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Langeland W.,VU University Amsterdam | Heir T.,University of OsloOslo
Journal of Trauma and Dissociation | Year: 2014

This study examined the clinical relevance of differences in psychoform and somatoform dissociative symptoms in 55 early traumatized inpatients. The high psychoform and somatoform dissociative group (n = 18), somatoform dissociative group (n = 22), and nondissociative group (n = 15) did not differ on abuse severity, depressive symptoms, interpersonal problems, Axis I or II comorbidity, or deterioration rates. Compared to the other 2 groups, the highly dissociative group was characterized by younger age, living alone, higher levels of posttraumatic and general distress, more frequent reports of suicidality, self-mutilation, eating problems, and less favorable treatment response. The results highlight the clinical relevance of using dissociation measures for identifying subgroups of patients with severe psychopathology who may be more treatment resistant. © , Copyright © Taylor & Francis Group, LLC.


Gulbrandsen P.,University of OsloOslo | Gulbrandsen P.,Akershus University Hospital | Clayman M.L.,American Institutes for Research | Beach M.C.,Johns Hopkins University | And 4 more authors.
Patient Education and Counseling | Year: 2016

Objective We describe the different ways in which illness represents an existential problem, and its implications for shared decision-making. Methods We explore core concepts of shared decision-making in medical encounters (uncertainty, vulnerability, dependency, autonomy, power, trust, responsibility) to interpret and explain existing results and propose a broader understanding of shared-decision making for future studies. Results Existential aspects of being are physical, social, psychological, and spiritual. Uncertainty and vulnerability caused by illness expose these aspects and may lead to dependency on the provider, which underscores that autonomy is not just an individual status, but also a varying capacity, relational of nature. In shared decision-making, power and trust are important factors that may increase as well as decrease the patient's dependency, particularly as information overload may increase uncertainty. Conclusion The fundamental uncertainty, state of vulnerability, and lack of power of the ill patient, imbue shared decision-making with a deeper existential significance and call for greater attention to the emotional and relational dimensions of care. Hence, we propose that the aim of shared decision-making should be restoration of the patient's autonomous capacity. Practice implications In doing shared decision-making, care is needed to encompass existential aspects; informing and exploring preferences is not enough. © 2016 Elsevier Ireland Ltd


Eide P.K.,University of Oslo | Eide P.K.,University of OsloOslo | Pripp A.H.,University of Oslo | Ringstad G.A.,University of Oslo
Journal of the Neurological Sciences | Year: 2016

Background While most pineal cysts (PCs) are asymptomatic, some PCs are accompanied with symptoms of variable severity. We suggested that symptom severity in symptomatic patients with non-hydrocephalic PCs relates to venous compression causing central venous hypertension. This study explored whether possible magnetic resonance imaging (MRI) biomarkers of central venous hypertension could differentiate the severity of symptoms in individuals with non-hydrocephalic PCs. Methods The study included all individuals with PCs and MRI available for analysis followed conservatively within the department from 2003 to 2014. Severity of symptoms at follow-up were assessed from a questionnaire. Suggested MRI biomarkers indicative of central venous hypertension were explored, in addition to MRI measures of cyst size, aqueduct stenosis, and tectal compression. Results The study included 66 patients. As compared to the 27/66 patients (41%) with "None-Moderate" symptoms at follow-up, the 39/66 patients (59%) with "Much-Severe" symptoms presented with significantly altered indices of central venous hypertension (tectum-splenium-cyst ratio and indices of thalamic and periventricular edema). PC grading based on MRI biomarkers of central venous hypertension differentiated the severity of symptoms. Conclusion The results indicate an association between severity of symptoms and MRI biomarkers of central venous hypertension in symptomatic individuals with non-hydrocephalic PCs. © 2016 Elsevier B.V. All rights reserved.


Henao-Restrepo A.M.,World Health Organization | Longini I.M.,University of Florida | Egger M.,University of Bern | Egger M.,University of Cape Town | And 29 more authors.
The Lancet | Year: 2015

Background A recombinant, replication-competent vesicular stomatitis virus-based vaccine expressing a surface glycoprotein of Zaire Ebolavirus (rVSV-ZEBOV) is a promising Ebola vaccine candidate. We report the results of an interim analysis of a trial of rVSV-ZEBOV in Guinea, west Africa. Methods For this open-label, cluster-randomised ring vaccination trial, suspected cases of Ebola virus disease in Basse-Guinée (Guinea, west Africa) were independently ascertained by Ebola response teams as part of a national surveillance system. After laboratory confirmation of a new case, clusters of all contacts and contacts of contacts were defined and randomly allocated 1:1 to immediate vaccination or delayed (21 days later) vaccination with rVSV-ZEBOV (one dose of 2×107 plaque-forming units, administered intramuscularly in the deltoid muscle). Adults (age ≥18 years) who were not pregnant or breastfeeding were eligible for vaccination. Block randomisation was used, with randomly varying blocks, stratified by location (urban vs rural) and size of rings (≤20 vs >20 individuals). The study is open label and masking of participants and field teams to the time of vaccination is not possible, but Ebola response teams and laboratory workers were unaware of allocation to immediate or delayed vaccination. Taking into account the incubation period of the virus of about 10 days, the prespecified primary outcome was laboratory-confirmed Ebola virus disease with onset of symptoms at least 10 days after randomisation. The primary analysis was per protocol and compared the incidence of Ebola virus disease in eligible and vaccinated individuals in immediate vaccination clusters with the incidence in eligible individuals in delayed vaccination clusters. This trial is registered with the Pan African Clinical Trials Registry, number PACTR201503001057193. Findings Between April 1, 2015, and July 20, 2015, 90 clusters, with a total population of 7651 people were included in the planned interim analysis. 48 of these clusters (4123 people) were randomly assigned to immediate vaccination with rVSV-ZEBOV, and 42 clusters (3528 people) were randomly assigned to delayed vaccination with rVSV-ZEBOV. In the immediate vaccination group, there were no cases of Ebola virus disease with symptom onset at least 10 days after randomisation, whereas in the delayed vaccination group there were 16 cases of Ebola virus disease from seven clusters, showing a vaccine efficacy of 100% (95% CI 74·7-100·0; p=0·0036). No new cases of Ebola virus disease were diagnosed in vaccinees from the immediate or delayed groups from 6 days post-vaccination. At the cluster level, with the inclusion of all eligible adults, vaccine effectiveness was 75·1% (95% CI -7·1 to 94·2; p=0·1791), and 76·3% (95% CI -15·5 to 95·1; p=0·3351) with the inclusion of everyone (eligible or not eligible for vaccination). 43 serious adverse events were reported; one serious adverse event was judged to be causally related to vaccination (a febrile episode in a vaccinated participant, which resolved without sequelae). Assessment of serious adverse events is ongoing. Interpretation The results of this interim analysis indicate that rVSV-ZEBOV might be highly efficacious and safe in preventing Ebola virus disease, and is most likely effective at the population level when delivered during an Ebola virus disease outbreak via a ring vaccination strategy. Funding WHO, with support from the Wellcome Trust (UK); Médecins Sans Frontières; the Norwegian Ministry of Foreign Affairs through the Research Council of Norway; and the Canadian Government through the Public Health Agency of Canada, Canadian Institutes of Health Research, International Development Research Centre, and Department of Foreign Affairs, Trade and Development. © 2015 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved.


Schumann H.,Norwegian University of Science and Technology | Schumann H.,Sintef | Tutkun M.,Institute for Energy Technology of Norway | Tutkun M.,University of OsloOslo | Nydal O.J.,Norwegian University of Science and Technology
Journal of Petroleum Science and Engineering | Year: 2016

Droplet size measurements in premixed oil-water flow are presented. Three traversable focused beam reflectance measurement probes (FBRM) positioned along the test section allowed for measuring averaged droplet size profiles over the cross section. Measurements for two mixture velocities, Umix=0.5 m/s and Umix=1 m/s, and the complete range of input water fractions were performed with tap water and medium viscosity mineral oil. The flow facility provided a 10 cm inner diameter test section of 24 m total length. Flow development in terms of droplet growth was documented. Averaged droplet sizes showed to be a function of the dispersed phase fraction with sizes increasing towards a maximum at phase inversion. Different flow patterns show characteristic droplet size profiles over the cross-section. Common models over-predict the presented droplet size data, most probably as a result of enhanced inlet mixing and underdeveloped flow. © 2016 Elsevier B.V.


Fonnelop A.E.,Norwegian Institute of Public Health | Fonnelop A.E.,University of OsloOslo | Egeland T.,Norwegian Institute of Public Health | Egeland T.,Norwegian University of Life Sciences | And 2 more authors.
Forensic Science International: Genetics | Year: 2015

Abstract With the introduction of new multiplex PCR kits and instrumentation such as the Applied Biosystems 3500xl, there has recently been a rapid change in technology that has greatly increased sensitivity of detection so that a DNA profile can routinely be obtained from only a few cells. Research to evaluate the risks of passive transfer has not kept pace with this development; hence the risk of innocent DNA transfer at the crime-scene is currently not properly understood. The purpose of this study was to investigate the possibility of investigator-mediated transfer of DNA traces with disposable nitrile-gloves used during crime-scene examinations. We investigated the primary transfer of freshly deposited DNA from touched plastic, wood or metal substrates and secondary and tertiary transfer by a person wearing disposable nitrile-gloves and onto a third object. We show that with use of the new highly sensitive technologies available in forensic DNA analysis there is an enhanced probability to obtain a DNA-profile which has not been directly deposited on the object but is an outcome of one or more transfer events. The nitrile-gloves used by investigators during exhibit examination can act as a vector for DNA transfer from one item to another. We have shown that the amount of DNA deposited on an object affects the probability of transfer. Secondly, the type of substrate material that DNA is deposited onto has an impact on transfer rates. © 2015 Elsevier Ireland Ltd.


Buchholz D.,University of Gottingen | Stormer E.,University of OsloOslo
Communications in Mathematical Physics | Year: 2015

The concepts of superposition and of transition probability, familiar from pure states in quantum physics, are extended to locally normal states on funnels of type I∞ factors. Such funnels are used in the description of infinite systems, appearing for example in quantum field theory or in quantum statistical mechanics; their respective constituents are interpreted as algebras of observables localized in an increasing family of nested spacetime regions. Given a generic reference state (expectation functional) on a funnel, e.g. a ground state or a thermal equilibrium state, it is shown that irrespective of the global type of this state all of its excitations, generated by the adjoint action of elements of the funnel, can coherently be superimposed in a meaningful manner. Moreover, these states are the extreme points of their convex hull and as such are analogues of pure states. As further support of this analogy, transition probabilities are defined, complete families of orthogonal states are exhibited and a one-to-one correspondence between the states and families of minimal projections on a Hilbert space is established. The physical interpretation of these quantities relies on a concept of primitive observables. It extends the familiar framework of observable algebras and avoids some counter intuitive features of that setting. Primitive observables admit a consistent statistical interpretation of corresponding measurements and their impact on states is described by a variant of the von Neumann-Lüders projection postulate. © Springer-Verlag Berlin Heidelberg 2015.


PubMed | Copenhagen University, University of Lausanne, U.S. National Institute of Standards and Technology, Flinders University and 3 more.
Type: | Journal: Frontiers in genetics | Year: 2016

When forensic scientists evaluate and report on the probative strength of single DNA traces, they commonly rely on only one number, expressing the rarity of the DNA profile in the population of interest. This is so because the focus is on propositions regarding the source of the recovered trace material, such as the person of interest is the source of the crime stain. In particular, when the alternative proposition is an unknown person is the source of the crime stain, one is directed to think about the rarity of the profile. However, in the era of DNA profiling technology capable of producing results from small quantities of trace material (i.e., non-visible staining) that is subject to easy and ubiquitous modes of transfer, the issue of source is becoming less central, to the point that it is often not contested. There is now a shift from the question whose DNA is this? to the question how did it get there? As a consequence, recipients of expert information are now very much in need of assistance with the evaluation of the meaning and probative strength of DNA profiling results when the competing propositions of interest refer to different activities. This need is widely demonstrated in day-to-day forensic practice and is also voiced in specialized literature. Yet many forensic scientists remain reluctant to assess their results given propositions that relate to different activities. Some scientists consider evaluations beyond the issue of source as being overly speculative, because of the lack of relevant data and knowledge regarding phenomena and mechanisms of transfer, persistence and background of DNA. Similarly, encouragements to deal with these activity issues, expressed in a recently released European guideline on evaluative reporting (Willis et al., 2015), which highlights the need for rethinking current practice, are sometimes viewed skeptically or are not considered feasible. In this discussion paper, we select and discuss recurrent skeptical views brought to our attention, as well as some of the alternative solutions that have been suggested. We will argue that the way forward is to address now, rather than later, the challenges associated with the evaluation of DNA results (from small quantities of trace material) in light of different activities to prevent them being misrepresented in court.


Rydsaa J.H.,University of OsloOslo | Stordal F.,University of OsloOslo | Tallaksen L.M.,University of OsloOslo
Biogeosciences | Year: 2015

Amplified warming at high latitudes over the past few decades has led to changes in the boreal and Arctic climate system such as structural changes in high-latitude ecosystems and soil moisture properties. These changes trigger land-atmosphere feedbacks through altered energy partitioning in response to changes in albedo and surface water fluxes. Local-scale changes in the Arctic and boreal zones may propagate to affect large-scale climatic features. In this study, MODIS land surface data are used with the Weather Research and Forecasting model (WRF V3.5.1) and Noah land surface model (LSM), in a series of experiments to investigate the sensitivity of the overlying atmosphere to perturbations in the structural vegetation in the northern European boreal ecosystem. Emphasis is placed on surface energy partitioning and near-surface atmospheric variables, and their response to observed and anticipated land cover changes. We find that perturbations simulating northward migration of evergreen needleleaf forest into tundra regions cause an increase in latent rather than sensible heat fluxes during the summer season. Shrub expansion in tundra areas has only small effects on surface fluxes. Perturbations simulating the northward migration of mixed forest across the present southern border of the boreal forest, have largely opposite effects on the summer latent heat flux, i.e., they lead to a decrease and act to moderate the overall mean regional effects of structural vegetation changes on the near-surface atmosphere. © Author(s) 2015.


Amundsen Ostby K.,Norwegian Institute of Public Health | Czajkowski N.,Norwegian Institute of Public Health | Czajkowski N.,University of OsloOslo | Knudsen G.P.,Norwegian Institute of Public Health | And 7 more authors.
Social Psychiatry and Psychiatric Epidemiology | Year: 2014

Purpose To determine whether personality disorders (PDs) are associated with increased risk of disability pensioning in young adults, independent of other common mental disorders.Methods 2,770 young adults from the general population were assessed for PDs by the Structured Interview for DSM-IV Personality, and for common mental disorders by the Composite of International Diagnostic Interview. These data were linked to the Norwegian National Insurance Administration’s recordings of disability benefits for a 10-year period. Logistic regression analyses were applied to investigate the association between PDs and disability pensioning. The analyses were conducted for three types of PD measures: categorical diagnoses (any PD), dimensional scores of individual PDs and higher order components retrieved by principal component analyses. Results Having any PD was strongly associated with disability pensioning, regardless of disability diagnosis. The estimated odds ratio (OR) was substantially higher for PDs [OR 4.69 (95% confidence interval (CI) 2.6-8.5)] than for mood disorders [OR 1.3 (CI 0.7-2.3)] and anxiety disorders [OR 2.3 (CI 1.3–4.3)]. Measured dimensionally, all PD traits except antisocial traits were significantly associated with disability pensioning. After adjusting for co-occurring traits of other PDs, only schizoid, dependent and borderline PD traits showed a significant positive association with disability pension, while antisocial traits showed a significant negative association. The principal component analyses showed that negative affectivity, psychoticism, and detachment was associated with an increased risk of disability pensioning, while antagonism/ disinhibition and obsessivity were not. Conclusions PDs are strongly associated with disability pensioning in young adults, and might be more important predictors of work disability than anxiety and depressive disorders. Certain aspects of pathologic personalities are particularly important predictors of disability. © Springer-Verlag Berlin Heidelberg 2014

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