The literature on associated medical diseases in autism is contradictory and so are the guidelines for medical routine screening. Recommendations draw on epidemiological and population-based research. It was necessary to know the diagnostic yield from patient groups referred to psychiatric clinics. 49 autistic probands were selected from a large clinic pool referred to the Department of Child Psychiatry, Haukeland Sykehus, University Hospital in Bergen, Norway, over the 25 years 1970 to 1995. Detailed analyses were performed regarding referring agent, family history, perinatal data, medical and developmental history, psychometric data, and clinical, neurological and laboratory examination. Our clinical sample deviated from the accepted characteristics of autism: All except one (98%) were mentally retarded. Yet tuberous sclerosis, fragile X syndrome and other known medical disorders said to be associated with autism were not found. More common medical disturbances were found regularly also in those with a higher level of functioning. The likelihood that our blind screening, with comprehensive laboratory examination, would yield positive results was negligible. These clinically important differences, together with a unique make-up of developmental deviances and delays, necessitated individually tailored assessment and treatment in most cases.
The article reviews general principles and an intervention program for the care of children in a crisis situation. The author reports on assistance to children after an air crash in a remote district of Northern Norway, when all 36 on board the plane were killed. Intervention along these guidelines is also recommended for use by general practitioners, nurses and social workers in cases of lesser crisis. It is important to ensure that plans are made in all Norwegian regions to follow-up children who have experienced disaster.
The article presents a one year study of 227 immigrant children admitted to the Paediatric Department at Aker hospital, Oslo. Immigrant children comprised 16.5% of the admissions and, on average, had a longer stay in hospital than was the case for the department as a whole. Pakistani children were in the majority and accounted for 57.7% of the total number of admissions. Immigrant children show a higher incidence of imported diseases, due to visits to their native countries, mainly third world countries. Nutritional problems such as iron deficiency were particularly frequent in children between one and three years of age. An interpreter was used for 17.5% of the admitted children. The study showed, however, that interpreters should have been used even more. An increasing number of immigrant and refugee children impose new demands on today's health personnel: the need for further knowledge about the immigrants' cultural background and way of life. A larger proportion of immigrants among health personnel in our hospitals would prove beneficial.
BACKGROUND: Norwegian adolescents report very high-perceived morning sleepiness. Delayed sleep phase may be biologically linked to puberty; adolescents sleep less, but may need more sleep than prepubertal children. The study was designed to investigate sleep habits, circadian rhythm and subjective satisfaction with sleep. MATERIAL AND METHODS: Twenty-two high school students, age 17, and parents of 16 primary school pupils, age seven, answered a questionnaire on estimated sleep need, actual time in bed, sleep latency and adequacy of sleep. RESULTS: The average length of nocturnal sleep in the adolescents was 7.3 hrs on weekdays and 10.1 hrs on weekends. They went later to bed and rose earlier than the children, sleeping 1.7 hrs less before schooldays and 1.6 hrs more during the weekend than the 8.5 hrs which were their own sleep estimate. All the children were reported to satisfy their need for sleep, but none of the adolescents reported feeling content. The larger the difference between hours in bed on weekdays and hours in bed on weekends, the more dissatisfaction was observed. INTERPRETATION: The present data suggest that the adolescents were chronic partially sleep deprived and had a tendency toward delayed sleep phase. They did not satisfy their need for sleep as defined by themselves, due to late bedtime throughout the week. Also, the late bedtime and late rise time on weekends maintained or furthered the delayed sleep phase.
To report a descriptive study of interruptions in hospital nurses' work and discuss their consequences for nursing work.
Interruptions negatively affect procedures, work flow and patient safety. They disturb the emotional atmosphere, reflective processes and the interaction with patients. The constant rearranging of priorities forced by interruptions are a source of frustration to nurses and may lead to a feeling of being pressed for time that results in reduced job satisfaction and stress-related symptoms.
An ethnographic study.
Observation of five nurse's work over three weeks in January 2007 and qualitative interviewing of two nurses.
Nurses were interrupted primarily by brief question-answer exchanges between nurse colleagues. Grouped by task, interruptions during medicine preparation in the ward's drug storage room were the most frequent, while the patients were responsible for fewer interruptions than was any other group. Nurses regarded some interruptions as unavoidable, others as avoidable, while the perception of other professional groups as the primary instigators of interruptions was not corroborated.
Interruptions confront nurses with a dilemma between being accessible to others and remaining focused in order to 'see the big picture'. Nurses' professional 'groundedness' seems to determine their ability to retain a state of equilibrium in a field of unnecessary interruptions and to prevent interruptions from occurring.
The study contributes new knowledge to the discussion of issues concerning organisation, management, training and clinical work, including nurse's ability to 'see the big picture'. It further seeks to clarify conditions for nursing that take into account professional standards and values as well as mutual understanding between colleagues.