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Biomedical subjects

O Bjarnason

Publications and source records attributed to O Bjarnason.

At least 19 recordsLinked to original sources
PubMed2002

Living situation, subjective quality of life and social network among individuals with schizophrenia living in community settings.

OBJECTIVE: To investigate the relationships between characteristics of the living situation in the community and subjective quality of life and social network among community-based individuals with schizophrenia. METHOD: A total of 418 individuals with schizophrenia from 10 sites were interviewed with regard to quality of life, psychopathology, social network and needs for care. Characteristics of the living situation investigated were: living alone or not, living with family or not, and having an independent or a sheltered housing situation. RESULTS: An independent housing situation was related to a better quality of life concerning living situation and living with the family to a better quality of life concerning family relations. An independent housing situation was associated with a better social network regarding availability and adequacy of emotional relations. CONCLUSION: People with schizophrenia with an independent housing situation have a better quality of life associated with more favorable perceptions of independence, influence, and privacy. Their social network is better irrespective of whether they live alone or not, or with family or not.

Activities of Daily Living↗
PubMed2001

Predictors of social relations in persons with schizophrenia living in the community: a Nordic multicentre study.

BACKGROUND: Deinstitutionalisation has led to persons with serious mental illness spending most of their time outside psychiatric institutions. Not much is known about their social life. The paper presents the results of structured interviews with non-institutionalised persons with schizophrenia about treatment, care and social network. The network data are analysed from three perspectives: finding predictors of the number and of the quality of social contacts, and establishing the respective variables that characterise persons with high, and those with low, scores on both the quantity and quality dimensions of social integration. METHODS: Random samples of persons with schizophrenia receiving outpatient services in ten psychiatric centres in the four Nordic countries were interviewed. The following instruments were used: Interview Schedule for Social Interaction (ISSI), Camberwell Assessment of Needs, Lancashire Quality of Life Profile, General Assessment of Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS), in addition to a checklist covering the utilisation of different services. The ISSI provided the main data for this paper. A restricted number of possible predictors were used in General Linear Model (GLM) factorial analysis and discriminant analysis. RESULTS: A total of 418 persons took part in the study. The overall participation rate was 55%. Social integration in terms of number of contacts was related to a high GAF score, few BPRS negative and hostility symptoms, having contact with user organisations and living in urban (in contrast to rural) areas. Availability of emotional relations was predicted by female sex, low scores on the BPRS hostility dimension, high GAF score, having contact with one's family more than once a month, and living in urban areas. Work, adequate leisure activities and GAF score discriminated between the best and worst integrated groups. CONCLUSIONS: Living in urban areas, being female, having a high GAF score and low scores on hostility predicted better integration in terms of number of contacts and emotional relations.

Adult↗
PubMed2001

The Nordic Study on schizophrenic patients living in the community. Subjective needs and perceived help.

In a community sample of 418 persons diagnosed with schizophrenia, subjective needs and perceived help was measured by the Camberwell Assessment of Need (CAN). The mean number of reported needs was 6.2 and the mean number of unmet needs 2.6. The prevalence of needs varied substantially between the need areas from 3.6% ('telephone') to 84.0% ('psychotic symptoms'). The rate of satisfaction estimated as the percentage of persons satisfied with the help provided within an area varied between 20.0% ('telephone') and 80.6% ('food'). The need areas concerning social and interpersonal functioning demonstrated the highest proportion of unmet to total needs. In a majority of need areas the patients received more help from services than from relatives, but in the areas of social relations the informal network provided substantial help. In general the patients reported a need for help from services clearly exceeding the actual amount of help received. In a linear regression model symptom load (BPRS) and impaired functioning (GAF) were significant predictors of the need status, explaining 30% of the variance in total needs and 20% of the variance in unmet needs. It is concluded that the mental health system fails to detect and alleviate needs in several areas of major importance to schizophrenic patients. Enhanced collaboration between the care system and the informal network to systematically map the need profile of the patients seems necessary to minimise the gap between perceived needs and received help.

Activities of Daily Living↗
PubMed2001

Comparison of key worker and patient assessment of needs in schizophrenic patients living in the community: a Nordic multicentre study.

OBJECTIVE: The present study is part of a Nordic multicentre study investigating the life and care situation of community samples of schizophrenic patients. The specific aim of the present part of the study was to examine the agreement between patients and their key worker concerning the presence of met and unmet needs in a number of life domains, and help or support given in these domains. METHOD: The comparisons were based on 300 matched pairs of assessments of need using the Camberwell Assessment of Need interview. RESULTS: The results showed that key workers identified slightly more needs, 6.17 vs. 5.76, a significant difference. There was a moderate or better agreement on the presence of a need in 17 of 22 life domains investigated, but in only 11 life domains concerning the presence of an unmet need. Disagreement concerning whether the patient was given the right kind of help or support was even more substantial. CONCLUSION: It is concluded that key workers and patients disagree particularly concerning unmet needs and that this is potentially related to a number of factors associated with the key worker and patient. It is also concluded that further research is needed to increase the knowledge concerning the sources of this disagreement if need assessment is to become a valid basis for service planning and individual treatment planning.

Adult↗
PubMed2000

[Death and dying - definition and determination.].

For the first half of this century there was no major dispute over the criteria for death. This was to change dramatically with major technological breakthroughs in modern medicine starting with the advent of the respirators. The consequences of their use raised serious questions about the traditional ways of diagnosing death. Today there are two different philosophical positions about what it means to be dead in terms of brain functions: One, which is not currently law in any jurisdiction, would pronounce a person dead when there is an irreversible loss of higher brain functions. This has been called cognitive death. The patient is not in a coma, because arousal mechanisms are present, the brain stem functions being relatively intact. The other philosophical position considers a person dead if there is an irreversible loss of the functions of the brain stem or the entire brain. The neurologic syndrome of brain death has been accepted by the medical profession as a distinct clinical entity that experienced physicians can diagnose with an extremely high degree of certainty, and can usually easily be distinguished from other neurologic syndromes. However, we must not lose sight of the fact that this is less a conclusion than a beginning. It is the task of philosophy to offer analyses of personhood and of personal identity that might support practical formulations for the determination of death and theology has reflected upon the meaning of death, if not its definition, from time immemorial. To define the death of a human being we must recognize the characteristics that are essential to humaneness. It is quite inadequate to limit the discussion to the death of the heart or the brain.

English Abstract↗
PubMed1999

Predictors of subjective quality of life in schizophrenic patients living in the community. A Nordic multicentre study.

As part of a Nordic multi-centre study investigating the life and care situation of community samples of schizophrenic patients the aim of the present part of the study was to examine the relationship between global subjective quality of life and objective life conditions, clinical characteristics including psychopathology and number of needs for care, subjective factors such as satisfaction with different life domains, social network, and self-esteem. A sample of 418 persons with schizophrenia from 10 sites was used. The results of a final multiple regression analysis, explaining 52.3% of the variance, showed that five subjective factors were significantly associated with global subjective quality of life, together with one objective indicator, to have a close friend. No clinical characteristics were associated with global subjective quality of life. The largest part of the variance was explained by satisfaction with health, 36.3% of the variance, and self-esteem, 7.3% of the variance. It is concluded that the actual relationship between objective life conditions and subjectively experienced quality of life still remains unclear. Furthermore, it seems obvious that personality related factors such as self-esteem, mastery and sense of autonomy also play a role in the appraisal of subjective quality of life, which implies that factors like these are important to consider in clinical and social interventions for patients with schizophrenia in order to improve quality of life for these persons.

Adult↗
PubMed1992

Latent thyroid carcinoma in Iceland at autopsy.

The annual incidence rate of thyroid carcinoma in Iceland is high, 4.4 pr. 100,000 men, and 11.7 pr. 100,000 women, as published by the Icelandic Cancer Registry for the period 1955-1984. This rate is more than twice that in the other Nordic countries and one of the highest incidence rates reported anywhere. This led us to investigate the prevalence rate of latent thyroid carcinoma in Iceland. We serially sectioned and examined thyroid glands from 201 consecutive forensic autopsies. Altogether, sixteen carcinomas were identified in fourteen glands: fourteen papillary, one follicular and one medullary carcinoma. We conclude that the prevalence rate of latent thyroid carcinoma in each sex does not follow the frequency distribution of clinical disease, being 7.5% in males and 5.1% in females. Comparisons between populations show the same lack of consistency. Further, most, but not all, latent carcinomas of the thyroid gland are of the papillary type. These findings suggest that promoting factors might be of particular importance where incidence and mortality rates are high, but further research is needed into the role of host resistance.

Adolescent↗
PubMed1988

Tumours in Iceland. 10. Malignant tumours of the female breast. A histological classification, laterality, survival and epidemiological considerations.

The Icelandic Cancer Registry has records of 1,720 cases of malignant tumours of the female breast diagnosed in 1,659 patients in the 30-year period 1955-1984. Of these, 1,658 tumours were invasive. Sufficient histological material existed for 1,666 malignant tumours to make it possible to classify them according to the criteria published by the WHO. The most frequent histological type was Ductal carcinoma: 1,064 neoplasms, or 64%. Second in frequency was Lobular carcinoma: 175 neoplasms, or 10%; third was Mucinous carcinoma: 115 neoplasms, or 7%; and fourth in frequency was Medullary carcinoma: 69 neoplasms, or 4%. The incidence of carcinoma of the breast increased by 74% from 37.0 per 100,000 per annum in 1955-59 to 64.4 per 100,000 in 1980-84. This increase in incidence affected all morphological types, but Lobular and Mucinous more than Ductal and Medullary. The survival times have improved with time. Unilateral tumours were 710 in the right and 837 in the left breast. Both breasts were involved 167 times (106 patients), and in 6 patients the side was not recorded. A second primary was more likely to develop when the first one was in the right breast. This study of malignant tumours of the breast is the tenth in a series of investigations into histological classification of tumours occurring in Iceland.

Age Factors↗
PubMed1987

Tumours in Iceland. 9. Malignant tumours of the ovary. A histological classification, epidemiological considerations and survival.

In the period 1955-1979, 337 patients with carcinoma of the ovary were reported to the Icelandic Cancer Registry. Sufficient histological material existed for 314 of these to make it possible to classify the tumours according to the Histological Typing of Ovarian Tumours of WHO (11). The tumour was in the right ovary in 85 and the left in another 85 patients. In 137 patients both ovaries were involved at the time of diagnosis and in 30 patients the side was not known. The most frequent tumours were the group of serous adenocarcinomas, papillary adenocarcinomas and papillary cystadenocarcinomas (IA3a), occurring in 113 patients, giving an age-standardized incidence of 4.4 per 100.000. Second in frequency was the endometrioid adenocarcinoma (IC3a1), in 58 patients, and the third the group of mucinous adenocarcinoma and cystadenocarcinomas (IB3a) in 43 patients. The fourth type in frequency was undifferentiated carcinoma (IG) in 18 patients. During the period, the overall incidence of ovarian cancer did not change. However, there was an increase in the frequency of mucinous and endometrioid types of carcinoma and a decrease in serous carcinoma. Granulosa cell carcinoma was found to have been under-reported to the Icelandic Cancer Registry. ABO blood groups for 192 of the patients were available and showed a significant excess of blood group A, with patients of blood group B significantly fewer than expected. This study of malignant tumours of the ovary is the ninth in a series of investigations into the histological classification of tumours occurring in Iceland during the 20-year period between 1955 and 1974. The tumours occurring in the period 1975-1979 were included in this particular study to increase the number available for classification.

ABO Blood-Group System↗
PubMed1982

Familial breast cancer in Iceland.

Women who have relatives known to have had breast cancer are at an increased risk of getting the disease compared with the general population. On the basis of an extensive collection of family trees of women with breast cancer, the magnitude of this increase in risk is computed. Previously published results on other breast cancer risk factors are drawn upon and it has been possible to take account of some of these e.g., age, decade of birth, age at first childbirth and parity in the risk estimates. The relative risk with such adjustment is found to be 2.59 for mothers and 2.56 for sisters.

Adult↗
PubMed1982

Association between changes in psychiatric services and increases in suicide rates.

The purpose of the study is to discover whether there is an association between changes in the psychiatric services offered by the largest psychiatric hospital in Iceland during the period 1955-1978 and changes in the rate of suicide. Marked changes occurred in the services after 1965. The rate of suicide in the patient population was significantly higher during 1965-1978 than during 1955-1964. It is concluded that the changes in the psychiatric services are associated with an increase in the rate of suicide and that this increase may to some extent be a side effect of therapeutic methods introduced after 1965. The conclusion is thought to imply the necessity for further evaluation of those therapeutic methods as applied in the hospital and increasing the application of measures for the prevention of suicide.

Community Mental Health Services↗
PubMed1981

Incidence of different morphological types of thyroid cancer in the Nordic countries.

In order to determine the incidence of different morphological types of thyroid cancer in the Nordic countries, all cases of thyroid cancer reported to the national cancer registries of Finland, Iceland, Norway and Sweden over periods ranging from 1 to 14 years were re-examined (a total of 706 cases) by one or two pathologists from each country. The age-adjusted incidence rate for Iceland was clearly higher than those for the other Nordic countries. The rate for Finland was the lowest, and a five-fold difference was seen between Iceland and Finland. The differences in the incidence rates applied to all age groups and to both sexes. The differences also concerned all histological types and were more pronounced for papillary and medullary carcinomas. In papillary carcinoma, an almost 10-fold difference was found between Finland and Iceland. The causes of the differences are not known. There has been and probably still is some endemic goitre in Finland, Norway and Sweden, but no endemic goitre occurs in Iceland. Thus, no positive association was found between the presence of endemic goitre and the risk of follicular carcinoma. There was a marked negative association between endemic goitre and the risk of papillary carcinoma.

Adenocarcinoma↗
PubMed1980

Causes of death in a subarctic population.

Some of the main causes of death prior to 1900 are mentioned, including disastrous epidemics of high mortality such as plague, smallpox and the so-called hunger epidemics. Also discussed are two chronic diseases remarkable for Iceland in old times i.e., leprosy and hydatid disease. In the first third of the 20th century, infectious diseases still were the main cause of death in Iceland. The importance of tuberculosis in this connection is stressed. The very high infant mortality up to the beginning of this century is stressed. The changes in the main causes of death in the last decades are described and the growing influence of degenerative vascular diseases and cancer in that connection pointed out. Last, the remarkable fall in the infant mortality and increasing life expectancy from the beginning of this century with growing prosperity of the nation is stressed.

Cardiovascular Diseases↗