Long-term therapy in COPD: any evidence of adverse effect on bone?

Patients with COPD have high risk for osteoporosis and fractures. Hip and vertebral fractures might impair mobility, and vertebral fractures further reduce lung function. This review discusses the evidence of bone loss due to medical treatment opposed to disease severity and risk factors for COPD, and therapeutic options for the prevention and treatment of osteoporosis in these patients. A review of the English-language literature was conducted using the MEDLINE database until June 2009. Currently used bronchodilators probably lack adverse effect on bone. Oral corticosteroids (OCS) increase bone resorption and decrease bone formation in a dose response relationship, but the fracture risk is increased more than reflected by bone densitometry. Inhaled corticosteroids (ICS) have been associated with both increased bone loss and fracture risk. This might be a result of confounding by disease severity, but high doses of ICS have similar effects as equipotent doses of OCS. The life-style factors should be modified, use of regular OCS avoided and use of ICS restricted to those with evidenced effect and probably kept at moderate doses. The health care should actively reveal risk factors, include bone densitometry in fracture risk evaluation, and give adequate prevention and treatment for osteoporosis

Flom i Tovdalsvassdraget gjennom 800 år - Flomrekonstruksjon basert på sedimentkjerner fra Flakksvann

I oktober 2017 ble Sørlandet rammet av en stor regnflom som resulterte i skader på over 500 milloner kroner (Langsholt og Holmqvist, 2017). Flommen er ved Flakksvann i Tovdalsvassdraget registrert som den største i et vannføringsarkiv som strekker seg tilbake til 1899. I et stadig varmere og v°atere klima forventes regnflommene i fremtiden å bli større og forekomme hyppigere (Hanssen-Bauer et al., 2015). Kunnskap om fortidens flommer er derfor nødvendig for å kunne forutse og minimere skadeomfanget av fremtidige flommer. Som en del av forskningsprosjektet “Climate Hazards and Extremes” (CHEX), skal denne oppgaven undersøke hvor vidt sedimentkjerner fra Flakksvann kan benyttes for å rekonstruere flommer i Tovdalsvassdraget de siste 800 år. Sedimentenes geokjemiske, magnetiske og fysiske signatur er identifisert med røntgenfluorescens (XRF), magnetisk susceptibilitet (MS) og gråskalaverdier og visualisering fra CT–røntgenbilder. Flomlagene består av minerogene lag (MN–lag) karakterisert av høy Ca/(inc+coh), MS og gråskalaverdier og terrestriske makrofossiler (OM–lag) karakterisert av lave gråskalaverdier. Basert på miljømagnetiske egenskaper (χBulk) kan stor variabilitet i MN–lag knyttes til ulike blandingsforhold av sedimenter fra ulike kildeområder eller kornstørrelser. Antall flommer er kvantifisert med endringsrater (RoC) av gråskalaverdier, Ca/(inc+coh) og MS. Volumet av flomtransporterte MN–lag og OM–lag er estimert fra CT–røntgenbilder. Variabiliteten av MN– og OM–lag kan ved sammenligning med vinternedbør og temperatur henholdsvis knyttes til snøsmelteflommer og regnflommer. Et høyt antall flommer og høyt volum MN– og OM–sediment er observert ved den lille istid, som markerer et skifte fra dominante snøsmelteflommer til regnflommer.Masteroppgave i geovitenskapGEOV399MAMN-GEO

Characterizing the Dynamics of Macrophage Polarization and Signaling

Apart from their primary functions in innate immunity and phagocytosis, macrophages are critical regulators of inflammation through their ability to adopt polarization states, a spectrum of phenotypes in which macrophages change their morphology and produce large amounts of pro/anti-inflammatory cytokines and biomolecules. Dysregulated macrophage polarization has been implicated in numerous chronic inflammatory diseases. However, as a result of the tightly-regulated nature of macrophage polarization, it is difficult to design immunomodulatory strategies for modulating macrophage polarization without a robust understanding of the temporal dynamics involved. As a result, there is a need for a deeper understanding of polarization dynamics that can be used in conjunction with computational modeling to develop better immunomodulatory strategies. In this thesis, RAW 264.7 murine macrophages are subject to a number of different stimulation strategies in order to temporally characterize how these cells translate inputs (such as pro-inflammatory cytokines and biomolecules) into a key marker of pro-inflammatory polarization output (iNOS expression over time). Specifically, I measured iNOS expression primarily through immunocytochemistry performed in either 96-well microwell plates or in PDMS microfluidic devices for three-dimensional (3D) culture experiments. Performing polarization experiments in microfluidic devices revealed that 3D culture environments exhibit differences in polarization dynamics. In particular, I found that the M1 response to lipopolysaccharide (LPS) stimulation is always transient regardless of whether macrophages are re-stimulated with fresh LPS-containing medium. Subsequently, I investigated re-stimulating with an M1 cytokine that activates different pathways than LPS to upregulate pro-inflammatory genes, referred to in this thesis as an orthogonal stimulus. Interestingly, further re-stimulation with an orthogonal stimulus, which upregulates iNOS through a separate pathway, such as interferon-γ, can extend M1 polarization and reach greater levels of iNOS expression than any single stimulus alone, in an order and dose-dependent fashion. I also showed that culturing macrophages in a three-dimensional environment within microfluidic devices delays their response to LPS but exhibits the same critical maximum of iNOS expression, suggesting a potential role for the extracellular matrix in regulating polarization dynamics. This thesis contributes novel findings to our understanding of macrophage polarization and proposes new avenues of investigation into the dynamics of other important cytokines in both 2D and 3D culture environments. These results may inform the development of novel models for understanding the temporal dynamics of macrophage polarization and direct further work into modulating polarization states for the treatment of inflammatory diseases.Undergraduat

Samarbeid mellom logoped og barnehagelærer om barn med språklydsvansker

Masteroppgave i logopedi - Nord universitet 202

Profesjonelle læringsfellesskap i skolen: En mulighet for kollektiv læring og bedre undervisning?

© Mette Marit Forsmo Jenssen (2023)Profesjonelle læringsfellesskap fremheves av empirisk skoleforskning som et mulig svar på lærerisolasjon og effektive læringsprosessforløp for å realisere lærersamarbeid og videreutvikle pedagogisk praksis. Retningen gjenspeiles i Læreplanverket for Kunnskapsløftet 2020 med tydelig krav om at alle ansatte i skolen må være aktivt deltakende i profesjonelle læringsfellesskap for å videreutvikle undervisningspraksis til beste for elevers læring og utvikling. Denne avhandlingen handler om profesjonelle læringsfellesskap og læreres undervisningspraksis, samt betydningen av pedagogisk skoleledelse tilknyttet kjernepraksiser. Avhandlingen legger til grunn en antakelse om at skolelederes pedagogiske ledelse påvirker det profesjonelle læringsfellesskapet, og at profesjonelle læringsfellesskap påvirker læreres undervisningspraksis. Den overordnede problemstillingen er: Hvilke kollektive dimensjoner finnes i de profesjonelle læringsfellesskapene i skolene i en region, og hvilke mønstre og sammenhenger er det mellom profesjonelle læringsfellesskap, læreres undervisningspraksis og pedagogisk skoleledelse? Problemstillingen undersøkes gjennom ulike forskningsspørsmål som behandles separat i tre artikler med statistiske analyser av kvantitative data. Avhandlingen er en ikke-eksperimentell tverrsnittstudie av lærer- og skoleledervurderinger fra en spørreundersøkelse i FOU-prosjektet «Kultur for læring» i tidligere Hedmark fylke. Artiklene tar utgangspunkt i vurderinger fra 1 940 grunnskolelærere (artikkel 1), 1 150 barneskolelærere (artikkel 2), og 221 skoleledere (artikkel 3). Hovedfunnene viser store variasjoner i kvaliteten på skolers profesjonelle læringsfellesskap. Variasjonene kan i stor grad forklares av skolens pedagogiske ledelse. Det er svake sammenhenger mellom læreres vurdering av egen undervisningspraksis og deres vurdering av skolens profesjonelle læringsfellesskap. Funnene indikerer likevel at profesjonelle læringsfellesskap har betydning, og at det kan handle om å utfordre og endre skolekoden. Studien finner sammenhenger mellom skolelederes vurdering av egne kjernepraksiser og deres kapasitet for pedagogisk skoleledelse, og det kan bety at de tilpasser kjernepraksisene til den konteksten de tilhører. Studien fremhever behov for mer forskning på analysenivået av profesjonelle læringsfellesskap for å klargjøre begrepet ytterligere, samt longitudinelle studier for å undersøke forholdet mellom profesjonelle læringsfellesskap og endring av undervisningspraksis, samt elevers læring.Abstract: Professional learning communities are highlighted in empirical school research as effective learning processes that can realise teacher collaboration and further develop teaching practice. This direction is reflected in the National Curriculum of the 2020, which states requirements for all school employees to actively participate in professional learning communities for developing teaching practices. This thesis focuses on professional learning communities as a collective learning process for developing teaching practices, as well as the importance of core practices in school’s leadership for learning. The thesis assumes that school leadership for learning nfluences the professional learning community, and that the professional learning community in turn influences teachers’ teaching practices. The overarching research problem is: What collective dimensions are there in professional learning communities in the schools of a specific region, and what relationships are there between professional learning communities, teachers’ teaching practices and school leadership for learning? This research problem is examined through different research questions that are investigated separately in three different articles with statistical analyses of quantitative ata. Crosssectional studies of teacher and school leaders’ assessments were carried out based on a survey that was conducted as a part of the Research and Development project “Culture for learning”, in the former Hedmark County. The articles are based on assessments by 1,940 compulsory schoolteachers (article 1), 1,150 primary schoolteachers (article 2), and 221 school leaders (article 3). The key finding is considerable variations regarding the quality of professional learning communities in schools. It can largely be explained by school leadership for learning. However, there is no correlation between the teachers’ assessment of their own teaching practices and their professional learning community. Yet there are findings to indicate that professional learning communities are of importance, and that it can be a matter of challenging and changing the school code. There are relationships between school leaders' core practices and their capacity for leadership for learning, which can be a matter of them adapting core practices of leadership to their work context. There is a need for a further clarification of professional learning communities as a concept, and more research is needed at the level of analysis, as ell as longitudinal studies to examine relationships between professional learning communities, and changes in teaching practice and student learning.publishedVersio

Utvikling av refleksjonsprosesser ved Motland og Varhaug skule: aksjonsforskning i egne virksomheter

Masteravhandlingen vår i kunnskap og innovasjonsledelse (MKIL) handler om refleksjonsprosesser og hvordan dette kan bidra til kunnskapsutvikling i våre ledergrupper. Problemstillingen er knyttet opp mot hvordan aksjonsforskning som utviklingsstrategi kan bidra til å få et løft rundt refleksjon og kunnskapsutvikling først og fremst i egen organisasjon. Det første forskerspørsmålet handler om hvordan vi skal utvikle gode refleksjonsprosesser i egen organisasjon. Det andre forskerspørsmålet handler om hvilken betydning samlingene på tvers av ledergruppene har hatt for utvikling av reflekterte ledergrupper. Vi arbeider som øverste leder i praksisfeltet. Fordeler og ulemper med å forske på egen arbeidsplass knyttet til nærhet og distanse vil bli tatt opp i avhandlingen

Erfaringsoverføring i Veidekke : En casestudie av hvordan erfaringsoverføring kan forbedres i Veidekke Drammen

Master's thesis in Industrial economics and technology management (IND590

Could screening participation bias symptom interpretation? An interview study on women's interpretations of and responses to cancer symptoms between mammography screening rounds

Objectives: To explore how women with negative mammography screening results, but who were later diagnosed with interval breast cancer, reacted when they observed breast symptoms that could indicate malignancy in-between screening rounds. Design: Semistructured individual interviews with women who have been diagnosed with breast cancer during mammography screening intervals. Setting: Two breast diagnostic units covering two counties in Norway. Participants: 26 women diagnosed with interval breast cancer. Results: Women with a screening negative result react in two ways when experiencing a possible symptom of breast cancer. Among 24 women with a self-detected palpable lesion, 14 sought medical advice immediately. Their argument was to dispose of potential cancer as soon as possible. Ten women delayed seeking medical advice, explaining their delay as a result of practical difficulties such as holidays, uncertainty about the symptom, and previous experiences of healthcare services’ ability to handle diffuse symptoms. Also, a recent negative mammography scan led some women to assume that the palpable lesion was benign and wait for the next screening round. Conclusions: Participating in mammography screening may contribute to a postponed reaction to breast cancer symptoms, although most women acted rapidly when detecting a palpable breast lesion. Furthermore, screening participation does not necessarily increase awareness of breast cancer symptoms.This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode

Microstructure of Bentonite in Iron Ore Green Pellets

Sodium-activated calcium bentonite is used as a binder in iron ore pellets and is known to increase strength of both wet and dry iron ore green pellets. In this article, the microstructure of bentonite in magnetite pellets is revealed for the first time using scanning electron microscopy. The microstructure of bentonite in wet and dry iron ore pellets, as well as in distilled water, was imaged by various imaging techniques (e.g., imaging at low voltage with monochromatic and decelerated beam or low loss backscattered electrons) and cryogenic methods (i.e., high pressure freezing and plunge freezing in liquid ethane). In wet iron ore green pellets, clay tactoids (stacks of parallel primary clay platelets) were very well dispersed and formed a voluminous network occupying the space available between mineral particles. When the pellet was dried, bentonite was drawn to the contact points between the particles and formed solid bridges, which impart strength to the solid compac

Low Serum Levels of 25-Hydroxyvitamin D Predict Hip Fracture in the Elderly: A NOREPOS Study

Background: Despite considerable interest, the relationship between circulating 25-hydroxyvitamin D and the risk of hip fracture is not fully established. Objective: The objective of the study was to study the association between serum 25-hydroxyvitamin D concentrations [s-25(OH)D] and the risk of hip fracture in Norway, a high-latitude country that has some of the highest hip fracture rates worldwide. Methods: A total of 21 774 men and women aged 65–79 years attended 4 community-based health studies during 1994–2001. Information on subsequent hip fractures was retrieved from electronic hospital discharge registers, with a maximum follow-up of 10.7 years. Using a stratified case-cohort design, s-25(OH)D was determined by HPLC-atmospheric pressure chemical ionization-mass spectrometry in stored serum samples in hip fracture cases (n = 1175; 307 men, 868 women) and in gender-stratified random samples (n = 1438). Cox proportional hazards regression adapted for the case-cohort design was performed. Results: We observed an inverse association between s-25(OH)D and hip fracture; those with s-25(OH)D in the lowest quartile (<42.2 nmol/L) had a 38% [95% confidence interval (CI) 9–74%] increased risk of hip fracture compared with the highest quartile (≥67.9 nmol/L) in a model accounting for age, gender, study center, and body mass index. The association was stronger in men than in women: hazard ratio 1.65 (95% CI 1.04–2.61) vs hazard ratio 1.25 (95% CI 0.95–1.65). Conclusion: In this prospective case-cohort study of hip fractures, the largest ever reported, we found an increased risk of hip fracture in subjects in the lowest compared with the highest quartile of serum 25-hydroxyvitamin D. In accordance with the findings of previous community-based studies, low vitamin D status was a modest risk factor for hip fracture.publishedVersio