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R Johnsen

Publications and source records attributed to R Johnsen.

At least 19 recordsLinked to original sources
PubMed1999

[Sick-listed persons think job adjustments might reduce sick-leave].

In the 1990's, improving the follow-up of sick-listed patients with a focus on job adjustments has been a priority in Norwegian social policy. In a study of 1,000 consecutive sick-listed patients (14 days or more) with a musculoskeletal or mental disorder as primary diagnosis, we asked 499 randomly selected sick-listed patients about their opinion on whether adjustments in their job situation might reduce their need for sick-leave in the current episode or in the future. 161 useful questionnaires were returned. Nearly 30% replied that job adjustments might bring down his or her current sick-leave, and 40% thought that job adjustments might reduce future needs for sick-leaves. One in four were of the opinion that they might return to work immediately if job adjustments were made. Among those who knew about job adjustments which had in fact been implemented at their place of work, there were no significant differences in the estimates of potential reductions by age, sex, diagnosis or occupation, with the exception that young women who worked in places where such adjustments had been made, had little belief in the potential of such adjustments. We may conclude that in the sick-listed patients' own opinion, job adjustments have a considerable potential for cutting down the number of working days lost by sickness. The Norwegian "active sick-leave" scheme is suitable and might be used more.

Adult↗
PubMed1999

[High admission rates--deficient communication between primary and secondary health care levels?].

GPs in Lofoten in the county of Nordland, Norway, were asked to consider and to propose suggestions for reducing the admission rates to the Department of Internal Medicine, Lofoten Hospital. The main suggestions were to open an outpatient clinic for emergency patients, improve the continuity among the GPs in primary care, increase the number of beds in nursing homes, and to establish a new forum where GPs and hospital doctors could meet. All suggestions, directly or indirectly expressed a need of closer collaboration and a better dialogue between doctors in primary and secondary health care. Only half of the GPs believed it would be possible to reduce the number of admissions to the hospital. This view might reflect some scepticism concerning the current organisation of the Norwegian health care services, and if so, there is a challenge to experiment with other organisation models.

Attitude of Health Personnel↗
PubMed1999

Endoscopic findings, Helicobacter pylori status, and dyspeptic complaints in vagotomized or medically treated peptic ulcer patients and healthy community controls.

BACKGROUND: The recommendation that Helicobacter pylori be eradicated in surgically treated peptic ulcer patients, regardless of complaints and ongoing ulceration, is controversial. To explore possible endoscopic changes associated with vagotomy and long-term acid suppression, the objectives of this study were to compare the endoscopic findings in the upper gastrointestinal mucosa in relation to H. pylori infection and dyspeptic symptoms in peptic ulcer patients treated surgically or medically. METHODS: Eighty-three randomly selected previously vagotomized peptic ulcer patients, 73 medically treated peptic ulcer patients, and a reference group of 88 healthy community controls underwent an endoscopic investigation. H. pylori infection was determined by culture growth augmented by histology. The endoscopist was blinded for the symptoms and the medical history of all subjects. RESULTS: H. pylori infection was found in 79% of the vagotomized patients, 75% of the medically treated patients, and 70% of the controls. No malignant lesions were found. Active peptic ulceration was the only endoscopic finding associated with abdominal complaints or H. pylori infection. More than half of subjects with normal endoscopy had H. pylori infection. CONCLUSIONS: No differences in endoscopic findings between the surgically and medically treated peptic ulcer patients could be found. The findings do not lend any support to H. pylori infection per se as an indication for eradication therapy in previously vagotomized peptic ulcer patients.

Adult↗
PubMed1998

Abdominal and dyspeptic symptoms in patients with peptic ulcer treated medically or surgically.

BACKGROUND: Abdominal and dyspeptic complaints, which are prominent symptoms in patients with peptic ulceration, are commonly reported in the general population. There are few reports of follow-up study of peptic ulcer therapies in which clinical outcome has been compared with symptom reporting in community controls. METHODS: Three populations of patients with peptic ulcer disease (patients who had elective proximal gastric vagotomy (PGV), those having PGV for emergency indications and those receiving medical treatment with H2-receptor antagonists) were included in a questionnaire survey and compared with a group of randomly selected community controls. RESULTS: The vagotomized patients reported fewer abdominal complaints (P = 0.0003) and fewer dyspeptic complaints lasting for more than 1 week (P = 0.05) than those treated medically. There was no significant difference between vagotomized patients and community controls in the reporting of abdominal (P = 0.2) or dyspeptic (P = 0.9) complaints. CONCLUSION: Taking abdominal complaints as the endpoint for former peptic ulcer treatment, surgical treatment with PGV seemed to be superior to therapy with H2-receptor antagonists and produced an almost identical level of complaints to that seen in the community population.

Adult↗
PubMed1998

Lansoprazole, amoxicillin, and clarithromycin triple therapy in vagotomized patients with dyspeptic complaints. A randomized, double-blind, placebo-controlled, clinical study without pretreatment diagnostic upper endoscopy.

BACKGROUND: The Maastricht Consensus Report advises that, in Helicobacter pylori-positive patients after surgery for peptic ulcer disease, H. pylori should be eradicated. The aim of the present study was to investigate the symptomatic response of H. pylori eradication in previously vagotomized peptic ulcer patients with persistent dyspeptic complaints. METHODS: The study was performed as a randomized, double-blind, placebo-controlled study. Pretreatment diagnostic upper endoscopy was omitted. All the results were submitted to intention-to-treat and efficacy analyses. RESULTS: We could not find any differences between the two groups with regard to intensity or frequency of upper abdominal pain, nausea, heartburn, or other abdominal symptoms during the 12-month follow-up. The triple therapy eradication rate was 88% at both 3- and 12-month controls. CONCLUSION: Vagotomized peptic ulcer patients with persistent dyspeptic complaints should undergo a diagnostic upper endoscopy to detect ulcer recurrence before H. pylori eradication treatment is considered.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1997

[Professional conditions and satisfaction in general practice in 1993. Practice profile of Norwegian primary physicians].

European study of General Practice (GP) task profiles was carried out in 30 European countries in 1993. We analyzed the Norwegian results. 164 primary care physicians, 51% of a random sample, answered a questionnaire. 147 kept a diary on their practice for one week. Compared with results from two earlier studies performed 15 years ago, the proportion of female GPs had doubled to 25%, there were more group practices, more time was spent on vocational training and continuous education, and night service was less frequent than in 1978. 45% were specialists in general practice and 7% in community medicine. Job satisfaction was high, and highest for women, fee-for-service GPs on contract, and GPs who cooperated with other health professionals.

Adult↗
PubMed1997

[Working hours and productivity of curative services in general practice in 1993. Practice profile of Norwegian primary physicians].

In a survey of task profiles in General Practice 164 general practitioners (GPs) in Norway, 51% of a random sample, answered a questionnaire and 147 doctors also kept a diary on their practice for one week, specifying their activities throughout the day. Men reported working more hours per week than women, and practitioners working on a fee-for-service basis had more consultations than colleagues on a fixed salary. Fixed salary GPs spent more time on emergency service. More women than men had part time jobs. The number of GPs has doubled from 1978 to 1993, but the total workload for a GP is approximately the same. The population must have doubled its consumption of primary health care services over this 15 year period.

Adult↗
PubMed1996

Control of C. elegans larval development by neuronal expression of a TGF-beta homolog.

The Caenorhabditis elegans dauer larva is specialized for dispersal without growth and is formed under conditions of overcrowding and limited food. The daf-7 gene, required for transducing environmental cues that support continuous development with plentiful food, encodes a transforming growth factor-beta (TGF-beta) superfamily member. A daf-7 reporter construct is expressed in the ASI chemosensory neurons. Dauer-inducing pheromone inhibits daf-7 expression and promotes dauer formation, whereas food reactivates daf-7 expression and promotes recovery from the dauer state. When the food/pheromone ratio is high, the level of daf-7 mRNA peaks during the L1 larval stage, when commitment to non-dauer development is made.

Amino Acid Sequence↗
PubMed1996

Headache and neck or shoulder pain--family learnt illnesses behaviour? The Bardu Muscoloskeletal Study, 1989-1990.

OBJECTIVE: To explore the gender difference in reporting headache and neck or shoulder pain, we analysed the association between reported own headache and reporting the same complaints among first grade relatives. Based on these associations we discuss 'learning' of illnesses within the family structures. METHOD: A cross-sectional study based on a self-administered postal questionnaire of musculoskeletal complaints in the total population aged 20-70 years was carried out. A population based study was conducted in the municipality of Bardu, northern Norway. A total population of men and women aged 20-70, altogether 2409 people, were sent a questionnaire. After one postal reminder 1939 questionnaires were returned, a response rate of 80.5%. The return rate was slightly higher among the eldest. The sex distribution was the same in both the responders and the non-responders. RESULTS: The females in the family and the brothers and sisters were the main family members imprinting the way in which the children were deciphering symptoms like headache and neck or shoulder pain later in life. These illnesses were changed to a very little extent by the impact from the spouse.

Adult↗
PubMed1996

Non-ulcer dyspepsia and peptic ulcer: the distribution in a population and their relation to risk factors.

BACKGROUND: The aetiology of non-ulcer dyspepsia and a possible connection to peptic ulcer disease is debated. This paper discusses this problem in a population based study. AIMS: The relation between non-ulcer dyspepsia and peptic ulcer disease was explored by the distribution in the general population and their associations to demographic, lifestyle, and psychological factors. METHODS: All inhabitants of a community aged 20-69 years received a questionnaire concerning abdominal complaints, health, lifestyle, diet, and social conditions. Reports on peptic ulcer were verified with medical records. Dyspeptic subjects and matched healthy, non-dyspeptic controls were endoscoped in a blinded procedure. SUBJECTS: Of 2027 persons invited, 1802 (88.9%) returned the questionnaire from which dyspeptic subjects and controls were identified. Of 782 subjects invited to endoscopy, 309 dyspeptic and 310 control subjects (79.2%), participated. RESULTS: Men reported dyspepsia (30.4%) and peptic ulcer (8.7%) more often than women (24.1% and 5.2%, respectively). Non-ulcer dyspepsia was frequent (between 10.6% and 17.2%) in both sexes and age groups up to 60 years, with a lower frequency in both men and women above this age (3.0% and 6.8%). Non-ulcer dyspepsia was associated with having a family history of dyspepsia and of peptic ulcer and the use of tranquillisers. Nearly one third of dyspeptic persons above the age of 40 years had peptic ulcer, but peptic ulcer prevalence was low under this age. Peptic ulcer was associated with a family history of peptic ulcer, smoking, and daily life stress, and also with poor living conditions during childhood, frequent recurrence of herpes labialis, conditions that were associated with Helicobacter pylori infection. CONCLUSIONS: Non-ulcer dyspepsia and peptic ulcer have different patterns of relations to lifestyle, social, and psychological factors. The results perhaps support the hypothesis of peptic ulcer being an infectious disease in contrast with non-ulcer dyspepsia.

Adult↗
PubMed1996

Non-migrainous headache, neck or shoulder pain, and migraine--differences in association with background factors in a city population.

OBJECTIVE: To study the pattern of association of background factors with reported migraine, non-migrainous headache, and neck or shoulder pain. DESIGN: In a cross-sectional survey the population of the municipality of Tromsø between 20 and 56 years of age was screened for risk factors of different diseases. Everybody attending the screening was given a questionnaire on psychosocial, lifestyle, and health factors. The odds ratios of reporting migraine, non-migrainous headache, and neck or shoulder pain were estimated by logistic regression for several background factors. SETTING: A population-based study conducted in the municipality of Tromsø, northern Norway. PARTICIPANTS: In a survey of risk factors for diseases in 1987/86, all the subjects between 20 and 56 years of age in the municipality of Tromsø were invited. The attenders were given a questionnaire about lifestyle, health, and psychosocial factors. Of the 18105 people who were given a questionnaire, 8537 men and 9162 women (97.7%) answered the questions about "non-migrainous headache", 8533 men and 9117 women (97.5%) answered the questions about neck or shoulder pain, and 8024 men and 7690 women (86.8%) the questions about migraine. MAIN RESULTS: "Self estimated health" had the strongest association with all three target conditions although the strength of the association between headache and neck or shoulder pain was far higher than that of migraine. The reporting of headache and neck or shoulder pain was associated with psychosocial factors, in contrast to migraine. The less educated women were prone to both headache and neck or shoulder pain, while there was no association between migraine and length of education. The explored lifestyle factors were not associated with any of the target conditions. CONCLUSIONS: Our findings underscore that migraine is reported by people with psychosocial backgrounds other than those of people who report chronic headache and neck or shoulder pain.

Acute Disease↗
PubMed1994

Aetiology of peptic ulcer: a prospective population study in Norway.

STUDY OBJECTIVE: To analyse simultaneously the effect of several risk factors for peptic ulcer. DESIGN: Cohort study where all patients with new or incident peptic ulcers in a well defined population were registered for a seven year period. The follow up started with a comprehensive health survey including a questionnaire on diet, lifestyle, psychological and social conditions, and health. Relative risks, both sex specific and separate, for gastric and duodenal ulcers were estimated from proportional hazard regression analysis. SETTING: A population based survey conducted in the municipality of Tromsø, northern Norway. PARTICIPANTS: In 1980, a total of 21,440 men and women, aged 20 to 54 years and 20 to 49 years respectively, were invited to participate. A total of 14,667 people attended and returned the questionnaire. MAIN RESULTS: A total of 328 people had their first peptic ulcer in the follow up period. Age, cigarette smoking, first degree relatives with peptic ulcer, and low educational level were shared risk factors for peptic ulcer in both men and women. In men, frequent upper respiratory infections increased the risk of gastric ulcer and drinking a great deal of milk increased the risk of duodenal ulcer. None of the other dietary variables, including coffee and alcohol consumption, contributed significantly to the risk. Use of analgesics was not a risk factor, and none of the psychological indicators analysed carried any significant risk. CONCLUSIONS: Age, inheritance, and cigarette smoking are all important risk factors for peptic ulcer. The increased risk associated with low educational background indicate that social strains, comprising lifestyle and diet habits, are part of the multifactorial aetiology of peptic ulcer. No support was found for the assumption that peptic ulcer disease is a psychosomatic disorder. This study did not support the view that duodenal and gastric ulcers have different aetiologies-rather it showed a similarity in risk patterns.

Adult↗
PubMed1993

Headache and neck or shoulder pain--frequent and disabling complaints in the general population.

OBJECTIVE: to describe the prevalences of reported headache and neck or shoulder pain as unspecified complaints, and to explore the consequences of these complaints measured as unfitness for work. DESIGN: self-administered questionnaire as part of a general health screening. SETTING: all persons aged between 20 and 56 years, in the municipality of Tromsø were invited. Of 29,026 invited, 21,826 attended, and of these 20,026 answered the questionnaire. Some 17,700 answered the questions on headache, and 17,650 on neck or shoulder pain. RESULTS: 6.0% of the males reported weekly or more frequent headache, and 15.4% reported neck or shoulder pain. The corresponding prevalences in women were 13.1% and 24.9%. This female preponderance was present also among subjects expressing the complaints daily or monthly. The prevalences of reported neck or shoulder pain increased significantly with age, while the prevalences of reported headache were not influenced by age. Of the subjects with weekly headache, as many as 30% of both sexes reported being "seriously hampered or unable to perform ordinary work". CONCLUSIONS: many people in the general population live with disabling complaints, but the numbers seeking medical care for them are far fewer. It is important to demonstrate the high prevalence of headache and neck or shoulder pain, and also to understand the complexity of the causal factors, and the reason why only a proportion of sufferers seek professional help.

Adult↗
PubMed1992

Is Helicobacter pylori the cause of dyspepsia?

OBJECTIVE: To determine the association between infection with Helicobacter pylori and dyspepsia. DESIGN: Cross sectional study of dyspeptic subjects and age and sex matched controls identified by a questionnaire survey of all inhabitants aged 20-69. (Endoscopy, histological examination, and microbiological examinations of biopsies from the gastric mucosa were performed blind.) SETTING: Population based survey in Sørreisa, Norway. SUBJECTS: All 782 dyspeptic subjects (excluding those with a previous history of peptic ulcer, gall stones or kidney stones, and coronary heart disease) and controls were offered an endoscopy, of whom 309 dyspeptic subjects and 310 controls attended. MAIN OUTCOME MEASURES: Prevalences of endoscopic and histological diagnoses and of cultures positive for H pylori. RESULTS: A high prevalence of positive cultures, increasing with age, was found in both dyspeptic subjects (48%) and non-dyspeptic controls (36%) (p = 0.004). Positive cultures in both dyspeptic subjects and controls were strongly associated with histological gastritis (70%, 95% confidence interval 65.5 to 85.3; 60%, 52.7 to 67.7, respectively) and peptic ulcer (92%, 61.5 to 99.8; 64.1, 9.4 to 99.2, respectively). Only 3% of subjects with a histologically non-inflamed gastric mucosa had this infection (dyspeptic subjects 2%, 0.2 to 7.0; controls 4%; 1.2 to 8.8). CONCLUSIONS: The relation between dyspeptic symptoms and H pylori is dubious; H pylori seems to have a pathogenetic role in gastritis and may be a contributing factor but not a cause of peptic ulcer.

Adult↗
PubMed1992

Changing incidence of peptic ulcer--facts or artefacts? A cohort study from Tromsø.

STUDY OBJECTIVE: The aim was to estimate the age and sex specific incidences of duodenal and gastric ulcers censored for death and migration. DESIGN: A population based cohort was followed seven years through records of x ray examinations, endoscopies, and operations in the only hospital serving the area. SETTING: The study was conducted in the municipality of Tromsø, Northern Norway, where all men aged 20 to 54 years and women aged 20 to 49 years in 1980, a total of 21,440, were included. MAIN RESULTS: We found an incidence of 1.47 (95% CI 1.21-1.76) and 0.88 (0.67-1.14) per 1000 person-years for gastric and 1.98 (1.69-2.31) and 0.85 (0.64-1.11) for duodenal ulcers in men and women, respectively. A small and insignificant sex difference for gastric ulcer was noted. The duodenal preponderance in men was only recognised among the ulcers identified by x ray, not among ulcers diagnosed by endoscopy. CONCLUSIONS: This population based study has, in contrast to recent studies from other areas, revealed an unchanged high incidence of gastric and duodenal ulcer in both sexes. Compared to earlier studies from this area it indicates a preponderance of duodenal ulcers. The study also shows the impact of attendance rate, death, and migration, and of diagnostic methods on the incidence estimates. Ignoring these potential biases may lead to conclusions on peptic ulcer trends that reflect artefacts rather than real changes in peptic ulcer occurrence.

Adult↗