How can overweight people be motivated to physical activity during a lifestyle change process?

Bacheloroppgave folkehelse, 2017Problemstilling: «Hvordan kan sosial støtte og motiverende intervju påvirke psykologiske behov og motivasjon ved livsstilsendring i fysisk aktivitet hos overvektige?» Metode: I oppgaven har vi gjennomført en litteraturstudie der vi har benyttet oss av tidligere forskning som kan relateres til valgt problemområde, for å kunne diskutere oss frem til svar på problemstillingen. Resultater: Indre motivasjon tyder på å være viktig for å lykkes med en livsstilsendring. Tilfredsstillelse av psykologiske behov kan være med på å påvirke autonom og indre motivasjon positivt. Sosial støtte påvirker de psykologiske behovene, og kan bidra til økt motivasjon og en intensjon om å være fysisk aktiv. Motiverende intervju styrker indre motivasjon og knyttes til selvbestemmelsesteorien ved at de psykologiske behovene kan bli tilfredsstilt. Relasjonen mellom helsepersonell og overvektige kan være avgjørende for utfallet

Do Bankart lesions heal better in shoulders immobilized in external rotation?: A randomized single-blind study of 55 patients examined with MRI

Background and purpose Immobilization in external rotation (ER) for shoulder dislocation has been reported to improve the coaptation of Bankart lesions to the glenoid. We compared the position of the labrum in patients treated with immobilization in ER or internal rotation (IR). A secondary aim was to evaluate the rate of Bankart lesions

A portable toolkit for detecting negation

In this work, we have developed an open source, portable toolkit for detecting negation cues and their scope in natural language. Our tool is designed with a two-phase architecture, where cue detection and scope resolution are solved using two independent machine learning classifiers. In our implementation, we have built upon the best practices from previous work, in terms of feature design, machine learning algorithms, datasets and evaluation methods, and built the entire system from scratch through large- scale experiments to assess the utility of features and different classifiers

Hvordan kan overvektige motiveres til fysisk aktivitet gjennom en livsstilsendringsprosess?

Problemstilling: «Hvordan kan sosial støtte og motiverende intervju påvirke psykologiske behov og motivasjon ved livsstilsendring i fysisk aktivitet hos overvektige?» Metode: I oppgaven har vi gjennomført en litteraturstudie der vi har benyttet oss av tidligere forskning som kan relateres til valgt problemområde, for å kunne diskutere oss frem til svar på problemstillingen. Resultater: Indre motivasjon tyder på å være viktig for å lykkes med en livsstilsendring. Tilfredsstillelse av psykologiske behov kan være med på å påvirke autonom og indre motivasjon positivt. Sosial støtte påvirker de psykologiske behovene, og kan bidra til økt motivasjon og en intensjon om å være fysisk aktiv. Motiverende intervju styrker indre motivasjon og knyttes til selvbestemmelsesteorien ved at de psykologiske behovene kan bli tilfredsstilt. Relasjonen mellom helsepersonell og overvektige kan være avgjørende for utfallet

Young men in sports are at highest risk of acromioclavicular joint injuries: a prospective cohort study

Purpose To study the incidence of acromioclavicular joint injuries in a general population. Methods All acute shoulder injuries admitted to an orthopaedic emergency department were registered prospectively, using electronic patient records and a patient-reported questionnaire. The regional area was the city of Oslo with 632,990 inhabitants. Patients with symptoms from the acromioclavicular joint without fracture were registered as a dislocation (type II–VI) if the radiologist described widening of the joint space or coracoclavicular distance on standard anteroposterior radiographs. Patients without such findings were diagnosed as sprains (type I). Results Acromioclavicular joint injuries constituted 11% of all shoulder injuries (287 of 2650). The incidence was 45 per 105 person-years (95% confidence interval [CI] 40–51). 196 (68%) were diagnosed as sprains and 91 (32%) as dislocations. Median age of all acromioclavicular joint injuries was 32 years (interquartile range 24–44), and 82% were men. Thirty percent of all acromioclavicular joint injuries were registered in men in their twenties. Sports injuries accounted for 53%, compared to 27% in other shoulder injuries [OR 3.1 (95% CI 2.4–4.0; p < 0.001)]. The most common sports associated with acromioclavicular joint injuries were football (24%), cycling (16%), martial arts (11%), alpine skiing and snowboarding (both 9%), and ice hockey (6%). Conclusion Our study suggests that in the general population, one in ten shoulder injuries involves the acromioclavicular joint and young men in sports are at highest risk. A prognostic level II cohort study

Interrater reliability of physical examination tests in the acute phase of shoulder injuries

Background The physical examination is one of the cornerstones of the diagnostic process in patients with acute shoulder injuries. The discriminative properties of a given examination test depend both on its validity and reliability. The aim of the present study was to assess the interrater reliability of 13 physical examination manoeuvres for acute rotator cuff tears in patients with acute soft tissue shoulder injuries. Methods In a large walk-in orthopaedic emergency department, 120 consecutive patients ≥40 years of age were included in a diagnostic study. Patients who had follow-up within three weeks of an acute shoulder injury without fracture on radiographs were eligible. Four emergency department physicians participated as examiners. In a subset of 48 patients, the physical examination tests were performed by two physicians, randomly chosen by their work rotation. The physicians were blinded to the findings of each other and the results of the ultrasound screening. The interrater reliability was assessed by Cohen’s kappa, intraclass correlation coefficient (ICC), standard error of measurement (SEM) and Bland-Altman plots depending on whether the examination test result was registered as a binary, ordered categorical or continuous numerical variable. Results The median age was 55.5 years, 46% were female. Twenty-seven percent had a rotator cuff full-thickness tear on ultrasound screening; all but one involved the supraspinatus tendon. Cohen’s kappa for binary tests ranged from excellent to fair. Excellent agreement (kappa > 0.8) was found for the inability to abduct above 90° and abduction strength. External rotation strength expressed substantial agreement (kappa 0.7). The lowest scores were registered for Hawkins` test and the external rotation lag sign (kappa 0.25 and 0.40, respectively). The ICCs for active range of abduction and external rotation were 0.93 (0.88–0.96) and 0.84 (0.72–0.91), whereas the SEM was 15 and 9, respectively. Conclusions The results indicate that examination manoeuvres assessing abduction and external rotation range of motion and strength are more reliable than manoeuvres assessing pain in patients in the acute phase of traumatic shoulder injury. The poor agreement observed is likely to limit the validity in the present setting of two commonly used tests. Trial registration The Norwegian Regional Ethics Committee South East (2015/195)

Lisfranc injuries: Incidence, mechanisms of injury and predictors of instability

Background In Lisfranc injuries the stability of the tarsometatarsal joints guides the treatment of the injury. Determining the stability, especially in the subtle Lisfranc injuries, can be challenging. The purpose of this study was to identify incidence, mechanisms of injury and predictors for instability in Lisfranc injuries. Methods Eighty-four Lisfranc injuries presenting at Oslo University Hospital between September 2014 and August 2015 were included. The diagnosis was based on radiologically verified injuries to the tarsometatarsal joints. Associations between radiographic findings and stability were examined. Results The incidence of Lisfranc injuries was 14/100,000 person-years, and only 31% were high-energy injuries. The incidence of unstable injuries was 6/100,000 person–years, and these were more common in women than men (P = 0.016). Intraarticular fractures in the two lateral tarsometatarsal joints increased the risk of instability (P = 0.007). The height of the second tarsometatarsal joint was less in the unstable injuries than in the stable injuries (P = 0.036). Conclusion The incidence of Lisfranc injuries in the present study is higher than previously published. The most common mechanism of injury is low-energy trauma. Intraarticular fractures in the two lateral tarsometatarsal joints, female gender and shorter second tarsometatarsal joint height increase the risk of an unstable injury

Sports-related acute shoulder injuries in an urban population

More than a third of sports injuries involve the upper extremity. The primary aim was to quantify and describe sports-related shoulder injuries in a general population cohort. A secondary aim was to compare aspects of these injuries to those that were not sports-related.We performed a prospective registration of the activity at the time of shoulder injury in all cases admitted during 1 year in a combined primary care and orthopaedic emergency department serving a defined population. The electronic patient records and patient reported questionnaires were reviewed.Twenty-nine per cent (n=781) of 2650 registered shoulder injuries were reported to be sports-related, with the highest proportion in acromioclavicular injuries (&gt;50%). Patients with sports injuries were younger than those injured during other activities (median age 28 and 43 years, respectively, p&lt;0.001), and more often male (78% and 52%, respectively, p&lt;0.001). There was a strong gender disparity in incidence of sports-related shoulder injuries in adolescents and young adults, which was not observed in non-sports shoulder injuries. Football (soccer) (6–29 years), cycling (30–49 years), skiing (50–69 years) and martial arts were the dominating sports activities. Fractures were more common in skiing and cycling than in other major sports in the study.Almost a third of the shoulder injuries occurred during sports. The types of sports involved varied with age and gender. The comparison of sport to non-sport shoulder injury incidence rates suggests that the increased risk of shoulder injuries in young males is mainly attributable to sports injuries

Astroglial endfeet exhibit distinct Ca2+ signals during hypoosmotic conditions

Astrocytic endfeet cover the brain surface and form a sheath around the cerebral vasculature. An emerging concept is that endfeet control blood–brain water transport and drainage of interstitial fluid and waste along paravascular pathways. Little is known about the signaling mechanisms that regulate endfoot volume and hence the width of these drainage pathways. Here, we used the genetically encoded fluorescent Ca2+ indicator GCaMP6f to study Ca2+ signaling within astrocytic somata, processes, and endfeet in response to an osmotic challenge known to induce cell swelling. Acute cortical slices were subjected to artificial cerebrospinal fluid with 20% reduction in osmolarity while GCaMP6f fluorescence was imaged with two‐photon microscopy. Ca2+ signals induced by hypoosmotic conditions were observed in all astrocytic compartments except the soma. The Ca2+ response was most prominent in subpial and perivascular endfeet and included spikes with single peaks, plateau‐type elevations, and rapid oscillations, the latter restricted to subpial endfeet. Genetic removal of the type 2 inositol 1,4,5‐triphosphate receptor (IP3R2) severely suppressed the Ca2+ responses in endfeet but failed to affect brain water accumulation in vivo after water intoxication. Furthermore, the increase in endfoot Ca2+ spike rate during hypoosmotic conditions was attenuated in mutant mice lacking the aquaporin‐4 anchoring molecule dystrophin and after blockage of transient receptor potential vanilloid 4 channels. We conclude that the characteristics and underpinning of Ca2+ responses to hypoosmotic stress differ within the astrocytic territory and that IP3R2 is essential for the Ca2+ signals only in subpial and perivascular endfeet