgi). Lotuofátskvarðinn er 16 atriða sjálfsmatslisti ætlað að meta vanda tengdan átköstum og hefur verið notaður til að skima fyrir lotuofátsröskun hjá fólki sem glímir við offitu. Kvarðinn var lagður fyrir fimm hópa: þrjá hópa einstaklinga í offitumeðferð (n=53), einstaklinga með lotugræðgi (n=12) og samanburðarhóp (n=26). Niðurstöður sýndu að hlutfall lotuofátsröskunar meðal skjólstæðinga í offitumeðferð var 24,5%. Kvarðinn reyndist hafa góðan innri áreiðanleika og styðja niðurstöður réttmæti túlkunar á niðurstöðum kvarðans. Skimunareiginleikar Lotuofátskvarðans voru góðir (næmi 77% og sérhæfni 98%) og gefa vendigildi 24–25 besta samspil næmis og sérhæfni. Niðurstöður sýna að próffræðilegir eiginleikar Lotuofátskvarðans eru viðunandi. Getur kvarðinn því nýst í klínísku starfi hérlendis en mikilvægt er að hafa mælitæki með raunprófaða eiginleika til að meta einkenni lotuofátsröskunar hjá þeim sem eru í offitumeðferð svo að bæta megi meðferðarárangur.The aim of this study was to investigate the psychometric properties of the Icelandic translation of the Binge Eating Scale (BES) and its relation to depressive symptoms and bulimia. The BES is a sixteen-item questionnaire that assesses binge eating severity among obese persons. The BES was administered to individuals in obesity treatment (n=53), individuals with a diagnosis of bulimia nervosa (n=12) and kindergarten employees (n=26). The prevalence of binge eating indicative of binge eating disorder (BED) was 24.5% among individuals in obesity treatment. The results showed that using a scoring threshold of 24–25 sensitivity was 77% and specificity 98%. The scale has good internal consistency and reliability as well as a good construct-, convergent- and discriminant validity. The results of the study support the use of the Icelandic BES among individuals in obesity treatment

Mental health and sociodemographic characteristics among Icelanders, data from a cross-sectional study in Iceland

Abstract Background Mental health challenges are on the rise worldwide. In Iceland, little is known about the sociodemographic factors associated with poor mental health. This study aimed to investigate symptoms of depression, anxiety, stress, and psychiatric medication for mental disorders in a nationally representative sample in Iceland and to explore its associations with sociodemographic factors. Methods This Icelandic cross-sectional study ‘Health and Wellbeing of Icelanders’ was conducted in 2017 and included 9,887 randomly chosen adults. Participants’ depression, anxiety, and stress levels were measured with the Depression Anxiety and Stress scale-21(DASS-21) and the association with sociodemographic factors and prescribed psychiatric medication was assessed in a multinominal logistic regression analysis. Results The youngest age group (18 to 29 years old) had the poorest mental health. Males had a higher risk of medium and high depression scores than females, RRR 1.23 (95% CI 1.06–1.44) and RRR 1.71 (95% CI 1.25–2.33) when adjusted for sociodemographic factors (age, sex, education, marital status, financial status, living area, employment) and use of psychiatric medication. Participants with the most considerable financial difficulties had the highest risk of high scores on depression RRR 11.19 (95% CI 5.8—21.57), anxiety RRR 12.35 (95% CI 5.62—27.14) and stress RRR 11.55 (95% CI 4.75—28.04) when compared to those that do not. Conclusions The youngest participants and those with the most extensive financial difficulties had the highest depression, anxiety, and stress scores. Males scored higher than females on depression. There was a trend towards worse mental health with lower sociodemographic status. Higher education, living with someone, and financial security were associated with better mental health. These results implicate the importance of government actions to counteract social inequalities in the Icelandic nation

Qantas Empire Airways Lockheed L-749 Constellation with two crew members standing beneath the nose, ca. 1952 [transparency] /

Title devised by cataloguer from list.; Condition: Fair, colour faded.; "Lawrence Hargrave"--Painted on fuselage..; Part of: Allan James Hughes collection of lantern slides of Qantas Empire Airways.; Also available in an electronic version via the Internet at: http://nla.gov.au/nla.pic-vn4253468