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Karterud H.N.,University of Oslo | Risor M.B.,Arctic University of Norway | Haavet O.R.,University of Oslo
Seizure | Year: 2015

Purpose: This qualitative study explored the impact of using a biopsychosocial approach to explain the diagnosis of non-epileptic seizures (NES). Methods: Semi-structured interviews of eleven adolescents and young adults who had participated in an inpatient follow-up stay of the diagnosis were used. The interviews were taped, transcribed, and analysed using systematic text condensation. Results: Three key themes were identified: 1. "Threatened self-image": Patients initially perceived their diagnosis as being purely psychological. As they did not accept that they had mental disorders, they interpreted this as frightening and threatening, and resisted the diagnosis. 2. "Being believed and belief in oneself": Participants had many experiences of being suspected by healthcare providers of staging their seizures. Some had even begun to have doubts themselves as to whether the attacks were voluntary or not. Explaining that unconscious processes are involved in NES contributed towards increasing patients' feelings of being believed, and thereby acceptance of the diagnosis. 3. "Getting an explanation that makes sense": Some participants identified connections between their personal histories and their seizures and became seizure-free. Others found that the explanatory models gave personal meaning, but did not become seizure-free, while a few continued to doubt whether NES was the correct diagnosis. Conclusion: Being believed was the most elemental factor for coping with the condition. Using a biopsychosocial approach to explain the diagnosis may facilitate identification with the explanatory models, and thus acceptance of the diagnosis. © 2014 Published by Elsevier Ltd on behalf of British Epilepsy Association.

Ellingsen G.,Arctic University of Norway
Advances in Intelligent Systems and Computing | Year: 2015

For several years, telemedicine practitioners have struggled to establish their field as an autonomous scientific discipline, which is often reflected in diverging definitions of what telemedicine is. However, the telemedicine community depends on and draws heavily on established scientific areas such as medicine, economics, informatics and social science, which each have their own criteria for good scientific work. In addition, new technological innovations appear to pave the way for new applications within the field, thus challenging perceptions of what the field encompasses. The aim of this paper is to contribute to this debate by conceptualizing the notion of telemedicine as being something people do rather than numerous definitions of what the field is. © Springer International Publishing Switzerland 2015.

Froisland D.H.,Lillehammer University College | Arsand E.,University Hospital of North Norway | Arsand E.,Arctic University of Norway
Journal of Diabetes Science and Technology | Year: 2015

The goal of modern diabetes treatment is to a large extent focused on self-management to achieve and maintain a healthy, low HbA1c. Despite all new technical diabetes tools and support, including advanced blood glucose meters and insulin delivery systems, diabetes patients still struggle to achieve international treatment goals, that is, HbA1c < 7.5 in children and adolescents. In this study we developed and tested a mobile-phone-based tool to capture and visualize adolescents' food intake. Our aim was to affect understanding of carbohydrate counting and also to facilitate doctor-adolescent communication with regard to daily treatment. Furthermore, we wanted to evaluate the effect of the designed tool with regard to empowerment, self-efficacy, and self-treatment. The study concludes that implementing a visualization tool is an important contribution for young people to understand the basics of diabetes and to empower young people to define their treatment challenges. By capturing a picture of their own food, the person's own feeling of being in charge can be affected and better self-treatment achieved. © 2015 Diabetes Technology Society Reprints and permissions.

Silsand L.,University Hospital of Northern Norway | Ellingsen G.,Arctic University of Norway
Proceedings of the ACM Conference on Computer Supported Cooperative Work, CSCW | Year: 2016

Clinical Decision Support (CDS) Systems are considered crucial for diagnosis, treatment and care of patients. However, practical benefits of such systems have been far below expectations. This paper explores how the evolving interdependencies in organizational, clinical, political, and behavioral terms influence the design and implementation of CDS. The paper discusses how these interdependencies complicate clinical use of CDS where cross-departmental patient pathways increasingly dominate approaches to dealing with patients with complex conditions. Empirically, we report from an acute geriatric patient pathway project. The aim was to design and implement a decision-support form for triage of elderly patients in the emergency unit. The study emphasizes the intertwined collaborative nature of healthcare work, and the resulting need to consider the whole context when designing and implementing CDS tools. The contribution is to emphasize the "extended design" perspective to capture how workplace technologies and practices are shaped across multiple contexts and prolonged periods. © 2016 ACM.

Gumaa M.M.,Kassala Veterinary Research Laboratory | Osman H.M.,Veterinary Research Institute | Omer M.M.,Kassala Veterinary Research Laboratory | El Sanousi E.M.,Veterinary Research Institute | And 3 more authors.
OIE Revue Scientifique et Technique | Year: 2014

Brucellosis is one of the important zoonotic diseases among livestock. This study was carried out to estimate the prevalence of brucellosis and isolate Brucella spp. in sheep in Kassala State in the east of Sudan. Two thousand and five serum samples were randomly collected from nine different localities. All serum samples were examined by the Rose Bengal plate test (RBPT) and the modified RBPT(mRBPT). Forty-three (2.15%, 95% confidence interval [CI]: 1.6,3.0) and 68 (3.4%, 95% CI: 2.6, 4.2) samples were positive with the RBPT and the mRBPT, respectively. According to a known diagnostic sensitivity of 86.6% and a known diagnostic specificity of 97.6% for the mRBPT, the true prevalence was estimated to be 1.2% (95% CI: 0.3, 2.2). Different tissue samples were collected from 41 mRBPT seropositive animals. Brucella abortus biovar 6 was isolated from a pyometra of a seropositive ewe. It is important to note that B. abortus biovar 6 cannot be differentiated from Brucella melitensis biovar 2 by routine bacteriology. Only phage typing performed in reference laboratories will allow accurate identification of the strain. The fact that B. abortus biovar 6 does not require CO2 for growth, combined with the fact that it has been isolated from a small ruminant in this study, could easily have led to misidentification (as B. melitensis biovar 2), to wrong epidemiological inferences and to the implementation of inappropriate control measures. The results presented here suggest that sheep are spillover hosts, as previously described for camels, and that the actual reservoir of B. abortus biovar 6 is cattle in Kassala State, Eastern Sudan. This study highlights the importance of isolating and identifying Brucella spp. in different livestock species in order to accurately decipher brucellosis epidemiology in sub-Saharan Africa.

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