Et dypdykk i karriereveiledningens verden for elever med nedsatt funksjonsevne

Overordnet hensikt har vært å finne ut hvordan karriereveiledning kan bidra til at elever med nedsatt funksjonsevne får jobb eller tar høyere utdanning etter fullført videregående skole. Dette er gjort ved å identifisere en rekke predikatorer som har en positiv effekt på sannsynligheten for å få seg jobb eller ta høyere utdanning etter videregående skole. Utfallet kan knyttes opp mot læringsprosesser tilknyttet karriereutvikling og overgang. Det viser seg at læring og utvikling gjennom ulike aktiviteter i overgangsprogrammer kan bidra til at elever lærer seg ferdigheter tilknyttet det å bo, arbeide, ta utdanning og leve selvstendig i samfunnet. Problemstillingen ble utforsket ved å gjennomføre en litteraturstudie med hovedvekt på kvantitativ forskning. Problemstillingen ble utviklet videre til to forskningsspørsmål for å strukturere litteraturgjennomgangen. Spørsmålene ble delt etter hva som burde inngå i skolens karriereveiledningstilbud for å øke sannsynligheten for at elever med nedsatt funksjonsevne (1) får jobb eller (2) tar høyere utdanning etter 13 års skolegang. Fremgangsmåten tar utgangspunkt i Machi og McEvoy (2012) sine seks steg til en suksessfull litteraturstudie, som handler om å velge et tema, søke etter litteratur, utvikle argumenter og forskningsspørsmål, undersøke litteraturen, være kritisk til litteraturen og skrive litteraturgjennomgangen. Totalt er 21 forskningsstudier inkludert, som til sammen tar for seg 20 ulike predikatorer som viser en positiv effekt på sannsynligheten for at elever med nedsatt funksjonsevne får jobb eller tar høyere utdanning etter videregående skole. Effektresultatet er forenklet og kategorisert som liten, moderat eller stor, for å unngå utfordrende sammenligning av resultater på tvers av ulike analyser. Resultatene er sortert etter utfallene rundt høyere utdanning og jobb. Predikatorene som viser seg å ha størst effekt er arbeidserfaring, familiens involvering og forventninger, elevens inkludering i vanlig undervisningsprogram, tilegning av ferdigheter tilknyttet det å leve et selvstendig liv, karriereveiledning og samfunnsbasert kurs, opplæring og instruksjoner

Midlertidig ansattes affektive tilknytning til organisasjonen

Overordnet hensikt med denne undersøkelsen har vært å se om det foreligger en forskjell i den affektive tilknytningen til organisasjonen mellom midlertidig og faste ansatte. I tillegg til dette har vi sett det hensiktsmessig å inkludere noen faktorer for å potensielt forklare variasjoner i den affektive tilknytningen til organisasjonen for alle ansatte. Teoretiske og forskningsbaserte sammenhenger tilsier at opplevd trygghet, opplevd tilhørighet, opplevd motivasjon og opplevd jobbtilfredshet, har potensialet til å forklare variasjoner i den affektive tilknytningen til organisasjonen. Et kvantitativt forskningsdesign har blitt brukt for å besvare hovedhypotesen og våre fem delhypoteser. Hovedhypotesen tar for seg om det er en forskjell i den affektive tilknytningen til organisasjonen mellom faste og midlertidig ansatte, mens fire av delhypotesene tar for seg hver sin faktors forklaringskraft på affektiv tilknytning. Den siste delhypotesen tar for seg kontraktstypens innvirkning på de fire faktorenes forklaringskraft på den affektive tilknytningen til organisasjonen. For å forsøke å minimere målefeil, begrenset vi populasjonen og interessen mot ett yrke – lærere i Norge. 352 lærere besvarte undersøkelsen, og alle besvarelsene ble analysert. I t-testen kom det frem at det er en signifikant forskjell i den affektive tilknytningen til organisasjonen mellom faste og midlertidig ansatte lærere. Regresjonsanalysen viste at de fire faktorene forklarer variasjon i affektiv tilknytning. Til slutt viste moderatoranalysen at kontraktstype moderer effekten som trygghet har på den affektive tilknytningen til organisasjonen, men modererer ikke effekten av tilhørighet, motivasjon og jobbtilfredshet. Dette gjør at hovedhypotesen, samt fire av fem delhypoteser, bekreftes. Den siste delhypotesen kan verken bekreftes eller avkreftes. Konklusjonen er dermed at kontraktstype har en effekt på den affektive tilknytningen til organisasjonen blant lærere, samt at opplevd trygghet, tilhørighet, motivasjon og jobbtilfredshet forklarer positive variasjoner i affektiv tilknytning. Kontraktstype moderer kun effekten som trygghet har på den affektive tilknytningen til organisasjonen. Funnene fra undersøkelsen har hatt til hensikt å generalisere for populasjonen, men vi anser dette som vanskelig da det er flere aspekter som spiller inn på sluttresultatet

Neuropsychological functioning in survivors of childhood medulloblastoma/CNS-PNET: The role of secondary medical complication

To investigate the long-term cognitive consequences of malignant pediatric brain tumor and its treatment, and factors explaining variability in cognitive functioning among survivors. Method: A geographical cohort of survivors of pediatric medulloblastoma (MB) and supratentorial primitive neuroectodermal tumor (CNS-PNET), treated between 1974 and 2013, was invited to participate. Of the 63 surviving patients, 50 (79%) consented to participation. The participants were tested with a battery of neuropsychological tests covering a wide age range. Verbal cognition, nonverbal cognition, processing speed, attention, memory, executive functioning, and manual dexterity were assessed. The participants were between 5:5 and 51:11 years of age at time of assessment. Assessments took place on average 19 years after primary tumor resective surgery. Results: One participant had a severe intellectual disability. For the rest, IQ varied from 52 to 125, with a mean score of 88.0 (SD 19.7). Twenty-eight (56%) of the participants had full-scale IQ scores in the age-average range or above. Gender, age at operation, time since operation, the presence of secondary medical complications, and treatment variables explained 46% of the variability in IQ scores, F(4,44) =  9.5, p<.001. The presence of endocrine insufficiency in combination with either epilepsy and/or hydrocephalus was associated with lowered IQ, lowered processing speed, and memory impairments. Conclusion: Patients treated for childhood MB and CNS-PNET have a lifelong risk of medical sequelae, including impaired cognitive functioning. This study adds to the literature by demonstrating the importance of following neuropsychological functioning closely, especially processing speed, learning, and memory, in survivors who have multiple secondary medical complications

Unmet rehabiliation needs in 86% of Norwegian paediatric embryonal brain tumour survivors

Aim To study incidence, types and degrees of late effects in a geographical cohort of paediatric medulloblastoma and central nervous system primitive neuroectodermal tumour (CNS‐PNET) survivors, and identify the need for rehabilitation. Methods Between 1974 and 2013, 63 patients survived treatment for paediatric medulloblastoma and CNS‐PNET at Oslo University Hospital, Norway. Of these, 50 accepted invitation and were included in this study. Results Median follow‐up was 20 years (range 3.2‐41), and 96% of participants had developed late effects. Cognitive impairment was found in 72%, reduced hearing in 68%, endocrine deficits in 66%, epilepsy in 32% and another 30% had been diagnosed with one or more second primary neoplasms. Radiotherapy significantly increased risk of secondary primary neoplasms and endocrinological deficits, chemotherapy risk of ototoxicity and endocrinological deficits, and epilepsy was found significantly more often in CNS‐PNET than medulloblastoma patients. Epilepsy was the main cause of cognitive impairments (full‐scale IQ) in our study. 86% of participants had an unmet rehabilitation need. Conclusion Significant late effects and unmet rehabilitation needs were documented in the large majority of survivors after treatment for paediatric medulloblastoma and CNS‐PNET

Taste and smell function in long-term survivors after childhood medulloblastoma/CNS-PNET

Abstract Purpose To investigate taste and smell function in survivors, with a minimum of 2 years since treatment of childhood medulloblastoma (MB)/central nervous system supratentorial primitive neuroectodermal tumor (CNS-PNET). Methods This cross-sectional study included 40 survivors treated ≤ 20 years of age. Taste strips with four concentrations of sweet, sour, salt, and bitter were used to assess taste function in all participants. Score from 0 to 16; ≥ 9 normogeusia, &lt; 9 hypogeusia, and complete ageusia which equals no sensation. No sensation of a specific taste quality equals ageusia of that quality. Thirty-two participants conducted smell testing using three subtests of Sniffin’ sticks: threshold, discrimination, and identification. Together they yield a TDI-score from 1 to 48; functional anosmia ≤ 16.00, hyposmia &gt; 16.00– &lt; 30.75, normosmia ≥ 30.75– &lt; 41.50, and ≥ 41.50 hyperosmia. Results were compared with normative data. Survivors rated their taste and smell function using a numerical rating scale (NRS) score 0–10. Results Forty survivors with a mean time since treatment of 20.5 years, 13 (32.5%) were diagnosed with hypogeusia, nine (22.5%) of these being ageusic to one or more taste qualities. Seventeen (53%) of 32 participants were diagnosed with hyposmia. The mean scores of the olfactory subtests, and TDI score were significantly lower than normative data ( P  &lt; 0.0001). The mean NRS scores of smell and taste function were 7.9 ± 1.5 and 8 ± 1.3, respectively. Conclusion Our study showed impaired taste and smell function in survivors of childhood MB/CNS-PNET using objective measurements. However, subjective ratings did not reflect objective findings

Interval and Consecutive Round Breast Cancer after Digital Breast Tomosynthesis and Synthetic 2D Mammography versus Standard 2D Digital Mammography in BreastScreen Norway

Background: Screening that includes digital breast tomosynthesis (DBT) with two-dimensional (2D) synthetic mammography (SM) or standard 2D digital mammography (DM) results in detection of more breast cancers than does screening with DM alone. A decrease in interval breast cancer rates is anticipated but is not reported. Purpose: To compare rates and characteristics of (a) interval breast cancer in women screened with DBT and SM versus those screened with DM alone and (b) screen-detected breast cancer at consecutive screenings with DM. Materials and Methods: This prospective cohort study from BreastScreen Norway included women screened with DBT and SM (study group) or DM alone (control group) between February 2014 and December 2015 (baseline). All women, except nonattendees, women with breast cancer, and those who exceeded the upper age limit, were consecutively screened with DM after 2 years. Interval breast cancer, sensitivity, and specificity were estimated for women screened at baseline. Recall, screen-detected breast cancer, and positive predictive value were analyzed for consecutively screened women. A χ2 test, t test (P < .001 after Bonferroni correction indicated a significant difference), and binomial regression model were used to analyze differences across groups. Results: A total of 92 404 women who underwent baseline screening (mean age, 59 years ± 6 [standard deviation]) were evaluated; 34 641 women in the study group (mean age, 59 years ± 6) were screened with DBT and SM and 57 763 women in the control group (mean age, 59 years ± 6) were screened with DM. A total of 26 474 women in the study group (mean age, 60 years ± 5) and 45 543 women in the control group (mean age, 60 years ± 5) were consecutively screened with DM. Rates of interval breast cancer were 2.0 per 1000 screened women in the study group and 1.5 per 1000 screened women in the control group (P = .12). No differences in histopathologic characteristics of interval breast cancer were observed. In the consecutive screening round, rates of screen-detected breast cancer were 3.9 per 1000 screened women (study group) and 5.6 per 1000 screened women (control group) (P = .001). Rates of histologic grade 1 invasive cancer were 0.5 per 1000 screened women (study group) and 1.3 per 1000 screened women (control group) (P = .001). Conclusion: No differences in interval breast cancer rates or tumor characteristics were observed in women screened with DBT and SM compared with women screened with DM. Higher rates of low-grade screen-detected tumors were observed in the control group at consecutive screening

Gene expression profiles of primary colorectal carcinomas, liver metastases, and carcinomatoses

<p>Abstract</p> <p>Background</p> <p>Despite the fact that metastases are the leading cause of colorectal cancer deaths, little is known about the underlying molecular changes in these advanced disease stages. Few have studied the overall gene expression levels in metastases from colorectal carcinomas, and so far, none has investigated the peritoneal carcinomatoses by use of DNA microarrays. Therefore, the aim of the present study is to investigate and compare the gene expression patterns of primary carcinomas (n = 18), liver metastases (n = 4), and carcinomatoses (n = 4), relative to normal samples from the large bowel.</p> <p>Results</p> <p>Transcriptome profiles of colorectal cancer metastases independent of tumor site, as well as separate profiles associated with primary carcinomas, liver metastases, or peritoneal carcinomatoses, were assessed by use of Bayesian statistics. Gains of chromosome arm 5p are common in peritoneal carcinomatoses and several candidate genes (including <it>PTGER4</it>, <it>SKP2</it>, and <it>ZNF622</it>) mapping to this region were overexpressed in the tumors. Expression signatures stratified on <it>TP53 </it>mutation status were identified across all tumors regardless of stage. Furthermore, the gene expression levels for the <it>in vivo </it>tumors were compared with an <it>in vitro </it>model consisting of cell lines representing all three tumor stages established from one patient.</p> <p>Conclusion</p> <p>By statistical analysis of gene expression data from primary colorectal carcinomas, liver metastases, and carcinomatoses, we are able to identify genetic patterns associated with the different stages of tumorigenesis.</p