Exclusion to Inclusion: Lived Experience of Intellectual Disabilities in National Reporting on the CRPD

This article critically examines the application of an innovative project aimed at developing a mechanism for people with intellectual disabilities to provide input to the Icelandic government’s report on its implementation of the Convention on the Rights of Persons With Disabilities (CRPD). The project was undertaken to comply with the CRPD’s obligation to ensure the participation of disabled people in the review process and to respond to the recognized need for changes to consultation processes to accommodate the needs of people with intellectual disabilities. The project was successful in producing its intended outcome, to facilitate meaningful input by people with intellectual disabilities to the national review process. However, the research reveals that effective use of the outcome report by the authorities, which had both funded the project and praised its work, was lacking. These findings draw attention to the need to address unspoken norms and biases, and to take assertive steps to institutionalize a more structured and transparent process of co‐creation to ensure that the voices of marginalized groups are in fact heard and effectively taken into account in outcome processes. The research this article draws on is qualitative, comprised of data gathered through document analysis, as well as in‐depth interviews with representatives of disabled people’s organizations and the authorities

Lifrarbólga A á Íslandi

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 FilesInngangur: Faraldrar af völdum lifrarbólgu A veiru (hepatitis A virus, HAV) komu endurtekið upp á Íslandi á fyrrihluta 20. aldar en síðan þá hafa fá tilfelli greinst og engir þekktir faraldrar komið upp síðan 1952. Síðustu íslensku rannsóknir á lifrarbólgu A frá því um 1990 sýndu lágt nýgengi sýkingar og lækkandi algengi mótefna. Markmið rannsóknarinnar var að kanna nýgengi og birtingarmynd lifrarbólgu A á Íslandi og uppruna smits, er­lendis eða innanlands. Efniviður og aðferðir: Klínískum upplýsingum var safnað afturskyggnt úr sjúkraskrám um einkenni við greiningu, blóðprufuniðurstöður og mögulegar smitleiðir hjá öllum einstaklingum með jákvæð lifrarbólgu A IgM mótefni í gagnagrunni veirufræðideildar Landspítala á 11 ára tímabili, 2006-2016. Niðurstöður: Alls greindust 12 manns með bráða lifrarbólgu A á tímabilinu en framkvæmdar voru 6691 mæling á heildarmótefnum og 1984 mælingar á IgM mótefnum. Níu (75%) höfðu verið erlendis innan 7 vikna frá upphafi einkenna. Algengustu einkennin voru gula (10/12, 83%), hiti (67%) og ógleði og/eða uppköst (58%). Alls lögðust 50% inn á sjúkrahús og 42% fengu hækkun á INR/PT. Allir lifðu af sýkinguna án fylgikvilla. Ályktun: Að meðaltali greindist um eitt tilfelli af bráðri lifrarbólgu A árlega á Íslandi en mjög margar mótefnamælingar voru gerðar. Mikill meirihluti tilfella greindist hjá einstaklingum sem höfðu nýlega dvalið erlendis. Ef sjúklingar hafa gulu, hita og ógleði er ástæða til að kanna lifrarbólgu A sýkingu. Lifrarbólga A er ekki landlæg á Íslandi.Senda grein,Prenta greinEnglishFacebookTwitter Introduction: Hepatitis A virus (HAV) epidemics occurred repeatedly in Iceland in the early 20th century, but since then few cases have been reported and no epidemics since 1952. The latest Icelandic studies on HAV from around 1990 showed low incidence of infection and de­- creasing prevalence of antibodies. The objective of this study was to determine the incidence, clinical presentation and origin of HAV, abroad or in Iceland. Material and methods: A retrospective search was undertaken on all patients with positive anti-HAV IgM during the 11 years period of 2006-2016 in the virological database of the National University Hospital of Iceland. Clinical data was collected from medical records on symptoms at diagnosis, blood test results and possible route of transmission. Results: A total of 12 individuals were diagnosed with acute hepatitis A during the period and 6691 HAV total andibody tests and 1984 HAV IgM antibody tests were performed. Nine (75%) had been abroad within 7 weeks from initial symptoms. The most common symptoms were jaundice (83%), fever (67%) and nausea and/or vomiting (58%). 50% were admitted to a hospital. 42% had elevated INR/PT. Everyone sur­vived without complications. Conclusion: Annually, approximately one case of acute hepatitis A was diagnosed in Iceland during the study period but a very high number of antibody tests were performed. The majority of cases occurred among individuals who had recently been abroad. If patients have jaundice, fever and nausea, testing for HAV infection should be undertaken. HAV is not endemic in Iceland

Employees’ Conceptions of Coworkership in a Swedish Health Care Organization

The concept of coworkership is widely established as a top-down communication strategy within organizations. However, interpretations may differ between organizational levels, and the employees’ point of view is still largely unexplored. The aim of this study was to explore and describe conceptions of coworkership among employees with different professions in a Swedish health care organization. Twelve focus group interviews were conducted with 68 employees, and the data were analyzed using phenomenography. Coworkership was experienced as a collective process, which included colleagues but not explicitly managers. Five categories emerged, representing different conceptions of coworkership: group coherence and striving toward a common goal, cooperation over professional and organizational boundaries, work experience and trusting each other’s competence, social climate and sense of community, and participation and influence. The collective process in terms of cooperation is closely related to team climate, which in turn influences the quality of patient care and a health-promoting work environment

Regression models for analyzing radiological visual grading studies – an empirical comparison

Background: For optimizing and evaluating image quality in medical imaging, one can use visual grading experiments, where observers rate some aspect of image quality on an ordinal scale. To analyze the grading data, several regression methods are available, and this study aimed at empirically comparing such techniques, in particular when including random effects in the models, which is appropriate for observers and patients. Methods: Data were taken from a previous study where 6 observers graded or ranked in 40 patients the image quality of four imaging protocols, differing in radiation dose and image reconstruction method. The models tested included linear regression, the proportional odds model for ordinal logistic regression, the partial proportional odds model, the stereotype logistic regression model and rank-order logistic regression (for ranking data). In the first two models, random effects as well as fixed effects could be included; in the remaining three, only fixed effects. Results: In general, the goodness of fit (AIC and McFaddens Pseudo R-2) showed small differences between the models with fixed effects only. For the mixed-effects models, higher AIC and lower Pseudo R-2 was obtained, which may be related to the different number of parameters in these models. The estimated potential for dose reduction by new image reconstruction methods varied only slightly between models. Conclusions: The authors suggest that the most suitable approach may be to use ordinal logistic regression, which can handle ordinal data and random effects appropriately

Varicella in Icelandic children - epidemiology and complications

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenIntroduction: Varicella is a common disease with possible consequences. The disease is usually contracted in childhood and persistent antibodies are produced. Varicella vaccine is not widely used in Iceland. The aim of the study was to investigate the epidemiology of varicella in Icelandic children and it s complications. The results may prove important when deciding on varicella immunization in Iceland. Material and methods: The study was retrospective cross sectional. Varicella antibodies were measured from children 10 years had antibodies. Hospital admittions were 58, annual admittions were or 3.6/100.000 children 10 ára með mótefni. Börn sem lögð voru inn vegna hlaupabólu eða fylgikvilla voru 58 eða 3,6 /100.000 börn á ári. Bakteríusýkingar voru algengasta ástæða innlagnar, einkum húðsýkingar en hnykilslingur, þurrkur og vannæring voru einnig algeng. Ályktun: Flest börn á Íslandi fá hlaupabólu fyrir 10 ára aldur. Fylgikvillar geta verið alvarlegir. Mikilvægt er að þekkja sjúkdóminn, viðbrögð við honum og kanna hvort hefja eigi almenna bólusetningu gegn honum hér á landi

Long Term Nationwide Analysis of HIV and AIDS in Iceland, 1983-2012.

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.Introduction: Iceland is well suited for epidemiological research due to well-kept patient records, easy followup of patients and nation-wide health care databases. This study provides a nationwide 30-year epidemiological overview of the HIV epidemic in the country. Materials and methods: Retrospective study on all HIV positive individuals in Iceland, 1983-2012. Clinical data, CD4+ T-cell counts, plasma HIV RNA, proportion of late presenters and effectiveness of combined antiretroviral therapy (cART) were compared by different time intervals. Results: In total, 313 were diagnosed with HIV in 1983-2012, thereof 222 (71%) men and 91 (29%) women. Most infections (65%) were acquired outside the country. Mean incidence of HIV was 3.7/100,000 inhabitants/year, with a significant increase in 2010-2012 (p=0.0113), related to misuse of the prescription drug methylphenidate among intravenous drug users. Official prescriptions for this drug increased from 3.5 in 2002 to 17.4 defined daily doses/ 1,000 inhabitants/day in 2012. Mortality decreased by 70% during the study period (p=0.0275). Proportion of late presenters decreased from 74% in the first decade to 36% during the third (p=0.0001). After 6 months of ART, CD4+ T-cells increased by only 26 cells/µl on average during the monotherapy era (1987-1995; p=0,174), by 107 cells/µl during the early-cART era (1996-2004; p<0.0001) and by 159 cells/µl during the late-cART era (2005-2012; p<0,0001). Similarly, progressively greater reductions in plasma HIV RNA were observed from 1996-2004 to 2005-2012 (p<0.0001). Conclusions: HIV incidence remained relatively low in Iceland until 2010, when it increased significantly due to spread among IDUs. The majority of HIV infections diagnosed in Iceland were imported. With ever more effective drug treatments on CD4+ T-cells and plasma HIV RNA, the number of AIDS diagnoses and deaths has decreased dramatically.University of Iceland Research Fund, Gilead Nordic fellowshi

European outbreak of Hepatitis A in Iceland in 2017. Common radiological changes of the gallbladder

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 FilesTILGANGUR Lifrarbólga A er afar sjaldgæf á Íslandi og hefur greinst um eitt tilfelli á ári undanfarin 20 ár. Frá árinu 2016 hefur verið greint frá faraldri í Evrópu meðal karla sem hafa haft mök við karla. Tilgangur rannsóknarinnar var að skoða hugsanleg tengsl tilfella af lifrarbólgu A á Íslandi árið 2017 við þennan faraldur. EFNIVIÐUR OG AÐFERÐIR Farið var afturskyggnt yfir gögn allra sjúklinga sem greindust með lifrarbólgu A á Íslandi árið 2017. NIÐURSTÖÐUR Af 5 sjúklingum sem greindust árið 2017 voru fjórir karlar og ein kona. Þrjú tilfelli greindust á innan við viku sumarið 2017. Sjúklingarnir voru á aldrinum 25 til 39 ára. Hjá karlkyns sjúklingum var smitleið talin vera gegnum mök við karlmenn frá meginlandi Evrópu. Allir sjúklingarnir voru með klíníska mynd lifrarfrumuskaða og í þremur af tilfellunum voru merki um væga lifrarbilun. Sjúklingarnir voru allir jákvæðir fyrir lifrarbólgu A mótefnum. Aðrar orsakir lifrarbólgu voru útilokaðar með viðeigandi prófum. Myndgreiningar vöktu grun um gallblöðrubólgu hjá fjórum af 5 sjúklingum og fór einn þeirra síðar í gallblöðrutöku sem valaðgerð. ÁLYKTUN Faraldur lifrarbólgu A í Evrópu meðal karla sem áttu mök við karla náði til Íslands sumarið 2017. Mikilvægt er að áhættuhópar láti bólusetja sig gegn veirunni. Breytingar í gallblöðru á myndgreiningu, svo sem þykknun á gallblöðruvegg án steina, eru algengar við bráða lifrarbólgu A. Nauðsynlegt er að gera greinarmun á þessum breytingum og bráðri steinalausri gallblöðrubólgu sem getur haft alvarlega fylgikvilla í för með sér.Senda grein,Prenta greinEnglishFacebookTwitter Aim The incidence of hepatitis A (HAV) in Iceland is low with about one case per year in the last decades. Since 2016, there has been an ongoing outbreak of HAV in men who have sex with men (MSM). The aim of this study was to inves­tigate whether cases diagnosed in Iceland during 2017 had any link to the HAV outbreak in Europe. Methods All cases of HAV in Iceland during 2017 were reviewed retrospectively. Results Four of five cases diagnosed during 2017 were MSM and one was a female. Three cases presented the same week in the summer 2017. The age of the patients was between 25 and 39 years. All the male patients had had sex with men from Europe and/or had travelled to Europe prior to admission. All cases had typical signs and symptoms of HAV infection and in all cases recent infection was confirmed by positive serology and exclusion of other causes of acute hepatitis. Four of five patients had radiological signs of changes in the gallbladder with thickening of the wall and oedema and one underwent later an elective cholecystectomy. Conclusion The outbreak of HAV in MSM Europe reached Iceland in the summer 2017, emphasizing the importance of vaccination in this risk group as recommended by the Icelandic Health Authorities. The review of these cases indicate that changes such as thickening of the gallbladder wall without gallstones in patients with HAV are common. It is important to discrimi­nate patients with these changes associated with HAV from patients with acute acalculus cholecystitis

Vom nicht abgegebenen Schuss zum nicht erzählten Ereignis. Schmid\u27sche Äquivalenzen

This collection brings together the articles dedicated to the 60th birthday of Professor Wolf Schmid, one of the foremost literary scholars of our times who made a crucial contribution to a wide range of scholarly fields: narratology, poetics, history of Russian and Slavic literature, Pushkin and Dostoevsky. The contributors form a distinguished international group of prominent scholars whose essays in this volume further develop Wolf Schmid\u27s narratological theory, shed new light on major works of literature and offer fascinating new insights into various periods of literary history.This collection brings together the articles dedicated to the 60th birthday of Professor Wolf Schmid, one of the foremost literary scholars of our times who made a crucial contribution to a wide range of scholarly fields: narratology, poetics, history of Russian and Slavic literature, Pushkin and Dostoevsky. The contributors form a distinguished international group of prominent scholars whose essays in this volume further develop Wolf Schmid\u27s narratological theory, shed new light on major works of literature and offer fascinating new insights into various periods of literary history