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Erlend Hem

Publications and source records attributed to Erlend Hem.

36 records · Page 2Linked to original sources
PubMed2005

Identification with the role of doctor at the end of medical school: a nationwide longitudinal study.

OBJECTIVE: Given the sparse literature on the topic, there is a need to know more about student identification with the role of doctor, particularly with respect to the possible impact of pre-existing and medical school factors. DESIGN AND PARTICIPANTS: Medical students at all 4 Norwegian universities (n = 421) were mailed questionnaires on entry to their medical course (T1). Respondents were surveyed again halfway through (T2) and at the end (T3) of their 6-year courses. The study sample comprised the 236 students who responded on all 3 occasions. RESULTS: No significant variation occurred between medical schools in the level of student identification with the role of doctor, except for a significant gender difference at 1 university. Among pre-existing factors, interpersonal problems and confidence in one's own knowledge had independent impact on role identification controlled for gender, age, parental relationships, personality and mental health. This impact was mediated through perceived stress and perceived recording skills, while confidence in knowledge also maintained impact in the final model. Women had a lower level of role identification, with the strongest impact coming from pre-existing factors like interpersonal problems, fear of encountering demanding work, and confidence in own knowledge. For men, change in perceived medical school stress from T2 to T3 and perceived recording/clinical skills had significant impact on the level of role identification. CONCLUSION: Pre-existing factors, partly mediated through skill acquisition and stressful medical school experiences, influenced role identification. In women, pre-existing factors had a significant impact upon role identification, contrasting with men, whose role identification was more influenced by medical school factors.

Adult↗
PubMed2004

[Changes in Norwegian obstetric practices, 1915-1961].

BACKGROUND: Established in 1967, the Medical Birth Registry of Norway has detailed accounts of all births in Norway. We have, however, only limited knowledge of obstetric practices in Norway in the decades before the Birth Registry was established. One important source is the annual reports of the Maternity Clinic in Oslo. MATERIAL: We analysed the annual reports for the period 1915-1961 with special emphasis on operative deliveries. RESULTS: The obstetric forceps was used in 6.5-12.5% (median 8.7%) of cephalic presentations. In 1960, the vacuum extractor was used for the first time. The rate of caesarean sections increased from 1.5% in the late 1930s to 6.3% in 1961. The proportion of operative deliveries increased up until 1944-55 when it was 14-16%, then fell in the years to 1960 when it was about 12%. Between 1915-1934, maternal mortality was as high as 6.4 per thousand. From the mid-1930s, it steadily decreased to 0.6 per thousand in the last five-year period. Well over one third of the deaths were caused by eclampsia or serious preeclampsia. INTERPRETATION: Birth traumas and neonatal death was the price paid for saving the mothers' lives and health. The operative activity was higher than what might be expected on the basis of the late-1960s data in the Birth Registry. The increase in caesarean sections was steepest during the Second World War, at a time when the number of deliveries in the clinic rose substantially.

Birth Rate↗
PubMed2004

Suicide risk in cancer patients from 1960 to 1999.

PURPOSE: Suicide risk is reportedly higher for cancer patients than for the general population, but estimates vary and analyses of trends are few. The aim of the present study was to determine whether cancer patients had a higher suicide risk between 1960 and 1999. PATIENTS AND METHODS: A cohort comprising patients from the Cancer Registry of Norway 1960 to 1997 was linked to suicide diagnosis in the Register of Deaths at Statistics Norway and observed during 1960 to 1999. The cohort consisted of all cancer patients registered in the Cancer Registry of Norway 1960 to 1997 (N = 490,245 patients with 520,823 cancer diagnoses). Suicide was defined according to death certificates based on the International Classification of Diseases (versions 7, 8, 9, and 10). RESULTS: During the period, 589 cancer patients (407 males and 182 females) committed suicide. The relative risk was elevated for males and females, with standardized mortality ratios (SMRs) of 1.55 (95% CI, 1.41 to 1.71) and 1.35 (95% CI, 1.17 to 1.56), respectively. Risk was highest in the first months after diagnosis. For both sexes, there was a significant decrease in the relative suicide risk over decades. The risk was markedly increased among male patients with cancer of respiratory organs (SMR, 4.08; 95% CI, 2.96 to 5.47). Otherwise, the SMRs varied from 0.76 to 3.67 across cancer types. CONCLUSION: Cancer may be a risk factor for suicide, particularly shortly after diagnosis. However, the relative risk gradually decreased during the period 1960 to 1999.

Adolescent↗
PubMed2004

The process of suicidal planning among medical doctors: predictors in a longitudinal Norwegian sample.

BACKGROUND: The suicidal process is a common underlying perspective on suicidal behaviour, but the process has hardly been empirically studied. This study investigates the process from suicidal thoughts to suicidal planning among physicians; an occupational group with a raised risk of suicide. The process is studied in two ways: First, predictors at medical school of postgraduate suicidal planning are identified. Second, the transition from suicidal thoughts to planning over three to four years is explored. METHODS: A nationwide cohort of Norwegian medical students (N=631) were approached initially in their final semester (T1), and then again in the first (T2) and fourth (T3) postgraduate years. The average observation time was 3.6 years. RESULTS: Twenty-eight participants (6%) reported suicidal planning in the postgraduate years. Adjusted predictors at T1 were vulnerability trait (neuroticism), severe depressive symptoms, and negative life events. Among those with previous suicidal thoughts at T1, 13 (8%) reported suicidal planning at T2 or T3. Adjusted predictors of transition from thoughts to planning were reality weakness trait, severe depressive symptoms, and a low level of perceived medical school stress. A minority of the postgraduate planners had sought professional care. LIMITATIONS: The effect of severe depressive symptoms may be overestimated, and the sample size is relatively small. CONCLUSIONS: Common predictors for both postgraduate suicidal planning and transition from thoughts to planning were depressive symptoms and personality traits. Reality weakness was the most decisive trait for aggravation in suicidal ideation, and this personality trait needs further study in suicidal research and clinical awareness.

Adult↗
PubMed2003

[A watershed in Norwegian obstetrics].

BACKGROUND: Professional obstetrics in Norway developed during the 19th century. This paper analyses the development through the second half of the 19th century at the Maternity Clinic in Christiania (now Oslo). MATERIAL AND METHODS: All patient files from the years 1852, 1872 and 1892, a total of 1231 records, were analysed. Socio-demographic and gynaecologic data were registered as well as data about the delivery and the child. RESULTS: The number of deliveries increased nearly five times during the period. The proportion of married women increased from less than 20% to nearly 50%. Maternal mortality decreased from above 3% to below 1%, mostly because childbed fever became infrequent. The number of operative deliveries increased substantially, particularly the use of the obstetric forceps, in 1892 utilised in 6 % of deliveries. In the reviews published in those days, eclampsia and reduced contractions were the most frequently cited indications for the use of the obstetric forceps. Problems with the heart sound of the fetus were not mentioned. However, patient files demonstrate that a weak or missing heart sound of the fetus was also an important indication for the use of the forceps. INTERPRETATION: Giving birth at the clinic was gradually becoming an alternative for other than poor women, because it was safer than before and in some cases the obstetricians could offer effective help. However, at the end of the 19th century, not more than about 15% of all deliveries took place at the clinic. This paper demonstrates the importance of scrutinising patient files as a supplement to register data, as is the case today, too.

Adult↗
PubMed2003

Max Sänger - father of the modern caesarean section.

The major turning point in the development of the caesarean section appeared in 1882, when the German gynaecologist Max Sänger (1853-1903) suggested closing the uterine wound. Until this point, the wound was not sutured and so haemorrhage was a common cause of maternal death. Sänger's method quickly became standard, leading to a spectacular drop in maternal mortality. Sänger was one of the most renowned German gynaecologists at the end of the 19th century. He contributed to the entire fields of obstetrics and gynaecology, in particular in founding Monatsschrift für Geburtshülfe und Gynaekologie, the predecessor of this journal.

Cesarean Section↗
PubMed2003

Suicidal ideation and attempts in Norwegian police.

Studies on suicide among police show inconsistent results, thereby contributing to considerable speculation regarding why police officers commit suicide. The present paper is the first nationwide study on suicidal ideation and attempts among police. 3,272 Norwegian police completed Paykel's Suicidal Feelings in the General Population questionnaire. Lifetime prevalence of specific questionnaire items ranged from 24% for the feeling that life was not worth living, 6.4% for having seriously considered suicide, and 0.7% for attempted suicide. Independent predictors of serious suicidal ideation were marital status, subjective health complaints, reality weakness, anxiety, and depression. Serious suicidal ideation was mainly attributed to personal and family problems.

Adult↗
PubMed2002

[The gynecologist Max Sänger and his relationship with Nina and Edvard Grieg].

Hundred years ago, on 12 January 1903 the gynaecologist Max Sänger (1853-1903) died. He was one of the most well-known German gynaecologists at the end of the 19th century, and during the 20 years he practiced in Leipzig, he achieved an international reputation. His scientific work covered almost the whole field of contemporary obstetrics and gynaecology, and he is still remembered for his modification of the Caesarean operation, which substantially reduced maternal mortality. Sänger was closely linked to Norway, both professionally and personally. This paper describes his work as gynaecologist and his relationship to Norway, especially his friendship with Nina and Edvard Grieg.

Cesarean Section↗
PubMed2002

[Chronic fatigue].

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Chronic Disease↗