Small- and large-fiber neuropathy after 40 years of type 1 diabetes associations with glycemic control and advanced protein glycation: the Oslo Study

OBJECTIVE To study large- and small-nerve fiber function in type 1 diabetes of long duration and associations with HbA1c and the advanced glycation end products (AGEs) N-&#949-(carboxymethyl)lysine (CML) and methylglyoxal-derived hydroimidazolone. RESEARCH DESIGN AND METHODS In a long-term follow-up study, 27 persons with type 1 diabetes of 40 &#177 3 years duration underwent large-nerve fiber examinations, with nerve conduction studies at baseline and years 8, 17, and 27. Small-fiber functions were assessed by quantitative sensory thresholds (QST) and intraepidermal nerve fiber density (IENFD) at year 27. HbA1cwas measured prospectively through 27 years. Serum CML was measured at year 17 by immunoassay. Serum hydroimidazolone was measured at year 27 with liquid chromatography– mass spectrometry. RESULTS Sixteen patients (59%) had large-fiber neuropathy. Twenty-two (81%) had smallfiber dysfunction by QST. Heat pain thresholds in the foot were associated with hydroimidazolone and HbA1c. IENFD was abnormal in 19 (70%) and significantly lower in diabetic patients than in age-matched control subjects (4.3 &#177 2.3 vs. 11.2 &#177 3.5 mm, P , 0.001). IENFD correlated negatively with HbA1c over 27 years (r = 20.4, P = 0.04) and CML (r = 20.5, P = 0.01). After adjustment for age, height, and BMI in a multiple linear regression model, CML was still independently associated with IENFD. CONCLUSIONS Small-fiber sensory neuropathy is a major manifestation in type 1 diabetes of 40 years duration and more prevalent than large-fiber neuropathy. HbA1c and the AGEs CML and hydroimidazolone are important risk factors in the development of large- and small-fiber dysfunction in long-term type 1 diabetes

Rehabilitation Needs, Service Provision, and Costs in the First Year Following Traumatic Injuries: Protocol for a Prospective Cohort Study

Background: Traumatic injuries, defined as physical injuries with sudden onset, are a major public health problem worldwide. There is a paucity of knowledge regarding rehabilitation needs and service provision for patients with moderate and major trauma, even if rehabilitation research on a spectrum of specific injuries is available. Objective: This study aims to describe the prevalence of rehabilitation needs, the provided services, and functional outcomes across all age groups, levels of injury severity, and geographical regions in the first year after trauma. Direct and indirect costs of rehabilitation provision will also be assessed. The overarching aim is to better understand where to target future efforts. Methods: This is a population-based prospective follow-up study. It encompasses patients of all ages with moderate and severe acute traumatic injury (New Injury Severity Score >9) admitted to the regional trauma centers in southeastern and northern Norway over a 1-year period (2020). Sociodemographic and injury data will be collected. Upon hospital discharge, rehabilitation physicians estimate rehabilitation needs. Rehabilitation needs are assessed by the Rehabilitation Complexity Scale Extended–Trauma (RCS E–Trauma; specialized inpatient rehabilitation), Needs and Provision Complexity Scale (NPCS; community-based rehabilitation and health care service delivery), and Family Needs Questionnaire–Pediatric Version (FNQ-P). Patients, family caregivers, or both will complete questionnaires at 6- and 12-month follow-ups, which are supplemented by telephone interviews. Data on functioning and disability, mental health, health-related quality of life measured by the EuroQol Questionnaire (EQ-5D), and needs and provision of rehabilitation and health care services are collected by validated outcome measures. Unmet needs are represented by the discrepancies between the estimates of the RCS E–Trauma and NPCS at the time of a patient’s discharge and the rehabilitation services the patient has actually received. Formal service provision (including admission to inpatient- or outpatient-based rehabilitation), informal care, and associated costs will be collected. Results: The project was funded in December 2018 and approved by the Regional Committee for Medical and Health Research Ethics in October 2019. Inclusion of patients began at Oslo University Hospital on January 1, 2020, and at the University Hospital of North Norway on February 1, 2020. As of February 2021, we have enrolled 612 patients, and for 286 patients the 6-month follow-up has been completed. Papers will be drafted for publication throughout 2021 and 2022. Conclusions: This study will improve our understanding of existing service provision, the gaps between needs and services, and the associated costs for treating patients with moderate and major trauma. This may guide the improvement of rehabilitation and health care resource planning and allocation

An introduction to MatPIV v. 1.6.1

Particle Image Velocimetry (PIV) has seen a rapid growth over the last two decades, much owing to the developments in digital cameras and solid state laser technologies. PIV can essentially be looked upon as an application of pattern mathching principles to experiments. We rely upon hardware such as lasers and cameras for illumination and image capture. Subsequently we use computer code to perform the pattern matching. MatPIV is one of a variety of different computer coedes available written specifically for this purpose. The vast majority of codes are commercially available, but in the last 7-8 years several Open Source PIV codes have been created and are currently being more or less actively maintained. MatPIV is one of these codes and it is distributed under the GNU General Public License [MatPIV is free software; you can redistribute it and/or modify it under the terms of the GNU General Public License as published by the Free Software Foundation; either version 2 of the License, or (at your option) any later version. This program is distributed in the hope that it will be useful, but WITHOUT ANY WARRANTY; without even the implied warranty of MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the GNU General Public License for more details. The GNU General Public License can be found on the World Wide Web at http://www.gnu.org/copyleft/gpl.html or it can be obtained by writing to the Free Software Foundation, Inc., 59 Temple Place - Suite 330, Boston, MA 02111-1307, USA.] This document acts as the entry level tutorial fr using the MatPIV code. Very basic theory is reviewed and references to appropiate sources are included. The focus, however, is on the use of MatPIV and how it is implemented

Er sluttbrukere forberedt på elektronisk kurve? : Sluttbrukeres erfaring med opplæring i elektronisk kurve og medikasjon

Masteroppgave helse- og sosialinformatikk HSI500 - Universitetet i Agder 2019BackgroundAs part of the digitalisation of health Norway, a newdigital system is introduced for the documentation of clinical protocolsand medication throughout the Helse Sør-ØstRHF. The system MetaVision replaces today's paper solutions and a few cases of other electronic systems on all health establishments. In that context, there are thousands of employees who needs to be trained. While large sums of money are being used on clinical-ICT in health care, there is little evidence of what works and what doesn't work when it comes to training. The purpose of the project is to look at this. The following issue is the starting point for the study: "how well prepared are end-users on using the electronic protocol?".MethodTo obtain answersto the question,a quantitative method has beenused and a cross-sectional study was conducted. As part of this, an online questionnaire was issued to physicians and nurses at the medical clinic at OUS.ResultThere are 52 respondents who satisfy the requirements and form the basis for the data analysis. The findings show a general positive attitude to the training. This applies to both e-learning and classroom instruction.ConclusionThe study is too small to draw general conclusions, but the findings give a certain picture of the situation. It shows that the training model used by the OUS seems to work. It can then be assumed that the employees are better equipped to adopt the electronic courier solution after completing training.KeywordsTraining, blended learning, electronicclinicalprotocol, MetaVision, hospitals, clinical-ICT

Er sluttbrukere forberedt på elektronisk kurve? : Sluttbrukeres erfaring med opplæring i elektronisk kurve og medikasjon

BackgroundAs part of the digitalisation of health Norway, a newdigital system is introduced for the documentation of clinical protocolsand medication throughout the Helse Sør-ØstRHF. The system MetaVision replaces today's paper solutions and a few cases of other electronic systems on all health establishments. In that context, there are thousands of employees who needs to be trained. While large sums of money are being used on clinical-ICT in health care, there is little evidence of what works and what doesn't work when it comes to training. The purpose of the project is to look at this. The following issue is the starting point for the study: "how well prepared are end-users on using the electronic protocol?".MethodTo obtain answersto the question,a quantitative method has beenused and a cross-sectional study was conducted. As part of this, an online questionnaire was issued to physicians and nurses at the medical clinic at OUS.ResultThere are 52 respondents who satisfy the requirements and form the basis for the data analysis. The findings show a general positive attitude to the training. This applies to both e-learning and classroom instruction.ConclusionThe study is too small to draw general conclusions, but the findings give a certain picture of the situation. It shows that the training model used by the OUS seems to work. It can then be assumed that the employees are better equipped to adopt the electronic courier solution after completing training.KeywordsTraining, blended learning, electronicclinicalprotocol, MetaVision, hospitals, clinical-ICT

West Scandinavian Ditransitives as a Family of Constructions: With a Special Attention to the Norwegian V-REFL-NP Construction

In this article we show that the semantic characterization of the English ditransitive construction, primarily based on the concept of transfer and generally assumed in the international literature within Construction Grammar, is insufficient for the remaining branches of Germanic, in particular for the West-Scandinavian languages, both modern and ancient. On the basis of our findings from West-Scandinavian we suggest eight semantic subconstructions of the ditransitive construction, which in turn can be divided into 17 different narrowly-circumscribed semantic verb classes. We depict the semantics of the construction on a semantic map, and lay out the internal structure of the construction on a lexicality–schematicity hierarchy where both higher-level generalizations and lower-level idiosyncrasies are captured. Finally, we investigate a specific subconstruction of the ditransitive in Norwegian, the V-REFL-NP construction, which shows certain idiosyncratic properties, not derivable from any general or specific syntactic rules of Norwegian, nor from the semantics of the individual parts. We conclude that a constructional analysis is needed to satisfactorily account for all the facts of the ditransitive construction in Norwegian and West-Scandinavian

Bichromatic synthetic schlieren applied to surface wave measurements

acceptedVersio

Ombruk av eldre trevirke

Begrensningen med ressurser vi har og kan nytte, sammen med de miljøpåvirkninger som bruk av ressurser gir, er det et ønske å gjenbruke materialer. Vi har derfor i denne oppgaven sett på hvordan direkte ombruk av trevirke i konstruksjoner kan nyttes. Eldre trevirke har i dag ikke noen form for sortering som sier hvilket kvaliteter det har. Man vil derfor vær avhengig av å kunne finne en metode som både er effektiv, og som enkelt lar seg nytte, og kan dokumentere de gitte kvalitetene knyttet opp til de vi i dag finne i standardene. For å kunne dokumentere kvalitetene er det gjort test etter standardene NS-INSTA 142, NS-EN 408 og NS-EN 13183-1 for å se om virket ville kunne bli nyttet, og til hvilket formål som ville være best mulig. Det var litt variasjon for hvilken styrke vi fikk ut etter å ha gjennomført testene, men resultatet viser at den maskinelle testen ga høyere kvalitet enn hva vi fikk ved den visuelle testen. Resultatet viste også at det var en sammenheng mellom målt kvalitet ved bøyeteste og densiteten vi fikk ut. Resultatet fra målingene vi gjorde viser at virket vil få en minste bøyemotstand på 35 N/mm2, noe som er bedre kvalitet enn det en i dag kjøper i butikk. Flere av de parameterne vi har målt virket på, viser at det har gode kvaliteter som gjør det mulig å kunne nytte dem om igjen. Men vårt målegrunnlag er begrenset, og det vil være nødvendig å gjennomføre flere målinger før en kan gi en klar konklusjon på at det er slik. De resultatene vi fikk, viser at det bør jobbes videre med, og kan være en god løsning på å sikre at vi holder en større mengde av de materialene vi har i bruk over flere livsløp

Psykisk helse i et helsefremmende perspektiv: Stigma, en barriere som må brytes

Bakgrunn for oppgaven: Psykiske lidelser er et økende problem på verdensbasis. Stigmatiseringen er en stor barriere i behandlingen av psykisk lidelse og er en unødvendig påkjenning for dem som sliter psykisk lidelse. For å skape et best mulig miljø og fremme den lidendes helse, er det slik at man må arbeide for at stigmatiseringen av dem må fjernes. Dette er samfunnsrelevant og noe den Norske regjeringen nå aktivt arbeider for å finne løsning på. Hensikt: Hensikten med oppgaven er å belyse sykepleiers ansvarsrolle i hvordan fremme psykisk lidendes livskvalitet og hvordan stigmatisering av psykiske lidelser kan reduseres. Problemstilling: Hvordan kan stigmatisering av psykisk syke reduseres gjennom helsefremmende tilnærming? Metode: Oppgaven er gjort i form av en systematisk litteraturstudie. Fagstoff er hentet fra tidligere forskning, fagbøker, lovverk og forskningsartikler. Det er blitt benyttet metodetriangulering, en kombinasjon av kvalitative og kvantitative studier, for å kunne gi en mer helhetlig fremvisning av forskning innenfor temaet. Resultater: Seks artikler er inkludert i oppgaven. Hovedfunnene i disse artiklene belyser følgende temaer: Utdanning, holdninger, relasjon og tillit og verdighet og livskvalitet. Konklusjon: Reduksjon av stigma kan oppnås gjennom utdanning og kontinuerlig oppdatering av kunnskap, relasjon og tillit, holistisk tilnærming, sykepleiers rolle som opplyser, holdninger og arbeid for at den lidende har en opplevelse av verdighet