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.     

Effects of unilateral endoscopic facetectomy on spinal stability

There are various definitions for spinal instability and its exact clinical usefulness is uncertain. Facetectomy has been considered a potential source of instability via conventional approaches. Studies have suggested that if the ligament structure of the spine is maintained then instability may not occur with an endoscopic facetectomy. This study is a prospective analysis of 10 patients who underwent unilateral endoscopic facetectomy for the treatment of severe foraminal stenosis to determine whether endoscopic facetectomies result in instability. The patients underwent pre and postsurgical x-rays that were evaluated via a specialized computer program that determined whether or not there was any altered mobility between the 2 sets of x-rays. These were compared with controls to determine whether instability was present. Of the 10 endoscopic facetectomy patients, none had any statistically significant change in sagittal rotational or translational motion when compared to controls. Thus, endoscopic removal of a unilateral facet joint does not necessarily cause spinal instability possibly because of the reduction in tissue damage associated with an endoscopic approach and the maintenance of the ligament structure of the spine.     

Muscle activity onset in the lumbar multifidus muscle recorded simultaneously by ultrasound imaging and intramuscular electromyography

BACKGROUND: Delayed anticipatory muscle activity response in deep abdominal and back muscles has been observed in patients with low back pain, indicative of a pathological condition. Muscle activity onset is traditionally recorded by intramuscular electromyography, but there is a need for a non-invasive and less cumbersome recording method in large clinical studies. An experimental study was carried out to explore whether high-frame rate m-mode ultrasound could measure anticipatory muscle responses ("onset") in the lumbar multifidus muscle reliably and comparably accurate to intramuscular electromyography. METHODS: Muscle activity onset was recorded by ultrasound m-mode and intramuscular electromyography. Ultrasound m-mode with a temporal resolution of 500 s(-1) (frames per second) was used to record rapid movements caused by muscle deformations in multifidus. In ultrasound m-mode, the frequency of each echo signal from 0.15 mm incremental depth levels is analysed. The frequency of these signals is proportional to the velocity of the interrogated tissue. The mean amplitude of the high-pass filtered echo signals within a pre-set depth range was plotted against time, and used to indicate onset. The results were compared to muscle activity onset in the multifidus recorded simultaneously by intramuscular electromyography. FINDINGS: High inter-rater agreement was found for visual determination of onset within both methods. The smallest detectable difference was 21 and 24 ms for electromyography and the ultrasound methods, respectively. The ultrasound m-mode method recorded muscle activity onset in the deep multifidus on average 16 ms (SD 21) later than intramuscular electromyography. For single trials, large variation and thus unacceptable method agreement was found. INTERPRETATION: Ultrasound m-mode imaging at high time resolution can detect onset of muscle activity comparably accurate to intramuscular electromyography, but with a small systematic delay that should be corrected for in onset determination by m-mode ultrasound. Regardless of recording method, onset estimates should be based on averaged values of repeated trials. Further studies are needed to explore the applicability of the ultrasound method in clinical settings.     

Incidence and survival of squamous cell carcinoma of the tongue in Scandinavia,with special reference to young adults

In several countries, increased incidence of squamous cell carcinoma (SCC) of the tongue in young adults has been suspected during the last decades. Some reports indicate a lower survival rate for young patients compared to older patients. In other reports, there has not been any considerable difference in survival when comparing young adults to older patients, whereas some authors have shown better survival for young adults. This disease is rare in young adults, and early reports were based on comparable small numbers and selected patients. Our aim was first to perform a population-based study to determine if an increased incidence in SCC of the tongue could be verified in a larger population comprising the Scandinavian countries Denmark, Finland, Sweden and Norway. A second aim was to determine survival rates for young adults compared to older patients. The material was based on the annual cancer incidence and survival reports from the Scandinavian cancer registries. The study period was 1960-1994. During that period, 5,024 SCCs of the tongue were reported. Of these, 276 (5.5%) were young adults (20-39 years). The incidence increased at all ages except for women 65-79 years old. The increase was most pronounced in young adults: 0.06-0.32 for men and 0.03-0.19 for women, counted by 100,000 person-years. Relative survival was significantly better for young adults compared to older patients.     

Comparing two approaches for aligning representations of anatomy

OBJECTIVE: To analyze the comparison, through their results, of two distinct approaches applied to aligning two representations of anatomy. MATERIALS: Both approaches use a combination of lexical and structural techniques. In addition, the first approach takes advantage of domain knowledge, while the second approach treats alignment as a special case of schema matching. The same versions of FMA and GALEN were aligned by each approach. Two thousand one hundred and ninety-nine concept matches were obtained by both approaches. METHODS AND RESULTS: For matches identified by one approach only (337 and 336, respectively), we analyzed the reasons that caused the other approach to fail. CONCLUSIONS: The first approach could be improved by addressing partial lexical matches and identifying matches based solely on structural similarity. The second approach may be improved by taking into account synonyms in FMA and identifying semantic mismatches. However, only 33% of the possible one-to-one matches among anatomical concepts were identified by the two approaches together. New directions need to be explored in order to handle more complex matches.     

Risk analysis of information security in a mobile instant messaging and presence system for healthcare

INTRODUCTION: Instant messaging (IM) is suited for immediate communication because messages are delivered almost in real time. Results from studies of IM use in enterprise work settings make us believe that IM based services may prove useful also within the healthcare sector. However, today's public instant messaging services do not have the level of information security required for adoption of IM in healthcare. We proposed MedIMob, our own architecture for a secure enterprise IM service for use in healthcare. MedIMob supports IM clients on mobile devices in addition to desktop based clients. METHODS: Security threats were identified in a risk analysis of the MedIMob architecture. The risk analysis process consists of context identification, threat identification, analysis of consequences and likelihood, risk evaluation, and proposals for risk treatment. RESULTS: The risk analysis revealed a number of potential threats to the information security of a service like this. Many of the identified threats are general when dealing with mobile devices and sensitive data; others are threats which are more specific to our service and architecture. Individual threats identified in the risks analysis are discussed and possible counter measures presented. DISCUSSION: The risk analysis showed that most of the proposed risk treatment measures must be implemented to obtain an acceptable risk level; among others blocking much of the additional functionality of the smartphone. To conclude on the usefulness of this IM service, it will be evaluated in a trial study of the human-computer interaction. Further work also includes an improved design of the proposed MedIMob architecture.