Ultrasound assessed carotid atherosclerosis in a general population : the Tromsø study

As a neurologist with a special interest in cerebrovascular diseases, and with several years of practice with ultrasound examinations of extra- and intracranial arteries, I have some times experienced patients in whom ultrasound revealed unexpected findings which surprised mc, and made me wonder about etiological relationships and clinical implications. Thus, ultrasound examinations of the carotid arteries in some very old people showed smooth vessels without visible atherosclerosis, whereas in some young people with low cardiovascular risk factor levels, I found pronounced atherosclerosis with stenotic or occluded carotid arteries. Similarly, I have wondered why many patients with high-degree carotid stenosis did not suffer from ipsilateral ischemic cerebral stroke, whereas others who had a lower degree of stenosis experienced cerebral embolic events and had carotid endarterectomy. Was one of the causes that atherosclerosis might be a condition differing also in terms of pathogenicity? Such unexpected and intriguing findings evoked my curiosity for a more scientific approach to carotid atherosclerosis. The opportunity arose when I was invited to participate in the fourth survey of the Tromsø Study

ConvMixerSeg: Weakly Supervised Semantic Segmentation for CT Liver Images

The predictive power of modern deep learning approaches is posed to revolutionize the medical imaging field, however, their usefulness and applicability are severely limited by the lack of well annotated data. Liver segmentation in CT images is an application that could benefit particularly well from less data hungry methods and potentially lead to better liver volume estimation and tumor detection. To this end, we propose a new semantic segmentation model called ConvMixerSeg and experimentally show that it outperforms an FCN with a ResNet-50 backbone when trained to segment livers on a subset of the Liver Tumor Segmentation Benchmark data set (LiTS). We have further developed a novel Class Activation Map (CAM) based method to train semantic segmentation models with image level labels without adding parameters. The proposed CAM method includes a Neighborhood Correlation Enforcement module using Gaussian smoothing that reduces part domination and prediction noise. Additionally, our experiments show that the proposed CAM method outperforms the original CAM method for both classification and segmentation with high statistical significance given the same ConvMixerSeg backbone

Selektion auf wurfgrösse bei mausen und einige korrelierte reaktionen

International audienc

Tilbakemelding som vurdering for læring. Læreres tolkninger av det politiske konseptet

Masteroppgave i tilpassa opplæring - Nord universitet 201

Hvordan møte aggresjon hos pasienter som er innlagt på en akutt psykiatrisk avdeling for å unngå bruk av tvang? - En kvalitativ systematisk litteratur oversikt.

Master's thesis in Relational treatmentHensikten med denne oppgaven har vært å sette fokus på hvilke forebyggende tiltak en sykepleier kan iverksett for å unngå bruk av tvangsbruk hos en aggressiv pasient. Gjennom en litteraturstudie er det søkt oversikt og innsikt i hva forskning sier om hvilke tiltak som fungerer for å roe ned en aggressiv pasient. Problemstillingen er følgende: Hvordan møte aggresjon hos pasienter som er akutt innlagt ved psykiatrisk avdeling for å unngå bruk av tvang? Det teoretiske rammeverket har vært Thorgaard, Haga, and Psykiatrisk opplysning (2006) relasjonsverktøy og teori rundt avmakt. Metoden har vært en kvalitativ innholdsanalyse med en systematisk oversiktsartikkel. Studien har vist at på tross av ulike kulturer og land er det flere fellestrekk ved de tiltak som sykepleierne iverksetter for å unngå bruk av tvang. Blant annet å fokusere på pasientens mestringsstrategier og personalets holdninger og ferdigheter.submittedVersio

Methods and measures used to evaluate patient-operated mobile health interventions:Scoping literature review

Background: Despite the prevalence of mobile health (mHealth) technologies and observations of their impacts on patients’ health, there is still no consensus on how best to evaluate these tools for patient self-management of chronic conditions. Researchers currently do not have guidelines on which qualitative or quantitative factors to measure or how to gather these reliable data. Objective: This study aimed to document the methods and both qualitative and quantitative measures used to assess mHealth apps and systems intended for use by patients for the self-management of chronic noncommunicable diseases. Methods: A scoping review was performed, and PubMed, MEDLINE, Google Scholar, and ProQuest Research Library were searched for literature published in English between January 1, 2015, and January 18, 2019. Search terms included combinations of the description of the intention of the intervention (eg, self-efficacy and self-management) and description of the intervention platform (eg, mobile app and sensor). Article selection was based on whether the intervention described a patient with a chronic noncommunicable disease as the primary user of a tool or system that would always be available for self-management. The extracted data included study design, health conditions, participants, intervention type (app or system), methods used, and measured qualitative and quantitative data. Results: A total of 31 studies met the eligibility criteria. Studies were classified as either those that evaluated mHealth apps (ie, single devices; n=15) or mHealth systems (ie, more than one tool; n=17), and one study evaluated both apps and systems. App interventions mainly targeted mental health conditions (including Post-Traumatic Stress Disorder), followed by diabetes and cardiovascular and heart diseases; among the 17 studies that described mHealth systems, most involved patients diagnosed with cardiovascular and heart disease, followed by diabetes, respiratory disease, mental health conditions, cancer, and multiple illnesses. The most common evaluation method was collection of usage logs (n=21), followed by standardized questionnaires (n=18) and ad-hoc questionnaires (n=13). The most common measure was app interaction (n=19), followed by usability/feasibility (n=17) and patient-reported health data via the app (n=15). Conclusions: This review demonstrates that health intervention studies are taking advantage of the additional resources that mHealth technologies provide. As mHealth technologies become more prevalent, the call for evidence includes the impacts on patients’ self-efficacy and engagement, in addition to traditional measures. However, considering the unstructured data forms, diverse use, and various platforms of mHealth, it can be challenging to select the right methods and measures to evaluate mHealth technologies. The inclusion of app usage logs, patient-involved methods, and other approaches to determine the impact of mHealth is an important step forward in health intervention research. We hope that this overview will become a catalogue of the possible ways in which mHealth has been and can be integrated into research practice

Effects of vitamin D supplementation on bone turnover markers and other bone-related substances in subjects with vitamin D deficiency

In observational studies, vitamin D deficiency is a risk factor for low bone density and future fractures, whereas a causal relation has been difficult to show in randomized controlled trials (RCTs). Similarly, vitamin D deficiency has been associated with increased bone turnover, but RCTs with vitamin D have not shown conclusive effects. This could be due to inclusion of vitamin D sufficient subjects and low vitamin D doses. In the present study 399 subjects with mean baseline serum 25-hydroxyvitamin D (25(OH)D) 34.0 nmol/L completed a four months intervention with vitamin D3 20,000 IU per week versus placebo. Mean serum 25(OH)D increased to 89.0 nmol/L in the vitamin D group and decreased slightly in the placebo group. A small, but significant, decrease in the bone formation marker procollagen of type 1 amino-terminal propeptide (P1NP) was seen in the vitamin D group as compared to the placebo group (mean delta P1NP -1.2 pg/mL and 1.5 ng/mL, respectively, P  6.5 pmol/L and post-intervention decrease in PTH, the decrease in P1NP was more pronounced, they also exhibited significantly reduced serum CTX-1 and increased serum sclerostin. In conclusion, supplementation with vitamin D appears to suppress bone turnover, possibly mediated by PTH reduction. Our findings need to be confirmed in even larger cohorts with vitamin D insufficient subjects

Er superledelse arbeidslivets supermat?

Denne kvalitative undersøkelsen ser på kunnskapsmedarbeidernes behov for ledelse. Vi utfordrer realismen til antakelsen omkring medarbeidernes behov for “superlederen”, som i sin kraft skal hjelpe de på vei til selvrealisering og maksimal utnyttelse av deres menneskelige potensiale. I det teoretiske grunnarbeidet for denne undersøkelsen har vi sett på ledelsesteorier og ledelsesutviklingsstrategier som til dels kan synes å være i favør av et ledelsesperspektiv, hvor lederen er supermennesket og medarbeiderne er de som følger ham eller henne dit lederen vil. På den andre siden har vi brukt Critical Management innen fagfeltet ledelse og sett på hva de sentrale akademikerne innenfor dette perspektivet søker å kritisere av eksisterende ledelseslitteratur og forskning. Vi har gjennomført dybdeintervjuer med ni medarbeidere, fordelt over to store og veletablerte organisasjoner innen utvikling av høyteknologi i Norge. Det empirien av denne undersøkelsen viser er at kunnskapsmedarbeiderne etterspør mer oppgaveorientert ledelse enn relasjonsorientert. Det sentrale for medarbeiderne er oppgave- og problemløsningen i seg selv. De viser at det relasjonelle til lederen ikke er et sentralt behov, men at det å være i et fagmiljø med medarbeidere de kan dele kunnskap med er viktigere enn å ha en dyp relasjon med lederen. Videre kommer det frem at autonomi i arbeidet og evne til selvledelse anses som selvsagte sider ved disse medarbeiderne. På den måten at det er noe de selv forvalter med bakgrunn i kompetanse og stilling, og ikke noe som er i lederens besittelse å gi. Det interessante ved disse funnene er at de er motstridende til, og utfordrer både teori og forskning som har bred aksept, innen både transformerende og relasjonsorientert ledelse etablert i nyere tid. Vi har i denne kvalitative undersøkelsen brukt “Mystery as Method”, en metodikk av Alvesson og Kärreman (2011). Denne metoden dreier seg i hovedsak om å ikke kun verifisere eller falsifisere eksisterende teorier, ei heller drive med “gap-spotting”. Hensikten med denne metoden er derimot å kaste lys på og utfordre underliggende antakelser som kan være av verdi når det blir sett i en større sammenheng. Formålet er dermed ikke å komme frem til svar med to streker under, men å peke på sider ved det som foreligger på en ny måte og videre implisere hvordan dette kan ses på eller brukes i en større sammenheng. Dette mot fagfeltet, for ledelse i praksis og i videre forskning

Physical Activity Reduces the Risk of Fragility Fracture

The authors discuss a new study, with a 35 year follow up, showing that exercise reduces the risk of fragility fractures in men