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Biomedical subjects

Erlend Hem

Publications and source records attributed to Erlend Hem.

At least 19 recordsLinked to original sources
PubMed2006

[Was it a physician Ibsen wanted to become?].

It is a widespread view, even today, that Henrik Ibsen (1828-1906) as a young man intended to study medicine. This opinion was probably first expressed by his friend Paul Botten-Hansen in his Ibsen biography from 1863, when the poet was 35 years old. Since then, it has been repeated several times, for example in Henrik Jaeger's biography from 1888 and in Jens B. Halvorsen's Norwegian Author Encyclopedia from 1892. Ibsen proofread both of these books and did not change this information. Although the sources are weak, Ibsen may have wanted to study medicine. However, we do not know when he got this idea, for how long it occupied his mind or how deeply rooted it was. When Ibsen as a 22-year-old moved from Grimstad to Christiania in 1850 to complete his examen artium, he had other plans. This story illustrates an important message: What should we require from sources before we accept a piece of information?

Famous Persons↗
PubMed2006

[A peculiar speech disorder due to bomb injury of the brain].

Oslo was bombed by British bombers 6 September 1941, and a 28-year-old woman was hit on the head by a bomb fragment. She was seriously wounded with a large defect in the cranium frontally on the left side, and it was believed that she was not going to survive. She was unconscious for 3-4 days, and when she woke up she had right-sided hemiplegia and complete aphasia. She gradually recovered, and two months later she was discharged from hospital. Remarkably, the brain damage had altered her melody of language, and she spoke with a German-like accent. This led to problems for her during the war: she was for example not served in shops. The case story was published after the war by the Norwegian neurologist Georg Herman Monrad-Krohn (1884-1964), and it is the best known case of the so-called foreign accent syndrome. In this paper, this rare syndrome is presented, emphasising Monrad-Krohn's patient and based on his writings and the patient's medical record.

Adult↗
PubMed2006

[An apothecary apprentice crosses his tracks--about Ibsen's prescriptions].

As a youngster, Henrik Ibsen (1828-1906) worked as an apothecary apprentice for six years at the apothecary in Grimstad. Here, he learnt apothecary Latin, which he later on used in his literary works. Also in his own life, he used this knowledge during his last years of life when he prescribed drugs for himself. Ibsen's last six years were characterized by disease. The National Library in Oslo has three prescriptions in which the poet prescribes two different kinds of drugs, even though they should have been prescribed by a medical doctor. One of the drugs was iodide of sodium, a well-known drug for arteriosclerosis at that time. The other drug was a laxative called Brandt's Schweizer pills. Iodide of sodium was a relatively new drug introduced to the market at the end of the 19th century. Even though there was uncertainty about the effect and mode of action, it had become an established part of medical practice. That was not the case for Brandt's Schweizer pills. They were produced by the German apothecary Richard Brandt (1828-1903) in 1877. Medical doctors warned against using them. It was a so-called arcanum, i.e. the producer kept the content secret. The use of such drugs came out of control in the 1890ies and was a serious community problem.

Cathartics↗
PubMed2006

An exploration of job stress and health in the Norwegian police service: a cross sectional study.

BACKGROUND: Police work is regarded as a high-stress occupation, but so far, no nationwide study has explored the associations between work stress and health. AIMS: To explore physical and mental health among Norwegian police and associations to job stress. Comparisons were made with a nationwide sample of Norwegian physicians and the general Norwegian population. METHODS: Comprehensive nationwide questionnaire survey of 3,272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey with two factors (serious operational tasks and work injuries), the Job Stress Survey with two factors (job pressure and lack of support), the Basic Character Inventory, the Subjective Health Complaint questionnaire, the Hospital Anxiety and Depression Scale, the Maslach Burnout Inventory, and Paykel's Suicidal Feelings in the General Population. RESULTS: The frequency of job pressure and lack of support was mainly associated to physical and mental health problems. Females showed higher means on anxiety symptoms than males (4.2, SD 2.9 and 3.7, SD 2.9, respectively; p < 0.01), while males showed higher means on depressive symptoms (3.1, SD 2.9 and 2.4, SD 2.5, respectively; p < 0.001). Police reported more subjective health complaints, depersonalization and higher scores on three of four personality traits than physicians, but lower scores on anxiety and depressive symptoms than the general population. CONCLUSION: This is the first nationwide study to explore job stress and physical and mental health in police. The results indicate that Norwegian police have high levels of musculoskeletal health problems mainly associated to the frequency of job pressure and lack of support. However, also frequent exposure to work injuries was associated to health problems. This may indicate that daily routine work as well as police operational duties must be taken into consideration in assessing job stress and police health.

Journal Article↗
PubMed2006

Life satisfaction and resilience in medical school--a six-year longitudinal, nationwide and comparative study.

BACKGROUND: This study examined the relationship between life satisfaction among medical students and a basic model of personality, stress and coping. Previous studies have shown relatively high levels of distress, such as symptoms of depression and suicidal thoughts in medical undergraduates. However despite the increased focus on positive psychological health and well-being during the past decades, only a few studies have focused on life satisfaction and coping in medical students. This is the first longitudinal study which has identified predictors of sustained high levels of life satisfaction among medical students. METHODS: This longitudinal, nationwide questionnaire study examined the course of life satisfaction during medical school, compared the level of satisfaction of medical students with that of other university students, and identified resilience factors. T-tests were used to compare means of life satisfaction between and within the population groups. K-means cluster analyses were applied to identify subgroups among the medical students. Analysis of Variance (ANOVA) and logistic regression analyses were used to compare the subgroups. RESULTS: Life satisfaction decreased during medical school. Medical students were as satisfied as other students in the first year of study, but reported less satisfaction in their graduation year. Medical students who sustained high levels of life satisfaction perceived medical school as interfering less with their social and personal life, and were less likely to use emotion focused coping, such as wishful thinking, than their peers. CONCLUSION: Medical schools should encourage students to spend adequate time on their social and personal lives and emphasise the importance of health-promoting coping strategies.

Adaptation, Psychological↗
PubMed2006

Health status in the ambulance services: a systematic review.

BACKGROUND: Researchers have become increasingly aware that ambulance personnel may be at risk of developing work-related health problems. This article systematically explores the literature on health problems and work-related and individual health predictors in the ambulance services. METHODS: We identified the relevant empirical literature by searching several electronic databases including Medline, EMBASE, PsychINFO, CINAHL, and ISI Web of Science. Other relevant sources were identified through reference lists and other relevant studies known by the research group. RESULTS: Forty-nine studies are included in this review. Our analysis shows that ambulance workers have a higher standardized mortality rate, higher level of fatal accidents, higher level of accident injuries and a higher standardized early retirement on medical grounds than the general working population and workers in other health occupations. Ambulance workers also seem to have more musculoskeletal problems than the general population. These conclusions are preliminary at present because each is based on a single study. More studies have addressed mental health problems. The prevalence of post-traumatic stress symptom caseness was > 20% in five of seven studies, and similarly high prevalence rates were reported for anxiety and general psychopathology in four of five studies. However, it is unclear whether ambulance personnel suffer from more mental health problems than the general working population. CONCLUSION: Several indicators suggest that workers in the ambulance services experience more health problems than the general working population and workers in other health occupations. Several methodological challenges, such as small sample sizes, non-representative samples, and lack of comparisons with normative data limit the interpretation of many studies. More coordinated research and replication are needed to compare data across studies. We discuss some strategies for future research.

Accidents↗
PubMed2006

[The fatal story--Ibsen's health during the last years of his life].

In contrast to Henrik Ibsen's literary work, the author's health during the last years of his life has not attracted much attention. Ibsen suffered from a variety of symptoms due to arteriosclerotic cardiovascular disease. He was first hit by a stroke in March 1900, which resulted in paresis of his left foot. During the summer 1900 he was ill with erysipelas. Thereafter, in 1901 and in 1903, he was hit by two more strokes, which left him with severe right hemiparesis and aphasia. Ibsen's varying health might indicate that he was hit by several additional minor stokes in both hemispheres, most likely tromboembolic cerebral infarcts. During his last years he developed symptoms of cardiac failure, and it was probably an increasing cardiac failure that led to the cardiac arrest that ended his life.

Aged↗
PubMed2006

[Ibsen's last years of life--the physicians and the demanding patient].

Henrik Ibsen's last six years were characterized by disease, and the relationship between the famous patient and his doctors during these years has a certain historical interest. Ibsen was a demanding patient, partly due to his personality and social situation, gradually also due to the clinical picture. Ibsen had great and almost unreasonable expectations and demands on his doctors, but if the doctor won Ibsen's confidence, he followed the ordinances with great accuracy. After his return to Norway in 1891, Ibsen became acquainted with Christian Sontum (1858-1902), whom he chose to be his doctor. After Sontum's death in 1902, Professor Peter F. Holst (1861-1935) was Ibsen's doctor for about one year. However, Holst did not get along with Ibsen and his family and Dr. Edvard Bull (1845-1925) succeeded him. Bull and Ibsen were close friends during the last three years of Ibsen's life. The story about Ibsen's doctors illustrates challenges in the doctor-patient-relationship. Edvard Bull's patience, great human and sympathetic insight, and the fact that he from the very beginning saw Ibsen as an individual and not only the diseases, represents a thought-provoking example.

Aged↗
PubMed2006

Help-seeking in the Norwegian Police Service.

A traditional view is that police officers possess negative attitudes toward seeking professional help. However, few empirical studies have investigated help-seeking behaviour in police services. This study aimed to investigate help-seeking behaviour, gender differences, and the relationship to self-reported physical and mental health problems in the Norwegian police service. Comparisons were made with a sample of the general Norwegian population. A comprehensive nationwide questionnaire survey of 3,272 Norwegian police officers at all hierarchical levels was conducted; measurements included help-seeking, Subjective Health Complaint questionnaire (SHC), the Hospital Anxiety and Depression Scale (HADS), Paykel's Suicidal Feelings in the General Population, alcohol and medication to cope, self reported health, and sick leave. Female police officers contacted nearly all health professionals more than their male counterparts. Help-seeking was largely unaffected by age. Less than 10% of those reporting anxiety or depressive symptoms or serious suicidal ideation had contacted a psychologist or psychiatrist. A chiropractor had been contacted by 14.5% of the sample during the past year, compared with 7% in the general Norwegian population. Anxiety symptoms were associated with seeking a chiropractor (OR 1.9, 95% CI 1.3-2.7). The strongest association with contacting a psychologist or psychiatrist was medication used to cope (OR 5.8, 95% CI 3.0-11.1). The first nationwide study on help-seeking behaviour showed that police officers sought help among specialists in private practice, physiotherapists and chiropractors relatively often. However, they contacted a psychologist or psychiatrist rarely, even when reporting serious suicidal ideation.

Adult↗
PubMed2005

Self-prescribing among young Norwegian doctors: a nine-year follow-up study of a nationwide sample.

BACKGROUND: Self-prescribing among doctors is common, but no longitudinal studies have documented this issue. We studied the self-prescribing behaviour among young Norwegian physicians and the predictors of self-prescribing. METHODS: We conducted a nationwide, prospective and longitudinal study following young Norwegian physicians from internship through the subsequent nine years using three postal questionnaires. Chi-square tests and logistic regression models were applied. RESULTS: About 54% of the physicians in their fourth and ninth postgraduate years had self-prescribed medication at least once during the previous year. Among those who had used prescription medication during the previous year, about 90% had self-prescribed. Self-prescribing behaviour did not differ significantly between men and women, or according to the type of work at any time. The most frequently self-prescribed medications were antibiotics (71%-81%), contraceptives (24%-25%), analgesics (18%-21%), and hypnotics (9%-12%). Those who had needed treatment for mental problems had self-prescribed hypnotics and sedatives to a greater extent than the others. Being male, having self-prescribed during internship, somatic complaints, mental distress, subjective health complaints, and not having sought help from a general practitioner, were significant adjusted predictors of self-prescribing in the ninth postgraduate year. CONCLUSION: The level of self-prescribing among young Norwegian physicians is relatively high, and this behaviour is established early in their professional lives. Although self-prescribing is acceptable in some situations, physicians should seek professional help for illness. Efforts to inculcate more rational help-seeking behaviour should probably start in medical schools.

Analgesics↗
PubMed2005

[Psychological intervention after trauma--does it work?].

A Cochrane review from 1998 concluded that single-session intervention does not prevent the onset of post-traumatic stress disorder. This led to a debate about what is the best, if any, psychological treatment after traumas. In consequence, some clinicians have become doubtful about as how to deal with traumatized patients. We present three examples in order to illustrate situations in which psychological intervention is useful. The conclusions in the Cochrane review are well documented. However, insufficient correspondence between the traumas and the intervention offered gave us cause to question the clinical importance of existing studies. Future studies of psychological intervention after traumas should use an individualized design in which the intervention is in proportion to the trauma. Based on knowledge not given by randomized controlled studies, we recommend clinicians to offer psychological help to those exposed to traumatic incidents. Most people need adequate information after traumas. For those who develop health problems, intervention until recovery is recommended.

Accidents↗
PubMed2005

Which young physicians are satisfied with their work? A prospective nationwide study in Norway.

BACKGROUND: Few studies have investigated personality and medical school variables in regard to job satisfaction after graduation. It is of great importance to investigate these factors because this information may be used in the recruitment/admittance process to medical schools, and possibly to improve medical education. METHODS: We conducted a nationwide prospective 10-year follow-up study of medical students at all medical schools in Norway. They were approached three times during their medical training: at very beginning (T1), in the middle (T2), in the last year of medical school (T3), and then four years after graduation (T4). There were 210 participants who responded on all four occasions. Job satisfaction was measured with the Job Satisfaction Scale, which was used as the outcome variable. In addition to conducting multiple regression analysis for the total sample, we also conducted similar analyses separately for men and women. RESULTS: Among the demographic and personality variables, 'having a father who is a physician' and 'interpersonal functioning (being withdrawn)' were significantly associated with job satisfaction at T4. Among the medical school variables, 'well-being with peers', 'identification with the doctor's role at the end of curriculum', 'perceived medical school stress', and 'perceived clinical skills' were significantly associated with job satisfaction. In the multiple regression analysis only 'father as a physician' and 'perceived clinical skills' yielded an independent influence on the outcome variable in separate analyses within sub-groups of male and female students, 'perceived clinical skills' differentiated among woman only, while 'well-being with peers' differentiated only among men. CONCLUSION: The main finding of this study is that the young physicians who are the most satisfied in their work are those whose fathers are physicians and those who have a high level of perceived clinical skills at the end of medical school. There are also differences in regard to predictors of job satisfaction among men and women. These findings indicate that medical schools should invest substantial effort in clinical skills training, and this seems to be especially important among female students.

Adult↗
PubMed2005

Suicide rates according to education with a particular focus on physicians in Norway 1960-2000.

BACKGROUND: Suicide rates are higher in certain educational groups. The highest rates are generally found in the medical and allied professions, but the empirical evidence for high suicide rates may be questionable. This study compares the rate of suicide among trained physicians, dentists, nurses, police officers and theologians with the rate among other university graduates and the general population according to sex, age and time period. METHOD: Census data from 1960, 1970, 1980 and 1990 relating to education were linked to suicide as cause of death data from Statistics Norway, and followed up for the period 1960-2000, comprising 46 and 49 million person-years among men and women respectively. RESULTS: Physicians still have a higher rate compared with other graduates and the general population, both among males [43.0, 95% confidence interval (CI) 35.3-52.5] and females (26.1, 95% CI 15.1-44.9). Suicide rates increased steeply by age among physicians and other graduates, whereas for non-graduates the rate was highest in the 40-60 years age group. The suicide rate among female nurses was also elevated, whereas police officers seemed to have an intermediate suicide risk. The rate among theologians was low (7.0, 95% CI 2.9-16.9). The suicide rates in the 1990s were significantly lower than in the 1980s. CONCLUSIONS: The high suicide rates among physicians and elderly graduates are of concern. The reasons why graduates are more vulnerable than others when getting older and the low rate among theologians warrant further study.

Adult↗
PubMed2005

Should catatonia be part of the differential diagnosis of coma?

The descriptions of catatonia are complex and unclear. More than 40 different signs and symptoms have been included, but coma is not among them. Recently, a case report of coma in relation to catatonia was presented. We report two further cases where coma was a part of this syndrome of disturbed motility. They were successfully treated with ECT. Consequently, we suggest that catatonia may be a differential diagnosis of coma.

Adult↗
PubMed2005

Stress in the Norwegian police service.

BACKGROUND: High levels of stress have been attributed to the conditions of police work, but there is little empirical evidence for this. AIMS: To develop a new instrument to measure job stress in the police; to assess the most severe and frequent police stressors; to compare levels of stress according to the demographic and organizational factors; and to study stress in relation to personality traits, work locus of control and coping strategies. METHODS: A comprehensive nationwide questionnaire survey of 3272 Norwegian police at all hierarchical levels, including the Norwegian Police Stress Survey (NPSS), the Job Stress Survey, the Basic Character Inventory, the Work Locus of Control Scale, and the Coping Strategies Scale. RESULTS: Work injuries were appraised as the most stressful but least frequent stressor and job pressure was reported the least severe but most frequent stressor. Females experienced job stressors less frequently, but appraised them as more severe than men did. Older police officers reported more job pressure severity and fewer work injuries. The police in districts where peer support was planned but not implemented, and who worked in districts with more than 50,000 inhabitants, perceived the lack of support more severely than others. The correlations between stress and personality traits, work locus of control, and coping were moderate. CONCLUSIONS: The NPSS captures police-specific stressors that are not adequately measured by global stress instruments. The study of stress in police work should preferably involve a nationwide use of police-specific stress instruments.

Adaptation, Psychological↗