Supportive care for patients with breast cancer by using an interactive app during neoadjuvant chemotherapy : a randomized controlled trial

Background: Patients with breast cancer undergoing neoadjuvant chemotherapy are often treated as outpatients and experience several distressing symptoms and concerns over a long period, which must be managed at home. Routine use of patient reported outcomes facilitates communication with the healthcare of what needs the patient may have. To support patients with cancer during treatment, the use of mHealth has shown promising results in reducing symptoms and improving quality of life. Aim: To evaluate how an interactive app for reporting and managing symptoms provides supportive care in patients with breast cancer during neoadjuvant chemotherapy. Methods: Through the app patients report symptoms daily as well as write free text messages. The reports are monitored and responded to by a contact nurse at the clinic. Further, the patients have access to self-care advice and can view their reported symptoms in graphs. This randomized controlled trial was conducted according to the Medical Research Council’s framework for complex interventions. In Study I, the patients were randomized to an intervention group (n = 74), who used the app during treatment in combination with standard care, and to a control group (n = 75), who received standard care alone. Both groups answered questionnaires regarding symptoms and healthrelated quality of life before start of treatment and two weeks after end of treatment, to evaluate if the intervention had any effects on the patients’ symptoms and health-related quality of life. Study II investigated the patients’ engagement in using the app. Logged data from the patient’s app usage (n = 74) and predictors of usage were analyzed. Telephone interviews were conducted with the patients about how they perceived using the app during treatment. In Study III, face-to-face interviews were conducted three months after end of neoadjuvant chemotherapy with patients from both groups (n = 40) about perceptions of care during treatment with or without using the app. Results: In Study I, patients who used the app during treatment perceived less prevalence of symptoms and symptom distress and better emotional functioning two weeks after end of treatment compared with the patients in the control group. In Study II, the adherence to reporting in the app was 83%. The components included in the app, such as self-care advice and graphs, were used by most of the patients. Higher age predicted fewer free text messages sent. The app was considered easy to use with a relevant content, which facilitated support for symptom management and own monitoring of symptoms as well as having a close, continuous, and interactive contact with the contact nurse. In Study III, results showed that most of the patients, whether they had used the app or not, were satisfied with the care during the treatment. The patients who had used the app perceived it as an added value for support as they were provided easy access to information and communication regarding experienced symptoms with the contact nurse. Moreover, Interaktor facilitated performing self-care by using the self-care advice and promoted own participation in care. Conclusions: This thesis shows that patients with breast cancer can receive supportive care by using an app such as Interaktor during neoadjuvant chemotherapy. By facilitating interaction and communication with the contact nurse, symptoms can be identified and managed in a timely manner as well as enhancing patients’ participation in their own care

Lærerstudenter og læring

Artikkelen beskriver og drøfter et innovasjonsarbeid på Høgskolen i Oslo hvor intensjonen var å bedre studentenes prestasjoner i pedagogikkfaget ved å arbeide med deres motivasjon og læringsstrategier. Det teoretiske grunnlaget for prosjektet er motivasjonsteori (Self Determination Theory). Deltakerne var førsteårsstudenter som selv hadde meldt seg på et tilbud for å jobbe med egen læring. Intervensjonen var gruppeveiledning. Tre pedagogikk- lærere som alle har teoretisk bakgrunn og erfaring med veiledning var veiledere. Dataene som ble samlet inn er både kvalitative og kvantitative. Resultatene er lovende: Analysene viser at de studentene som hadde fått veiledning, gjorde det signifikant bedre til eksamen enn studentene som ikke hadde fått veiledning. De kvalitative dataene kan tyde på at studentene har fått større bevissthet om læringsstrategier og økt motivasjo

Preventive home visits among older people : risk assessment, self-rated health and experiences of healthy ageing

Background: The worldwide population is ageing and life expectancy is increasing. This increase in age is associated with physiological and psychosocial challenges and changes that lead to decreased intrinsic capacity and functional ability. To meet these challenges, preventive home visits have been reported to help older people meet their needs with regard to age-related changes, the intention being to enable older people to live at home for as long as possible. Although preventive home visits may have a positive impact on the lives of older people, it is still necessary to gain more knowledge not only about approaches and content, so as to optimise preventive home visits, but also about how older people perceive the ageing process and their need for support from the healthcare services and the environment. Aim: The aim of this thesis is to increase the level of knowledge about the content of preventive home visits to older people who are living at home and about how older people who live at home perceive the ageing process; the overall purpose is to contribute knowledge to help develop risk prevention and health-promotion activities within this population. Methods: The setting is three municipalities in Western Norway, representing a small, a medium and a large municipality. Older persons aged 75 and older participated in preventive home visits performed by trained nurses using a questionnaire. The questionnaire included questions and tests on falls, nutrition, polypharmacy and cognitive impairment as well as questions regarding lifestyle, health and medical diagnoses, including medications. Descriptive and inferential statistics were applied (Studies I to III), including logistic regression (Study II) and linear blockwise regression (Study III). Study IV used focus group interviews of participants aged 65 and older from the medium and large municipalities. The data was analysed using qualitative content analysis. Results: In Study I, 60% (n=166) of the invited persons accepted a preventive home visit invitation. The main reason for declining a visit was that the person was “feeling too healthy”. Thirty-six persons (21.7%) were identified as being at increased risk of developing illness. Study II showed that 34% were at risk of polypharmacy, 13% at risk of falls and 12% at risk of malnutrition. Of the 106 persons who completed the Mini-Cog test, 28% were at risk of cognitive impairment. Poor self-rated health was associated with increased risk of falls, malnutrition and polypharmacy as well as increased risk of developing illness. In Study III, the blockwise regression model showed that being limited by disease and had pain were negatively associated with self-rated health and that use of the internet was positively associated with self-rated health. The model had a R2 0.432. Being limited by disease was the variable that resulted in the largest change in the model (R2 Change=0.297, p-value < 0.001). Study IV suggests that most old persons enjoy life and they want to continue enjoying life for as long as possible. It is important to sustain networks and feel useful. Unexpected changes were described as threats, and the need to use healthcare services was associated with illness and being dependent. The results are categorised according to: embracing life, dealing with challenges and considering the future. Conclusion and implications: The findings from the overall study show that the focus areas of falls, nutrition, polypharmacy and cognitive impairment are relevant and should be assessed in preventive home visits for the purpose of risk identification. Self-rated health had associations with various risks and other factors related to everyday life. Therefore, self-rated health is suggested as starting point in preventive home visits for a personalised conversation regarding positive and negative factors in the older person’s life. The findings from the focus interviews show that social networks and activities are important in order for older persons to maintain good quality of life and to age well. Therefore, it is suggested that preventive homes visits are used to identify social needs and the ability to meet these needs. The findings also show that older persons did not included or wanted services from healthcare professionals as long they were feeling healthy. The older persons view their appreciation of social arenas and contributing to society as health promotion, and healthcare services and other sectors must contribute to health promotion in these areas

Transfer of high-lysine trait to adapted sorghum varieties

Call number: LD2668 .T4 1978 F58Master of Scienc

Suvremeni festivali: polifonija glasova i neki novi čimbenici

The concepts and roles of new, modern festivals of today are the most striking and the most visible within the field of culture. Alongside their popularity and multiple set of new “voices”, there come politics, money and business. Traditionally, this combination of thought and ideology would eventually escalate into a conflict of interests. Through empirical examples the author of this paper will give an outline of how such a conflict emerges by using the “model of conflict” by Eric Brahm. He will outline categories of agents within the field of festivals.U ovom članku autor opisuje kako se sukobi naizbježno javljaju u nekom trenutku tijekom procesa festivalizacije. Autor navodi da postoje određene prekretnice u tom procesu koje svaki festival i njegovo polje utjecaja susreću od svojih začetaka pa do zaključka, ili do njegova sadašnjeg stanja, na putu prema kraju koji mu je predodređen. Jedan od načina vizualiziranja toga obrasca jest korištenje teorije Erica Brahmsa o teško rješivim sukobima. Ova teorija pokazuje da u polju društvenih interakcija, u kojima mora postojati sporazum oko zajedničke ideologije (kao što je menadžment), postoji latentni sukob, koji u određenom trenutku može prerasti u otvoreni sukob; sukob se zatim zaoštrava, prolazi kroz fazu pat-pozicije te se nakon toga ublažava pregovaranjem; on se po mogućnosti rješava pa nastupa poslijekonfliktni period stvaranja i održavanja mira. U polju u u kojem se očituju različite ideologije i područja važna je terminologija Pierrea Bourdieua. Koristeći izraze kao što su područje, kapital i habitus, predstojeći sukob možemo jasnije ograničiti, pojasniti ga i učiniti vjerodostojnim tako što ukažemo na borbu unutar samoga menadžmenta te između različitih sfera u kojima se festivali ostvaruju. Primjenom ove teorije i terminologije na empirijske podatke lakše možemo sagledati sferu sukoba, a ujedno možemo sukob između različitih ideologija i područja učiniti vidljivijim. Konkretno, na primjerima suvremenoga norveškog glazbenog festivala Lost Weekend i «tradicionalnijega» vikinškog festivala Up-Helly-Aa na Šetlandskom otočju autor pokazuje kako se ti sukobi mogu zbiti. Lost Weekend se suočava s istim problemima kao i Up-Helly-Aa, ali na sasvim drukčji način zbog različitih lokacija, menadžmenta i ideologija. Sukobi se čine neizbježnima, ali ne i nerješivima. Ako postanu svjesni svih razina sukoba, drugi će se festivali moći pripremiti na neizbježno te cijeli proces preokrenuti u svoju korist. Time se ukazuje na različita područja i kategorije čimbenika u okviru festivalske sfere, što autoru omogućuje da raspravi o tome kako se festivali razvijaju služeći kao forumi i skupovi ideologija te koji to utjecaj ima na određenu zajednicu. Kroz navedene empirijske primjere autor također pokazuje kako se lokalne zajednice bore kako bi postale dio globaliziranog svijeta te kako festivali mogu biti jedan od načina ulaska u globalnu zajednicu

Evaluation of a deep neural network for acoustic classification using simulated echo sounder data

An important part of fisheries acoustics is the classification of fish species. Sound waves are transmitted through water to detect fish species, and the echoes returning from the fish are categorized to be used for fish abundance estimates. These estimates are import for fishery management. Recently, it has been shown that a deep learning model performs well on the task of classifying acoustic data. However, these models are often criticized for being “black boxes” and hard to interpret. We have created a pipeline to test a neural network model, in order to shed light on what features of the data impact the predictions of the model. In this pipeline, simulated data is utilized, created by a model that emulates the performance of a multi-frequency echo sounder. The simulated data enables the possibility of adjusting one feature of the data at a time. We have concentrated on two features: the relative frequency response, an energetic characteristic of the data, and the shape of the fish schools. A neural network is trained to recognize two types of fish schools, dissimilar only in shape and relative frequency response. The network is then tested on data where either shape or relative frequency is changed, to evaluate the importance of each feature. From these tests we conclude that the relative frequency response affects the model's performance more than shape.Masteroppgåve i anvend og utrekningsorientert matematikkMAB399MAMN-MA

Izazovi postavljeni istraživačkim metodama i etikom u kulturalnim studijima – zamagljene granice između javnog i privatnog

This article reflects on the use of internet sources and the associated challenges relating to research methods and ethics. It appears that the premise on which dividing lines are drawn between the private and public spheres, between what lies in the public domain and what is published is not the same in internet discussion forums as in real life. Taking part in an online conversation or posting a contribution to a forum may be perceived as a private or semi-private activity, even if we know that anyone may read the posting: the activity takes place in the public sphere, but is an innately private act and is instinctively felt to be so. Furthermore, the page owners recognise this blurred boundary between private and public spheres, which reinforces the view that text can indeed be published without necessarily becoming part of the public domain. Consequently, research academics and students need to reflect in greater depth on the ways in which they introduce themselves, on whether it is at all possible to obtain consent for the use of internet material, and if so – how. They also need to consider de-identifying internet material in the same way they de-identify data obtained from traditional sources.U članku se razmatraju upotreba internetskih izvora i s njome povezani izazovi u istraživačkim metodama i etici. Čini se da polazišta za iscrtavanje razdjelnica između privatne i javne sfere, između onoga što ostaje u javnoj domeni i onoga što se objavljuje, nije isto na internetskim forumima i u stvarnom životu. Sudjelovanje u online razgovorima ili postavljanje komentara na forum može se shvatiti kao privatna ili poluprivatna aktivnost, čak i ako znamo da svatko može pročitati naše objave: aktivnost se odvija u javnoj sferi, ali je suštinski privatni čin i tako se instinktivno i doživljava. Nadalje, vlasnici stranica prepoznaju ovu zamagljenu granicu između privatne i javne sfere, što osnažuje stajalište da tekst zbilja može biti objavljen, a da ne postane nužno dijelom javne domene. Posljedično, istraživači i studenti trebaju podrobnije razmisliti o tome kako se predstavljaju, o tome je li uopće moguće dobiti dozvolu za upotrebu internetskog materijala i ako jest – kako. Također trebaju uzeti u obzir deidentifikaciju internetskog materijala na isti način na koji deidentificiraju podatke prikupljene iz tradicionalnih izvora