• Magabolsbólga - Helicobacter Pylori - Gastrin

      Fjölnir Elvarsson; Nick Cariglia; Ingi Þór Hauksson; Þorgeir Þorgeirsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2006-01-01)
      OBJECTIVE: Corpus gastritis is a common diagnosis. Studies have shown that about 25% of patients that undergo gastroscopy receive this diagnosis. This study was undertaken to investigate etiological associations in patients with corpus gastritis in our northern Icelandic population. MATERIAL AND METHODS: Patients who had had a histological diagnosis of chronic corpus gastritis between the years of 1994 to 1998 were retrieved from the computer files of the department of pathology. In all 172 patients fulfilled the Sydney pathological criteria. Pathology review was performed by the same pathologist. Blood samples were also taken for variable serology and a urea breath test for Helicobacter pylori (H. pylori) was performed. RESULTS: Mean age 71 year old (24-99 year). Males were 57%. H. pylori infection was diagnosed in 39%. There appears to be a relationship between active gastritis and H. pylori positivity, especially if there was only chronic gastritis without atrophy or metaplasia. Atrophy was significantly greater if anti-parietal antibody was present. No connections were found between anti-parietal antibody and anti-microsomal antibody. There was significantly higher mean gastrin levels in patients with atrophy or metaplasia compared with only chronic gastritis (p<0.05), present also in patients with chronic gastritis vs active gastritis (p<0.01). There was no difference in mean gastrin levels between H. pylori positive and H. pylori negative patients. Significantly higher mean gastrin levels were seen in patients with anti-parietal antibody (p<0.001). No difference was found in mean gastrin levels between patients with or with out antimicrosomal antibody. CONCLUSIONS: There is a high probability that corpus gastritis and related complications are related to H. pylori infection in a large proportion of our population. Serum gastrin may well be a predictor of the histological grading of the chronic gastritis. We did not see a relationship with antimicrosomal activity.
    • Magakrabbamein í Íslendingum 1955-1984 : afturskyggn rannsókn á meingerð og staðsetningu æxla í mögum teknum með skurðaðgerð

      Lárus Jónasson; Jónas Hallgrímsson; Helgi Sigvaldason; Guðríður Ólafsdóttir; Hrafn Tulinius (Læknafélag Íslands, Læknafélag Reykjavíkur, 1992-12-01)
      During the last decades the frequency of stomach cancer has declined among populations both at high-risk and at low-risk. The decline has been greater among populations at high-risk, including the Icelanders. Results of foreign investigations have shown that the decline has mostly been in one (the intestinal) of the two principal histological types of tumour (intestinal, diffuse) but that type has been considered to be mainly influenced by environmental factors. The purpose of our investigation was to determine the histological types and anatomical locations of carcinomas in resected stomachs during the period 1955-1984. The material derived from the Icelandic Cancer Registry and from the Department of Pathology at the University of Iceland. The final number of tumours under investigation was 1018. The histological slides were reviewed and the tumours classified according to the Lauren classification. The anatomical location was determined from the histological request forms and/or from the pathological reports. The decline in frequency of stomach cancers resected was mainly due to intestinal tumours. Among males the decrease in frequency of diffuse tumours, much fewer by number, was proportional to that of intestinal tumours but among females the decrease was only in intestinal tumours and diffuse tumours remained relatively unchanged. The frequency of tumours in the cardia region among males increased during the period while it decreased in the other gastric regions. The increase in the cardia region was all due to intestinal tumours among males. Tumours in the cardia region among females were few and all were of the intestinal type. Geographical variations in frequency and relative distribution of intestinal and diffuse types of stomach cancer has been considered to be due to differences in causal factors. Some of our findings do not conform to that theory. Variations in mucosal response to the same agents may explain these discrepancies. Mucosal inflammation and sex of the patient may lead to different responses and thus to different types of tumours. The relative death risk for stomach cancer patients increased with age. The relative death risk among those with tumours in the cardia region was 56 per cent higher than that among those with tumours in the other gastric regions. Overall survival increased during the observation period by 37%.
    • Magaraufun um húð með hjálp speglunar á Íslandi 2000-2009. Ábendingar, fylgikvillar og siðfræðileg álitamál

      Sigurbjörn Birgisson; Internal medicine, Landspitali The National University Hospital, Reykjavík, Iceland. (Læknafélag Íslands, Læknafélag Reykjavíkur, 2012-02)
      OBJECTIVE: Percutaneous endoscopic gastrostomy (PEG) is the preferred method for long term enteral feeding. No nationwide study has reported on the experience and outcome of PEG procedure. The aim of this study was to describe the frequency, indications, complications, mortality and ethical issues related to PEG procedures in Iceland. MATERIAL AND METHODS: A retrospective study was performed on all adult patients who had PEG procedures in Iceland between 2000-2009. Medical charts from patients found were reviewed and data regarding demographics, indications, complications, mortality and ethically controversial cases was obtained. RESULTS: A total of 278 patients had PEG procedures during the 10 year study period. There were 163 men and 115 women with a median age of 70 years. The mean annual incidence of PEG procedures was 12.8/100.000. Sufficient medical data for evaluation was obtained from 263 patients. The most common indications were neurological disorders (61%) and malignancies (13%). Dementia accounted for only 0.8% of the indications. Total complication rate was 6.5% with 1.9% being major and 4.6% minor complications. Peritonitis was the most common (2.7%) complication followed by peristomal skin infection (1.9%). Operative mortality was 0.8% and 30 day mortality rate was 13%. In seven (2.7%) cases the PEG procedure was considered to be ethically and medically controversial. CONCLUSION: This is the first published nationwide study on the experience of PEG procedures. The complication and mortality rates in Iceland are among the lowest reported. The indications reported here are in agreement with national guidelines with the rate of PEG procedures in ethically controversial cases being very rare.
    • Malaría á Íslandi, sjaldgæf en stöðug ógn fyrir ferðalanga

      Kristján Godsk Rögnvaldsson; Sigurður Guðmundsson; Magnús Gottfreðsson; 1 Læknadeild Háskóla Íslands, 2 Landspítali (Læknafélag Íslands, Læknafélag Reykjavi­kur, 2016-06-02)
      Inngangur: Malaría er sníkjudýrasýking og ein algengasta orsök ótímabærra dauðsfalla í þróunarlöndum, einkum meðal barna. Sjúkdómurinn greinist af og til á Íslandi í einstaklingum sem hafa dvalist á malaríusvæð- um. Í rannsókn sem gerð var á sjúkdómnum hérlendis 1980-1997 fundust 15 staðfest tilfelli. Tilgangur þessarar afturskyggnu rannsóknar var að rannsaka faraldsfræði malaríu 1998-2014 á Íslandi. Efniviður og aðferðir: Sjúkragögn þeirra sem greindust með malaríu hér á landi samkvæmt blóðstroki eða blóðdropa voru yfirfarin. Einnig var aflað gagna um sölu malaríulyfja og um utanlandsferðir Íslendinga á tímabilinu. Niðurstöður: Staðfestar malaríusýkingar reyndust vera 31. Í heild voru að meðaltali 1,8 tilfelli á ári, greiningartíðni um 0,6 tilfelli/100 þúsund íbúa/ ári. Á tímabilinu 1980-1997 var greiningartíðni 0,3/100 þúsund/ári. Ekki reyndist marktækur munur á tíðni milli tímabila (p=0,056). Plasmodium falciparum greindist í 71% tilfella, P. vivax í 16%, P. ovale og P. malariae hvor um sig í 7%. Einungis tveir sjúklingar (7%) höfðu tekið fyrirbyggjandi lyf. Einn sjúklingur fékk sýkingarbakslag. Tveir lögðust inn á gjörgæslu en enginn lést. Algengasta lyfjameðferð var atóvakón með prógúaníl. Sala þess sem fyrirbyggjandi lyfs stóð í stað árin 2010-2014 en á sama tíma varð aukning í utanlandsferðum Íslendinga. Ályktun: Á Íslandi hefur greiningum á malaríu fjölgað lítillega en á sama tímabili hefur tilfellum í nágrannaríkjunum fækkað. Fylgjast þarf með tíðni sjúkdómsins og afdrifum sjúklinga á Íslandi næstu ár. Mikilvægt er að efla forvarnir meðal ferðamanna á malaríusvæðum, þar með talið töku fyrirbyggjandi lyfja
    • Malaría og Ísland

      Ólafur Guðlaugsson; Sýkingavarnadeildar Landspítala (Læknafélag Íslands, Læknafélag Reykjavi­kur, 2016-06-02)
    • Manndauði úr kransæðasjúkdómum meðal íslenskra karla á tímabilinu 1951 til 1985

      Vilhjálmur Rafnsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1989-02-15)
      The mortality rates from ischemic heart disease among Icelandic men are described through 1951 to 1985. Information from death certificates according to five-years age groups (40-79) and calendar years were obtained from the Statistical Bureau of Iceland. Rates per 10s were calculated and plotted. Nonparametric tests were used to correlate death rates and calendar years. There was an increase in mortality from ischemic heart disease during the whole study period as during shorter periods through 1966 to 1985 and 1976 to 1985.
    • Many sequence variants affecting diversity of adult human height

      Gudbjartsson, Daniel F; Walters, G Bragi; Thorleifsson, Gudmar; Stefansson, Hreinn; Halldorsson, Bjarni V; Zusmanovich, Pasha; Sulem, Patrick; Thorlacius, Steinunn; Gylfason, Arnaldur; Steinberg, Stacy; et al. (Nature Pub. Co., 2008-05-01)
      Adult human height is one of the classical complex human traits. We searched for sequence variants that affect height by scanning the genomes of 25,174 Icelanders, 2,876 Dutch, 1,770 European Americans and 1,148 African Americans. We then combined these results with previously published results from the Diabetes Genetics Initiative on 3,024 Scandinavians and tested a selected subset of SNPs in 5,517 Danes. We identified 27 regions of the genome with one or more sequence variants showing significant association with height. The estimated effects per allele of these variants ranged between 0.3 and 0.6 cm and, taken together, they explain around 3.7% of the population variation in height. The genes neighboring the identified loci cluster in biological processes related to skeletal development and mitosis. Association to three previously reported loci are replicated in our analyses, and the strongest association was with SNPs in the ZBTB38 gene.
    • Marfans heilkenni á Íslandi

      Örn Einarsson; Ragnar Danielsen; Haraldur Sigurðsson; Einar Stefánsson (Læknafélag Íslands, Læknafélag Reykjavíkur, 1996-08-01)
      Marfan's syndrome is a heritable collagen disorder manifested by defects in the ocular, skeletal and cardiovascular systems. It is inherited as an autosomal dominant trait. The objectives of this study were to study the prevalence and clinical presentation of Marfan's syndrome in Iceland. We assessed the records of patients diagnosed with Marfan's syndrome during the years 1989-94 at all the major hospitals in Iceland. Hospital cardiologists, pediatricians and ophthalmologists gave valuable information, as did some general practitioners. All patients who agreed to participate were evaluated by an ophthalmologic inspection and an echocardiogram was obtained. A family history was taken and a general physical examination was performed. Twenty two patients were evaluated, at the age seven to 71 years. Seventeen of them had a definitive diagnosis of Marfan's syndrome with a mean age of 27 years. Five patients did not meet the clinical criteria for Marfan's syndrome. Accordingly the prevalence of Marfan's syndrome in Iceland is 6.5/100.000. Ocular involvement was observed in 14 (82%) and 11 (65%) had a dislocated lens. Cardiovascular abnormalities were seen in 11 (65%) patients, nine (53%) had aortic root dilatation and six (35%) had mitral valve prolaps. All patients had skeletal abnormalities. They were tall, skinny, with long extremeties and arachnodactyly. Pectus carinatum was observed in seven (41%) patients. A family history was noted in 12 patients and five (29%) seem to be sporadic cases. Thus, Marfan's syndrome exists in Iceland and it's prevalence and clinical presentation seems to be in concordance with other published studies in the western world.
    • Mat á alvarleika áráttu- og þráhyggjueinkenna með DOCS spurningalistanum

      Ragnar P. Ólafsson; Kristín G. Reynisdóttir; Sævar Þ. Sævarsson; Árni Kristjánsson; Daníel Þ. Ólason; Háskóli Íslands, Háskólinn í Amsterdam (Sálfræðingafélag Íslands, 2016)
      Vandasamt getur verið að mæla einkenni áráttu- og þráhyggjuröskunar (obsessive-compulsive disorder) vegna þess hversu margbreytileg svipgerð hennar er. Í þessari grein er nýlegum sjálfsmatsspurningalista, Dimensional Obsessive Compulsive Scale (DOCS) lýst, sem mælir alvarleika áráttu- og þráhyggjueinkenna ásamt því að birtar eru niðurstöður rannsóknar á próffræðilegum eiginleikum íslenskrar þýðingar listans. Þátttakendur í rannsókninni voru nemendur við Háskóla Íslands sem mættu í greiningarviðtal. Samkvæmt formlegu geðgreiningarviðtali voru 32 nemendur með áráttu- og þráhyggjuröskun (auk annarra raskana), 28 með kvíðaröskun og 22 uppfylltu ekki greiningarviðmið fyrir neina skilgreinda röskun. Þátttakendur svöruðu meðal annars öðrum spurningalista um áráttu- og þráhyggjueinkenni ásamt spurningalistum um kvíða-, depurðar-, og streitueinkenni og einkenni félagskvíða. Niðurstöður sýndu að áreiðanleiki heildarskors DOCS var góður í öllum þremur hópunum (0,88-0,89). Heildarstigatala og stigatala á fjórum undirkvörðum listans var hæst í hópi þátttakenda með áráttu- og þráhyggjuröskun og var þessi munur marktækur. Einnig reyndist samleitni- og aðgreinandi réttmæti DOCS viðunandi þar sem DOCS hafði sterkari fylgni við niðurstöðu á öðrum spurningalista fyrir áráttu- og þráhyggjueinkenni (OCI-R) heldur en spurningalista um kvíða, depurð, streitu (DASS) og félagskvíða (SPS, SIAS). Niðurstöðurnar renna stoðum undir réttmæti íslenskrar gerðar DOCS. Listinn getur gagnast í greiningu og meðferð áráttuog þráhyggjueinkenna hér á landi.
    • Mat á árangri hugrænnar atferlismeðferðar í hóp við félagsfælni

      Sóley Dröfn Davíðsdóttir; Guðrún Íris Þórsdóttir; Brynjar Halldórsson (Sálfræðingafélag Íslands, 2006)
      Á geðsviði Landspítala-háskólasjúkrahúss hefur undanfarin ár verið veitt hugræn atferlismeðferð í hóp við félagsfælni. Árangur af þessari meðferð, sem veitt var sex hópum við endurhæfingarsvið frá árinu 2002 til 2005, var borinn saman við biðlistamælingar. Alls hófu 54 manns hópmeðferðina og luku 45, eða 83,3% þátttakenda, meðferðinni. Þátttakendur lækkuðu töluvert á mælingum á einkennum félagsfælni á meðferðartímanum en einkennin stóðu í stað meðan þátttakendur voru á biðlista. Þátttakendur forðuðust félagslegar aðstæður síður undir lok hópmeðferðar, fundu minna fyrir líkamlegum kvíðaeinkennum, höfðu minni áhyggjur af kvíðaeinkennum og minna af neikvæðum hugsunum. Þeir mældust minna þunglyndir, beittu síður öryggishegðun og mátu félagslega færni sína meiri en þeir höfðu gert við upphaf hópmeðferðar. Þessar breytingar áttu sér ekki stað meðan þátttakendur voru á biðlista. Þrátt fyrir töluverða lækkun á mælingum á einkennum félagsfælni mældist hins vegar félagsfælni þátttakenda enn talsverð undir lok hópmeðferðar. Í ljósi þessa er nauðsynlegt að skoða hvort breyta þurfi fyrirkomulagi meðferðar og jafnvel lengja hana til að enn frekari árangur náist.
    • Mat á gildi spurningalista Manneldisráðs Íslands til könnunar á mataræði fullorðinna

      Inga Þórsdóttir; Ingibjörg Gunnarsdóttir; Laufey Steingrímsdóttir (Læknafélag Íslands, Læknafélag Reykjavíkur, 2004-01-01)
      Objective: The aim was to assess the validity of a food frequency questionnaire (FFQ). Material and methods: Participants (n=84, aged 36-/+6) filled in a food frequency questionnaire, and the intake of nutrients and food items was estimated. Vitamin-C and beta-carotene blood concentration was measured as well as sodium (Na), potassium (K) and nitrogen (N) excretion in the urine. Correlation between results from the FFQ and biological measurements was assessed. PABA test (para-amino benzoic acid) was used to assess the completeness of the urine collection. Results: There was a correlation between plasma vitamin-C concentration and vitamin-C intake (r=0.294, P=0.008). A correlation was also seen between plasma vitamin-C concentration and intake of tomatoes, cucumber, peppers and green salat (r=0.231, P=0.039), as well as to the total consumption of vegetables (r=0.291, P=0.009). There was no correlation between beta-carotene concentration in the blood and in the diet. However, beta-carotene concentration in the blood correlated with intake of onion, leak, and garlic (r=0.240, P=0.032). There was a strong correlation between all the groups of fruits and vegetables (P<0.001). Potassium intake correlated with potassium excretion (r=0.452, P<0.001), but sodium intake was not associated with sodium excretion. There was no statistical difference between nitrogen intake and total nitrogen excretion in the urine. Conclusion: FFQ developed by the Icelandic Nutrition Council is valid to assess intake of vitamin-C, potassium as well as vegetables. It also gives estimates of protein intake, but should not be used to assess sodium (salt) intake.
    • Mat á greiningu og meðferð bráðrar skútabólgu á þremur heilsugæslustöðvum

      Jón Pálmi Óskarsson; Sigurður Halldórsson; palmio@internet.is (Læknafélag Íslands, Læknafélag Reykjavíkur, 2010-09-01)
      OBJECTIVE: The objective of this study was to evaluate the diagnosis and treatment of acute sinusitis at three health care centers in northern and eastern Iceland. MATERIAL AND METHODS: Information on all those diagnosed with acute sinusitis (ICD 10 J01.0, J01.9) in the year 2004 at the communal health care centers in Akureyri, Husavik and Egilsstadir was obtained retrospectively from computerized clinical records. Key factors used for diagnosis and treatment were recorded. In order to obtain an equal distribution in population size only about one-third of the diagnoses made in Akureyri were included in the search (the first ten days of every month). RESULTS: The search yielded a total of 468 individuals. The average incidence of acute sinusitis was found to be 3.4 per 100 inhabitants per year. Adherence to clinical guidelines (albeit from other countries) regarding diagnosis of bacterial sinusitis was nearly nonexistent. There were considerable differences found between health care centers as to whether x-rays were used for diagnostic purposes. Blood tests were hardly used at all. The disease was diagnosed over the telephone in 28% of the cases (Husavik 38%, Akureyri 32%, Egilsstadir 10%). Over 90% of all individuals diagnosed with acute sinusitis received antibiotics, regardless of symptom duration. The antibiotics most often prescribed were Doxycyclin and Amoxicillin. CONCLUSIONS: The incidence of acute sinusitis in these three communities seems to be similar to other western countries. Acute bacterial sinusitis seems to be overdiagnosed and the use of antibiotics is in no context with clinical guidelines. Our results support the hypothesis that physicians tend to regard acute sinusitis as a bacterial disease, and treat it accordingly.
    • Mat á gulu hjá nýburum

      Ása Unnur Bergmann; Þórður Þórkelsson; Barnaspítala Hringsins (Ljósmæðrafélag Íslands, 2017-07)
      Inngangur: Nýburagula orsakast af auknum styrk gallrauða í blóði nýbura fyrstu dagana eftir fæðingu. Sýnileg gula kemur fram hjá allt að 60% nýbura. Yfirleitt þarf ekki að meðhöndla nýburagulu, en ef styrkur gallrauða í blóði verður of hár getur hann valdið varanlegum skaða á miðtaugakerfi. Mæla má styrk gallrauða í blóði með tvennum hætti; blóðmælingu og húðmælingu. Húðmæling er hentug þar sem hún er sársaukalaus og niðurstaða fæst samstundis. Tilgangur rannsóknarinnar var að meta áreiðanleika blossamæla við mat á styrk gallrauða í blóði nýbura. Húðmæling er framkvæmd með blossamæli. Dräger JM103 blossamælir var notaður í rannsókninni. Efni og aðferðir: Afturskyggn samanburðarrannsókn var gerð á húðmælingum og blóðmælingum á gallrauða hjá nýburum. Klínískra upplýsinga var aflað úr sjúkraskrám barnanna og mæðraskrám. Upplýsingum um meðgöngu, fæðingu og mælingu gallrauða var safnað. Alls voru 122 börn í rannsókninni. Niðurstöður: Fylgni milli húðgildis og blóðgildis var R2=0.7075. Fylgnin fór minnkandi þegar styrkur gallrauðans fór yfir 250 μmól/L, þannig að blóðgildið var þá oftast hærra en húðgildið. Blossamælirinn vanmetur því styrk gallrauða í blóði sé hann umfram 250 μmól/L. Ályktanir: Við teljum að húðmælingar við mat á nýburagulu hafi ásættanlega fylgni við blóðgildi á gallrauða upp að 250 μmól/L, en við hærri húðgildi sé rétt að taka blóðsýni til staðfestingar. Hugsanlega mætti fækka börnum sem fá alvarlega gulu með því að hvetja ljósmæður til að hafa lágan þröskuld við að blossamæla í heimaþjónustu. Lykilhugtök: Nýburagula, gallrauði, nýburar, blossamælir, húðmæling.
    • Mat á heilsufari og hjúkrunarþörf á elli og hjúkrunarheimilum : RAI mælitækið, þróun þess og sýnishorn af íslenskum niðurstöðum

      Pálmi V. Jónsson; Anna Birna Jensdóttir; Hlíf Guðmundsdóttir; Hrafn Pálsson; Ingibjörg Hjaltadóttir; Ómar Harðarson; Sigurbjörg Sigurgeirsdóttir (Læknafélag Íslands, Læknafélag Reykjavíkur, 1997-10-01)
      Those elderly living in institutions have multiple social, health and mental problems, in addition to loss of function. The Resident Assessment Instrument assesses the individual in detail and his caring needs. Resident Assessment Protocols come with the instrument and a handbook that describes how to evaluate specific problems further. Quality indicators allow comparisons between institutions and thus the quality of care can be assessed in comparable groups of residents. The elderly can be put into defined resource utilisation groups and an average cost calculated per unit or nursing home. A pilot study was conducted in Iceland in 1994 to examine the utility of the instrument. It was shown that most of the residents were viewed as competent according to documents, even if about half of them had considerable cognitive dysfunction. Dementia was the most common diagnosis. One fourth of the residents took antidepressant medications and 54-62% took sedatives or hypnotic drugs. Eight out of 10 had dentures and one third had difficulty chewing. Many more interesting findings showed up that are described in a special report.
    • Mat á járnbúskap með mælingu á transferrínviðtökum

      Vigfús Þorsteinsson
; Friðrik E. Yngvason; aufus@simnet.is (Læknafélag Íslands, Læknafélag Reykjavíkur, 2010-01-01)
      BACKGROUND: The purpose of this study was to estimate the value of the transferrin receptor in serum (sTfR) for detecting iron deficiency and compare it with the value of some other blood tests for that purpose. MATERIAL AND METHODS: All patients undergoing bone marrow aspiration in the FSA Hospital, Akureyri, Iceland, in the period 1999 to 2003 were eligible to participate in this prospective study. Included participants were 89. The sensitivity, specificity, efficiency, and Youden index of ferritin, MCV, CHr, sTfR, sTfR-Ferritin-index, the iron saturation of transferrin, and the Thomas-Plot method were calculated. The complete absence of stainable iron in bone marrow was used as the definitive marker of iron depletion. RESULTS: The best method to detect iron deficiency as estimated by the Youden index was the Thomas-Plot method. This method was very specific in cases without evidence of inflammatory processes (CRP <6 mg/L) and very sensitive in cases with elevated CRP (>6 mg/L). The sTfR-Ferritin-index came second and sTfR was the best single blood test to detect iron deficiency according to the Youden index. CONCLUSION: The Thomas-Plot method and the sTfR-Ferritin-index proved to be the most reliable blood tests to diagnose iron deficiency. These parameters can eliminate the need of using bone marrow aspirate to diagnose iron deficiency in some cases.
    • Mat á kvíða- og þunglyndiseinkennum íslenskra barna sem búið hafa við heimilisofbeldi

      Lucinda Árnadóttir; Urður Njarðvík; Skólaþjónusta Árborgar, Sálfræðideild Háskóla Íslands (Sálfræðingafélag Íslands, 2017)
      - Children who live with domestic violence can suffer many harmful consequences but little is known about the nature and consequences of domestic violence on children in Iceland. The aim of this study was to evaluate behavior and psychosocial wellbeing of children who have witnessed and/or suffered psychological and/or physical abuse in their homes. Participants in the study were 28 children who took part in a group therapy which was conducted by the Government Agency for Child Protection for children who have suffered violence in their homes and/or witnessed violence in Heimilisofbeldi og tilfinningavandi barna 82 Sálfræðiritið, 22. árg. 2017 their homes, and their guardians. The study’s sample consisted of 85% of all the children who accepted an offer to take part in the group therapy over a two year period. The research design is descriptive. The study is based upon data that was gathered at the beginning of treatment to evaluate various symptoms with participants but the treatment itself was not evaluated. Symptoms of anxiety and depression were evaluated with standardized assessment scales, MASC and CDI, that the children answered themselves. The children’s guardians answered a thorough half-standardized admission interview. Symptoms of anxiety and depression among participants were more common in comparison to children in the general population. Results showed that 30% of the children had clinically significant symptoms of anxiety and 20% showed clinically significant symptoms of depression. A high percentage of the children had been bullied (53,6%), 30% felt bad or very bad in school and 35,7% had suicidal thoughts. Results show high prevalence of anxiety, depression and psychosocial problems among Icelandic children who have been exposed to domestic violence. Widespread emotional and social difficulties of participants are an indicator of and underline the seriousness of the effects of domestic violence on children who are exposed to it, regardless of whether the violence is directed at themselves or not.
    • Mat á líkamlegri, andlegri og félagslegri færni og þarfir aldraðra sem biðu hvíldarinnlagnar á öldrunarsviði Landspítala

      Ingibjörg Hjaltadóttir; Sigrún Bjartmarz; Díana Dröfn Heiðarsdóttir; Steinunn Arna Þorsteinsdóttir (Félag íslenskra hjúkrunarfræðinga, 2010-06)
      Tilgangur þessarar rannsóknar var að fá lýsandi mynd af líkamlegri, andlegri og félagslegri færni og þörfum aldraðra sem biðu eftir hvíldarinnlögn á öldrunarsviði Landspítala vorið 2007. Einnig var leitast við að kanna væntingar aldraðra og aðstandenda til þjónustunnar. Rannsóknin var megindleg með lýsandi sniði. Úrtakið var 24 einstaklingar sem bjuggu á eigin heimilum og voru á biðlista fyrir hvíldarinnlögn á öldrunarsviði Landspítala. Tekin voru viðtöl við þátttakendur eða aðstandendur þeirra. Notað var RAI-HC-matstæki sem greinir þarfir og styrkleika einstaklinga á ýmsum sviðum og er ætlað heilbrigðis- og félagsþjónustu. Niðurstöður sýndu að allir þurftu aðstoð við böðun og almennt var mikil þörf fyrir aðstoð við daglegar athafnir. Hjá 16 af 24 hafði orðið afturför í sjálfsbjargargetu við daglegar athafnir síðustu mánuði. Um helmingur þátttakenda var með minnisskerðingu og þurftu margir aðstoð og eftirlit allan sólarhringinn. Af 24 þátttakendum töldu 16 þeirra töldu heilsufar sitt vera lélegt eða sæmilegt. Meðal þátttakenda var andleg vanlíðan, einangrun og einmanaleiki algeng og þátttaka í félagslífi lítil. Álykta má út frá niðurstöðum að þessi hópur aldraðra þarfnist mikillar aðstoðar og að hún sé að miklu leyti veitt af nánasta aðstandanda. Þar sem mikið álag er á aðstandendum er þörf á aukinni heilbrigðis- og félagsþjónustu fyrir þennan hóp. Hjúkrunarfræðingar og annað heilbrigðisstarfsfólk gegnir mikilvægu hlutverki við mat á þjónustuþörf þess aldraða og umönnunaraðila hans sem og að leiðbeina um hugsanleg þjónustuúrræði.
    • Mat á mótþróa, þrjósku og hegðunarröskun barna

      Einar Guðmundsson; Árný Helgadóttir; Alexandra Diljá Bjargardóttir,; Anna Marín Skúladóttir; Anna Gréta Oddsdóttir; Sálfræðideild, Háskóli Íslands (Sálfræðingafélag Íslands, 2013)
      Einkennalistar eru mikið notaðir við mat og greiningu á geðrænum vanda barna og unglinga. Margs konar mælifræðilegar klípur fylgja notkun og túlkun slíkra lista. Hér er önnur leið farin en tíðkast í algengum greiningartækjum fyrir geðrænan vanda barna. Hegðun barna er metin með atriðum um eðlilegan þroska og með hliðsjón af greiningarviðmiðum mótþróaþrjóskuröskunar og hegðunarröskunar í DSM-IV-TR. Greint er frá niðurstöðum úr tveimur sjálfstæðum gagnasöfnum. Í gagnasafni I var 62 atriða frumsaminn listi um félags-, tilfinninga-, og siðferðisþroska barna atriðagreindur. Samtals stóðust 24 atriði viðmið í atriðagreiningunni. Þessi atriði voru þáttagreind í úrtaki mæðra (N = 138) og feðra (N = 109). Þrír þættir komu fram í úrtaki mæðra og feðra. Þeir eru nefndir út frá inntaki þeirra: Skaplyndi, Hlýðni og Félagstilfinning. Áreiðanleiki þáttanna í báðum úrtökum var á bilinu 0,80 – 0,92 og fylgni þáttanna var á bilinu 0,29 – 0,45. Í gagnasafni II voru sömu 24 atriðin þáttagreind í úrtaki mæðra barna á aldrinum 6 – 12 ára (N = 217). Sömu þrír þættir komu fram og í gagnasafni I. Þáttabygging listans er því stöðug milli óháðra úrtaka. Samin voru 57 ný atriði, þau atriðagreind, þættirnir þrír breikkaðir að inntaki og nýr þáttur, Félagsfærni, búinn til. Tveir þættir af fjórum (Skaplyndi og Félagstilfinning) nálgast normaldreifingu og stígandi er í meðaltali eftir aldri á þremur þáttanna (Skaplyndi, Félagstilfinning og Félagsfærni). Neikvæð tengsl eru milli allra þáttanna og tveggja kvarða á frávikalista Conners (Mótþrói og Félagsvandi). -------------------------------------------------------------- Symptom and behaviour checklists are widely used in assessing and diagnosing mental health problems in children and adolescents. Psychometric weaknesses jeopardize the validity of inferences drawn from these instruments. Here children´s mental health is assessed with items describing normal development and diagnostic criteria of Oppositional Defiant Disorder and Conduct Disorder in the DSM-IV-TR. Results from two independent datasets are reported. In dataset I 62 items on social-, emotional- and moral development were constructed and item analysed in a sample of 138 mothers of nine to thirteen year-olds. Twenty-four items meeting item analysis criteria were factor analysed separately in samples of mothers (N = 138) and fathers (N = 109). Three factors emerged in both samples: Temperament, Conduct, Moral Behaviour. Their reliability ranged from .80 to .92 and their intercorrelation from .29 to .45. In dataset II the same 24 items were factor analysed in a sample of mothers of six to twelve year olds (N = 217). The same three factors emerged as in dataset I indicating a stable factor structure. Fifty-seven new items were subjected to item analysis. Items meeting criteria were added to the three factors and a new factor, Social skills, constructed. Two of the four factors (Temperament and Moral Behaviour) deviate slightly from a normal distribution. For three of the factors (Temperament, Moral Behaviour, Social Skills) means increase by age. There is a strong negative correlation between two scales on the Conners´ Parent Rating Scale (Opposition, Social Problems) and the four factors on the new instrument.
    • Mat á nýrnastarfsemi : serum kreatínín og áætlaður gaukulsíunarhraði

      Alda M. Hauksdóttir (Félag lífeindafræðinga, 2006-07-01)
      Skert nýrnastarfsemi er vaxandi heilbrigðisvandamál í heiminum sem endurspeglast í skertum lífsgæðum fólks og er mikil þörf á að bæta greiningu á nýrnaskemmdum þegar á byrjunarstigi. Mælt hefur verið með að reikna áætlaðan gaukulsíunarhraða til að meta skerta nýrnastarfsemi og nota til þess kreatínínmælingar í sermi og fleiri þætti. Kallað hefur verið eftir betri stöðlun á kreatínínmælingum til að gera þetta að raunhæfum kosti. Í þessu verkefni eru bornar saman 3 aðferðir við mælingar á S-kreatíníni: Jaffé kínetísk frá Roche og tvær ensímatískar; önnur frá Roche hin frá Ortho. Niðurstöður sýna að tveimur ensímatískum aðferðum við mælingu á S-kreatíníni ber betur saman en þegar Jaffé kínetísk aðferð er notuð. Mælióvissa er þó sú sama í öllum aðferðunum. Ennfremur eru skoðaðar þrjár aðferðir við að reikna áætlaðan gaukulsíunarhraða. Ein reikniaðferð er borin saman við mældan gaukulsíunarhraða frá Ísótópastofu Landspítala háskólasjúkrahúss (LSH) sem sýnir allmikla dreifingu á mæliniðurstöðum þótt áætlaður gaukulsíunarhraði gefi heldur betri vísbendingu um starfsgetu nýrna en S-kreatínín. Nýrnastarfsemi einstaklinga í Öldrunarrannsókn Hjartaverndar er síðan metin út frá áætluðum gaukulsíunarhraða með aðstoð þriggja reiknijafna og niðurstaðan borin saman við gildin á S-kreatíníni. Þegar horft er á viðmiðunarmörk sem eru í gildi fyrir S-kreatínín þá flokkast fleiri karlar en konur með skerta nýrnastarfsemi. Samkvæmt öllum þremur reiknijöfnunum flokkast fleiri konur en karlar með skerta nýrnastarfsemi og þarf að kanna nánar í hverju þetta misræmi felst. Reiknijafna nr. 2 flokkar mun fleiri með skerta nýrnastarfsemi, gaukulsíunarhraða ≤ 60 ml/ mín/1,73m2, en hinar tvær eða um 33% karla og 45% kvenna miðað við 22-25% karla og 25–26% kvenna með jöfnum 1 og 3. Áður en unnt er að ráðleggja notkun tiltekinnar reiknijöfnu til að áætla gaukulsíunarhraða í íslensku þýði þarf augljóslega að gera ítarlegri samanburð á mældum og reiknuðum gaukulsíunarhraða. Taka þarf tillit til breytileika í mæliniðurstöðum á S-kreatíníni en ekki er síður mikilvægt að meta hvaða reiknijafna hentar best til að áætla gaukulsíunarhraða og þá er ólíklegt að ein og sama jafnan dugi fyrir alla aldurshópa og alla sjúklingahópa.
    • Mat á réttmætiskvörðum Personality Assessment Inventory

      Sigurður Viðar; Rúnar Helgi Andrason; Ársæll Már Arnarsson; Daníel Þór Ólason; Reykjalundur, Hákóli Íslands, Háskólinn á Akureyri (2011)
      The purpose of this study was to examine whether the Icelandic version of the Personality Assessment Inventory (PAI) discriminates between subjects who portray an inaccurate self-impression and those who give an accurate self-impression. The PAI is used to assess constructs relevant to psychopathology, interpersonal style, treatment acceptability and response validity. Participants were selected using a convenience sample and consisted of 243 university students who answered the PAI honestly, 110 patients from Reykjalundur rehabiliation center, 25 university students who simulated depression (negative impression management), 23 university students who simulated schizophrenia (negative impression management) and 25 university students who portrayed a very favorable self-impression (positive impression management). A comparison was made between six validity scales; three negative impression scales (NIM, MAL og RDF) and three positive impression scales (PIM, DEF og CDF). The results showed that the RDF scale performed best of the three negative impression scales and discriminated well between the clinical group and the groups simulating mental disorders. Of the positive impression management scales, the PIM and DEF were similar in detetecting positive self-impression from honest responding. However, the performance of the CDF scale was poor. In general are these results consistent with previous studies in other cultures.