Møte med en ny arbeidsplass - et essay

Da jeg startet på dette studiet jobbet jeg enda i Forsvaret. Etter to år sluttet jeg, og begynte i ny stilling ved Høgskolen i Bodø. Dette skjedde samtidig som jeg skulle begynne på denne oppgaven. Hele dette studiets formål, slik jeg ser det, handler om å fordype og dyktiggjøre seg innenfor eget praksisfelt. Å være forsker på sin egen praksis. Forutsetningene mine endret seg noe underveis, og mitt problem ble hvilket felt jeg skulle forholde meg til. Hva var min praksis? Dette var vanskelig for meg. Alt jeg kunne, var jo relatert til min praksis fra Forsvaret. Samtidig kom jeg fjernere og fjernere fra dette feltet for hver dag som gikk. Nå er det nesten 3 år siden jeg forlot Forsvaret. Jeg følte samtidig at jeg hadde så lite erfaring og innsikt i det nye feltet. Jeg var en nybegynner i min egen praksis, samtidig som jeg skulle skrive denne oppgaven. Etter å ha grunnet og grublet lenge, og samtidig skiftet tema flere ganger, kom problemstillingen til meg. Jeg var jo ny på arbeidsplassen, og det slo meg at det er vi jo alle en eller flere ganger i løpet av vårt arbeidsliv. Etter hvert innså jeg at jeg hadde skiftet både jobb og arbeidsplass en del ganger. Her måtte det ligge mye, både i min egen erfaring og andres. Etter som jeg sakte men sikkert formet en problemstilling, ble det stadig mer klart for meg at jeg følte det var nødvendig å gjøre et arbeid innen det å være ny medarbeider ved en virksomhet. Ikke for å komme med en fasit, men først og fremst for min egen del. For at jeg som leder skal kunne stå bedre rustet når jeg tar i mot nye medarbeidere. Det er dette oppgaven min handler om. Jeg kommer ikke med noen absolutte sannheter om hvordan man skal ta i mot nye medarbeidere. Men jeg prøver å kaste lys over hva som står på spill når vi møter andre mennesker og miljøer, og da i en sammenheng hvor en nyansatt møter sin nye virksomhet. Overfor deg som leser, er det viktig å understreke at denne oppgaven ikke er en dyp vitenskapelig analyse, med absolutte og dokumenterbare funn. Dette er mye mer et eksplorativt essay. Vil at du skal ha dette i mente når jeg kommer med utsagn og konklusjoner. Et essay av denne karakter går 6 ikke like dypt som en vitenskapelig evidensbasert utredning, men er mer bygget på mine egne erfaringer og synspunkter. Selvsagt har jeg benyttet informanter og litteratur, men utvalget er ikke systematisk. Mer om arbeidsformen og hvordan jeg har gått frem fremgår av oppgaven generelt og metodekapittelet spesielt. God lesning

Clinical features of gastroenteritis during a large waterborne Campylobacter outbreak in Askøy, Norway

Purpose: Outbreaks of Campylobacter infection are common, but studies exploring the clinical features of acute illness in the outbreak setting are scarce in existing literature. The main purpose of the present study was to investigate the clinical features of self-reported acute illness in gastroenteritis cases during a large waterborne Campylobacter outbreak in Askøy municipality, Norway, in 2019. Methods: A web-based self-administered questionnaire, and invitation to participate was sent by the municipality of Askøy as text message to mobile phones using the municipality’s warning system to the inhabitants during the ongoing outbreak. Results. Out of 3624 participants, 749 (20.7%) were defined as cases, of which 177 (23.6%) reported severe gastroenteritis. The most common symptoms were loose stools (90.7%), abdominal pain (89.3%) and diarrhea (88.9%), whereas 63.8% reported fever, 50.2% joint pain and 14.2% bloody stools. Tiredness, a symptom non-specific to gastroenteritis, was the overall most common symptom (91.2%). Conclusion: About one in four of the cases reported symptoms consistent with severe gastroenteritis. We found more joint pain and less bloody stools than reported in published studies of laboratory confirmed campylobacteriosis cases. Tiredness was common in the current study, although rarely described in previous literature of acute illness in the outbreak setting.publishedVersio

Prevalence of fibromyalgia 10 years after infection with Giardia lamblia: A controlled prospective cohort study

Objectives To investigate whether acute infection with Giardia lamblia is associated with fibromyalgia 10 years after infection and whether fibromyalgia is associated with irritable bowel syndrome (IBS) and chronic fatigue (CF) in this setting. Methods A cohort study was established after an outbreak of G. lamblia in Bergen, Norway, 2004. Laboratory-confirmed cases and a matched control group were followed for 10 years. The main outcome was fibromyalgia 10 years after giardiasis, defined by the 2016 revisions of the fibromyalgia diagnostic criteria using the Fibromyalgia Survey Questionnaire (FSQ). Results The prevalence of fibromyalgia was 8.6% (49/572) among Giardia exposed compared to 3.1% (21/673) in controls (p<0.001). Unadjusted odds for having fibromyalgia was higher for Giardia exposed compared to controls (odds ratio (OR): 2.91, 95% confidence interval (CI): 1.72, 4.91), but adjusted for IBS and CF it was not (OR: 1.05, 95% CI: 0.57, 1.95). Among participants without CF the odds for fibromyalgia was 6.27 times higher for participants with IBS than those without (95% CI: 3.31, 11.91) regardless of exposure. Among participants without IBS the odds for fibromyalgia was 4.80 times higher for those with CF than those without (95% CI: 2.75, 8.37). Conclusions We found a higher prevalence of fibromyalgia among Giardia exposed compared to controls 10 years after the acute infection. Fibromyalgia was strongly associated with IBS and CF, and the difference between the exposed and controls can be attributed to the high prevalence of IBS and CF among the Giardia exposed. Notably, this study was not designed to establish causality between Giardia exposure and the outcomes.publishedVersio

Estimating the cumulative impact and zone of influence of anthropogenic features on biodiversity

1. The concept of cumulative impacts is widespread in policy documents, regulations and ecological studies, but quantification methods are still evolving. Infrastructure development usually takes place in landscapes with preexisting anthropogenic features. Typically, their impact is determined by computing the distance to the nearest feature only, thus ignoring the potential cumulative impacts of multiple features. We propose the cumulative ZOI approach to assess whether and to what extent anthropogenic features lead to cumulative impacts.2. The approach estimates both effect size and zone of influence (ZOI) of anthropogenic features and allows for estimation of cumulative effects of multiple features distributed in the landscape. First, we use simulations and an empirical study to understand under which circumstances cumulative impacts arise. Second, we demonstrate the approach by estimating the cumulative impacts of tourist infrastructure in Norway on the habitat of wild reindeer (Rangifer t. tarandus), a near-threatened species highly sensitive to anthropogenic disturbance.3. In the simulations, we showed that analyses based on the nearest feature and our cumulative approach are indistinguishable in two extreme cases: when features are few and scattered and their ZOI is small, and when features are clustered and their ZOI is large. The empirical analyses revealed cumulative impacts of private cabins and tourist resorts on reindeer, extending up to 10 and 20 km, with different decaying functions. Although the impact of an isolated private cabin was negligible, the cumulative impact of `cabin villages' could be much larger than that of a single large tourist resort. Focusing on the nearest feature only underestimates the impact of `cabin villages' on reindeer.4. The suggested approach allows us to quantify the magnitude and spatial extent of cumulative impacts of point, linear, and polygon features in a computationally efficient and flexible way and is implemented in the oneimpact R package. The formal framework offers the possibility to avoid widespread underestimations of anthropogenic impacts in ecological and impact assessment studies and can be applied to a wide range of spatial response variables, including habitat selection, population abundance, species richness and diversity, community dynamics and other ecological processes

Исследование тепловых характеристик в виброаппарате - утилизаторе отработавшего топлива АЗС

Purpose: Self-management is crucial for effective COPD management. This study aimed at identifying associations between self-management and sociodemographic characteristics, clinical characteristics, and symptom burden in people with COPD.Patients and methods: In this cross-sectional study with 225 participants diagnosed with COPD grades II&ndash;IV, multiple linear regression analysis was conducted, using sociodemographic and clinical characteristics and symptom burden (COPD Assessment Test) as the independent variables and the eight self-management domains of the Health Education Impact Questionnaire (heiQ) as the outcome variables.Results: Higher symptom burden was significantly associated with worse scores in all self-management domains (p&lt;0.003), except for self-monitoring and insight (p=0.012). Higher disease severity (p=0.004) and numbers of comorbidities (p&lt;0.001) were associated with more emotional distress, and women scored higher than men on positive and active engagement in life (p=0.001). Higher score in pack-years smoking was associated with lower score in health-directed activities (p=0.006) and self-monitoring and insight (p&lt;0.001), and participation in organized physical training was associated with higher score in health-directed activities (p&lt;0.001). The final models explained 3.7%&ndash;31.7% of variance (adjusted R2) across the eight heiQ scales.Conclusion: A notable finding of this study was that higher symptom burden was associated with worse scores in all self-management domains, except for self-monitoring and insight. In addition, sex, disease severity, comorbidity, pack-years smoking, and participation in organized physical training were associated with one or two self-management domains. The study contributes to improved understanding of self-management in COPD. However, the explained variance levels indicate that more research needs to be done to uncover what else explains self-management domains in COPD.<br /

Cutpoints for mild, moderate and severe pain in patients with osteoarthritis of the hip or knee ready for joint replacement surgery

<p>Abstract</p> <p>Background</p> <p>Cutpoints (CPs) for mild, moderate and severe pain are established and used primarily in cancer pain. In this study, we wanted to determine the optimal CPs for mild, moderate, and severe pain in joint replacement surgery candidates with osteoarthritis (OA) of the hip or knee, and to validate the different CPs.</p> <p>Methods</p> <p>Patients (n = 353) completed the Brief Pain Inventory (BPI), the WOMAC Arthritis Index, and the SF-36 health status measure. Optimal CPs for categorizing average pain with three severity levels were derived using multivariate analysis of variance, using different CP sets for average pain as the independent variable and seven interference items from the BPI as the dependent variable. To validate the CPs, we assessed if patients in the three pain severity groups differed in pain as assessed with WOMAC and SF-36, and if BPI average pain with the optimal CPs resulted in higher correlation with pain dimensions of the WOMAC and SF-36 than other CPs.</p> <p>Results</p> <p>The optimal CPs on the 0–10 point BPI scale were CP (4,6) among hip patients and CP (4,7) among knee patients. The resulting pain severity groups differed in pain, as assessed with other scales than those used to derive the CPs. The optimal CPs had the highest association of average pain with WOMAC pain scores.</p> <p>Conclusion</p> <p>CPs for pain severity differed somewhat for patients with OA of the hip and knee. The association of BPI average pain scores categorized according to the optimal CPs with WOMAC pain scores supports the validity of the derived optimal CPs.</p

Severity of Giardia infection associated with post-infectious fatigue and abdominal symptoms two years after

<p>Abstract</p> <p>Background</p> <p>A high rate of post-infectious fatigue and abdominal symptoms two years after a waterborne outbreak of giardiasis in Bergen, Norway in 2004 has previously been reported. The aim of this report was to identify risk factors associated with such manifestations.</p> <p>Methods</p> <p>All laboratory confirmed cases of giardiasis (n = 1262) during the outbreak in Bergen in 2004 received a postal questionnaire two years after. Degree of post-infectious abdominal symptoms and fatigue, as well as previous abdominal problems, was recorded. In the statistical analyses number of treatment courses, treatment refractory infection, delayed education and sick leave were used as indices of protracted and severe <it>Giardia </it>infection. Age, gender, previous abdominal problems and symptoms during infection were also analysed as possible risk factors. Simple and multiple ordinal logistic regression models were used for the analyses.</p> <p>Results</p> <p>The response rate was 81% (1017/1262), 64% were women and median age was 31 years (range 3-93), compared to 61% women and 30 years (range 2-93) among all 1262 cases. Factors in multiple regression analysis significantly associated with abdominal symptoms two years after infection were: More than one treatment course, treatment refractory infection, delayed education, bloating and female gender. Abdominal problems prior to <it>Giardia </it>infection were not associated with post-infectious abdominal symptoms. More than one treatment course, delayed education, sick leave more than 2 weeks, and malaise at the time of infection, were significantly associated with fatigue in the multiple regression analysis, as were increasing age and previous abdominal problems.</p> <p>Conclusion</p> <p>Protracted and severe <it>giardiasis </it>seemed to be a risk factor for post-infectious fatigue and abdominal symptoms two years after clearing the <it>Giardia </it>infection.</p

Genome-wide analysis of 53,400 people with irritable bowel syndrome highlights shared genetic pathways with mood and anxiety disorders

Funder: Kennedy Trust Rheumatology Research Prize StudentshipFunder: DFG Cluster of Excellence “Precision Medicine in Chronic In-flammation” (PMI; ID: EXC2167)Funder: EC | EC Seventh Framework Programm | FP7 Ideas: European Research Council (FP7-IDEAS-ERC - Specific Programme: “Ideas” Implementing the Seventh Framework Programme of the European Community for Research, Technological Development and Demonstration Activities (2007 to 2013)); doi: https://doi.org/10.13039/100011199; Grant(s): 715772Funder: NWO-VIDI grant 016.178.056, the Netherlands Heart Foundation CVON grant 2018-27, and NWO Gravitation grant ExposomeNLFunder: Li Ka Shing Foundation (Li Ka Shing Foundation Limited); doi: https://doi.org/10.13039/100007421Abstract: Irritable bowel syndrome (IBS) results from disordered brain–gut interactions. Identifying susceptibility genes could highlight the underlying pathophysiological mechanisms. We designed a digestive health questionnaire for UK Biobank and combined identified cases with IBS with independent cohorts. We conducted a genome-wide association study with 53,400 cases and 433,201 controls and replicated significant associations in a 23andMe panel (205,252 cases and 1,384,055 controls). Our study identified and confirmed six genetic susceptibility loci for IBS. Implicated genes included NCAM1, CADM2, PHF2/FAM120A, DOCK9, CKAP2/TPTE2P3 and BAG6. The first four are associated with mood and anxiety disorders, expressed in the nervous system, or both. Mirroring this, we also found strong genome-wide correlation between the risk of IBS and anxiety, neuroticism and depression (rg > 0.5). Additional analyses suggested this arises due to shared pathogenic pathways rather than, for example, anxiety causing abdominal symptoms. Implicated mechanisms require further exploration to help understand the altered brain–gut interactions underlying IBS