Search

Diagnostic evaluation of patients with suspected encephalitis (PDF 184 kb)

Objectives To develop and validate a scoring system for laparoscopic skills for five specific tasks on a virtual reality simulator. Study design A longitudinal, experimental, non-randomised study including 30 gynecologists and gynecological trainees at three hospitals. The participants were categorized as inexperienced (Group 1), moderately experienced (Group 2), and experienced (Group 3). The study participants performed ten repetitions of three basic skill tasks, a salpingectomy and a laparoscopic supracervical hysterectomy on a virtual reality simulator. Assessment of skills was based on time, error parameters and economy of movements measured by the simulator. We used the results (mean and SD for each parameter in all tasks) of the four last repetitions performed by the experienced gynecologists as the basic for the scoring system. Performance equal to, and higher than, this mean score gave 2 points. A decrease of 1 SD from the mean gave 1 point. Every score below gave 0 points. The mean score for the inexperienced, moderately experienced and experienced study participants was compared. Results The mean scores in Task 1 were 3.4 (SD 0.6) in Group 1, 3.4 (SD 0.6) in Group 2 and 5.1 (SD 1.1) in Group 3, respectively. There was a statistically significant difference in score between Group 1 and 3 (p = 0.01), and group 2 and 3 (p = 0.01). In Task 2 no statistical significant differences were found. In Task 3, the total mean scores were 1.7 (SD 0.7) in Group 1, 1.9 (SD 0.9) in Group 2 and 2.8 (SD 0.5) in Group 3, respectively. The difference in score between study groups was statistically significant when comparing Group 1 and Group 3 (p

ROC curves of relevant parameters showing AUC for predicting encephalitis in an encephalopathic population; Legend (in figure): AUC of probability of encephalitis for individual symptoms and findings, data from univariate logistic regression analyses. Figure 2a: personality change: 0.62 (95% CI, 0.47–0.76), focal findings: 0.63 (95% CI, 0.49–0.78), fever: 0.63 (95% CI, 0.50–0.76), travel: 0.64 (95% CI, 0.49–0.79), nausea: 0.69 (95% CI, 0.56–0.82). Figure 2b: ESR

Assisted Questionnaire for weeks 1, 2, and 3. (DOCX 18 kb)

Supplement QI Success Domains. (DOCX 350Â kb)

Supporting material for the AVRre study. (DOCX 82 kb)

SPIRIT 2013 checklist: recommended items to address in a clinical trial protocol. (DOC 123 kb)

Cox regression to evaluate the effect of selected covariates on prostate cancer incidence ignoring death as competing event (treated as censored), n = 1997. Table S2A. Cox and competing risk regression to evaluate the effect of selected covariates on (a) localized and (b) advanced stage prostate cancer incidence. N = 1997, whereof 137 localized and 62 advanced stage prostate cancer cases. Table S2B. Cox and competing risk regression to evaluate the effect of selected covariates on advanced stage prostate cancer incidence and prostate cancer-specific death in combined. N = 1997, whereof 105 events (62 advanced stage prostate cancer cases and 43 deaths of prostate cancer). Table S3. Number and age of death stratified by quartiles of cholesterol, Oslo Ischemia Study. Table S4. Competing risk regression to evaluate the effect of selected covariates on prostate cancer-specific death in men diagnosed with prostate cancer. 213 men were diagnosed with prostate cancer, whereof 81 died of prostate cancer (failure), 82 died of other causes (competing event), and 50 were alive at end of follow-up (censored). Figure S1. Cumulative incidence of prostate cancer death by quartiles of cholesterol in men diagnosed with prostate cancer, n = 213. Death of other causes was considered as competing events. P-value achieved from the Pepe and Mori test comparing the cumulative incidence of cholesterol quartile 1 versus quartile 4. (DOC 147 kb)

Objectives 1. To assess the long-term effectiveness of a comprehensive cardiac rehabilitation programme on quality of life and survival in patients with a large spectrum of cardiovascular diseases (myocardial infarction, acute coronary syndrome, percutaneous transluminal coronary angioplasty and coronary artery bypass grafting). 2. To establish the degree of correlation between expected improvement of health-related quality of life and improvement in physical function attributable to rehabilitation in the intervention group, in comparison with similar changes in the conventional care group. Design Randomized, controlled, parallel-group design (intervention/conventional care). Setting Akershus County, southeast of Oslo City, Norway. Participants 500 patients, men and women, aged 40-85 years, who have sustained at least one of the above-mentioned cardiovascular diseases. Interventions 8 weeks of supervised, structured physical training of three periods of 20 min per week, targeting a heart rate of 60-70% of the individual's maximum; home-based physical exercise training with the same basic schedule as in the supervised period; quantification of patients' compliance with the exercise programme by the use of wristwatches, information stored in the watch memory being retrieved once a month during the 3-year follow-up period; and life-style modification with an emphasis on the cessation of smoking and on healthy nutrition and weight control.

Bakgrunn: En biopsykososial forståelsesmodell setter økte krav til kartlegging grunnet kompleksiteten knyttet til langvarige muskelskjelettsmerter. I Norge har 30% av befolkningen langvarige smerter, og muskelskjelettsmerter er den vanligste typen. Langvarige muskelskjelettsmerter er knyttet til ulike grader av kompleksitet og komorbiditet. Traumatiske livserfaringer har høy forekomst og store helsemessige konsekvenser, men er underidentifisert og underdiagnostisert i helsevesenet. Det er høy samforekomst av traumatiske livserfaringer og langvarige muskelskjelettsmerter. Hensikt: Studiens hensikt er å belyse avtalefysioterapeuters kartlegging av pasienter med langvarige muskelskjelettsmerter og mulige traumatiske livserfaringer, med spesielt fokus på forhold knyttet til kartlegging av traumatiske livserfaringer. Metode: Studien er en kvantitativ tverrsnittstudie med bruk av spørreskjema. Det ble inkludert 107 tilfeldig utvalgte respondenter fordelt på tre subgrupper; allmennfysioterapeuter, manuellterapeuter og psykomotoriske fysioterapeuter. Spørreskjemaet besto av avkrysningsspørsmål for kartleggingsområder, samt utsagnsspørsmål forankret i studiens tematikk. Det ble utført både univariate og bivariate analyser i fortolkningsarbeidet, samt konfunderanalyser. Resultater: Resultatene i studien viser at avtalefysioterapeutene kartla flere aspekter av det som kan ansees som komplekse og relevante forhold rundt langvarige muskelskjelettsmerter og mulige traumatiske livserfaringer. Funnene antyder at ulike kategorier av avtalefysioterapeuter har ulike kartleggingsrutiner. Psykomotoriske fysioterapeuter kartla grundigst rundt psykososiale faktorer i forhold til de andre avtalefysioterapeutene. Dette gjaldt spesielt i kategoriene traumatiske livserfaringer og psykososiale forhold i oppvekst. Manuellterapeutene benyttet seg av kartleggingsskjema i større grad enn de andre avtalefysioterapeutene når det gjaldt å identifisere psykososiale faktorer. De fleste avtalefysioterapeutene kartla gjennom samtale med pasienten. Det var også ulikheter mellom kategorier av avtalefysioterapeuter når det gjaldt hvilke forhold som påvirket avtalefysioterapeuters valg om å inkludere traumatiske livserfaringer i kartleggingen. Både faglige og organisatoriske faktorer ble trukket frem. Konklusjon: Studiens resultater indikerer at de fleste avtalefysioterapeutene kartla relevante psykososiale faktorer som inngår i kompleksiteten knyttet til langvarige muskelskjelettsmerter og traumatiske livserfaringer. Funnene antyder at flere av avtalefysioterapeutene hadde et ønske om å inkludere traumatiske livserfaringer i kartleggingen, selv om resultatene sett i sammenheng med teorien indikerer at fåtallet kartla adekvat for dette. Det teoretiske grunnlaget i studien fremhever at traumatiske livserfaringer bør vurderes som en del av den psykososiale kartleggingen for pasienter med langvarig muskelskjelettsmerter, men at en forsvarlig traumekartlegging skjer i en traumeinformert praksis. Dette har konsekvenser for fysioterapi som praksisfelt. Det anbefales at det forskes videre på fysioterapi i relasjon til traumatiske livserfaringer. Nøkkelord: langvarige muskelskjelettsmerter, traumatiske livserfaringer, kartlegging, avtalefysioterapeut, primærhelsetjeneste Background: The biopsychosocial model places increased demands on the assessment procedures due to the complexity associated with persistent musculoskeletal pain. In Norway, 30% of the population has persistent pain, and musculoskeletal pain is the most common type. Persistent musculoskeletal pain is associated with varying degrees of complexity and comorbidity. Traumatic life experiences have high prevalence and major health consequences, but they are underidentified and underdiagnosed in the health care system. There is a high co-occurence of traumatic life experiences and persistent musculoskeletal pain. Purpose: The purpose of the study is to explore physiotherapists' assessment procedures for patients with persistent musculoskeletal pain and possible traumatic life experiences in a primary care setting with an emphasis on aspects associated with the assessment of traumatic life experiences. Method: The study is a quantitative cross-sectional survey study. The study included data from 107 randomly sampled respondents, and they were stratified into three subgroups: general physiotherapist, manual therapists and psychomotor physiotherapists. The survey included checkbox questions for areas of assessment, and likert scale questions for self-perceived competency. Both univariate and bivariate analyses were executed, in addition to confounder analysis. Results: The results of this study show that physiotherapists assessed several aspects pertaining to the complexity associated with persistent musculoskeletal pain and possible traumatic life experiences. The findings suggest that different categories of physiotherapists have different assessment procedures. Psychomotor physiotherapists assessed more thoroughly associated with psychosocial factors compared to the other physiotherapists in this study. This was especially evident in the categories that were emphasized in this study; traumatic life experiences and psychosocial conditions growing up. The manual therapists used screening tools to a greater extent than the other physiotherapists when it came to identifying psychosocial factors. Collectively, most physiotherapists assessed through conversation with the patient. When it came to the factors that influenced the physiotherapists' choice to include traumatic life experiences in the assessment, there were also differences between the physiotherapists. Both organizational and professional factors contributed. Conclusion: The results of the study indicate that most physiotherapists assessed relevant psychosocial factors considered part of the complexity that surrounds persistent musculoskeletal pain and traumatic life experiences. The physiotherapists wanted to include traumatic life experiences in their assessments, although the results in relation to the theory may indicate that the minority assessed adequately at the time the study was conducted. The theoretical basis of the study suggests that traumatic life experiences should be considered as part of a psychosocial assessment for patients with persistent musculoskeletal pain, but that a sound trauma assessment takes place in a trauma-informed practice. This has consequences for physiotherapy as a field of practice. It is recommended that further research be conducted on physiotherapy in relation to traumatic life experiences. Key words: Persistent musculoskeletal pain, traumatic life experiences, assessment, physiotherapist, primary healthcare