Non-Suicidal Self-Injury and Indirect Self-Harm Among Danish High School Students

Background: Non-suicidal self-injury (NSSI) and indirect self-harm are prevalent among adolescents, but it is rare to see them described as related topics.Objective: The purpose of this study was to investigate whether there is a correlation between the frequencies of NSSI and indirect self-harm (e.g., eating problems, alcohol and drug use) and how this may be influenced by gender.Method: Questionnaires about NSSI (e.g., cutting, burning, scratching, hitting oneself) and indirect self-harm were distri­buted to high school students in theCopenhagen area (N = 5650; response rate 53%; females 60.8%).Results: A total of 21.5% of the survey respondents had engaged in NSSI (lifetime prevalence), and 16.2% had practiced NSSI within the previous year. Gender differences in NSSI methods were identified. A total of 53.9% of the students had engaged in one or more types of indirect self-harm. The correlation between NSSI and indirect self-harm is twice as high for males (0.44; P < .001) as compared with females (0.20; P < .001).Conclusions: Clinicians must be aware of both NSSI and indirect self-harm. A positive correlation is seen, especially among young males. Males often perform other kinds of NSSI as compared with females, and clinicians must look for gender-specific signs of NSSI. It is argued that NSSI can be perceived as a “social pathology,” but it is also indicated that NSSI and indirect self-harm can be evaluated as an expression of ordinary behavior among modern high school students that must not be medicalized

Elbiladopsjon i Europa : En empirisk studie av insentiver for kjøpe elbil

I denne oppgaven studeres forskjellige insentiver og deres effekt på markedsandelen til elbiler i 28 europeiske land. Bakgrunnen for valget av tematikk er det økende søkelyset på det grønne skiftet og veitransportsektorens rolle i denne sammenhengen. Til dette formålet er det hentet data fra offentlige kilder og satt sammen et datasett med markedsandeler og 15 andre variabler, som inneholder informasjon om forskjellige insentiver for elbiladopsjon. Alle observasjoner er fra året 2022. Variablene som er relatert til engangsavgift, merverdiavgift og årsavgift er beregnet som den økonomiske differansen mellom å kjøpe en fossil bil og kjøpe en elbil. Dette utrykker fordelen ved å kjøpe elbil dersom landets myndigheter har valgt å benytte insentivet. På denne måten uttrykker variablene tydelig hvilken påvirkning de nevnte insentivene har på kjøpsbeslutningen til forbrukeren. For å evaluere hvorvidt de forskjellige insentivene har en signifikant effekt på markedsandelen til elbiler, er det gjennomført enkel lineær regresjonsanalyse for hver av de 15 variablene. Denne analysen resulterer i fire statistisk signifikante insentiver: ladeinfrastruktur, bensinpris, inntektsnivå og andel fornybar strøm. Det er flere lignende studier som konkluderer med noe av det samme, men ingen av studiene som er undersøkt i forbindelse med dette arbeidet har fullstendig sammenfallende konklusjon. Kanskje mest overraskende blant disse funnene er at det kun er bensinprisen blant de finansielle insentivene som viser seg å være viktig for elbiladopsjon. Dette resultatet strider mot de fleste studiene på området. I tillegg til regresjonsanalysen er det gjennomført en grundig deskriptiv analyse, for å få bedre oversikt over forskjellene i insentiver mellom landene.nhhma

Mortality and one-year functional outcome in elderly and very old patients with severe traumatic brain injuries: observed and predicted

Published version. Source at http://doi.org/10.1155/2015/845491.The aim of the present study was to evaluate mortality and functional outcome in old and very old patients with severe traumatic brain injury (TBI) and compare to the predicted outcome according to the internet based CRASH (Corticosteroid Randomization After Significant Head injury) model based prediction, from the Medical Research Council (MRC). Methods. Prospective, national multicenter study including patients with severe TBI ≥65 years. Predicted mortality and outcome were calculated based on clinical information (CRASH basic) (age, GCS score, and pupil reactivity to light), as well as with additional CT findings (CRASH CT). Observed 14-day mortality and favorable/unfavorable outcome according to the Glasgow Outcome Scale at one year was compared to the predicted outcome according to the CRASH models. Results. 97 patients, mean age 75 (SD 7) years, 64% men, were included. Two patients were lost to follow-up; 48 died within 14 days. The predicted versus the observed odds ratio (OR) for mortality was 2.65. Unfavorable outcome (GOSE < 5) was observed at one year follow-up in 72% of patients. The CRASH models predicted unfavorable outcome in all patients. Conclusion. The CRASH model overestimated mortality and unfavorable outcome in old and very old Norwegian patients with severe TBI

Oslos forbudte markedsføring - Hvordan markedsføres cannabis til rekreasjonsbrukere i Oslo?

Hensikten med vår undersøkelsen er å forstå meningen bak forbruk av cannabis og hvordan det markedsføres til rekreasjonsbrukere i Oslo. Undersøkelsen har en fenomenologisk tilnærmning hvor vi studerer rekreasjonsbrukere, deres erfaringer, og forståelsen om markedsføring av cannabisfenomenet. Før vi starter undersøkelsen tar vi for oss to analyser for å avgrense fenomenet. Dette er en innføring til undersøkelsen som vil hjelpe oss å holde relevansen i resultatene mer reliable. Analysen anvendes med teorier fra ulike fag vi har hatt ved markedshøyskolen. Det er viktig at forskeren og leseren har en samme forståelse av hvordan undersøkelsen har kommet frem til sine resultater. Funnene i analysen ble tolket gjennom meningen av hva informantene sier. Hvor vi fant ut at flere benytter seg av det det offentlige markedet. Andre markedet igjen er basert på grupperinger av vennegjenger, eller å henge seg på en annen gjeng. Vi ser at grupper påvirker hyppighet av kjøp og bruk og at det er vesentlig funksjonelt forbruk av cannabis. Det ligger et sosialt ledd i markedsføringen hvor nøkkelordene er tilgjengelighet og gruppen. Ut i fra resultatene av undersøkelsen ser vi at markedsføringen er avhengig av at det eksisterer to markeder, og derfor deler den seg i to. Vi ser at en fellesnevner er at rekreasjonsbrukerene oppsøker selgeren selv. I begge markedet blir det markedsført gjennom produktets betydning. Det er også et skille mellom disse markedene, hvor den enten baserer seg på det sosiale nettverket som bygges gjennom relasjoner eller et uforpliktende marked hvor en kjøper ut ifra sine egne behov og ønsker

Health-related Quality of Life 12 months after severe traumatic brain injury: A prospective nationwide cohort study

OBJECTIVE: To assess health-related quality of life in individuals with severe traumatic brain injury at 12 months post-injury, applying the Quality of Life after Brain Injury (QOLIBRI) instrument, and to study the relationship between injury-related factors, post-injury functioning and health-related quality of life. Design/subjects: The study is part of a prospective, Norwegian multicentre study of adults (≥ 16 years old) with severe traumatic brain injury, as defined by a Glasgow Coma Scale score of 3–8 during the first 24 h post-injury. A total of 126 patients were included. METHODS: Socio-demographic data and injury severity variables were collected. Functioning at 3 and 12 months was assessed with the Glasgow Outcome Scale Extended (GOSE), the Functional Independence Measure (FIM), the Rivermead Post-concussion Questionnaire (RPQ), and the Hospital Anxiety and Depression Scale (HADS). Hierarchical regression analysis was applied. RESULTS: Mean QOLIBRI score was 68.5 (standard deviation = 18.8). Predictors of the QOLIBRI in the final regression model were: employment status (p = 0.05), GOSE (p = 0.05), RPQ (p < 0.001) and HADS (p < 0.001). The adjusted R2 showed that the model explained 64.0% of the variance in the QOLIBRI score. CONCLUSION: Symptom pressure and global functioning in the sub-acute phase of traumatic brain injury and psychological distress in the post-acute phase are important for health-related quality of life at 12 months post-injury. These domains should be the focus in rehabilitation aiming to improve health-related quality of life in patients with severe traumatic brain injury

Neuropsychological functioning in a national cohort of severe traumatic brain injury: demographic and acute injury-related predictors

Objectives: To determine the rates of cognitive impairment 1 year after severe traumatic brain injury (TBI) and to examine the influence of demographic, injury severity, rehabilitation, and subacute functional outcomes on cognitive outcomes 1 year after severe TBI. Setting: National multicenter cohort study over 2 years. Participants: Patients (N = 105), aged 16 years or older, with Glasgow Coma Scale score of 3 to 8 and Galveston Orientation and Amnesia Test score of more than 75. Main Measures : Neuropsychological tests representing cognitive domains of Executive Functions, Processing Speed, and Memory. Injury severity included Rotterdam computed tomography score, Glasgow Coma Scale score, and posttraumatic amnesia (PTA) duration, together with length of rehabilitation and Glasgow Outcome Scale&ndash;Extended score. Results: In total, 67% of patients with severe TBI had cognitive impairment. Executive Functions, Processing Speed, and Memory were impaired in 41%, 58%, and 57% of patients, respectively. Using multiple regression analysis, Processing Speed was significantly related to PTA duration, Glasgow Outcome Scale&ndash;Extended score, and length of inpatient rehabilitation (R 2 = 0.30); Memory was significantly related to Glasgow Outcome Scale&ndash;Extended score (R 2 = 0.15); and Executive Functions to PTA duration (R 2 = 0.10). Rotterdam computed tomography and Glasgow Coma Scale scores were not associated with cognitive functioning at 1 year postinjury. Conclusion: Findings highlight cognitive consequences of severe TBI, with nearly two-thirds of patients showing cognitive impairments in at least 1 of 3 cognitive domains. Regarding injury severity predictors, only PTA duration was related to cognitive functioning.acceptedVersio

Prognostic value of early magnetic resonance imaging in dogs after traumatic brain injury: 50 cases

Retrospective study of dogs with TBI that underwent 1.5T MRI within 14 days after head trauma. MRI evaluators were blinded to the clinical presentation, and all images were scored based on an MRI grading system (Grade I [normal brain parenchyma] to Grade VI [bilateral lesions affecting the brainstem with or without any lesions of lesser grade]). Skull fractures, percentage of intraparenchymal lesions, degree of midline shift, and type of brain herniation were evaluated. MGCS was assessed at presentation. The presence of seizures was recorded. Outcome was assessed at 48 h (alive or dead) and at 3, 6, 12, and 24 months after TBI

Severe traumatic brain injury in Norway: Impact of age on outcome

Objective: The aim of this study was to investigate the influence of age on mortality and 3-month outcome in a Norwegian cohort of patients with severe traumatic brain injury (TBI). Methods: Norwegian residents ≥ 16 years of age who were admitted with a severe TBI to the country’s 4 major trauma centres in 2009 and 2010 were included, as were adults (16– 64 years) and elderly patients (≥ 65 years). Results: Half of the adult subjects and 84% of the elderly subjects were injured by falls. One-third of the adults and half of the elderly subjects were admitted to a local hospital before being transported to a regional trauma hospital. Subdural haematomas were more frequent in the elderly subjects. One-quarter of adults and two-thirds of the elderly subjects died within 3 months. At 3 months, 41% of the adult survivors were still in-patients, mainly in rehabilitation units (92%). Of the surviving elderly subjects, 14% were in-patients and none were in rehabilitation units. There was no difference in functional level for survivors at the 3-month follow-up. Conclusion: Old age is associated with fall-induced severe TBI and high mortality rates. Less intensive treatment strategies were applied to elderly patients in the present study despite high rates of haemorrhage. Few surviving elderly patients received rehabilitation at 3 months post-injury.publishedVersio

Global Characterisation of Coagulopathy in Isolated Traumatic Brain Injury (iTBI): A CENTER-TBI Analysis

Background - Trauma-induced coagulopathy in patients with traumatic brain injury (TBI) is associated with high rates of complications, unfavourable outcomes and mortality. The mechanism of the development of TBI-associated coagulopathy is poorly understood. Methods - This analysis, embedded in the prospective, multi-centred, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, aimed to characterise the coagulopathy of TBI. Emphasis was placed on the acute phase following TBI, primary on subgroups of patients with abnormal coagulation profile within 4 h of admission, and the impact of pre-injury anticoagulant and/or antiplatelet therapy. In order to minimise confounding factors, patients with isolated TBI (iTBI) (n = 598) were selected for this analysis. Results - Haemostatic disorders were observed in approximately 20% of iTBI patients. In a subgroup analysis, patients with pre-injury anticoagulant and/or antiplatelet therapy had a twice exacerbated coagulation profile as likely as those without premedication. This was in turn associated with increased rates of mortality and unfavourable outcome post-injury. A multivariate analysis of iTBI patients without pre-injury anticoagulant therapy identified several independent risk factors for coagulopathy which were present at hospital admission. Glasgow Coma Scale (GCS) less than or equal to 8, base excess (BE) less than or equal to − 6, hypothermia and hypotension increased risk significantly. Conclusion - Consideration of these factors enables early prediction and risk stratification of acute coagulopathy after TBI, thus guiding clinical management

Moderate Traumatic Brain Injury:Clinical Characteristics and a Prognostic Model of 12-Month Outcome

BACKGROUND: Patients with moderate traumatic brain injury (TBI) often are studied together with patients with severe TBI, even though the expected outcome of the former is better. Therefore, we aimed to describe patient characteristics and 12-month outcomes, and to develop a prognostic model based on admission data, specifically for patients with moderate TBI. METHODS: Patients with Glasgow Coma Scale scores of 9-13 and age ≥16 years were prospectively enrolled in 2 level I trauma centers in Europe. Glasgow Outcome Scale Extended (GOSE) score was assessed at 12 months. A prognostic model predicting moderate disability or worse (GOSE score ≤6), as opposed to a good recovery, was fitted by penalized regression. Model performance was evaluated by area under the curve of the receiver operating characteristics curves. RESULTS: Of the 395 enrolled patients, 81% had intracranial lesions on head computed tomography, and 71% were admitted to an intensive care unit. At 12 months, 44% were moderately disabled or worse (GOSE score ≤6), whereas 8% were severely disabled and 6% died (GOSE score ≤4). Older age, lower Glasgow Coma Scale score, no day-of-injury alcohol intoxication, presence of a subdural hematoma, occurrence of hypoxia and/or hypotension, and preinjury disability were significant predictors of GOSE score ≤6 (area under the curve = 0.80). CONCLUSIONS: Patients with moderate TBI exhibit characteristics of significant brain injury. Although few patients died or experienced severe disability, 44% did not experience good recovery, indicating that follow-up is needed. The model is a first step in development of prognostic models for moderate TBI that are valid across centers