Bostedsløse i Norge 2012 – en kartlegging

Download for free A summary in English can be downloaded here (PDF). Associated project Bostedsløshet i Norge 201

Telemedicin: Et maktperspektiv

Til tross for betydelige statlige investeringer over flere år, er ikke telemedisin en etablert behandlingsform i norsk helsevesen. Lav utbredelse forklares ofte med at leger og andre helseprofesjonelle fungerer som portvakter. Etter vår mening er det behov for å heve blikket og supplere forklaringene på individnivå. I denne artikkelen presenterer vi en empirisk analyse inspirert av Bourdieus maktperspektiv. Vi har brukt intervju, observasjons og dokumentmateriale fra to empiriske case, teleslag og teledermatologi. I begge casene var legene positive til bruk av telemedisin, men løsningene ble lite brukt. Analysen får frem hvordan telemedisin er mer enn nye verktøy for klinkerne, og faktisk trigger diskusjoner om selve kjernen i helsefeltets autonomi; spørsmålet om hva som er den riktige behandling. Vi konkluderer med at mottagelsen av telemedisin i klinisk praksis må forstås i lys av pågående maktkamper i helsefeltet, mellom statlige styringsinteresser på den ene siden og profesjonell autonomi på den andre.Telemedicine; power disruptions in health careAlthough the development of telemedicine has been a priority in Norwegian public health care for over 20 years, only a limited number of applications have been established as routine services. Dominant explanations of slow diffusion points to clinicians and their role as gatekeepers. We argue there is a need to look beyond the ubiquitous accounts of individual influences, and include power structures in the analysis of telemedicine diffusion. In this paper, we present an empirical analysis inspired by Bourdieu’s conceptual framework. The data consist of interviews, observations, and public- and project documents from two case studies; telestroke and teledermatology. In both cases, the clinicians were positive and involved in the implementation of telemedicine. Nevertheless, the services were not developed into routine practice; in fact, they were rarely used. Telemedicine touches upon the core value of health care activity: how to define the best patient treatment. The paper argues telemedicine might disrupt and be disrupted by existing power struggles in the health care sector. We conclude that slow diffusion of telemedicine should be understood in light of ongoing negotiations and power struggles between state regulatory powers on the one hand and health professional autonomy on the other

Association between blood pressure measures and recurrent headache in adolescents: cross-sectional data from the HUNT-Youth study

The relationship between blood pressure and headache in youth has not been explored and the objective of the present study was to provide data on this association in an adolescent population. Cross-sectional data from a large population-based survey, the Young-HUNT study, on 5,847 adolescents were used to evaluate the association between blood pressure (systolic, diastolic, mean arterial and pulse pressure) and recurrent headache, including migraine and tension-type headache. Increasing pulse pressure was inversely related to recurrent headache prevalence, and both tension-type headache and migraine. For systolic blood pressure such an inverse relationship was present for recurrent headache and tension-type headache prevalence. For migraine, the results were not significant, although there was a tendency in the same direction (p = 0.05). High-pulse pressure has previously been found to be inversely related to the prevalence of migraine and tension-type headache in an adult population. This inverse relationship has now been demonstrated to be present among adolescents also, supporting the results from a previous study in adults, that blood pressure regulation may be linked to the pathophysiology of headache

Parent and child agreement for acute stress disorder, post-traumatic stress disorder and other psychopathology in a prospective study of children and adolescents exposed to single-event trauma

Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined by structured interview in a prospective study of assault and motor vehicle accident (MVA) child survivors, assessed at 2-4 weeks and 6 months post-trauma. Children were significantly more likely to meet criteria for ASD, as well as other ASD and PTSD symptom clusters, based on their own report than on their parent's report. Parent-child agreement for ASD was poor (Cohen's κ = -.04), but fair for PTSD (Cohen's κ = .21). Agreement ranged widely for other emotional disorders (Cohen's κ = -.07-.64), with generalised anxiety disorder found to have superior parent-child agreement (when assessed by phi coefficients) relative to ASD and PTSD. The findings support the need to directly interview children and adolescents, particularly for the early screening of posttraumatic stress, and suggest that other anxiety disorders may have a clearer presentation post-trauma

Family structure and posttraumatic stress reactions: a longitudinal study using multilevel analyses

<p>Abstract</p> <p>Background</p> <p>There is limited research on the relevance of family structures to the development and maintenance of posttraumatic stress following disasters. We longitudinally studied the effects of marital and parental statuses on posttraumatic stress reactions after the 2004 Southeast Asian tsunami and whether persons in the same households had more shared stress reactions than others.</p> <p>Method</p> <p>The study included a tourist population of 641 Norwegian adult citizens, many of them from families with children. We measured posttraumatic stress symptoms with the Impact of Event Scale-Revised at 6 months and 2 years post-disaster. Analyses included multilevel methods with mixed effects models.</p> <p>Results</p> <p>Results showed that neither marital nor parental status was significantly related to posttraumatic stress. At both assessments, adults living in the same household reported levels of posttraumatic stress that were more similar to one another than adults who were not living together. Between households, disaster experiences were closely related to the variance in posttraumatic stress symptom levels at both assessments. Within households, however, disaster experiences were less related to the variance in symptom level at 2 years than at 6 months.</p> <p>Conclusions</p> <p>These results indicate that adult household members may influence one another's posttraumatic stress reactions as well as their interpretations of the disaster experiences over time. Our findings suggest that multilevel methods may provide important information about family processes after disasters.</p

Prevalence of headache in Europe: a review for the Eurolight project

The main aim of the present study was to do an update on studies on headache epidemiology as a preparation for the multinational European study on the prevalence and burden of headache and investigate the impact of different methodological issues on the results. The study was based on a previous study, and a systematic literature search was performed to identify the newest studies. More than 50% of adults indicate that they suffer from headache in general during the last year or less, but when asked specifically about tension-type headache, the prevalence was 60%. Migraine occurs in 15%, chronic headache in about 4% and possible medication overuse headache in 1–2%. Cluster headache has a lifetime prevalence of 0.2–0.3%. Most headaches are more prevalent in women, and somewhat less prevalent in children and youth. Some studies indicate that the headache prevalence is increasing during the last decades in Europe. As to methodological issues, lifetime prevalences are in general higher than 1-year prevalences, but the exact time frame of headache (1 year, 6 or 3 months, or no time frame stated) seems to be of less importance. Studies using personal interviews seem to give somewhat higher prevalences than those using questionnaires

Discovery of 95 PTSD loci provides insight into genetic architecture and neurobiology of trauma and stress-related disorders

Posttraumatic stress disorder (PTSD) genetics are characterized by lower discoverability than most other psychiatric disorders. The contribution to biological understanding from previous genetic studies has thus been limited. We performed a multi-ancestry meta-analysis of genome-wide association studies across 1,222,882 individuals of European ancestry (137,136 cases) and 58,051 admixed individuals with African and Native American ancestry (13,624 cases). We identified 95 genome-wide significant loci (80 novel). Convergent multi-omic approaches identified 43 potential causal genes, broadly classified as neurotransmitter and ion channel synaptic modulators (e.g., GRIA1, GRM8, CACNA1E ), developmental, axon guidance, and transcription factors (e.g., FOXP2, EFNA5, DCC ), synaptic structure and function genes (e.g., PCLO, NCAM1, PDE4B ), and endocrine or immune regulators (e.g., ESR1, TRAF3, TANK ). Additional top genes influence stress, immune, fear, and threat-related processes, previously hypothesized to underlie PTSD neurobiology. These findings strengthen our understanding of neurobiological systems relevant to PTSD pathophysiology, while also opening new areas for investigation

Getting the Whole Picture? New information and communication technologies in healthcare work and organization

Considerable effort has been invested in telemedicine and e-health, but relatively few applications have endured beyond the research and development phase. Research within different academic disciplines points to the significance of established working and organizational relations within healthcare in shaping the outcome of particular projects, whether successful or otherwise. Even so, the findings appear as disparate and discrete observations which make it difficult for those involved in the field to get an overview of ICT in healthcare work and organization or to interpret the implication of the studies. The aim of our article is to demonstrate the importance/value of situating ICT initiatives within a sociological framework of heath care work and organisation and to show how this enables us to carry-out systematic analysis across a range of ICT initiatives in different clinical settings