Advantages, opportunities and challenges achieved through strategic alliances positioned for the oil service industry in Northern Norway

Masteroppgave i Energy Managemen

Digital psykisk helse - Finnes det en sammenheng mellom behandlers intensjon til og faktiske bruk av digital behandling i psykisk helse og avhengighetsbehandling?

Etterspørselen fra pasienter med behov for psykisk helse og avhengighetsbehandling øker. Digital behandling fremheves av helsemyndigheter som en moderne og innovativ måte å møte dette behovet på. Imidlertid er det mer uklart hvordan klinikere i poliklinikker oppfatter bruken av digital behandling. Hensikten med studien har vært å identifisere hvor det er muligheter for intervensjon til å kunne påvirke bruken av digital behandling. Studien har undersøkt om det er sammenheng mellom behandleres intensjon til, og faktisk bruk av digital behandling. Studien har undersøkt hvilke bakgrunnsvariabler som påvirker bruken av digital behandling, og om det er en sammenheng mellom digital helsekompetanse og bruken av digital behandling. Studien har en kvantitativ metode, med Theory of planned behavoir (TPB) som teoretisk rammeverk. Behandlere (n=31) ved poliklinikker inne psykisk helse og avhengighetsbehandling på Sørlandet Sykehus har besvart et spørreskjema, og informasjon om bruk av digital behandling ble hentet fra DIPS. Sti-analyse, multippel lineær regresjonsanalyse og Goodman and Kruskal's gamma ble benyttet for å analysere data. Det er funnet en signifikant sammenheng mellom holdninger og intensjon til å benytte digital behandling, men det er ikke funnet en sammenheng mellom behandleres intensjon til og faktisk bruk av digital behandling. Studien viser at høyere alder øker sannsynligheten for å benytte digital behandling, og at digital behandling brukes mest i fagområdet psykisk helse for voksne. Videre studier trengs for å undersøke om bruken av digital behandling endrer seg, dersom mulighetene for intervensjon påvirkes

Volume and Visual Field Defects in Occipital Stroke: The NOR-OCCIP Study

Introduction. The majority of patients with occipital infarcts display homonymous visual field defects (VFD), with negative implications on activities of daily living and quality of life. To overcome the disability, better prognostic markers in the acute phase, as well as more targeted rehabilitation, would be useful. The aim of the current study was to present an overview of the topographic distribution of occipital infarcts and to investigate whether lesion volume can predict VFD at baseline and after six months. Materials and Methods. Multicenter, prospective study including patients with acute occipital infarcts (NOR-OCCIP project). All patients were examined by a neurologist in the acute phase, admitted to a stroke unit, and further assessed by an ophthalmologist within two weeks. Topographic and volumetric data from brain imaging in 72 patients were analyzed and computed by an experienced neuroradiologist. Results. A majority (81%) had occipital infarcts with involvement of the primary visual cortex, and VFD were detected on perimetry in 80% of the examined patients. Higher infarct volume led to more severe VFD at baseline (p = 0,019); this was more evident if the infarct was located on the right side (p = 0.001). The odds for VFD improvement after six months were higher the larger the infarcts were (p = 0,020). There was a statistically significant association between volume of infarcts and atrial fibrillation (p = 0,016), previous myocardial infarction (p = 0,023), and modified Rankin Scale at three months (p = 0,007). Conclusion. Higher infarct volumes led to more severe VFD at baseline. More than half of the patients (54%) experienced improvement of their VFD at six months; a higher grade of improvement was seen in patients with larger occipital infarcts. Large infarcts were more common in patients with cardiovascular disease, strengthening the argument for secondary prevention.publishedVersio

Can the cardiovascular family history reported by our patients be trusted? The Norwegian Stroke in the Young Study

Background and purpose: Family history (FH) is used as a marker for inherited risk. Using FH for this purpose requires the FH to reflect true disease in the family. The aim was to analyse the concordance between young and middle-aged ischaemic stroke patients' reported FH of cardiovascular disease (CVD) with their parents' own reports. Methods: Ischaemic stroke patients aged 15–60 years and their eligible parents were interviewed using a standardized questionnaire. Information of own CVD and FH of CVD was registered. Concordance between patients and parents was tested by kappa statistics, sensitivity, specificity, predictive values and likelihood ratios. Regression analyses were performed to identify patient characteristics associated with non-concordance of replies. Results: There was no difference in response rate between fathers and mothers (P = 0.355). Both parents responded in 57 cases. Concordance between patient and parent reports was good, with kappa values ranging from 0.57 to 0.7. The patient-reported FH yielded positive predictive values of 75% or above and negative predictive values of 90% or higher. The positive likelihood ratios (LR+) were 10 or higher and negative likelihood ratios (LR−) were generally 0.5 or lower. Interpretation regarding peripheral arterial disease was limited due to low parental prevalence. Higher age was associated with impaired concordance between patient and parent reports (odds ratio 1.05; 95% confidence interval 1.01–1.09; P = 0.020). Conclusions: The FH provided by young and middle-aged stroke patients is in good concordance with parental reports. FH is an adequate proxy to assess inherited risk of CVD in young stroke patients.publishedVersio

Can the cardiovascular family history reported by our patients be trusted? The Norwegian Stroke in the Young Study

Background and purpose: Family history (FH) is used as a marker for inherited risk. Using FH for this purpose requires the FH to reflect true disease in the family. The aim was to analyse the concordance between young and middle-aged ischaemic stroke patients' reported FH of cardiovascular disease (CVD) with their parents' own reports. Methods: Ischaemic stroke patients aged 15–60 years and their eligible parents were interviewed using a standardized questionnaire. Information of own CVD and FH of CVD was registered. Concordance between patients and parents was tested by kappa statistics, sensitivity, specificity, predictive values and likelihood ratios. Regression analyses were performed to identify patient characteristics associated with non-concordance of replies. Results: There was no difference in response rate between fathers and mothers (P = 0.355). Both parents responded in 57 cases. Concordance between patient and parent reports was good, with kappa values ranging from 0.57 to 0.7. The patient-reported FH yielded positive predictive values of 75% or above and negative predictive values of 90% or higher. The positive likelihood ratios (LR+) were 10 or higher and negative likelihood ratios (LR−) were generally 0.5 or lower. Interpretation regarding peripheral arterial disease was limited due to low parental prevalence. Higher age was associated with impaired concordance between patient and parent reports (odds ratio 1.05; 95% confidence interval 1.01–1.09; P = 0.020). Conclusions: The FH provided by young and middle-aged stroke patients is in good concordance with parental reports. FH is an adequate proxy to assess inherited risk of CVD in young stroke patients

Young ischaemic stroke incidence and demographic characteristics - The Norwegian stroke in the young study - A three-generation research program

Introduction: Norwegian Stroke in the Young Study (NOR-SYS) is a three-generation research program of young ischaemic stroke. In this study, we assessed ischaemic stroke incidence, education and work status among young stroke patients. Furthermore, we evaluated the participation of family members for future validated information on hereditary cardiovascular events. Patients and methods: Patients aged 15–60 years with radiologically verified acute ischaemic stroke, admitted to Haukeland University Hospital in Bergen, Norway from 2010 to 2015, were included. Patients’ partners, common offspring ≥ 18 years and biological parents of patients and partners were invited to participate. Ischaemic stroke incidence was analysed with respect to year, age and sex using multiple logistic regression. Results: A total of 385 patients, 260 partners (80.0%) and 414 offspring (74.6%) were clinically examined. The mean annual ischaemic stroke incidence rate was 30.2 per 100,000. Incidence was higher in men, and the difference was accentuated with increasing age (p = 0.008). There was no sex difference in educational status (p = 0.104) in contrast to work status (p < 0.001) for patients. In all, 84.1% of men worked, and of these, 80.3% are fulltime. In all, 74.4% of women worked, and of these, 52.9% are fulltime. Parents participated by returning a questionnaire. For patients, 91 fathers (55.2%) and 142 mothers (57.3%) participated. For partners, 48 fathers (38.4%) and 68 mothers (40.2%) participated. Conclusion: The mean annual incidence rate of young stroke was 30.2 per 100,000, and the incidence rate was higher in men. Work status was high among both sexes. Active participation rates were high for patients, partners and offspring.acceptedVersio

Obesity, Waist Circumference, Weight Change, and Risk of Incident Psoriasis: Prospective Data from the HUNT Study.

Although psoriasis has been associated with obesity, there are few prospective studies with objective measures. We prospectively examined the effect of body mass index, waist circumference, waist-hip ratio, and 10-year weight change on the risk of developing psoriasis among 33,734 people in the population-based Nord-Trøndelag Health Study (i.e., HUNT), Norway. During follow-up, 369 incident psoriasis cases occurred. Relative risk (RR) of psoriasis was estimated by Cox regression. One standard deviation higher body mass index, waist circumference, and waist-hip ratio gave RRs of 1.22 (95% confidence interval [CI] = 1.11-1.34), 1.26 (95% CI = 1.15-1.39), and 1.18 (95% CI = 1.07-1.31), respectively. Compared with normal weight participants, obese people had an RR of 1.87 (95% CI = 1.38-2.52), whereas comparing the fourth with the first quartile of waist circumference gave an RR of 1.95 (95% CI = 1.46-2.61). One standard deviation higher weight change gave an RR of 1.20 (95% CI = 1.07-1.35), and people who increased their body weight by 10 kg or more had an RR of 1.72 (95% CI = 1.15-2.58) compared with being weight stable. In conclusion, obesity and high abdominal fat mass doubles the risk of psoriasis, and long-term weight gain substantially increases psoriasis risk. Preventing weight gain and promoting maintenance of a normal body weight could reduce incidence of psoriasis

Comorbidities treated in primary care in children with chronic fatigue syndrome

Background: Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a complex condition. Causal factors are not established, although underlying psychological or immunological susceptibility has been proposed. We studied primary care diagnoses for children with CFS/ME, with children with another hospital diagnosis (type 1 diabetes mellitus [T1DM]) and the general child population as comparison groups. Methods: All Norwegian children born 1992–2012 constituted the study sample. Children with CFS/ME (n = 1670) or T1DM (n = 4937) were identified in the Norwegian Patient Register (NPR) (2008-2014). Children without either diagnosis constituted the general child population comparison group (n = 1337508). We obtained information on primary care diagnoses from the Norwegian Directorate of Health. For each primary care diagnosis, the proportion and 99 % confidence interval (CI) within the three groups was calculated, adjusted for sex and age by direct standardization. Results: Children with CFS/ME were more often registered with a primary care diagnosis of weakness/general tiredness (89.9 % [99 % CI 88.0 to 91.8 %]) than children in either comparison group (T1DM: 14.5 % [99 % CI: 13.1 to 16.0 %], general child population: 11.1 % [99 % CI: 11.0 to 11.2 %]). Also, depressive disorder and anxiety disorder were more common in the CFS/ME group, as were migraine, muscle pain, and infections. In the 2 year period prior to the diagnoses, infectious mononucleosis was registered for 11.1 % (99 % CI 9.1 to 13.1 %) of children with CFS/ ME and for 0.5 % (99 % CI (0.2 to 0.8 %) of children with T1DM. Of children with CFS/ME, 74.6 % (1292/1670) were registered with a prior primary care diagnosis of weakness / general tiredness. The time span from the first primary care diagnosis of weakness / general tiredness to the specialist health care diagnosis of CFS/ME was 1 year or longer for 47.8 %. Conclusions: This large nationwide registry linkage study confirms that the clinical picture in CFS/ME is complex. Children with CFS/ME were frequently diagnosed with infections, supporting the hypothesis that infections may be involved in the causal pathway. The long time span often observed from the first diagnosis of weakness / general tiredness to the diagnosis of CFS/ME might indicate that the treatment of these patients is sometimes not optimal.publishedVersio

Vascular risk factors and staging of atherosclerosis in patients and controls: The Norwegian Stroke in the Young Study

publishedVersio