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Biomedical subjects

A Bjørndal

Publications and source records attributed to A Bjørndal.

At least 19 recordsLinked to original sources
PubMed2002

Impact of antenatal HIV screening to prevent HIV infection in children in Norway 1987-99.

OBJECTIVE: To assess the impact of the antenatal HIV screening programme in Norway in preventing HIV infection in children. SETTING: Norway, 1987-99. METHODS: In a simulated retrospective cohort design data were used from the mandatory HIV surveillance system to compare the observed number of children born infected with HIV in Norway 1987-99 to the expected number without the antenatal screening programme. The main measures were relative and absolute performance of the screening programme. Other measures were uptake and false positive rate of screening, and number and exposure category of screen positive women. RESULTS: 96% of 961 000 eligible pregnant women were tested. 0.1% had an indeterminate test result and 46 women (5.0/100 000) were confirmed screen positive. 27 were African or south east Asian women infected before immigration to Norway. Nine out of 739 000 live born children (1.2/100 000) were infected compared with the expected 18 with no screening. The absolute impact of the screening programme was 1.3 (95% confidence interval (95% CI) -0.1 to 2.7) prevented infections in 100 000 women screened. The relative preventive impact was 51% (-15% to 81%). CONCLUSIONS: The limited absolute impact is because of the very low prevalence of undetected HIV infection among pregnant women in Norway.

AIDS Serodiagnosis↗
PubMed2001

The potential for research-based information in public health: identifying unrecognised information needs.

OBJECTIVE: To explore whether there is a potential for greater use of research-based information in public health practice in a local setting. Secondly, if research-based information is relevant, to explore the extent to which this generates questioning behaviour. DESIGN: Qualitative study using focus group discussions, observation and interviews. SETTING: Public health practices in Norway. PARTICIPANTS: 52 public health practitioners. RESULTS: In general, the public health practitioners had a positive attitude towards research-based information, but believed that they had few cases requiring this type of information. They did say, however, that there might be a potential for greater use. During five focus groups and six observation days we identified 28 questions/cases where it would have been appropriate to seek out research evidence according to our definition. Three of the public health practitioners identified three of these 28 cases as questions for which research-based information could have been relevant. This gap is interpreted as representing unrecognised information needs. CONCLUSIONS: There is an unrealised potential in public health practice for more frequent and extensive use of research-based information. The practitioners did not appear to reflect on the need for scientific information when faced with new cases and few questions of this type were generated.

Attitude of Health Personnel↗
PubMed2000

[Observational units--same good service to lower costs?].

BACKGROUND: With increased demand for hospital services and limited resources in the health sector, modes of organisation of services which give the same health outcome, but at lower cost, are of interest. Observation units in hospitals imply rapid diagnostic procedures and/or brief, but adequate treatment. We looked at the evidence for whether stays in observational units provide similar health outcome and reduce the admissions costs for hospitals compared to standard inpatient stays. MATERIAL AND METHODS: We systematically evaluated four randomized controlled studies that have compared the outcome for chest pain and asthma patients admitted to either observational units or directly to ordinary hospital units. The outcomes in focus were health effects measured as mortality and/or complications, length of stay and direct hospital costs. RESULTS: The studies indicate that for the conditions included, there are no health outcome differences between patients treated in observational units on one hand or in ordinary hospital units on the other. Stays in observational units do not seem to imply increased risk of complication. Furthermore, the studies show a reduction in length of stay and hospital costs associated with the use of observational units. INTERPRETATION: The main reason for the reduction in length of stay and cost is quicker diagnosis in observational units than in the ordinary hospital units. The preconditions for these results are clear by defined criteria for selection of patients to the different units and well-defined protocols for making diagnoses and treating patients. If many patients after staying in observational units are transferred to ordinary hospital units or are discharged and then readmitted, the economic benefits of observational units could be undermined.

Angina Pectoris↗
PubMed2000

A population study of factors associated with general practitioner consultation for non-inflammatory musculoskeletal pain.

OBJECTIVE: To investigate factors associated with visiting a general practitioner (GP) for non-inflammatory musculoskeletal pain, and to examine whether these factors were affected by duration (chronic v non-chronic) or location (widespread v regional) of pain. METHODS: From a cross sectional postal survey of 20 000 (response rate 59%) randomly selected adults in two counties of Norway, 6408 subjects who had experienced musculoskeletal pain during the past month were included. Patients who reported inflammatory rheumatic diagnoses made by a doctor were excluded. RESULTS: 2909 (45%) had consulted a GP for their musculoskeletal pain during the past 12 months. The odds of consulting were significantly increased by being a woman, by having a higher age and lower education, and by being a pensioner or on sick leave. Patients with widespread pain were more likely to consult than those with regional pain, as were patients with chronic compared with non-chronic pain. Greater than median pain intensity was the factor most prominently associated with consultation for men (odds ratio (OR)=2.4; 95% confidence interval (95% CI) 2.0 to 2.9) and for women (OR=2.6; 95% CI 2.3 to 2.9). Overall, consultation was significantly associated with mental distress for women but not for men. Subgroup analyses showed that consultation for chronic pain was significantly associated with greater than median mental distress for both women (OR=1.3; 95% CI 1.1 to 1.6) and men (OR=1.2; 95% CI 1. 0 to 1.4), whereas consultation for non-chronic pain was not. CONCLUSION: The results show that about half of the patients with musculoskeletal pain consult a general practitioner (GP) each year, that demographic factors are associated with consulting, and that the role of mental distress for consulting a GP varies with duration of pain.

Absenteeism↗
PubMed1999

[Do public health practitioners have satisfactory access to important information sources?].

We asked Norwegian public health practitioners which information sources they used as support for their professional medical counselling, how they gathered their information, and how they evaluated the validity of the information. 348 (67%) questionnaires were returned. Legal sources, other types of reference books/textbooks, different types of expertise from other institutions, and colleagues were considered the most important information sources. The majority had difficulties accessing libraries. Bibliographic databases were used very little. 30% often had problems finding relevant information, while 56% had problems occasionally. Many respondents felt that it was too difficult to get hold of information, that it was difficult to know where to search and that it was difficult to find the time to do it. In judging the scientific validity of an article the majority compared the content with their own experience. Relevant scientifically based medical information was seldom obtained and utilized. Public health practitioners were surprisingly homogeneous in their description of their handling of information. We found for instance almost no differences between specialists and non-specialists. The survey shows that public health practitioners do not have satisfactory access to potentially important information sources. The type of barriers many of them meet when searching for information, indicates that public health physicians would benefit from tailored information services.

Clinical Competence↗
PubMed1999

Rapid changes in the prevalence of obesity and known diabetes in an adult Norwegian population. The Nord-Trøndelag Health Surveys: 1984-1986 and 1995-1997.

OBJECTIVE: To determine whether changes in mean BMI and the prevalence of obesity in a total adult population during a short (11-year) period were associated with changes in the prevalence of diabetes. RESEARCH DESIGN AND METHODS: This study involved cross-sectional surveys of all inhabitants aged > or = 20 years of the county of Nord-Trøndelag from 1984 to 1986 (n = 85,100) and from 1995 to 1997 (n = 92,434). Attendance rates were 88.1 and 71.3%, respectively, and 90.0% in an additional survey of people aged 13-19 years from 1995 to 1997 (n = 9,593). Main outcome measures were age-specific mean BMI for the diabetic and nondiabetic subgroups and the prevalence of obesity and diabetes. For comparison, mean BMIs from 18 of 19 Norwegian counties for the group aged 40-42 years were examined. RESULTS: Mean BMI increased from 27.2 to 29.0 kg/m2 in the diabetic population and from 25.1 to 26.3 kg/m2 in the nondiabetic population. The BMI distribution curve shifted to the right, but homogeneity was also reduced. A comparison with other Norwegian counties indicated that this increase occurred during the last 6 years between the surveys. The prevalence of obesity (BMI > or = 30 kg/m2) increased from 7.5 to 14% in nondiabetic men and from 13 to 18% in nondiabetic women. The increase was particularly great in men aged < 60 years and in women aged < 50 years. The overall prevalence of known diabetes increased between the two surveys (from 2.9 to 3.2%) but only in men. The largest increase was observed in the corresponding younger sex and age-groups. CONCLUSIONS: A substantial increase in mean BMI and the prevalence of obesity occurred in the younger age-groups at the same time as an increase in the prevalence of diabetes. A greater increase in diabetes prevalence in this ethnically stable Western European population may follow if effective primary preventive strategies are not undertaken.

Adolescent↗
PubMed1998

The limits of leadership: opinion leaders in general practice.

OBJECTIVE: To explore the importance and characteristics of opinion leaders in general practice, particularly in relationship to the use of laboratory tests. DESIGN: Focus group discussions and a mailed survey. SUBJECTS: Five focus groups (n = 29 participants) in four different municipalities and a random sample of 85 general practitioners (GPs) in Norway. RESULTS: While Norwegian GPs recognised colleagues who were influential in determining how they practised, they found it difficult to identify opinion leaders specifically with respect to the use of laboratory tests. Opinion leaders were thought to be less important in influencing the use of laboratory tests than continuing medical education activities and practice guidelines, but more important than industry, patients or personal financial interests. Norwegian GPs recognised and characterised opinion leaders in much the same way as physicians in the USA. Influential colleagues were characterised as being good conveyers of information and willing to take time, as well as being up-to-date and having a high level of clinical expertise. GPs expressed a negative attitude towards 'superspecialists' who give advice without knowing the epidemiology of general practice, people who are arrogant and people who do not show respect towards GPs. CONCLUSIONS: The potential to identify and use opinion leaders to improve the use of laboratory tests by GPs in Norway appears to be limited.

Attitude of Health Personnel↗
PubMed1998

Ex-smokers and risk of hip fracture.

OBJECTIVES: The purpose of this study was to examine the reversibility of the effect of smoking on hip fracture incidence rates. METHODS: A 3-year follow-up cohort study was conducted involving 35,767 adults 50 years of age or older. Of these individuals, 421 suffered a hip fracture. RESULTS: Among participants less than 75 years of age, the relative risk (RR) of hip fracture was elevated for ex-smokers, even for those who had quit smoking more than 5 years previously (men: RR = 4.4, 95% confidence interval [CI] = 1.2, 15.3; women: RR = 1.3, 95% CI = 0.6, 3.0), but was not as high as that for current smokers (men: RR = 5.0, 95% CI = 1.5, 16.9; women: RR = 1.9, 95% CI = 1.2, 3.1). CONCLUSIONS: The effect of smoking on risk of hip fracture was not reversed completely 5 years after smoking cessation.

Aged↗
PubMed1997

[Self-reported chronic muscle pain among women in Oslo].

The prevalence and epidemiological features of chronic muscle pain were investigated in a cross-sectional postal survey of 2,664 females aged 25-55 years, out of a random sample of 4,000 females in Oslo, Norway. The three-month prevalence of chronic widespread musculoskeletal pain was 22%, while 25% reported chronic localised pain. Chronic widespread pain was significantly associated with a number of sociodemographic factors, whereas no such associations were found for localised pain. Other health complaints, insomnia and low satisfaction with life, were more common among women with widespread pain than among women with localised pain.

Adult↗