Janus endurhæfing, hlutverk sjúkraþjálfara í einstaklingsmiðaðri starfsendurhæfingu

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 DownloadJanus endurhæfing er læknisfræðileg starfs- og atvinnuendurhæfing þar sem þverfaglegt teymi sérfræðinga aðstoða þátttakendur aftur út á vinnumarkaðinn. Flestir þátttakendur glíma við flókin og fjölþætt vandamál bæði andleg og/eða líkamleg. Þeir þarfnast starfsendurhæfingar sem er aðlöguð að mismunandi þörfum þeirra. Starfsemin tekur tillit til þessara þarfa meðal annars með því að bjóða upp á mismundandi brautir. Þróun hefur átt sér stað innan starfseminnar meðal annars er fyrirtækið brautryðjandi í notkun gervigreindar innan starfsendurhæfingar. Hlutverk sjúkraþjálfara í endurhæfingunni hefur þróast í takt við breytta tíma, en snýr í dag að mestum hluta að fræðslu og þjálfun í hóp, auk einstaklingsmeðferða.Janus rehabilitation is a medical vocational rehabilitation centre where an interdisciplinary team of specialists assist participants back to the labour market. Most participants are dealing with a multitude of complex psychological and physical difficulties. Therefore, it is necessary that each participant receive a bespoke treatment. Different paths are available in the rehabilitation with the aim to fit each participant’s needs. Janus rehabilitation has been rapidly developing and is for ans example a pioneer in the use of Artificial Intelligence in vocational rehabilitation. The part of physical therapist has developed with changing times, but the primarily focus is on group lessons and training, as well as individualised treatments. Key words: Physical Therapist, Vocational Rehabilitation, Innovation, Quality of Lif

Five decades of coronary artery disease in Iceland. Data from the Icelandic Heart Association

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 FilesKransæðasjúkdómar hafa verið algengasta dánarorsök Íslendinga frá miðri síðustu öld allt fram undir síðasta áratug. Frá 1980 hefur staða helstu áhættuþátta kransæðasjúkdóma farið sífellt batnandi og hefur sú þróun skýrt 72% þeirrar fækkunar sem orðið hefur í ótímabærum dauðsföllum vegna kransæðasjúkdóma á síðustu þremur áratugum. Hins vegar hafa vaxandi offita og sykursýki dregið nokkuð úr þeim ávinningi. Verði ekkert að gert má búast við því að dauðsföllum vegna kransæðasjúkdóma fari aftur fjölgandi á næstu áratugum. Kemur þar annars vegar til breytt staða helstu áhættuþátta og hins vegar vaxandi öldrun þjóðarinnar. Á sama tíma hefur lifun eftir hjartaáfall aukist. Afleiðingin verður ekki eingöngu sú að öldruðum fjölgar og þeir verða sífellt stærra hlutfall þjóðarinnar, heldur koma aldraðir til með að lifa með aukna byrði langvinnra sjúkdóma á næstu áratugum. Þetta mun hafa í för með sér verulega aukinn kostnað í heilbrigðiskerfinu. Út frá mannfjöldaspá Hagstofunnar má áætla að fjöldi Íslendinga á vinnufærum aldri (16-66 ára) fyrir hvern ellilífeyrisþega (67 ára og eldri) muni lækka úr 5,6 árið 2016 í 3,3 árið 2040 og í 2,6 árið 2060. Í þessari grein veður fjallað nánar um áhrifaþætti þessarar þróunar og staða áhættuþátta kynnt með uppfærðum tölum fram til ársins 2013.Coronary artery disease has been the leading cause of death and disability in Iceland during the past decades although in recent years, malignancy has taken over that position. A steady improvement in the level of major risk factors has been evident since 1980. This trend explains 72% of the decrease in premature mortality from coronary artery disease during the past three decades. However, an opposing trend in increasing obesity and type 2 diabetes has attenuated this decline in premature deaths. Unchanged risk factor trends will lead to increasing cardiovascular mortality in the years to come. This will result from the above mentioned changes in major risk factors as well as an increased ageing of the Icelandic population. At the same time case fatality after myocardial infarction has declined substantially. This will result in a steadily growing proportion of elderly in the population as well as a high burden of chronic non-communicable diseases among the elderly population. The resulting increase in long term disease and disability will put a major constraint on the health care system and economy alike. According to vital statistics and secular trends the rate of Icelanders in working age for each one reaching retirement age will decrease from the current 5.6 to 2.6 by year 2060. This paper addresses the driving factors of risk factor change in Iceland with previously unpublished data extending to 2013

Socioeconomic factors from midlife predict mobility limitation and depressed mood three decades later; findings from the AGES-Reykjavik Study.

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 Files. This article is open access.Taking into account our rapidly ageing population, older people are of particular interest in studying health inequalities. Most studies of older persons only include measures of current socioeconomic status (SES) and do not take into account data from earlier stages of life. In addition, only classic SES measures are used, while alternative measures, such as car ownership and house ownership, might equally well predict health. The present study aims to examine the effect of midlife socioeconomic factors on mobility limitation and depressed mood three decades later.Data were from 4,809 men and women aged 33-65 years who participated in the Reykjavik Study (1967-1992) and who were re-examined in old age in the Age, Gene/Environment Susceptibility (AGES) -Reykjavik Study (2002-2006).Education and occupation predicted mobility limitation and depressed mood. Independently, home and car ownership and the availability of housing features predicted mobility limitation. Shortages of food in childhood and lack of a car in midlife predicted depressed mood.Socioeconomic factors from midlife and from childhood affect mobility limitation and depressed mood in old age. Prevention of health problems in old age should begin as early as midlife.NIH/N01-AG-12100 NIA Intramural Research Program Hjartavernd (the Icelandic Heart Association) Althingi (the Icelandic Parliament

Review of epidemiology of fractures in the Icelandic Heart Association cohort

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 FilesÁ síðustu árum hafa birst nokkrar greinar í vísindatímaritinu Osteoporosis International um faraldsfræði beinbrota á Íslandi, byggðar á hóprannsóknum Hjartaverndar. Við höfum tekið saman nokkur atriði úr þessum vísindagreinum og fylgiskjölum þeirra með áherslu á meiriháttar beinþynningarbrot (framhandleggsbrot, upphandleggsbrot, hryggsúlubrot og mjaðmarbrot). Þessi fjögur brot eru talin valda um 90% af heildarbyrði allra beinþynningarbrota. Nýgengistölur þessara beinbrota í Hjartaverndarhópnum mynda grunn að notkun alþjóðlegs áhættureiknis, FRAX Ísland, fyrir Íslendinga 40-90 ára og spá fyrir um líkur á meiriháttar beinbroti næstu 10 árin. Þessi áhættureiknir var opnaður á veraldarvefnum árið 2013. Sérstaklega bendum við á mikilvægi fyrri beinbrotasögu þar sem tæp 40% allra meiriháttar beinþynningarbrota verða í kjölfar fyrsta brots síðar á ævinni samkvæmt gögnum Hjartaverndar. Niðurstöðurnar benda á mikilvægi tímalengdar frá broti þar sem mesta áhættan á að fá síðar brot er á fyrstu tveimur árunum eftir brot enda þótt aukin áhætta haldist næstu 20 árin. Þetta bendir því til mikilvægis forvarna strax eftir fyrsta beinbrot, sérstaklega meðal aldraðra. Rannsóknirnar gefa góða heildarsýn yfir beinbrot á Íslandi í samanburði við erlendar rannsóknir og sýna að aldursstaðlað nýgengi alvarlegustu brotanna, mjaðmarbrotanna, náði hámarki um aldamótin en lækkaði til 2008 meðal kvenna, svipað og lýst hefur verið í Svíþjóð og Danmörku.In recent years, scientific papers have been published in Osteoporosis International on the epidemiology of fractures in Iceland based on the Icelandic Heart Association cohort. We report the main results with emphasis on the major osteoporotic fractures (MOF), distal forearm, upper arm, clinical vertebral and hip. Those four types of fractures have been reported to cause about 90% of the total burden of all osteoporotic fractures. The incidence of those four fractures in the Icelandic Heart Association cohort have been used as the basis for the international fracture risk calculator “FRAX “in Iceland. “FRAX” assesses the risk of those fractures for the next 10 years in both sexes in the age group 40-90 years. FRAX Iceland was opened on the internet in the year 2013. We emphasize the importance of previous fracture history as almost 40% of all major osteoporotic fractures occur after first MOF according to our cohort. The results demonstrate the importance of time from the first fracture as the risk of the second fracture is greater in the first two years although increased risk remains during the next 20 years. This indicates the importance of secondary prevention early after the first fracture especially amongst elderly people. These results give a good overall view about the epidemiology of fractures in Iceland in comparison with foreign studies and shows that age standardized incidence of the most important osteoporotic fracture, the hip fracture, reached a maximum around the millennium but has decreased among women until 2008 similar to what has been observed in Sweden and Denmark

Novel innovationCan Artificial Intelligence make Rehabilitation more Efficient?

Publisher Copyright: © 2019 Laeknafelag Islands. All rights reserved.Eftirspurn eftir starfsendurhæfingu á Íslandi hefur aukist síðastliðin ár og aðsókn ungs fólks þar hlutfallslega mest. Miklu máli skiptir að fjármunum samfélagsins sé vel varið án þess að gæði og þjónusta skerðist. Sú spurning vaknar því hvort gervigreind geti stuðlað að aukinni skilvirkni þessa geira. Nýsköpunarverkefni um þróun, prófun og innleiðingu á gervigreindarhugbúnaðinum Völvunni var innleitt í starfsemi Janusar endurhæfingar. Spár Völvunnar gefa meðal annars vísbendingar um hvar einstaklingur gæti hugsanlega þurft aðstoð og gefa sérfræðingum tækifæri til að bregðast við og gera viðeigandi ráðstafanir í meðferð. Nákvæmni, næmi og hittni Völvunnar hefur reynst vera framúrskarandi í tveimur rannsóknum þar sem tekist hefur að koma auga á dulin mynstur í aðstæðum skjólstæðinga sem gætu haft áhrif á endurhæfingarferlið. Völvan virðist því lofa góðu sem verkfæri í einstaklingsmiðaðri endurhæfingu þar sem fólk glímir við þung og flókin vandamál. Innan Janusar endurhæfingar er verið að innleiða Völvuna sem hlutlausan teymismeðlim. Markmið greinarinnar er að kynna Völvuna og rannsóknir tengdar henni. Demand for Vocational Rehabilitation in Iceland has been steadily rising in recent years where the presence of young patients has increased proportionally the most. It is essential that public spending is efficient without compromising the treatment quality. It is worth exploring if a solution for increasing the efficiency in this healthcare section is to use Artificial Intelligence (AI). An innovative project on developing, testing, and implementing specialised AI software in its services is being performed in Janus Rehabilitation. The software, named Völvan in Icelandic, can identify latent areas of possible interest in patient's circumstances which might affect the outcome of their treatment, and assist specialists in providing timely and appropriate interventions. The accuracy, precision, and recall of its predictions have been verified in two recent publications. Völvan seems to be a promising tool for individualised rehabilitation, where patients are dealing with difficult and complex problems. Janus Rehabilitation is in the process of launching Völvan as an unbiased member of the interdisciplinary teams of specialists. The aim of this report is to introduce Völvan and the associated research.Peer reviewe

Novel Innovation: Can Artifical Intelligence make Rehabilitation more Efficient?

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 DownloadEftirspurn eftir starfsendurhæfingu á Íslandi hefur aukist síðastliðin ár og aðsókn ungs fólks þar hlutfallslega mest. Miklu máli skiptir að fjármunum samfélagsins sé vel varið án þess að gæði og þjónusta skerðist. Sú spurning vaknar því hvort gervigreind geti stuðlað að aukinni skilvirkni þessa geira. Nýsköpunarverkefni um þróun, prófun og innleiðingu á gervigreindarhugbúnaðinum Völvunni var innleitt í starfsemi Janusar endurhæfingar. Spár Völvunnar gefa meðal annars vísbendingar um hvar einstaklingur gæti hugsanlega þurft aðstoð og gefa sérfræðingum tækifæri til að bregðast við og gera viðeigandi ráðstafanir í meðferð. Nákvæmni, næmi og hittni Völvunnar hefur reynst vera framúrskarandi í tveimur rannsóknum þar sem tekist hefur að koma auga á dulin mynstur í aðstæðum skjólstæðinga sem gætu haft áhrif á endurhæfingarferlið. Völvan virðist því lofa góðu sem verkfæri í einstaklingsmiðaðri endurhæfingu þar sem fólk glímir við þung og flókin vandamál. Innan Janusar endurhæfingar er verið að innleiða Völvuna sem hlutlausan teymismeðlim. Markmið greinarinnar er að kynna Völvuna og rannsóknir tengdar henni.Demand for Vocational Rehabilitation in Iceland has been steadily rising in recent years where the presence of young patients has increased proportionally the most. It is essential that public spending is efficient without compromising the treatment quality. It is worth exploring if a solution for increasing the efficiency in this healthcare section is to use Artificial Intelligence (AI). An innovative project on developing, testing, and implementing specialised AI software in its services is being performed in Janus Rehabilitation. The software, named Völvan in Icelandic, can identify latent areas of possible interest in patient's circumstances which might affect the outcome of their treatment, and assist specialists in providing timely and appropriate interventions. The accuracy, precision, and recall of its predictions have been verified in two recent publications. Völvan seems to be a promising tool for individualised rehabilitation, where patients are dealing with difficult and complex problems. Janus Rehabilitation is in the process of launching Völvan as an unbiased member of the interdisciplinary teams of specialists. The aim of this report is to introduce Völvan and the associated research

Associations of Quadriceps Torque Properties with Muscle Size, Attenuation, and Intramuscular Adipose Tissue in Older Adults

To access publisher's full text version of this article click on the hyperlink belowBACKGROUND: Atrophy and fatty infiltration of muscle with aging are associated with fractures and falls, however, their direct associations with muscle function are not well described. It was hypothesized that participants with lower quadriceps muscle attenuation, area, and greater intramuscular adipose tissue (IMAT) will exhibit slower rates of torque development (RTD) and lower peak knee extension torques. METHODS: Data from 4,842 participants (2,041 men, 2,801 women) from the Age Gene/Environment Susceptibility Reykjavik Study (mean age 76 ± 0.1 years) with complete thigh computed tomography and isometric knee testing. Regression models were adjusted for health, behavior, and comorbidities. Muscle attenuation was further adjusted for muscle area and IMAT; muscle area adjusted for IMAT and attenuation; and IMAT adjusted for muscle area and attenuation. Standardized betas (β) indicate association effect sizes. RESULTS: In the fully-adjusted models, attenuation (men β = 0.06, 95% CI: 0.01, 0.11; women β = 0.07, 95% CI: 0.03, 0.11) and muscle area (men β = 0.13, 95% CI: 0.07, 0.19; women β = 0.10, 95% CI: 0.06, 0.15) were associated with knee RTD. Attenuation (men β = 0.12, 95% CI: 0.08, 0.16; women β = 0.12, 95% CI: 0.09, 0.16) and muscle area (men β = 0.38, 95% CI: 0.33, 0.43; women β = 0.33, 95% CI: 0.29, 0.37) were associated with peak torque. CONCLUSIONS: These data suggest that muscle attenuation and area are independently associated with RTD and peak torque; and that area and attenuation demonstrate similar contributions to RTD.National Institutes of Health National Institute on Aging Intramural Research Program Hjartavernd (the Icelandic Heart Association) Althingi (the Icelandic Parliament