| Sammendrag: | The Arctic marine ecosystem is characterized by strong seasonality and a short but productive period of primary production in the spring when the ice breaks up. Calanus glacialis is one of the key links between primary producers and higher trophic levels, and it is adapted to the strong seasonality by life cycle traits such as; seasonal vertical migration, diapausing, reproduction in the spring and extensive energy storage. The timing of these events will have consequences for the success of C. glacialis and also for the energy available at higher trophic levels. The aim of this study was to increase the knowledge about these key life history traits with focus on the role of lipid accumulation, seasonal vertical migration and the transfer of energy from primary producers through Calanus, to higher trophic levels, such as seabirds and seals. Lipid accumulation and seasonal vertical migration of C. glacialis were studied in the Amundsen Gulf, in the Canadian Arctic (Paper I) and in Svalbard waters (Paper II and III). The transfer of energy to higher trophic levels was studied by comparing the fatty acid composition of predators to that of their prey and by using stable isotope analysis to calculate their trophic level. We analyzed five seabird species from Kongsfjorden; Little auk (Alle alle), Brünnich’s guillemot (Uria lomvia), Black-legged kittiwake (Rissa tridactyla), Northern fulmar (Fulmarus glacialis) and Glaucous gull (Larus hyperboreus) (Paper IV) as well as harp seals (Phoca groenlandica) and hooded seals (Cystophora cristata) from the West Ice (Paper V). The timing of the ascent of C. glacialis during spring, the match of reproduction with the primary production as well as the length of the primary production period determines the development of offspring , the overwintering stage the following winter, and hence the length of the life cycle. The shorter the period of primary production, the more important is the match between reproduction and bloom. Ice algae may fuel early maturation of the females and prolong the reproductive period. In the Amundsen Gulf, C. glacialis ascended to the surface water in time to feed on the ice algae bloom, but since CIII was the main overwintering stage, the ice algae fuelled development of CIII which could develop to females that possibly could spawn during the summer. The life history trait of accumulating energy in form of lipids is an adaptation of Calanus to the large seasonal and inter-annual fluctuations in food availability, and the lipids represent an effective transfer of energy up the food chain. High levels of the Calanus markers 20:1n9 and 22:1n11 in the seabirds Little auk, Black-legged kittiwake and Northern fulmar from Kongsfjorden, Svalbard, indicate that these seabirds are part of the Calanus based food web (Paper IV). Harp seals and hooded seals (Paper V) showed considerably overlap in diet, but the fatty acid composition of harp seals originated from a diatom–Calanus based food web, while the fatty acids of hooded seals originated from a food web based on dinoflagellates and the prymnosiophyte Phaeocystis pouchetii. To conclude, the diatom–Calanus food chain is an important driver for the high latitude pelagic arctic food web. The match between timing of primary production, either as ice algae or phytoplankton bloom, and the timing of reproduction of C. glacialis is crucial for the accumulation of lipids in Calanus may have consequences for the energy available for higher trophic levels. |
| Beskrivelse: | Papers 1,3,4 and 5 of this thesis are not available in Munin: 1. Wold A, Darnis G, Søreide JE, Leu E, Philippe B, Fortier L, Poulin M, Kattner G, Graeve M and Falk-Petersen S: 'Life strategy and diet of Calanus glacialis during the winterspring transition in Amundsen Gulf, southeastern Beaufort Sea' Polar Biology (2011) 34:1929-1946. Available at http://dx.doi.org/10.1007/s00300-011-1062-6 3. Wold A, Leu E, Walkusz W and Falk-Petersen S: 'Lipids in copepodite stages of Calanus glacialis', Polar Biology (2007) 30:655-658. Available at http://dx.doi.org/10.1007/s00300-006-0233-3 4. Wold A, Jæger I, Hop H, Geir Wing Gabrielsen GW and Falk-Petersen S: 'Arctic seabird food chains explored by fatty acid composition and stable isotopes in Kongsfjorden, Svalbard', Polar Biology (2011) 34:1147-1155. Available at http://dx.doi.org/10.1007/s00300-011-0975-4 5. Falk-Petersen S, Haug T, Hop H, Nilssen KT and Wold A: 'Transfer of lipids from plankton to blubber of harp and hooded seals off East Greenland', Deep-Sea Research II (2009) 56:2080-2086. Available at http://dx.doi.org/10.1016/j.dsr2.2008.11.020 |
| URI: | http://hdl.handle.net/10037/4152 |
| Sammendrag: | Insidensen av livmorhalskreft i regionen er blant verdens høyeste. Kontinentet er hardt rammet av HIV/AIDS, og da denne sykdommen medfører smitte av andre og flere typer onkogene HPV, samt raskere progresjon av dysplasi, vanskeliggjør dette arbeidet med å få ned nye krefttilfeller. Videre viser studier generelt manglende kunnskap om livmorhalskreft i befolkningen, også blant velutdannende og urbane kvinner. Det mangler også kunnskap om screeningmuligheter. Dette gjelder også for helsepersonell. På den andre siden finnes få eller ingen organiserte screeningprogram, og der behandling kan tilbys er denne ofte inadekvat. |
| URI: | http://hdl.handle.net/10037/3746 |
| Sammendrag: | Background: Data concerning incidence and prevalence of cancer in the different regions of Russia have traditionally not been provided on a basis that facilitated comparison with data from countries in western parts of Europe. The oncological hospital in Arkhangelsk, in co-operation with Universitetet i Tromsø (Norway), has established a population based cancer registry for Arkhangelskaja Oblast (AO). AO is an administrative unit with 1.3 million inhabitants in northwestern Russia. The aim of this investigation was to assess the content and quality of the AO cancer registry (AKR), and to present the site-specific cancer-incidence rates in AO in the period 1993–2001. Methods: The population in this study consisted of all individuals registered as residents of AO. All new cancer cases in the period 1993 – 2001, registered the AKR, were included in the study (ICD-10: C00-C95, except for C77-78). The annual gender and age-group-specific population figures were obtained from the AO statistics office. Results: A total of 34 697 cases of primary cancers were included. The age-adjusted (world standard) incidence rate for all sites combined was 164/100 000 for women and 281/100 000 for men. The highest incidence was for cancer of the trachea, bronchus and lung (16.3% of all cases), whereof 88.6 % of the cases were among men. Among women, cancer of the breast constituted 15.9 percent of all cases. The age-adjusted incidences of the most frequent cancer sites among men were: lung (77.4/100 000); stomach (45.9); rectum (13.4); oesophagus (13.0); colon (12.2); bladder (11.6); and prostate cancer (11.1). Among women they were: breast (28.5); stomach (19.7); colon (12.2); and ovary cancer (9.0). Conclusion: Our findings confirm and strengthen the indication that the incidences of stomach, larynx, liver, pancreas, prostate, colon, bladder and melanoma cancer are quite different in male populations in Russia compared to many other European countries. Among women, most major cancer types, except stomach, appear to be relatively low in Russian populations. The AKR provides quality data for estimations and insight to the cancer incidence in a northern Russian population, and we consider the reported incidence rates to reflect the cancer situation in AO well. |
| URI: | http://hdl.handle.net/10037/1127 |
| Sammendrag: | BACKGROUND: Cancer-Associated Fibroblasts (CAFs) are significant components of solid malignancies and play central roles in cancer sustainability, invasion and metastasis. In this study we have investigated the invasive capacity and matrix remodelling properties of human lung CAFs after exposure to ablative doses of ionizing radiation (AIR), equivalent to single fractions delivered by stereotactic ablative radiotherapy (SART) for medically inoperable stage-I/II non-small-cell lung cancers. METHODS: CAFs were isolated from lung tumour specimens from 16 donors. Initially, intrinsic radiosensitivity was evaluated by checking viability and extent of DNA-damage response (DDR) at different radiation doses. The migrative and invasive capacities of CAFs were thereafter determined after a sub-lethal single radiation dose of 18 Gy. To ascertain the mechanisms behind the altered invasive capacity of cells, expression of matrix metalloproteinases (MMPs) and their endogenous inhibitors (TIMPs) were measured in the conditioned media several days post-irradiation, along with expression of cell surface integrins and dynamics of focal contacts by vinculin-staining. RESULTS: Exposing CAFs to 1x18 Gy resulted in a potent induction of multiple nuclear DDR foci (>9/cell) with little resolution after 120 hours, induced premature cellular senescence and inhibition of the proliferative, migrative and invasive capacity. AIR promoted MMP-3 and inhibited MMP-1 appearance to some extent, but did not affect expression of other major MMPs. Furthermore, surface expression of integrins α2, β1 and α5 was consistently enhanced, and a dramatic augmentation and redistribution of focal contacts was observed. CONCLUSIONS: Our data indicate that ablative doses of radiation exert advantageous inhibitory effects on the proliferative, migratory and invasive capacity of lung CAFs. The reduced motility of irradiated CAFs might be a consequence of stabilized focal contacts via integrins. |
| URI: | http://hdl.handle.net/10037/4935 |
| Sammendrag: | This paper discusses if place names can be used to construct and express identity, with a focus on the Norwegian names of farms and parishes. Since the Norwegian Place Name Act came into existence in 1991, the many appeals in regard to official spellings as decided by the authorities give clear indication that Norwegians have different opinions of how the names of farms and parishes should be spelled compared to names referring to natural features. Many people prefer the spelling of names of natural features to be as close as possible to the dialectal pronunciation, whereas they prefer older, often ornamental spellings or spellings which differ from the pronunciation when it comes to the names of farms and parishes. This paper looks at the reasons for these attitudes towards the spelling of place names, and is highlighted by some theory pertaining to language and identity. |
| URI: | http://hdl.handle.net/10037/4950 |
| Sammendrag: | We evaluated the performance of the new 4-tiered melanoma-specific graded prognostic assessment (GPA) score and the previously published general GPA score in patients with brain metastases from malignant melanoma managed with different approaches including best supportive care. Materials and Methods: Retrospective analysis of 51 patients. Compared with the original analysis of the melanoma-specific GPA score, these patients were more representative of the general population of patients with brain metastases from this disease. The present data confirmed that both scores identify patients with favorable prognosis who might be candidates for focal treatments. However, survival in the 2 unfavorable prognostic subgroups defined by the melanoma-specific GPA was not significantly different. Median survival in the melanoma-specific GPA classes was 3.1, 3.7, 7.5, and 12.7 months. Karnofsky performance status (KPS) and serum lactatdehydrogenase (LDH) level significantly predicted survival. In order to select the right patient to the right treatment and avoid overtreatment and suboptimal resource utilization in patients with very limited survival, improved prognostic tools are needed. The melanoma-specific GPA does not include extracranial disease extent or surrogate markers such as LDH. We suggest that a combination of KPS <70 and elevated LDH might better predict short survival than any of the GPA scores. This hypothesis should be confirmed in larger studies. |
| URI: | http://hdl.handle.net/10037/3950 |
| Sammendrag: | Forskjellen i life expectancy at birth mellom kjønn varierer fra land til land og i de fleste tilfellene så lever kvinner lengre enn menn. Det globale gjennomsnittet er på ca 7% lengre levetid for kvinner enn menn, men man har forskjeller som er helt opp i 23%. Det finnes etablerte hypoteser på hvorfor kvinner lever lengre enn menn og i denne oppgaven vil jeg se på hvordan sosiale og strukturelle variabler påvirker disse og kjønns forskjellene i life expectancy at birth. |
| URI: | http://hdl.handle.net/10037/4638 |
| Sammendrag: | Background: Because mobile telephones may support video calls, emergency medical dispatchers may now connect visually with bystanders during pre-hospital cardiopulmonary resuscitation (CPR). We studied the quality of simulated dispatcher-assisted CPR when guidance was delivered to rescuers by video calls or audio calls from mobile phones. Methods: One hundred and eighty high school students were randomly assigned in groups of three to communicate via video calls or audio calls with experienced nurse dispatchers at a Hospital Emergency Medical Dispatch Center. CPR was performed on a recording resuscitation manikin during simulated cardiac arrest. Quality of CPR and time factors were compared depending on the type of communication used. Results: The median CPR time without chest compression (‘hands-off time’) was shorter in the video-call group vs. the audio-call group (303 vs. 331 s; P50.048), but the median time to first compression was not shorter (104 vs. 102 s; P50.29). The median time to first ventilation was insignificantly shorter in the video-call group (176 vs. 205 s; P50.16). This group also had a slightly higher proportion of ventiliations without error (0.11 vs. 0.06; P50.30). Conclusion: Video communication is unlikely to improve telephone CPR (t-CPR) significantly without proper training of dispatchers and when using dispatch protocols written for audio-only calls. Improved dispatch procedures and training for handling video calls require further investigation. |
| Beskrivelse: | Denne artikkelen er en del av doktorgradsavhandlingen til Stein Roar Bolle. Avhandlingen finnes i Munin http://hdl.handle.net/10037/3597 |
| URI: | http://hdl.handle.net/10037/3598 |
| Sammendrag: | In persons with Multiple sclerosis (MS) low bone mineral density (BMD) is more prevalent when compared with healthy controls and MS may be a possible cause of secondary osteoporosis. BMD is primarily determined by genetic and hormonal factors, body mass index, physical activity and intake of calcium and vitamin D. Vitamin D level at 50 nmol/L or higher is classified as sufficient, however, optimal vitamin D level for bone health is according to many experts at least 75 nmol/L. In this 96 week randomized controlled clinical trial, we aimed to asses whether a weekly dose of 20,000 IU vitamin D3 could prevent bone loss in fully ambulatory persons with MS age 18-50 years. 71 persons with MS where randomized to receive either a weekly dose of 20,000 IU vitamin D3 or placebo. Half of the study participants had sufficient winter vitamin D levels (50 nmol/l) at study start and the level was strongly predicted by sun exposure through sun vacation or solarium and by vitamin D intake. All participants in the vitamin D group achieved sufficient winter vitamin D levels and levels of 75 nmol/L or higher were achieved by 91% of the participants. BMD was lower than expected in 25% of the participants at screening and BMD at the hip decreased by 1% in the whole study population. There was no significant difference between the groups. Several studies have shown that in persons with MS, BMD decreases as disability increasingly limits physical activity and progressing physical handicap also increases the risk of falls and fractures. Even though this small study could not prove any effect of vitamin D supplementation on BMD loss, intake of vitamin D is an important factor in preventing osteoporosis. In order to achieve adequate vitamin D levels, MS patients who have no vitamin D efficient sun exposure and low dietary vitamin D intake during the winter months should take vitamin D supplements. |
| Beskrivelse: | Papers 1 and 3 of this thesis are not available in Munin: 1. Steffensen LH, Mellgren SI and Kampman MT: 'Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis', Journal of Neurology (2010), vol. 257(3):410-418. Available at http://dx.doi.org/10.1007/s00415-009-5337-6 Steffensen LH, Mellgren SI and Kampman MT: 'Erratum to: Predictors and prevalence of low bone mineral density in fully ambulatory persons with multiple sclerosis', Journal of Neurology (2010), vol. 257(3):497-498. Available at http://dx.doi.org/10.1007/s00415-010-5470-2 3. Steffensen L.H, Brustad M and Kampman M.T.: 'What is needed to keep persons with multiple sclerosis vitamin D-sufficient throughout the year?', Journal of Neurology (2013), vol. 260(1):182-188. Available at http://dx.doi.org/10.1007/s00415-012-6611-6 |
| URI: | http://hdl.handle.net/10037/4740 |
| Sammendrag: | Multiple sclerosis (MS) is a possible cause of secondary osteoporosis. In this phase II trial we assessed whether a weekly dose of 20,000 IU vitamin D3 prevents bone loss in ambulatory persons with MS age 18–50 years. ClinicalTrials.gov ID NCT00785473. All patients managed at the University Hospital of North Norway who fulfilled the main inclusion criteria were invited to participate in this double-blinded trial. Participants were randomised to receive 20,000 IU vitamin D3 or placebo once a week and 500 mg calcium daily for 96 weeks. The primary outcome was the effect of the intervention on percentage change in bone mineral density (BMD) at the hip, the spine, and the ultradistal radius over the study period. Of 71 participants randomised, 68 completed. Mean serum 25-hydroxyvitamin D [25(OH)D] levels in the intervention group increased from 55 nmol/L at baseline to 123 nmol/L at week 96. After 96 weeks, percentage change in BMD did not differ between groups at any site. BMD decreased at the hip, by 1.4% in the placebo group (95% CI -2.3 to -0.4, SD 2.7, p = 0.006) and by 0.7% in the treatment group (-1.6 to 0.2, 2.7, p = 0.118), difference 0.7% (-1.9 to 0.7, p = 0.332). Findings were not altered by adjustment for sex or serum 25(OH)D. Supplementation with 20,000 IU vitamin D3 a week did not prevent bone loss in this small population. Larger studies are warranted to assess the effect of vitamin D on bone health in persons with MS. |
| URI: | http://hdl.handle.net/10037/3956 |
| Sammendrag: | Depending on the particular institutional and organizational set-up, different management tasks can be suitable for different forms of co-management arrangement. This thesis focuses on examining the possibility of implementing the marketing-oriented fisheries co-management in Lake Victoria (Tanzanian side) for Nile perch fisheries. The community-based organization BMU was selected as fisher’s representative organization in order to investigate how it is possible to improve the fisher’s market performance and reduce poverty in that fishing community. The findings of this study indicated that the globalization of Nile perch fishery has attracted number of actors to join the fishery and among of them are middlemen, processing plants and fishers themselves. The current first-hand sales system has greater contribution on poverty situation to the majority fishers and made few players benefits over resource, especially investors of the fish processing plants and the fish agents. The deliberate ignoring to identify and incorporate the problems, needs and opportunities that exist in the fishing communities under the co-management arrangement has made the fishers community less motivated in the participation of resource management activities. Fight for better fish prices and issuing of credits to fishers were the most prioritized first-hand sales activities that proposed by fishers community to be undertaken by the BMU organization. Capacity building for the BMU is highly needed in order for the organization to undertake its responsibilities efficiently and effectively. Theories used in this study include the poverty theory, co-management, SLA and middlemen theory. Key words: Co-management, first-hand sales, poverty, BMU’s, Tanzania |
| URI: | http://hdl.handle.net/10037/1428 |
| Sammendrag: | ABSTRACT Absorption of water in concrete is often described by the simple linear water uptake vs. square-root-of-time law. However, a deviation from this behaviour is frequently seen depending on factors such as initial water content, water/binder ratio and specimen thickness. The deviation increases with thickness (typically from 25 to 100 mm) and is seen even for very dry specimens with capillary pores. We have applied Laplaces law for suction created under a curved meniscus between air and water to series of pipes with different lengths and radii. The resulting analytical model was first compared with numerical simulations at abrupt reduction or increase of pipe radius showing good agreement. Then a complete second order equation describing the relation between the capillary suction and the suction time was developed. Varying geometries of the pipes of the capillary system were investigated including the effects on the flow rate of varying combination of lengths, radii and sequence. The results showed that largest flow reductions occurred with very narrow sections causing a blocking, reducing the capillary flow rate vs. square root of time in the same manner as in concrete. The often observed phenomenon of reduced flow below the straight line water uptake vs. square root of time could be simulated with the multiple diameter pipe models, as seen by comparing simulations with experiments with varying concrete qualities and sample thicknesses in simple capillary absorption tests. Key-words: capillary suction, pipe geometry, model |
| URI: | http://hdl.handle.net/10037/5114 |
| Sammendrag: | The very positive effect of hydrogels on wounds and enhanced wound healing process has been proven. Hydrogels provide a warm, moist environment for wound that makes it heal faster in addition to their useful mucoadhesive properties. Moreover, hydrogels can be used as carriers for liposomes containing variety of drugs, such as antimicrobial drugs. This will provide a depot release of drug to the wound bed. In order to optimize the liposomal hydrogel formulation, texture properties responsible for the retention of gel on the wound, need to be well characterized. Characterizing the behaviour of Carbopol hydrogels by texture analyser as described in this Thesis is a new method. As a first step, we evaluated the effects of each parameter used in texture analysis in order to establish reproducible measuring conditions. Behaviour of Carbopol Ultrez 10 hydrogels was studied in regard to the polymer concentration and pH of the gel. Accelerated stability tests were conducted for both Carbopol gels and liposomal Carbopol gels. Chloramphenicol was used as a drug model to be entrapped in liposomes and its release from liposomal hydrogels was studied. Carbopol hydrogels are stable formulations and easy to produce. Their texture properties are affected by the pH values of the gel. Accelerated stability indicated that the attention needs to be given to the gel composition. When incorporating liposomal dispersions, there is a limit of proportion of the dispersion which could be incorporated without affecting the original properties of the gel. Liposomal Carbopol hydrogels show potential to be used as drug delivery system. |
| URI: | http://hdl.handle.net/10037/2755 |
| Sammendrag: | I studiene har vi undersøkt hjerteceller og isolerte hjerter under forhold som ligner på hjerteinfarkt. Denne kunnskapen brukte vi videre til å redusere hjerteinfarkt på rottehjerter. Vi har sett på effekten av hjerteinfarkt på mitokondrier og spesielle kanaler i hjertet som heter gap junctions og halvkanaler. Vi har vist at ved å holde spesielle halvkanaler lukket noen få minutter etter ett hjerteinfarkt reduseres hjerteinfarktet med ca 50 %. I samarbeid med en utenlandsk forskningsgruppe var vi de første i verden til å vise at gassen hydrogen sulfide i små mengder kunne redusere hjerteinfarkt størrelsen. Til tross for gode resultater i det eksperimentelle laboratorium gjenstår det fortsatt mye arbeid før vi kan implementere dette i pasienter. Den nye kunnskapen vi har kommet fram til er viktige for videre arbeid med å hjelpe pasienter som får akutte hjerteinfarkt, slik at de får bedre overlevelse og mindre risiko for kronisk hjertesykdom. |
| Beskrivelse: | The papers of this article is not available in Munin: 1. David Johansen, Véronique Cruciani, Rune Sundset, Kirsti Ytrehus, Svein-Ole Mikalsen: 'Ischemia induces closure of gap junctional channels and opening of hemichannels in heartderived cells and tissue', Cellular Physiology and Biochemistry (2011) vol. 28(1):103-14. Available at http://dx.doi.org/10.1159/000331719 2. David Johansen, Kirsti Ytrehus, Gary Baxter: 'Exogenous hydrogen sulfide (H2S) protects against regional myocardial ischemia-reperfusion injury--Evidence for a role of K ATP channels', Basic Research in Cardiology (2006), Vol. 101, No. 1:53-60. Available at http://dx.doi.org/10.1007/s00395-005-0569-9 3. David Johansen, Espen Sanden, Martin Hagve, Xi Chu, Rune Sundset, Kirsti Ytrehus: 'Heptanol triggers cardioprotection via mitochondrial mechanisms and mitochondrial potassium channel opening in rat hearts', Acta Physiologica (2011), (4):435-44. Available at http://dx.doi.org/10.1111/j.1748-1716.2010.02221.x 4. David Johansen, Espen Sanden, Svein-Ole Mikalsen, Kirsti Ytrehus: 'Pannexin 1, a new channel protein in cardiac mitochondria?' (manuscript) |
| URI: | http://hdl.handle.net/10037/4242 |
| Sammendrag: | Background: Immediate start of basic cardiopulmonary resuscitation (CPR) and early
defibrillation have been highlighted as crucial for survival from cardiac arrest, but despite new
knowledge, new technology and massive personnel training the survival rates from in-hospital
cardiac arrest are still low. National guidelines recommend regular intervals of CPR training to
make all hospital personnel able to perform basic CPR till advanced care is available. This study
investigates CPR training, resuscitation experience and self-confidence in skills among hospital
personnel outside critical care areas.
Methods: A cross-sectional study was performed at three Norwegian hospitals. Data on CPR training and CPR use were collected by self-reports from 361 hospital personnel. Results: A total of 89% reported training in CPR, but only 11% had updated their skills in accordance with the time interval recommended by national guidelines. Real resuscitation experience was reported by one third of the respondents. Both training intervals and use of skills in resuscitation situations differed among the professions. Self-reported confidence decreased only after more than two years since last CPR training. Conclusion: There is a gap between recommendations and reality in CPR training among hospital personnel working outside critical care areas. |
| URI: | http://hdl.handle.net/10037/2184 |
| Sammendrag: | Testikkelkreft er den vanligste kreftformen blant unge menn, og >95 % blir i dag helbredet av sykdommen. Dermed er kunnskap om mulige seneffekter etter behandlingen viktig.
Avhandlingen ”Cardiovascular risk factors and pulmonary function in long-term survivors of testicular cancer” ble forsvart for graden ph.d 24. april 2009. Takket være effektiv cytostatikabehandling som ble tatt i bruk på slutten av 70-tallet, er overlevelsen ved metastatisk testikkelkreft blitt betraktelig bedret de siste 30 årene. Standard behandling ved metastatisk testikkelkreft er i dag 3-4 kurer med cisplatin-basert kjemoterapi. Behandlingsmuligheter for pasienter med lokal sykdom er operasjon, stråleterapi eller kun en kjemoterapikur. Siden denne sykdommen primært rammer menn i 20- og 30-årene, og disse forventes å ha en nærmest normal levetid etter behandlingen, er det svært viktig å avklare om behandlingen kan føre til senbivirkninger. Vi har sett spesielt på risikofaktorer for kardiovaskulær sykdom og lungefunksjonen og om disse kan være relatert til noen av behandlingstypene. Avhandlingen er basert på en landsomfattende etterkontroll av norske menn som ble behandlet og kurert for testikkelkreft i perioden 1980-1994. Etterkontrollen ble utført ved fem universitetsklinikker i perioden 1998-2002, og bestod av et omfattende spørreskjema, klinisk undersøkelse ved kreftpoliklinikk inkludert måling av blodtrykk, vekt, høyde, blodprøver og spirometri. Totalt ble 1814 menn invitert til å delta, og av disse var det 1463 (81 %) som deltok. En kontrollgruppe bestående av menn uten tidligere testikkelkreft ble etablert gjennom Tromsøundersøkelsen. Vi fant ut at menn som tidligere var blitt behandlet med cisplatinbasert cytostatika, særlig i høye doser, hadde høyere forekomst av hypertensjon, fedme og metabolsk syndrom, både sammenlignet med menn som kun var behandlet med kirurgi og sammenlignet med kontroller. Menn behandlet med høye doser cisplatinbasert cytostatika og kombinasjonen cytostatika/lungekirurgi hadde redusert lungefunksjon sammenlignet med menn behandlet med kirurgi alene. Mennene som var blitt behandlet med cytostatika hadde også lavere nivåer av testosteron. Behandling med stråleterapi påvirket ikke kardiovaskulære risikofaktorer eller lungefunksjonen. |
| Beskrivelse: | Paper 2 of the thesis is not available in Munin due to publisher's restrictions:
2. Haugnes HS, Aass N, Fosså SD, Dahl O, Klepp O, Wist EA, Svartberg J, Wilsgaard T, Bremnes RM.: 'Components of the metabolic syndrome in long-term survivors of testicular cancer.' Annals of Oncology 18:241-248, 2007 (Oxford University Press), available at http://dx.doi.org/10.1093/annonc/mdl372 |
| URI: | http://hdl.handle.net/10037/1880 |
| Sammendrag: | Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a common disease, with serious short- and long-term complications and a potential fatal outcome. Despite the knowledge of several inherited and acquired risk factors for VTE, still 30-50 % of the VTE events occur in the absence of obvious predisposing factors. Traditionally, arterial and venous thrombosis has been considered as separate disease entities with different pathology, epidemiology and treatments. However, recently this concept has been challenged, and a potential link between arterial cardiovascular disease and VTE has been suggested. The aim of this thesis was to investigate the impact of traditional cardiovascular risk factors on the risk of VTE in a prospective population-based study. Subjects were recruited from the fourth survey of the Tromsø study, conducted in 1994-95. A total of 27 158 men and women, aged 25-97 years, participated. Incident VTE events were registered from the date of inclusion through the end of follow-up, September 1, 2007. In summary, age, male gender, obesity, mean platelet volume and family history of myocardial infarction were identified as risk factors for venous thrombosis, which makes these factors, shared risk factors for both arterial and venous thrombosis. Other traditional cardiovascular risk factors such as serum lipid levels, blood pressure, smoking and diabetes were not associated with risk of VTE. Subjects with the metabolic syndrome had higher risk of VTE, but this relationship was essentially dependent on the presence of abdominal obesity. Taken together, these findings imply that traditional atherosclerotic risk factors are not shared by arterial and venous thrombosis, and suggest that common determinants for arterial and venous thrombosis are probably related to mechanisms of thrombus formation. |
| Beskrivelse: | The papers of the thesis are not available in Munin, due to publisher's restrictions:
1. Brækkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Størmer J, Hansen JB: 'Family history of myocardial infarction is an independent risk factor for venous thromboembolism – The Tromsø Study', Journal of Thrombosis and Haemostasis, 2008, Nov; 6(11): 1851–1857 (Wiley-Blackwell). Available at http://dx.doi.org/10.1111/j.1538-7836.2008.03102.x 2. Borch KH, Brækkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Størmer J, Hansen JB: 'Abdominal obesity is essential for the risk of venous thromboembolism in the metabolic syndrome - the Tromsø study', Journal of Thrombosis and Haemostasis, 2009 May; 7(5): 739-45. Available at http://dx.doi.org/10.1111/j.1538-7836.2008.03234.x 3. Brækkan SK, Borch KH, Mathiesen EB, Njølstad I, Wilsgaard T, Hansen JB: 'HDL-cholesterol and future risk of venous thromboembolism – The Tromsø Study', Journal of Thrombosis and Haemostasis, 2009 Aug; 7(8): 1428-30. Available at http://dx.doi.org/10.1111/j.1538-7836.2009.03481.x 4. Brækkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Størmer J, Hansen JB: 'Mean platelet volume is an independent risk factor for venous thromboembolism – The Tromsø Study', Journal of Thrombosis and Haemostasis, 2010 Jan; 8(1): 157-162. Available at http://dx.doi.org/10.1111/j.1538-7836.2009.03498.x |
| URI: | http://hdl.handle.net/10037/2433 |
| Beskrivelse: | Paper number 1 of the thesis is not available in Munin due to publishers restrictions. Papers 2,3 and 4 are manuscripts, and not available in Munin. 1. Dybwad, T.E.: "The Structural Validity of Daidalos: A measure of career maturity." Scandinavian Journal of Educational Research 2008; 52(2): 135-152 (Taylor and Francis). Available at http://dx.doi.org/10.1080/00313830801915762 2. Dybwad, T.E.: "Career Maturity: A latent means and covariance structure analysis." Manuscript 3. Dybwad,T.E.: "A MACS approach to the study of work values." Manuscript 4. Dybwad,T.E.: "Dropout intentions and career uncertainty: A latent variable modelling approach to their prediction." Manuscript. |
| URI: | http://hdl.handle.net/10037/2592 |
| Sammendrag: | Aim: The aim of this study was to explore experiences with overnight respite care (ORC) of Norwegian carers who provided care to frail elderly
awaiting nursing home placement.
Background: In many Western countries respite care has become part of health care service provision, and various types of respite care are available. The intent with respite care can be twofold; caring for the care receiver and supporting the carer. Methods: This is a descriptive qualitative study. Interviews were conducted with 15 carers, transcribed and analysed by qualitative content analysis. Findings: The carers described various experiences with ORC. If ORC supported the whole family, it was welcomed by carers and experienced as supportive. If ORC did not support the whole family, many carers rejected ORC, and it was experienced as non-supportive. Two categories were constructed: ‘experiencing ORC as supportive for the family as a whole’ and ‘not experiencing ORC as supportive for the family as a whole’. Conclusion: To support more carers, nurses have to listen to carers’ experiences about ORC. Nurses need to take responsibility for the family as a whole and provide more flexible ORC services based on both carers’ and elderly’s needs. |
| URI: | http://hdl.handle.net/10037/2159 |
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