MRI compatible miniature motor system: Proof of Concept

Master's Thesis in PhysicsPHYS399MAMN-PHY

Disiplinærmyndigheten. Er refselse en del av lederskapet?

Denne studien undersøker bruken av disiplinærmyndigheten som en del av lederskapet hos kompanisjefer i Hæren. Problemstillingen i oppgaven består av tre deler. En del er å finne ut hvordan Forsvaret mener at disiplinærmyndigheten skal brukes som en del av lederskapet. En del er å finne ut hvordan kompanisjefene faktisk bruker disiplinærmyndigheten som en del av sitt lederskap. Siste del er å finne ut om Forsvaret har satt kompanisjefene i stand til å bruke disiplinærmyndigheten. Selve undersøkelse består også av tre deler. Første delen består av en undersøkelse av lover og forskrifter som understøtter militær ledelse ved bruk av juridisk metode. Andre delen er gjennomført som dokumentstudier av relevante lederskapsdokumenter i Forsvaret for å se om bruken av disiplinærmyndigheten er beskrevet som en del av hvordan kompanisjefene skal utøve sin ledelse. Tredje del er kvalitativ undersøkelse, der studien gjennom semistrukturerte intervjuer finner hvordan kompanisjefer i Hæren bruker disiplinærmyndigheten. Analysen av Forsvarets dokumenter for ledelse viser at de ikke beskriver hvordan disiplinærmyndigheten skal brukes i ett militært lederskap. Studien viser at de kompanisjefene som velger å bruke disiplinærmyndigheten, bruker den for å korrigere adferd, for å opprettholde militær orden og disiplin. Studien viser at de som ikke velger å bruke myndigheten, oppfatter den som en type lederskap de ikke ønsker å benytte seg av. Studien viser at kompanisjefene i Hæren ikke får utdanning i bruken av disiplinærmyndighet som en del av sitt lederskap. Det er opp til den enkelte kompanisjef å skaffe seg kunnskap om den praktiske bruken av den og hvordan de skal bruke den som en del av sitt eget lederskap. Studien viser at kompanisjefene i Hæren ikke får utdanning i bruken av disiplinærmyndighet som en del av sitt lederskap. Det er opp til den enkelte kompanisjef å skaffe seg kunnskap om den praktiske bruken av den og hvordan de skal bruke den som en del av sitt eget lederskap. This thesis examines the use of the disciplinary authority as part of the leadership for company commanders in the Norwegian Army. The thesis question consists of three parts. One part is to find out how the Armed Forces dictates that the disciplinary authority should be used as part of leadership. One part is to find out how the company commanders use the disciplinary authority as part of their leadership. The last part is to find out if the Norwegian Armed Forces have enabled the company commanders to use the disciplinary authority. The study itself also consists of three parts. The first part consists of a study of laws and regulations that support military leadership using legal methodology. The second part is carried out as document analysis of relevant leadership documents in the Norwegian Armed Forces. The third part is conducted as a qualitative research, through semi-structured interviews, by examining how company commanders in the Army use their disciplinary authority. The analysis of the documents for leadership in The Norwegian Armed Forces shows that they do not describe how the disciplinary authority should be applied as part of a military leadership. The study shows that the company commanders who choose to use the disciplinary authority, use it to correct behavior, and to maintain military order and discipline. The study shows that those who do not choose to use the disciplinary authority, perceive it as a type of leadership they do not want to use. The study shows that the company commanders do not receive adequate education in how to use of disciplinary authority as part of their leadership. It is up to the individual company commander to acquire knowledge about its practical use and how to use it as part of their own leadership

Konkurranse på ulike vilkår? : påvising av kryssubsidiering ved Kippermoen Idrettssenter

Tema for denne utredningen er kryssubsidiering av kommunale treningsstudio og tar for seg prosessen man må gjennom for å avdekke eventuell kryssubsidiering i en virksomhet. Jeg har brukt et case fra Vefsn Kommune; Kippermoen Idrettssenter, for å illustrere at kostnadsstrukturen i det kommunale regnskapet har betydning for om man klarer å påvise predasjon finansiert med kryssubsidiering. Det private treningssenteret Helsehuset, som er Kippermoens eneste konkurrent i Mosjøen, har anklaget Vefsn Kommune for å subsidiere drift av treningsstudioet ved Kippermoen. Helsehuset begrunner anklagen med at Kippermoens lave pris i markedet fører til at de ikke klare å dekke inn kostnadene som er relevante for drift av treningsstudioet. Ved hjelp av den presenterte teorien rundt kryssubsidiering, samt kostnadsteori, påvises kryssubsidiering av treningsstudioet i analysedelen gjennom først å avdekke Kippermoens utilbørlige utnyttelse av sin dominerende stilling i det relevante markedet. Jeg konkluderer derfor med at Kippermoens treningsstudio driver konkurranseskadelig kryssubsidiering og at dette fører til konkurranse på ulike vilkår i det relevante markedet

Importance of the physical exam and in-office tests in the evaluation of vulvovaginal irritation

Background: Vulvovaginal irritation is a common gynecologic complaint. A number of factors may lead to a trial of therapy without undertaking a physical exam or diagnostic testing. Case Report: A 45 year-old woman presented to our colposcopy clinic for evaluation of an abnormal Papanicolaou (Pap) test. She reported a one month history of vulvovaginal irritation, for which Premarin vaginal cream had been empirically prescribed. Examination of the external genitalia showed ulcers and erythema of the labia minora. Speculum exam was deferred because of the patient’s discomfort. Wet mount microscopy from a vaginal swab revealed evidence of Trichomonas vaginalis, bacterial vaginosis (BV), and yeast. A swab of the ulcers was sent for herpes simplex virus (HSV) polymerase chain reaction (PCR); this confirmed HSV-2. Treatment was initiated for each of these conditions, and the patient returned for colposcopy 21 days later. Conclusion: This case illustrates the importance of the physical exam when evaluating a complaint of vulvovaginal irritation. In many cases, the cause(s) of vulvovaginal irritation can be identified based on physical exam findings and in-office testing with wet mount microscopy, vaginal pH, and the amine “whiff” test. In some cases, additional testing may be required to establish or confirm a diagnosis. Accurate diagnosis is essential not only to initiate appropriate therapy, but also to prevent the transmission of sexually transmitted infections. In some cases, this may decrease the delay in diagnosing vulvar gynecologic malignancies

Å gjøre ADHD - En kvalitativ studie om kvinners opplevelser med å få diagnose ADHD i voksen alder.

Denne masteroppgaven omhandler opplevelser knyttet til sen-diagnostisering av ADHD hos kvinner. Det blir poengtert at det er positivt og viktig å få diagnosen, for å vite hvordan ADHD kan påvirke hvordan man opplever å mestre hverdagslivet. På lik linje som man må lære seg andre sosiale spilleregler, må man lære seg hvordan man lever med ADHD. I denne oppgaven blir opplevelser fra udiagnostisert barndom og utfordringer knyttet til feildiagnostisering belyst. Deltakernes historier danner et empirisk grunnlag som blir analysert og drøftet i et sosialkonstruktivistisk perspektiv. Innfallsvinkelen er basert på Doing gender av West og Zimmerman fra 1987, og bidrar til å forstå problemstillingen i en sosial kontekst. Det er brukt kvalitativ metode med forskingsintervjuer for innsamling av datamateriale. Tematisk analyse er benyttet for å presentere og tolke funn fra intervjuer. Førforståelsen for prosjektet har en sosial orientering fra et utenfra perspektiv, med den hensikt å lære mer om fenomenet ADHD hos kvinner. Det er gjort et strategisk utvalg, hvor deltakerne består av fem kvinner over 20 år som har fått diagnostisert ADHD i løpet av de siste tre årene. I tråd med behandling av materiale og kvinnenes personvern, er det tatt etiske hensyn i arbeidet med transkribering, lagring og anonymisering av informasjon for å kunne gjennomføre arbeid med analyse og videre drøfting. Prosjektets resultater viser at kvinner diagnostisert med ADHD i voksen alder, opplever at det er positivt å få diagnosen ADHD, da det kan bidra til livsmestring. Ved å vite om sin diagnose har kvinnene i det empiriske forskingsprosjektet opplevd at deres hverdagsliv har endret seg. Deltakerne forteller om utfordringer knyttet til sin udiagnostiserte barndom. Det blir vist til andre vansker og utfordringer som kan forekomme ved ubehandlet ADHD hos jenter og kvinner. Det blir presentert forandringer som har skjedd i kvinnenes liv etter at de fikk diagnose ADHD, da de har fått verktøy for å håndtere hverdagslivet. Viktigheten av kunnskap rundt tematikken blir trukket frem som en sosial faktor og knyttet opp mot livsmestring.This master's thesis deals with women’s experiences with being diagnosed with ADHD in adulthood. It is emphasized that it is positive and important to receive the diagnosis in order to know how ADHD can affect the ways one experiences coping with everyday life. Just as one must learn other social rules, one must also learn how to live with ADHD. In this thesis, experiences from undiagnosed childhood and challenges related to misdiagnosis are illuminated through lived stories. The stories form an empirical basis that is analyzed and discussed from a social constructivist perspective. The approach is based on West and Zimmerman’s Doing gender theory and contributes to understanding the problem in a social context. Qualitative research interviews were used to collect data material. Thematic analysis was used to present and interpret findings from the interviews. The pre-understanding for the project has a social orientation from an outsider perspective, with the aim of learning more about the phenomenon of ADHD in women. A strategic selection was made, where the participants consist of five women over the age of 20 who have been diagnosed with ADHD within the last three years. In line with how the empirical data has been treated, ethical considerations have been taken in the transcribing, anonymization and storage process to maintain their privacy. The project's results show that women diagnosed with ADHD in adulthood, experience it as positive to be diagnosed with ADHD as it can contribute to life management. By knowing about their diagnosis, the women in this empirical research project have experienced change in their everyday lives. The participants talk about challenges related to their undiagnosed childhood. Other difficulties and challenges that can occur as a consequence of untreated ADHD in girls and women were prominent in the participants. Changes that have occurred in the women's lives after being diagnosed with ADHD are presented, as they have received tools to manage everyday life. The importance of a more general knowledge about the topic is highlighted as a social factor that contributes to mastering our own everyday life

Obstetric care among refugee populations: reinforcing cultural humility in residency training—preliminary report

The burden of increasing obstetric morbidity and mortality in the United States disproportionately impacts certain populations more than others, one such group being refugees. Poor obstetric outcomes among refugee communities historically have been attributed to delayed initiation of prenatal care, failure to detect co-morbidities, as well as higher rates of Cesarean sections (C-sections), stillbirths, pre-term births, and low birth weight infants in comparison to host-country mothers. Therefore, understanding the contextual nuances that play a role in these poor outcomes among refugee populations is very important

Simulation training in forceps assisted vaginal birth: trainee competence, clinical behavior and procedural competence

To determine whether simulation training in forceps assisted vaginal delivery affected: · The confidence of the trainee in offering and performing forceps assisted vaginal delivery before and after the intervention · The frequency with which forceps assisted vaginal delivery is offered to the parturient compared to vacuum assisted vaginal delivery

Development and implementation of guided, self-directed learning modules in graduate medical education

This study sought to investigate the use of interactive iBook learning modules as a guided, self-directed learning resource for trainees within an obstetrics and gynecology residency program. The implementation of an iBook learning module as a supplement to lecture was studied in comparison to teaching sessions with lecture only

Upstream oncology: identifying social determinants of health in a gynecologic oncology population

Introduction: Social determinants of health (SDoH) are the factors that affect a patient’s health quality and outcomes and contribute to health disparities. Evidence suggests that clinical care contributes only 20% to patients’ health outcomes, while the remainder is under the influence of upstream factors. The upstream approach to healthcare aims to address SDoH before they contribute to less ideal outcomes downstream. Several SDoH may contribute to outcomes for cancer patients. This Upstream Gynecologic Oncology Initiative seeks to identify which SDoH affect a population of patients with gynecologic malignancies. Hypothesis: This study hypothesizes that women receiving care for gynecologic malignancies are affected by specific SDoH among the categories of housing, food, transportation, finances, health literacy and social support. This study aims to identify the frequency of these six social factors among the outpatient gynecologic oncology population at the University of Iowa. Methods: This needs assessment is the first phase in a quality improvement project assessing the SDoH affecting women with gynecologic cancers. Two hundred twenty-two patients receiving outpatient care for gynecologic malignancies completed an anonymous needs assessment survey. Validated survey questions regarding housing, food, transportation, finances, health literacy and social support were used to identify needs. Responses were considered positive if any degree of need was reported. Results: Responses demonstrated the most substantial need in the categories of social support (32%), health literacy (28%) and financial stability (24%). Less need was reported in the categories of food (11%), transportation (5%) and housing (4%). Fifty-seven percent of women reported at least one social need among the six categories screened. Conclusion: Upstream SDoH, most notably social support, health literacy and financial stability are identified to be present and likely contributing to health quality, outcomes, and disparities within this gynecologic oncology patient population. Overall, these findings support the idea that SDoH should be assessed for each unique patient population - and for each patient receiving care for gynecologic cancer. While social support was the most frequently reported SDoH, many patients already received adequate help at home; suggesting that meaningful efforts should next be directed at improving health literacy in the population. Appreciation and assessment of SDoH potential to impact care and management should be used to design a routine screening tool for the study population and organize resources to address or mitigate the identified needs

COVID-19 expands food insecurity disparities among rural, high-risk obstetrics patients

Objective: To compare rural and urban food insecurity in a high-risk obstetrics population prior to and during the COVID-19 pandemic. Methods: Utilizing convenience sampling of high-risk obstetrics patients, validated survey questions assessed self-reported food insecurity from March - October 2019 (pre-COVID-19) and March - October 2020 (COVID-19). Chi-squared analysis compared food insecurity between these two periods and among patients living in rural vs. urban counties.Results: A total of 1089 (pre-COVID-19) and 1246 (COVID-19) screenings were completed. Compared to 2019, the prevalence of food insecurity in 2020 was significantly higher from March-June only (7.8% pre-COVID-19 vs. 11.4 % COVID-19, p=0.04). Despite pre-COVID-19 similarity, rural patients reported significantly higher food insecurity prevalence during COVID-19 than urban counterparts (12.9% rural vs. 8.2% urban, p<0.01). Conclusions: The COVID-19 pandemic was associated with a disproportionate effect on food insecurity among rural patients with high-risk pregnancies. Rural health systems and agencies should explore proactive screening and intervention efforts to mitigate the adverse, downstream health effects of food insecurity