Verbbøyning: Hva skjer når hjernen får en skade? Eksperimentell evidens fra afasirammede og Alzheimer-pasienter

En test utviklet for å undersøke tilegnelse av preteritumsformer hos barn er gitt til en gruppe afasirammede, det vil si voksne med språkvansker etter fokal hjerneskade. Testen består av bilder av 60 verb representative for de tre store verbklassene i bokmål. De afasirammedes responser sammenlignes med resultatene fra normalspråklige voksne og Alzheimer-pasienter. Som gruppe skårer de afasirammede langt dårligere enn de to andre gruppene. En analyse av hva slags feil informantene gjør, avslører ulike feilmønstre i de tre informantgruppene. Resultatene diskuteres i forhold til hva de forteller om underliggende årsaker til vanskene, leksikonstruktur og bøyningssystem hos informantene, og vi diskuterer mulige konsekvenser for differensialdiagnostisering. Det er store individuelle forskjeller blant de afasirammede, og artikkelen gir også et innblikk i fire individuelle kasus

Risikobasert preventiv teknisk utbedring av aldrende vannkraftverk

Masteroppgave industriell økonomi og teknologiledelse- Universitetet i Agder, 2015(Konfidensiell til/confidential until 01.07.2020

Impaired cerebrovascular reactivity may predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

Introduction: Delayed cerebral ischemia (DCI) is a major cause of disability and death after aneurysmal subarachnoid hemorrhage. The literature suggests that impaired cerebrovascular reactivity (CVR) may be a predictor for DCI; still no CVR based prediction model has been developed. Increased knowledge about possible predictors of DCI can improve patient management in high-risk patients and allow for shorter hospital stay in low-risk patients. Method: CVR was examined in 42 patients with aneurysmal subarachnoid hemorrhage and 37 patients treated for unruptured intracranial aneurysm, using acetazolamide test with transcranial Doppler monitoring of blood flow velocities. Patients were followed for development of DCI, separated into clinical deterioration and radiographic infarction. Results: For all patients, regardless of aneurysm rupture status, CVR was on average 5.5 percentage points lower on the ipsilateral side of aneurysm treatment. Patients with clinical deterioration due to DCI had lower CVR than patients without DCI, and the difference was larger on the contralateral side (33.9% vs. 49.2%). Two prediction models were constructed for clinical deterioration due to DCI. The area under the receiver operating characteristic curve was 0.82 in the model using established predictors, and 0.86 in the model that also included CVR. Conclusion: Our findings support the hypothesis that impaired CVR may be an independent predictor of clinical deterioration due to DCI, and may assist in identifying patients at risk after aneurysmal subarachnoid hemorrhage. Ipsilateral CVR reduction occurs in all patients after aneurysm treatment, regardless of DCI development, thus highlighting the need to evaluate ipsi- and contralateral CVR separately.publishedVersio

Tilbakemeldinger til sykepleiestudenter i praksis : Prosjektrapport 2015-2016

Ortopedisk sengepost har gjennom flere år drevet kontinuerlig forbedringsarbeid for å heve kvalitet til studentveiledning i praksis og samarbeidet med Høgskolen i Innlandet. Det allerede veletablert samarbeidet førte til at ortopedisk sengepost våren 2014 søkte på samarbeidsprosjektmidler ved Høgskolen i Innlandet. De søkte om et fagutviklingsprosjekt for å kunne utarbeide et skriftlig tilbakemeldingsskjema til bruk for studenter ved ortopedisk sengepost. Det var en utfordring for både studenter og daglige veiledere med å bruke det eksisterende skjema fokus for uken og arbeidsplan. Bakgrunn for prosjektet var et ønske å kunne gi studenter mer individuell og tilpasset tilbakemeldinger samt et ønske om mer refleksjon og læring. Studentveiledning er et prioritert område fra avdelingens ledelse og fagutviklingssykepleier i gjennom flere år. Hovedveiledermodellen er veletablert og mange av sykepleierne har formell veilederutdanning. Gode rutiner i avdelingen er etablert med en praksismodell som organiserer studentteam for studenter i 6. semester praksis. Det vurderes også muligheter for etablering av studentteam med 3. semester studenter. Et kriterium for praksisprosjektets gjennomføring er at studentene i praksis skal være delaktige i prosjektet. Sykepleierstudentene i praksis har deltatt ved å dele sine erfaringer med skriftlig tilbakemeldinger gjennom refleksjonsnotater og fokusgruppeintervju. Sykepleierne på ortopedisk sengepost har delt sine erfaringer gjennom fokusgruppeintervju. Praksisprosjektet har sin formelle oppstart januar 2015 og ble avsluttet desember 2015

Combined cognitive and vocational interventions after mild to moderate traumatic brain injury: study protocol for a randomized controlled trial

Background A considerable proportion of patients with mild to moderate traumatic brain injury (TBI) experience long-lasting somatic, cognitive, and emotional symptoms that may hamper their capacity to return to work (RTW). Although several studies have described medical, psychological, and work-related factors that predict RTW after TBI, well-controlled intervention studies regarding RTW are scarce. Furthermore, there has traditionally been weak collaboration among health-related rehabilitation services, the labor and welfare sector, and workplaces. Methods/design This study protocol describes an innovative randomized controlled trial in which we will explore the effect of combining manualized cognitive rehabilitation (Compensatory Cognitive Training [CCT]) and supported employment (SE) on RTW and related outcomes for patients with mild to moderate TBI in real-life competitive work settings. The study will be carried out in the southeastern region of Norway and thereby be performed within the Norwegian welfare system. Patients aged 18–60 years with mild to moderate TBI who are employed in a minimum 50% position at the time of injury and sick-listed 50% or more for postconcussive symptoms 2 months postinjury will be included in the study. A comprehensive assessment of neurocognitive function, self-reported symptoms, emotional distress, coping style, and quality of life will be performed at baseline, immediately after CCT (3 months after inclusion), following the end of SE (6 months after inclusion), and 12 months following study inclusion. The primary outcome measures are the proportion of participants who have returned to work at 12-month follow-up and length of time until RTW, in addition to work stability as well as work productivity over the first year following the intervention. Secondary outcomes include changes in self-reported symptoms, emotional and cognitive function, and quality of life. Additionally, a qualitative RTW process evaluation focused on organizational challenges at the workplace will be performed. Discussion The proposed study will combine cognitive and vocational rehabilitation and explore the efficacy of increased cross-sectoral collaboration between specialized health care services and the labor and welfare system. If the intervention proves effective, the project will describe the cost-effectiveness and utility of the program and thereby provide important information for policy makers. In addition, knowledge about the RTW process for persons with TBI and their workplaces will be provided. Trial registration ClinicalTrials.gov, NCT03092713. Registered on 10 March 2017

Copynumber: Efficient algorithms for single- and multi-track copy number segmentation.

BACKGROUND: Cancer progression is associated with genomic instability and an accumulation of gains and losses of DNA. The growing variety of tools for measuring genomic copy numbers, including various types of array-CGH, SNP arrays and high-throughput sequencing, calls for a coherent framework offering unified and consistent handling of single- and multi-track segmentation problems. In addition, there is a demand for highly computationally efficient segmentation algorithms, due to the emergence of very high density scans of copy number. RESULTS: A comprehensive Bioconductor package for copy number analysis is presented. The package offers a unified framework for single sample, multi-sample and multi-track segmentation and is based on statistically sound penalized least squares principles. Conditional on the number of breakpoints, the estimates are optimal in the least squares sense. A novel and computationally highly efficient algorithm is proposed that utilizes vector-based operations in R. Three case studies are presented. CONCLUSIONS: The R package copynumber is a software suite for segmentation of single- and multi-track copy number data using algorithms based on coherent least squares principles.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are

Antibiotic-loaded bone cement in prevention of periprosthetic joint infections in primary total knee arthroplasty: A register-based multicentre randomised controlled non-inferiority trial (ALBA trial)

Introduction The current evidence on the efficacy of antibiotic-loaded bone cement (ALBC) in reducing the risk of periprosthetic joint infections (PJI) after primary joint reconstruction is insufficient. In several European countries, the use of ALBC is routine practice unlike in the USA where ALBC use is not approved in low-risk patients. Therefore, we designed a double-blinded pragmatic multicentre register-based randomised controlled non-inferiority trial to investigate the effects of ALBC compared with plain bone cement in primary total knee arthroplasty (TKA). Methods and analysis A minimum of 9,172 patients undergoing full-cemented primary TKA will be recruited and equally randomised into the ALBC group and the plain bone cement group. This trial will be conducted in Norwegian hospitals that routinely perform cemented primary TKA. The primary outcome will be risk of revision surgery due to PJI at 1-year of follow-up. Secondary outcomes will be: risk of revision due to any reason including aseptic loosening at 1, 6, 10 and 20 years of follow-up; patient-related outcome measures like function, pain, satisfaction and health-related quality of life at 1, 6 and 10 years of follow-up; risk of changes in the microbial pattern and resistance profiles of organisms cultured in subsequent revisions at 1, 6, 10 and 20 years of follow-up; cost-effectiveness of routine ALBC versus plain bone cement use in primary TKA. We will use 1:1 randomisation with random permuted blocks and stratify by participating hospitals to randomise patients to receive ALBC or plain bone cement. Inclusion, randomisation and follow-up will be through the Norwegian Arthroplasty Register. Ethics and dissemination The trial was approved by the Western Norway Regional Committees on Medical and Health Research Ethics (reference number: 2019/751/REK vest) on 21 June 2019. The findings of this trial will be disseminated through peer-reviewed publications and conference presentations. Trial registration number NCT04135170.publishedVersio