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Search Results: 1 - 10 of 82 matches for " Ingunn Harstad "
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Tuberculosis screening and follow-up of asylum seekers in Norway: a cohort study
Ingunn Harstad, Einar Heldal, Sigurd L Steinshamn, Helge Gar?sen, Geir W Jacobsen
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-141
Abstract: We assessed a national programme for screening, treatment and follow-up of tuberculosis infection and disease in a cohort of asylum seekers.Asylum seekers ≥ 18 years who arrived at the National Reception Centre from January 2005 to June 2006, were included as the total cohort. Those with a Mantoux test ≥ 6 mm or positive x-ray findings were included in a study group for follow-up.Data were collected from public health authorities in the municipality to where the asylum seekers had moved, and from hospital based internists in case they had been referred to specialist care.Individual subjects included in the study group were matched with the Norwegian National Tuberculosis Register which receive reports of everybody diagnosed with active tuberculosis, or who had started treatment for latent tuberculosis.The total cohort included 4643 adult asylum seekers and 97.5% had a valid Mantoux test. At least one inclusion criterion was fulfilled by 2237 persons. By end 2007 municipal public health authorities had assessed 758 (34%) of them. Altogether 328 persons had been seen by an internist. Of 314 individuals with positive x-rays, 194 (62%) had seen an internist, while 86 of 568 with Mantoux ≥ 15, but negative x-rays (16%) were also seen by an internist. By December 31st 2006, 23 patients were diagnosed with tuberculosis (prevalence 1028/100 000) and another 11 were treated for latent infection.The coverage of screening was satisfactory, but fewer subjects than could have been expected from the national guidelines were followed up in the community and referred to an internist. To improve follow-up of screening results, a simplification of organisation and guidelines, introduction of quality assurance systems, and better coordination between authorities and between different levels of health care are all required.As tuberculosis (TB) in native populations in Western countries decreases, the relative importance of cases among immigrants increases. Latent tuberculosis is preval
Screening for tuberculosis infection among newly arrived asylum seekers: Comparison of QuantiFERON?TB Gold with tuberculin skin test
Brita Winje, Fredrik Oftung, Gro Korsvold, Turid Manns?ker, Anette Jeppesen, Ingunn Harstad, Berit Heier, Einar Heldal
BMC Infectious Diseases , 2008, DOI: 10.1186/1471-2334-8-65
Abstract: The 1000 asylum seekers (age ≥ 18 years) enrolled in the study were voluntarily recruited from 2813 consecutive asylum seekers arriving at the national reception centre from September 2005 to June 2006. Participation included a QFT test and a questionnaire in addition to the mandatory TST and chest X-ray.Among 912 asylum seekers with valid test results, 29% (264) had a positive QFT test whereas 50% (460) tested positive with TST (indurations ≥ 6 mm), indicating a high proportion of latent infection within this group. Among the TST positive participants 50% were QFT negative, whereas 7% of the TST negative participants were QFT positive. There was a significant association between increase in size of TST result and the likelihood of being QFT positive. Agreement between the tests was 71–79% depending on the chosen TST cut-off and it was higher for non-vaccinated individuals.By using QFT in routine screening, further follow-up could be avoided in 43% of the asylum seekers who would have been referred if based only on a positive TST (≥ 6 mm). The proportion of individuals referred will be the same whether QFT replaces TST or is used as a supplement to confirm a positive TST, but the number tested will vary greatly. All three screening approaches would identify the same proportion (88–89%) of asylum seekers with a positive QFT and/or a TST ≥ 15 mm, but different groups will be missed.The incidence of tuberculosis in Norway is generally low (6.3/100 000 population in 2006), but high among immigrants from countries where tuberculosis is endemic [1]. Most cases of tuberculosis are due to imported new strains rather than transmission within Norway [2,3]. WHO have estimated the global prevalence of latent tuberculosis infection in 1997 to be 35% for Africa, 44% for Southeast Asia and 15% for Europe [4]. The enormous pool of persons with latent tuberculosis challenges control of tuberculosis in low endemic countries. National guidelines for prevention and control of tuberculo
School based screening for tuberculosis infection in Norway: comparison of positive tuberculin skin test with interferon-gamma release assay
Brita Winje, Fredrik Oftung, Gro Korsvold, Turid Manns?ker, Ingvild Ly, Ingunn Harstad, Anne Dyrhol-Riise, Einar Heldal
BMC Infectious Diseases , 2008, DOI: 10.1186/1471-2334-8-140
Abstract: This cross-sectional multi-centre study was conducted during the school year 2005–6 and the TST positive children were recruited from seven public hospitals covering rural and urban areas in Norway. Participation included a QFT test and a questionnaire regarding demographic and clinical risk factors for latent infection. All positive QFT results were confirmed by re-analysis of the same plasma sample. If the confirmatory test was negative the result was reported as non-conclusive and the participant was offered a new test.Among 511 TST positive children only 9% (44) had a confirmed positive QFT result. QFT positivity was associated with larger TST induration, origin outside Western countries and known exposure to tuberculosis. Most children (79%) had TST reactions in the range of 6–14 mm; 5% of these were QFT positive. Discrepant results between the tests were common even for TST reactions above 15 mm, as only 22 % had a positive QFT.The results support the assumption that factors other than tuberculosis infection are widely contributing to positive TST results in this group and indicate the improved specificity of QFT for latent tuberculosis. Our study suggests a very low prevalence of latent tuberculosis infection among 9th grade school children in Norway. The result will inform the discussion in Norway of the usefulness of the current TST screening and BCG-policy.The incidence of tuberculosis in Norway is generally low (6.3/100 000 population in 2006), but high among immigrants from countries where tuberculosis is endemic [1]. Although the tuberculin skin test (TST) has low specificity, it is still the major tool for detecting tuberculosis infection. Screening for tuberculosis infection by TST has in Norway been offered to all children in the 9th grade of school (age 14–15) for several decades. Historically there have been three objectives of this screening: (1) to measure the transmission rate of tuberculosis infection in the population, (2) to identify cases wi
The role of entry screening in case finding of tuberculosis among asylum seekers in Norway
Ingunn Harstad, Geir W Jacobsen, Einar Heldal, Brita A Winje, Saeed Vahedi, Anne-Sofie Helvik, Sigurd L Steinshamn, Helge Gar?sen
BMC Public Health , 2010, DOI: 10.1186/1471-2458-10-670
Abstract: We aimed to assess the effectiveness of entry screening of a cohort of asylum seekers. Cases detected by screening were compared with cases detected later. Further we have characterized cases with active tuberculosis.All asylum seekers who arrived at the National Reception Centre between January 2005 - June 2006 with an abnormal chest X-ray or a Mantoux test ≥ 6 mm were included in the study and followed through the health care system. They were matched with the National Tuberculosis Register by the end of May 2008.Cases reported within two months after arrival were defined as being detected by screening.Of 4643 eligible asylum seekers, 2237 were included in the study. Altogether 2077 persons had a Mantoux ≥ 6 mm and 314 had an abnormal chest X-ray. Of 28 cases with tuberculosis, 15 were detected by screening, and 13 at 4-27 months after arrival. Abnormal X-rays on arrival were more prevalent among those detected by screening. Female gender and Somalian origin increased the risk for active TB.In spite of an imperfect follow-up of screening results, a reasonable number of TB cases was identified by the programme, with a predominance of pulmonary TB.In recent years most new tuberculosis (TB) cases in Norway have occurred among immigrants from high incidence countries. Rarely, new cases are due to transmission within the country [1].Low incidence countries have diverse policies on entry screening of immigrants from high incidence countries. These range from no screening at all, to pre-immigration screening or screening after arrival [2-4]. There is an ongoing discussion about the content and effectiveness of different screening programmes to control tuberculosis [5,6]. Studies of screening of tuberculosis among immigrants have given TB prevalences that range from 0.1-1.2% [7-10], that can be due to differences in the characteristics of the populations and the screening programmes.Previous studies have shown differences between cases detected by or outside the screening
Christa Lykke Christensen: Visuelle f lelser - en unders gelse af unges billedoplevelser
Ingunn Hagen
MedieKultur : Journal of Media and Communication Research , 2004,
Abstract:
Juridiske rammevilk r for etablering av helseregistre og utlevering av data i forbindelse med forskning
Ingunn Myklebust
Norsk Epidemiologi , 2009,
Abstract: F r et forskningsprosjekt kan settes i gang, m forskere forholde seg til en rekke omfattende s knadsprosedyrer. I denne artikkelen belyses forhold som er spesielt aktuelle for forskere, slik som muligheter og begrensninger for innhenting av data til forskning og tilgjengelighet av data fra sentrale helseregistre. Som bakgrunn benyttes helseregisterloven og tilh rende forskrifter for de sentrale helseregistrene. Regler om dispensasjon fra taushetsplikt blir ogs n rmere belyst. English Summary Before a research project can be initiated, researchers must relate to a series of comprehensive procedures for making an application. In this article, the conditions that are particularly relevant for researchers, such as the possibilities and restrictions for collecting data for research purposes, and for obtaining access to data from central health registers, are discussed. The Personal Health Data Filing System Act and related regulations are used as background for the discussion. The regulations relating to exemption from the duty of confidentiality are also discussed.
Impacts of human activity on reindeer and caribou: The matter
Ingunn Vistnes,Christian Nellemann
Rangifer , 2007,
Abstract: The impacts of human activity and infrastructure development on reindeer and caribou (Rangifer tarandus) have been studied for decades and have resulted in numerous debates among scientists, developers and indigenous people affected. Herein, we discuss the development within this field of research in the context of choice of spatial and temporal scale and concurrent trends in wildlife disturbance studies. Before the 1980s, the vast majority of Rangifer disturbance studies were behavioural studies of individual animals exposed directly to potential disturbance sources. Most of these local studies reported few and short-term impacts on Rangifer. Around the mid 1980s focus shifted to regional scale landscape ecology studies, reporting that reindeer and caribou reduced the use of areas within 5 km from infrastructure and human activity by 50-95%, depending on type of disturbance, landscape, season, sensitivity of herds, and sex and age distribution of animals. In most cases where avoidance was documented a smaller fraction of the animals, typically bulls, were still observed closer to infrastructure or human activity. Local-scale behavioural studies of individual animals may provide complementary information, but will alone seriously underestimate potential regional impacts. Of 85 studies reviewed, 83% of the regional studies concluded that the impacts of human activity were significant, while only 13% of the local studies did the same. Traditional ecological knowledge may further increase our understanding of disturbance effects. Effekter av menneskelig aktivitet p rein og caribou: Betydningen av valg av skala Abstract in Norwegian / Sammendrag: Effektene av menneskelig aktivitet og utbygging p rein og caribou (Rangifer tarandus) har v rt studert i flere ti r og har resultert i utallige debatter mellom forskere, utbyggere og ber rt urbefolkning. I denne artikkelen diskuterer vi utviklingen innenfor dette forskningsfeltet i forhold til valg av skala i tid og rom, og i forhold til trender innen forskning p forstyrrelse av vilt generelt. F r 1980-tallet var st rsteparten av forstyrrelsesstudier p rein og caribou adferdsstudier av enkeltdyr eksponert direkte for potensielle forstyrrelseskilder. Flertallet av disse lokale studiene konkluderte med f og kortvarige effekter p Rangifer. Rundt midten av 1980-tallet skiftet fokus over til regionale landskaps kologi-studier, som fant at rein og caribou reduserte bruken av omr der innen 5 km fra infrastruktur og menneskelig aktivitet med 50-95%, avhengig av type forstyrrelse, landskap, rstid, toleranseniv et til
Anti-tumour activity of bisphosphonates in preclinical models of breast cancer
Ingunn Holen, Robert E Coleman
Breast Cancer Research , 2010, DOI: 10.1186/bcr2769
Abstract: In addition to the established role as inhibitors of osteoclast activity and bone resorption, bisphosphonates (BPs) also affect tumour cells. Their ability to induce apoptosis, reduce proliferation, and inhibit tumour cell migration and invasion has been demonstrated in numerous in vitro studies (reviewed in [1]). As nitrogen-containing BPs (NBPs) act by inhibiting key enzymes in the metabolic pathway responsible for cholesterol synthesis, which is essential for all nucleated cells, the drugs do have the potential to affect any cell type that takes up sufficient quantities of them [2].The anti-tumour effects reported from in vitro systems led to subsequent investigations using in vivo models in different tumour types, including breast cancer (reviewed in [3]). Most of these focussed on elucidating the effects of BPs on tumours in bone, and it quickly became clear that BP treatment prevented the development of cancer-induced bone disease, but that tumour growth was only temporarily halted and eventually progressed. Increasing the dosing frequency and/or starting therapy at early stages of the disease process increased the anti-tumour effect, but did not completely eradicate tumours.Subsequent studies explored the potential of BPs as part of combination therapy schedules. BPs were added to a range of standard chemotherapy agents used to treat breast, prostate and small cell lung cancer, multiple myeloma and osteosarcoma [3,4]. In all reports published to date, addition of a BP to other anti-cancer therapies caused significantly decreased tumour burden compared to that seen when the single agents were used. This has in turn led to clinical trials in breast cancer investigating whether adding BPs to standard treatment translates to additional benefit for patients [5,6]. Although substantial increased anti-tumour effects are demonstrated when BPs are added to a range of therapeutic agents, the underlying molecular and cellular mechanisms remain to be established.Over the
Tumour macrophages as potential targets of bisphosphonates
Thea L Rogers, Ingunn Holen
Journal of Translational Medicine , 2011, DOI: 10.1186/1479-5876-9-177
Abstract: Bisphosphonates (BPs), such as zoledronic acid, are anti-resorptive agents approved for treatment of skeletal complication associated with metastatic breast cancer and prostate cancer. These agents act on osteoclasts, key cells in the bone microenvironment, to inhibit bone resorption. Over the past 30 years this has led to a great reduction in skeletal-related events (SRE's) in patients with advanced cancer and improved the morbidity associated with cancer-induced bone disease. However, there is now a growing body of evidence, both from in vitro and in vivo models, showing that zoledronic acid can also target tumour cells to increase apoptotic cell death and decrease proliferation, migration and invasion, and that this effect is significantly enhanced in combination with chemotherapy agents. Whether macrophages in the peripheral tumour microenvironment are exposed to sufficient levels of bisphosphonate to be affected is currently unknown. Macrophages belong to the same cell lineage as osteoclasts, the major target of BPs, and are highly phagocytic cells shown to be sensitive to bisphosphonates in model studies; In vitro, zoledronic acid causes increased apoptotic cell death; in vivo the drug has been shown to inhibit the production of pro-angiogenic factor MMP-9, as well as most recent evidence showing it can trigger the reversal of the TAMs phenotype from pro-tumoral M2 to tumoricidal M1. There is thus accumulating evidence supporting the hypothesis that effects on TAMs may contribute to the anti-tumour effect of bisphosphonates. This review will focus in detail on the role of tumour associated macrophages in breast cancer progression, the actions of bisphosphonates on macrophages in vitro and in tumour models in vivo and summarise the evidence supporting the potential for the targeting of tumour macrophages with bisphosphonates.Breast cancer is the most commonly diagnosed cancer in the UK where women have a 1 in 8 lifetime risk of developing the disease [1]. The m
Gravity coupled to a scalar field in extra dimensions
Ingunn Kathrine Wehus,Finn Ravndal
Physics , 2006, DOI: 10.1088/1742-6596/66/1/012024
Abstract: In d+1 dimensions we solve the equations of motion for the case of gravity minimally or conformally coupled to a scalar field. For the minimally coupled system the equations can either be solved directly or by transforming vacuum solutions, as shown before in 3+1 dimensions by Buchdahl. In d+1 dimensions the solutions have been previously found directly by Xanthopoulos and Zannias. Here we first rederive these earlier results, and then extend Buchdahl's method of transforming vacuum solutions to d+1 dimensions. We also review the conformal coupling case, in which d+1 dimensional solutions can be found by extending Bekenstein's method of conformal transformation of the minimal coupling solution. Combining the extended versions of Buchdahl transformations and Bekenstein transformations we can in arbitrary dimensions always generate solutions of both the minimal and the conformal equations from known vacuum solutions.
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