Biomedical subjects

H Ursin

Publications and source records attributed to H Ursin.

At least 37 records · Page 2Linked to original sources

PubMed1999

A scoring system for subjective health complaints (SHC).

The aim of this study is to present a complete scoring system for subjective health complaints (SHC) as they are experienced by the lay population. The scoring system records the complaints, and does not map attributions or medical diagnoses. In all, 1,219 subjects (323 men, 896 women) from various occupations were tested with a scoring system, the SHC inventory, previously referred to as the Ursin Health Inventory (UHI). The SHC consists of 29 questions concerning severity and duration of subjective somatic and psychological complaints. The SHC inventory yields scores on single items and a total number of health complaints categorized into five factors: musculoskeletal pain (alpha=0.74), pseudoneurology (alpha=0.73), gastrointestinal problems (alpha=0.62), allergy (alpha=0.58) and flu (alpha=0.67). The SHC inventory is a systematic, easy, and reliable way to score subjective health complaints. The prevalence of these complaints is high, and should be considered before conclusions are reached about new diseases and new attributions of environmental hazards.

Adult↗

PubMed1998

Five-year follow-up study of a controlled clinical trial using light mobilization and an informative approach to low back pain.

STUDY DESIGN: A controlled clinical trial. OBJECTIVES: To examine the long-term effect of an informative approach to low back pain. SUMMARY OF BACKGROUND DATA: In management and prevention of low back pain, back school based on an ergonomic approach have played in important role. The effect of such informative interventions is not clear. METHODS: A 5-year follow-up study was done on patients included in a previous study. The outcome was measured by return to work or still on sick leave. The patients were allocated to an intervention group (n = 245) and a control group (n = 244). Only the intervention group was called in for examination and intervention and answered a battery of tests for psychological and health factors. The intervention apart from the clinical examination consisted of education in an "mini back school." The program was based on a new medical model for low back pain. RESULTS: Forty-seven (19%) of the patients in the intervention group, compared with 84 patients (34%) in the control group, were still on sick leave after 5 years (P < 0.001). There were fewer recurrences of sick leave (P < 0.03) in the intervention group than in the control group. Based on Internal Health Locus of Control, number of children, and income, 75% were correctly classified as nonreturners in the intervention group. CONCLUSIONS: This study indicates that subchronic low back pain may be managed successfully with an approach that includes clinical examination combined with information for patients about the nature of the problem, provided in a manner designed to reduce fear and give them reason to resume light activity.

Adolescent↗

PubMed1998

Patients with low back pain not returning to work. A 12-month follow-up study.

STUDY DESIGN: A prospective study of patients treated with a light mobilization program for long-term low back pain. OBJECTIVES: To examine whether medical, psychological, or social factors predict failure to return to work within 12 months in the Scandinavian system of compulsory workers' compensation and social insurance, after a light mobilization program administered 8-12 weeks after initial sick leave. SUMMARY OF BACKGROUND DATA: The relative power of predicting factors varies in previous work, and there are no previous data on prognostic factors for light mobilization programs. METHOD: Patients (n = 260) on sick leave for 8-12 weeks for low back pain were examined with a battery of psychological and medical tests, before entering a light mobilization program. The treatment was given regardless of radiographic or clinical findings. The patients were encouraged to be active participants in the management and prevention of their back pain. Their sick leave status then was checked through registers 12 months after they had entered the treatment program. RESULTS: For those not returning to work within 12 months (23%), only combined models had acceptable predictive power (77%; discriminant analyses). Dominant variables were low Internal Health Locus of Control Score, restricted lateral mobility, and reduced work ability. The predictive value of each set of variables, taken alone, was significant only for medical variables (67% correct prediction). CONCLUSIONS: The final discriminant function may have potential as a brief screening instrument for the number of patients with low back pain who do not benefit from the light mobilization program.

Adolescent↗

PubMed1998

The psychology in psychoneuroendocrinology.

This paper reviews the psychology (P) of psychoneuroendocrinology (PNE). The relationship between the P factors and the endocrine responses (E) is described within cognitive reformulations of stress theory and activation theory. The formulations are valid across species, including man. The emphasis is on acquired expectancies, which are assumed to determine the physiological response, including the E responses. The terms coping, helplessness, and hopelessness are defined, and related to other labels covering the same or similar phenomena. The implications of contemporary P theory for the typical PNE experimental situations are discussed. Finally, the PNE positions outlined in 1968 by Mason is revisited. The 30 years of PNE research that followed confirm and expand his conclusions.

Animals↗

PubMed1998

Predictors for outcome of a multi-modal cognitive behavioural treatment program for low back pain patients-a 12-month follow-up study.

Low back pain patients (n=142) on sick leave for at least 8 weeks were given a multi-modal cognitive behavioural treatment program (MMCBT) that lasted for 4 weeks. Before treatment, all patients were tested with a comprehensive test battery. The outcome at 12-month follow-up was predictable from the pretest, but only when combining medical and psychological data. Patients who returned to work (Returners, 50%) in the MMCBT group were characterised by less pain, more psychological strength, were evaluated by the physiotherapist as having a good prognosis for return to work, and were less educated. Patients who did not return to work (Non-returners) in the MMCBT group felt tense and unfit, felt hopelessness concerning the future, were less physically active, thought their complaints would worsen if they continued working, and reported fewer difficulties driving a car. Returners to work (58%) in the randomised control group (n=81), who received ordinary physical therapy, were characterised by high levels of energy, less subjective health complaints, less exhaustion for a condition test, and did not work in positions giving a constant load on the back. There was no significant differences between number of patients who had returned to work in the MMCBT and the control group. Non-returners in the control group lacked energy, trained less regularly, worked in occupations that gave an almost constant load on the back, and did not expect to be back to work in the course of a couple of weeks. It seems to be important to develop further diagnostic tools to identify those who might benefit from extensive or specific treatments. Copyright 1998 European Federation of Chapters of the International Association for the Study of Pain.

Journal Article↗

PubMed1998

Multimodal cognitive behavioral treatment of patients sicklisted for musculoskeletal pain: a randomized controlled study.

In a randomized controlled study multimodal cognitive behavioral treatment (MMCBT), including physical treatment, cognitive behavioral modification, education, and examination of the work situation for each patient, was given to patients sick-listed for musculoskeletal pain (n = 469). Patients were recruited through the National Insurance System. After a pre-test by an independent physiotherapist the patients were allocated at random to the intervention group (n = 312) or the control group (n = 157). The MMBCT program lasted for 4 weeks. The control group returned to their general practitioners, without any feedback or advice on therapy from the project. At the one year follow-up the MMCBT group had not returned to work at a higher rate than the control group receiving ordinary treatment available through their general practitioners. However, the MMCBT group had improved their ergonomic behavior, work potential, life quality, physical, and psychological health.

Activities of Daily Living↗

PubMed1998

Stress, control, and coping in elite athletes.

The main object of this study was to explore different dimensions of the stress experience and the following coping efforts among elite athletes. Sixty-nine Norwegian Winter Olympic athletes, competing in the Lille-hammer Games in 1994 participated in the study. Recall of the most stressful experiences was reported through open-ended questions following the Olympic Games, and the actual time of the experience with the following coping efforts were measured with the COPE inventory (19). The stress was mainly experienced during the time period prior to the competition. External distractions and expectations were the most frequently reported stress experiences. The coach was viewed as a major source of stress by some athletes, with a subsequent lack of control and low satisfaction with performance. Type of stress more than the time of the experience seemed to have a detrimental effect on performance. Problem-focused coping strategies were employed at all times, while cognitive defense strategies were employed more days before (time phase 1) and after the competition (time phase 4).

Adaptation, Psychological↗

PubMed1997

Health complaints and job stress in Norwegian physicians: the use of an overlapping questionnaire design.

An extensive research program has been undertaken in Norway on physician health, sickness, working conditions and quality of life. Data are collected from cross-sectional and longitudinal prospective and retrospective surveys, qualitative studies, and vital statistics. This paper presents findings on subjectively experienced health problems, emotional distress, experienced job stress and job satisfaction, based on an extensive cross-sectional postal questionnaire study in 1993. An overlapping questionnaire design was used to allow many relationships to be estimated without exhausting the recipients. 9266 active physicians were included, which comprises close to the total Norwegian physician work-force minus a representative sample of 2100, used for other studies. The primary questionnaire was returned by 6652 (71.8%), the great majority of which also returned three secondary questionnaires. The results indicate that health complaints were significantly more frequent in female physicians and decreased with age. Low job satisfaction, high job stress, and emotional distress were all found to be significant predictors of subjective health complaints, as measured by the Ursin Health Inventory.

Adult↗

PubMed1997

The CODE: a revised battery for coping and defense and its relations to subjective health.

A condensed test battery (the CODE) based on the Utrecht Coping List (UCL) and part of the Defense Mechanisms Inventory (DMI) has been developed to assess coping and defense in large population studies. It was tested for reliability and validity in students and back pain patients. Principal components factor analysis of the subscales of the UCL and DMI in the student sample revealed two coping clusters: "Instrumental mastery-oriented coping" and "Emotion-focused coping" and two defensive clusters: "Cognitive defense" and "Defensive hostility". "Instrumental mastery-oriented coping" was negatively related to subjective health complaints measured with Ursins Health Inventory (UHI). The back pain patients were clearly different from the students, using less coping and more defensive strategies. They had more subjective health complaints that showed negative correlations with "Instrumental mastery-oriented coping". The CODE is a comprehensive battery that may be valid for large population studies of psychological determinants of muscle pain and other subjective health problems.

Adaptation, Psychological↗

PubMed1997

Exercise and diet interventions improve perceptions of self in middle-aged adults.

The effect of a 1-year exercise and diet intervention program on global self-concept, perceptions of the body, physical competence, exercise mastery, social competence, social comfort, and fitness was examined with 208 healthy individuals (191 males, 17 females) aged 39-49 years (mean age 44.9) with elevated risk factors for cardiovascular disease. The relative utility of the skill development versus the self-enhancement model of the self-concept/behaviour relationship was tested. The participants were randomized into four groups: diet (n = 53), diet and exercise (n = 64), exercise (n = 48) and no active intervention (n = 43). Measurements were made by the Harter adult self perception profile (HASPP) and the self-perception in exercise questionnaire (SPEQ). Two-way ANOVA analyses revealed that exercise participation, with or without diet, enhanced self-perceptions of physical mastery and ability, body perception, fitness and social comfort. The unique contribution of diet indicated enhanced body perception. No effect was found of diet or exercise on global self-concept. Exercise participation had a positive effect on perceptions of the self, and the higher the compliance with the exercise program, the stronger were the effects on the self-perceptions. This supported the skill development model of the self-concept/behaviour relationship. As the pretest self-concept scores did not predict exercise compliance, the self-enhancement model of the self-concept/behaviour relationship was not supported.

Adult↗

PubMed1997

Sensitization, somatization, and subjective health complaints.

More than half of the days lost due to sickness absence are due to diagnostic groups that solely or mainly depend on subjective statements from the patient The most frequent subjective health complaints are musculoskeletal pain. These conditions do not seem to qualify as psychiatric or mental disorders, but are not strictly somatic states either. Terms like somatization may be inadequate terms for states that may be best understood as psychobiological feedback loops. Subjective health complaints is suggested as a neutral, descriptive term. Only a minority requires treatment and sickness compensation for prolonged periods for these very common states. In these patients the neurons in feed-forward and positive feedback loops may have developed sensitization. These patients tend to show an abnormal sensitivity to sensory input from muscles, the gastrointestinal tract, and to smell and taste. It seems to be futile to search for single-factor solutions. This approach opens up for the possible effectiveness of many different types of treatment, breaking the feedback loops.

Journal Article↗

PubMed1996

Crew compatibility and interaction.

A crew of four (three males and one male) were isolated for 60 days in hyperbaric chambers at DLR, Cologne, Germany. The aim of the study was to investigate how group functioning, relations with ground control, and interaction between crew members would change during isolation. A broad array of methods was used, including analysis of communication, peer ratings, questionnaires, and a post-isolation interview. The main findings are: 1. Group functioning declined at three times, immediately before and after the start of isolation, and in weeks 2 and 5; 2. Conflicts were often focused on project management. 3. Crew members showed a marked tendency to deny team conflicts, making them vulnerable to "group think;" 4. Towards the end of isolation, social factors were given more importance than task-related factors; 5. Lasting antagonism between two of the male crew members were noted, which made one of them withdraw from interaction, while the other one--the most dominant crew member--developed an alliance with the Commander. Several findings in this study are consistent with our earlier results from the ISEMSI study. The existence of several interpersonal issues has been identified, which are also likely to occur during actual space missions. Many of the interpersonal problems could probably be prevented or reduced through behavioral and sensitivity training, composition of crews according to compatibility, and monitoring of group functioning during the flight. We suggest that future simulation studies should be directed towards gaining practical experience in how to influence interpersonal relations in a desirable way. The joint training of ground crew and chamber crew created good co-operation between the two crews, but the adjustment to management requires more experience and new training procedures. The lack of formalized rules caused serious frustrations and negative feelings in both crews towards project management. Data from management and principal investigators were not available, but we suggest that such information should be collected in future simulation studies.

Adult↗

PubMed1996

Psychological defense mechanisms and electroencephalographic arousal.

The aim of this study was to examine the relationship between psychological defense as measured by the Kragh tachistoscopic Defense Mechanisms Test (DMT), and general arousal properties of the individual as measured with electroencephalogram (EEG). The DMT assesses defense by presenting neutral and threatening pictures with very short exposure times. EEG characteristics were measured in the 8-12 Hz EEG frequency band during DMT testing. Twenty-one male subjects participated in the study. All were US Air Force personnel on active duty. Personnel with high defense mechanisms, defined in this connection as slow perception of the threat, tended to have higher cortical arousal after Stimulus exposure than the subjects with low defense mechanisms. The differences occurred mainly with new stimulus material without any threatening content. The differences in arousal response to novel stimuli may contribute to an understanding of the relationships between the Kragh DMT test and performance in life-threatening situations.

Adult↗

PubMed1996

Musculoskeletal pain: concepts of disease, illness, and sickness certification in health professionals in Norway.

Concepts of disease, illness (being ill), and criteria for issuing sickness certificate for musculoskeletal pain have been investigated by a postal survey based on case histories. Questionnaires were filled in by 898 individuals; 194 General Practitioners, 76 medical consultants working for the National Insurance Administration, 307 insurance clerks, and a representative sample (N = 321) of the general public. The concepts disease and illness are meaningful and used consistently by medical doctors for infectious disease and somatic problems. Discrepancies between the medical profession representatives and the general public were, in general, attributable to differences in information and knowledge about these somatic conditions. However, for musculoskeletal pain all groups had conceptual problems. In particular, there was a lack of consensus for issuing sickness certificates. For musculoskeletal pain conditions the doctors, as a group, seemed to score at random or 50-50 level for sickness certification. All groups, including medical doctors, were reluctant to accept depression and social problems as diseases, or to accept social problems as reasons for sickness certification. The decision criteria should be identified and systematized in order to establish whether it is possible to reach a consensus for subjective complaints.

Absenteeism↗

PubMed1996

Psychological reactions during polar expeditions and isolation in hyperbaric chambers.

BACKGROUND: Psychological data from environments that are considered as analog to space was collected from 68 subjects; 18 in hyperbaric chambers, 16 in polar expeditions, and 34 on Arctic stations. The objective was to identify psychological reactions expected in different phases of spaceflights and examine personality variables associated with superior adaptation. METHOD: Helmreich Personality Characteristic Inventory was administered before the isolation. Adaptation to the environment was assessed through a questionnaire once a week. RESULTS: Crews in hyperbaric chambers indicated a steady increase in coping over the isolation. Polar expeditions members reported high aggressiveness and anxiety in the first quarter and an increase in homesickness over time. A personality characterized by strong expressiveness and instrumentality ("the right stuff") predicted superior adaptation in hyperbaric chambers. CONCLUSION: The data suggest that isolation in hyperbaric chambers and polar expeditions should be considered as models for different aspects of the space environment.

Adaptation, Psychological↗

PubMed1995

[Brain and behavior].

The author briefly reviews the milestones in recent developments in brain and behaviour research. The psychological and physiological disciplines have developed in parallell, with mutual benefit to both areas of research. Cognitive models in psychology, and taxonomy based on psychological analyses, have been instrumental in formulating proper hypotheses in brain research. Data from brain and behaviour research have confirmed cognitive models and taxonomy in cognitive science and in ethological studies of animals. A complex, multidisciplinary and multi-factorial concept of a self-regulating central nervous network emerges, to replace earlier concepts of single neurons functioning in simple reflex chains.

Animals↗

PubMed1995

Discriminant analysis of factors distinguishing patients with functional dyspepsia from patients with duodenal ulcer. Significance of somatization.

Patients with duodenal ulcer or functional dyspepsia do not differ on dyspeptic symptoms. The aim of the present study was to test the hypothesis that functional dyspepsia and duodenal ulcer are two different diagnostic entities by examining the discriminating power of several anamnestic, biological, and psychosocial variables. Ninety-four patients with duodenal ulcer and 86 patients with functional dyspepsia were included. Anamnestic data, global assessment, Helicobacter pylori status, blood group, Lewisa+ phenotype, and several measures of psychological distress and somatic complaints were registered. Compared to patients with functional dyspepsia, the duodenal ulcer patients were more often infected by Helicobacter pylori and had their stomach discomfort more often relieved by eating. Compared to patients with duodenal ulcer, patients with functional dyspepsia had higher scores of depression, trait anxiety, general psychopathology and different somatic complaints (called somatization). They were also less satisfied with the health care system, their disorder had a greater negative impact on their quality of life, and their global assessment of own health was poorer. Discriminant analysis including age, smoking, Helicobacter pylori status, global assessment, and somatic complaint classified 86.1% of the patients correctly (77.9% of the patients with functional dyspepsia and 93.6% of the patients with duodenal ulcer). It is concluded that duodenal ulcer and functional dyspepsia are two separate diagnostic entities. Patients with duodenal ulcer are older, smoke more often, and almost all are infected with Helicobacter pylori, while patients with functional dyspepsia are characterized by somatization and a negative assessment of their own health.

Adult↗

PubMed1995

Immune responses during an Antarctic summer.

The immune status of 29 members of the Australian National Antarctic Research Expeditions (ANARE) was investigated before, during, and after a 56 day summer voyage to Antarctica and correlated with psychological and physiological parameters. All subjects were healthy. Expedition personnel demonstrated decreased cell mediated immune responses (CMI) assessed by the CMI Multi-test; 21% were hypoergic. The major associated observation was a significant negative correlation with anxiety in Antarctica. However, perceived anxiety was greater before and after the voyage. No significant changes were found in T and B lymphocyte subsets, immunoglobulin and complement components and cutaneous blood flow, nor was there any clinical evidence of illness. Of the hormones examined only cortisol was low predeparture which may reflect increased perceived anxiety at that time. Changes in immune control mechanism were apparent as shown by reduced CMI responses and lowered tetanus antibody levels. Stress factors are postulated to induce depression of the immune response in Antarctica. The association with anxiety suggests that brain peptides or associated cytokines may have a role in mediating these immune events. Such alterations in immune status have implications for health management in isolated and extreme conditions.

Adult↗