Doktorgradsavhandlinger (Helsefak)
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Doktorgradsavhandlinger (Helsefak)
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Augestad, Knut Magne (Doctoral thesis; Doktorgradsavhandling, 10-May-2013)[+][-]
Description: Papers 1,2 and 3 of this thesis are not available in Munin:
1. Augestad KM, Lindsetmo RO, Stulberg JJ, Reynolds H, Senagore AJ, Champagne B, Heriot AG, Leblanc F and Delaney CP.: 'International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams', World Journal of Surgery (2010), vol. 34:2689-2700. Available at http://dx.doi.org/10.1007/s00268-010-0738-3
2. Augestad KM, Lindsetmo RO, Stulberg JJ, Reynolds H, Senagore AJ, Champagne B, Heriot AG, Leblanc F and Delaney CP.: 'International trends in surgical treatment of rectal cancer', American Journal of Surgery (2011), vol. 201:353–358. Available at http://dx.doi.org/10.1016/j.amjsurg.2010.08.030
3. Augestad KM, Lindsetmo RO, Stulberg J, Reynolds H, Champagne B, Senagore AJ and Delaney CP.: 'System-based factors influencing intraoperative decision-making in rectal cancer by surgeons. An international assessment', Colorectal Disease (2012), vol. 14(10):e679-88. Available at http://dx.doi.org/10.1111/j.1463-1318.2012.03093.xURI: http://hdl.handle.net/10037/5167 File(s) in this item: 3
paper_4.pdf (177.5Kb)paper_5.pdf (1.636Mb)thesis.pdf (1.832Mb) -
Erke, Maja Gran (Doctoral thesis; Doktorgradsavhandling, 30-May-2013)[+][-]
Abstract: Age-related macular degeneration (AMD) is an important cause of visual impairment and blindness worldwide. The number of people affected by the disease is expected to rise due to increasing longevity. Development of adequate eye care for these patients should be based on knowledge about the prevalence of AMD. Further, preventive measures are the best strategy for any disease. The aims of this thesis were to estimate the prevalence of AMD and examine risk factors associated with AMD. We described prevalence rates of AMD among Caucasian elderly participants from the Tromsø Eye Study, a population-based study in Norway. The overall prevalence of late AMD was 3.5 % among the participants aged 65-87 years old. Neovascular AMD outnumbered geographic atrophy. Symmetry between eyes was relatively low. Prevalence increased strongly with age. No significant sex differences in prevalence rates of AMD were observed. Refractive error was lower in eyes with late AMD than in eyes without late AMD. We then analysed relationships between traditional cardiovascular risk factors and AMD. Daily smoking was a strong predictor for the presence of late AMD. We found a significant interaction between age and sex for late AMD, suggesting that age may be a stronger risk factor for late AMD in women than in men. Higher systolic blood pressure, higher pulse pressure, infrequent physical exercise and overweight or obesity were in adjusted analyses associated with late AMD in females, but this was not observed in men. Based on our observation of sex and AMD, we studied associations between female hormone related factors and AMD. We found a significant inverse relationship between duration of lactation and late AMD. No significant relationships were found between late AMD and exogenous oestrogen exposure in the form of contraceptives or hormone therapy. Nor did we find an association between late AMD and onset, end or length of fertile years, bilateral oophorectomy or parity as surrogate measures. Description: The papers of this thesis are not available in Munin:
1. Bertelsen G, Erke MG, von Hanno T, Mathiesen EB, Peto T, Sjølie AK and Njølstad I.: 'The Tromsø Eye Study: study design, methodology and results on visual acuity and refractive errors', Acta Ophthalmologica (2012), Online before print. Available at http://dx.doi.org/10.1111/j.1755-3768.2012.02511.x
2. Erke MG, Bertelsen G, Peto T, Sjølie AK, Lindekleiv H and Njølstad I.: 'Prevalence of Age-Related Macular Degeneration in Elderly Caucasians: The Tromsø Eye Study', Ophthalmology (2012), vol.119(9):1737–1743. Available at http://dx.doi.org/10.1016/j.ophtha.2012.03.016
3. Erke MG, Bertelsen G, Peto T, Sjølie AK, Lindekleiv H and Njølstad I.: 'Cardiovascular risk factors associated with agerelated macular degeneration: The Tromsø Study' (manuscript)
4. Erke MG, Bertelsen G, Peto T, Sjølie AK, Lindekleiv H and Njølstad I.: 'Lactation, female hormones and age-related macular degeneration: The Tromsø Study' (manuscript)URI: http://hdl.handle.net/10037/5155 File(s) in this item: 1
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Kjærgaard, Marie (Doctoral thesis; Doktorgradsavhandling, 19-Apr-2013)[+][-]
Abstract: Vitamin D is well known for the effect in bone metabolism and calcium regulation. In the past decade increasing evidence that vitamin D might be important in other areas has emerged. Especially glucose metabolism, cardiovascular disease and infectious diseases have been investigated. In addition, several population studies have shown that an association between vitamin D and depression might be of importance. Furthermore, increasing headache prevalence with higher latitudes has led to theories about a relation between headache and vitamin D. Our analyses from the Tromsø Study confirm that low levels of vitamin D are associated with higher depression scores independent of lifestyle factors that might influence vitamin D. However, whether vitamin D has any effect in treatment of depression cannot be answered from this type of study. We further investigated this by treating 243 healthy persons with either vitamin D or placebo for six months and monitoring depression by use of questionnaires and interviews. We found no superior effect of vitamin D compared with placebo in our study, but other studies suggest vitamin D might be beneficial in persons with more severe depressive symptoms. Furthermore, we did analyses of the depression questionnaires used (BDI-II, HADS, MADRS), and found that they are solid instruments, which can also be used in a healthy population. The analyses of the data from the Tromsø Study in addition showed that Tension-Type Headache are associated with low vitamin D levels, but even though adjustment were made for lifestyle factors, it is possible that this association is caused by an unhealthy lifestyle in persons with headache. We did not find any association between vitamin D and migraine. Further studies are needed to confirm these findings. Description: The papers of this thesis are not available in Munin:
1. Paper I. Kjærgaard, M., R. Joakimsen, and R. Jorde: 'Low serum 25-hydroxyvitamin D levels are associated with depression in an adult Norwegian population', Psychiatry Research (2011), vol. 190(2-3):221-225. Available at http://dx.doi.org/10.1016/j.psychres.2011.06.024
2. Kjærgaard, M., K. Waterloo, C.E. Wang, B. Almås, Y. Figenschau, M.S. Hutchinson, J. Svartberg, and R. Jorde: 'Effect of vitamin D supplement on depression scores in people with low levels of serum 25-hydroxyvitamin D: nested case-control study and randomised clinical trial', British Journal of Psychiatry (2012), vol. 201(5):360-368. Available at http://dx.doi.org/10.1192/bjp.bp.111.104349
3. Kjærgaard M, C.E.A. Wang, K. Waterloo, and R. Jorde: 'A study of the psychometric properties of the Beck Depression Inventory-II, the Montgomery and Åsberg Depression Rating Scale and the Hospital Anxiety and Depression Scale in a healthy population' (manuscript)
4. Kjærgaard M, A.E. Eggen, E.B. Mathiesen, and R. Jorde: 'Association Between Headache and Serum 25-Hydroxyvitamin D; the Tromsø Study: Tromsø 6', Headache (2012), vol.52(10):1499-1505. Available at http://dx.doi.org/10.1111/j.1526-4610.2012.02250.xURI: http://hdl.handle.net/10037/5128 File(s) in this item: 1
thesis.pdf (1.040Mb) -
Meum, Torbjørg (Doctoral thesis; Doktorgradsavhandling, 05-Apr-2013)[+][-]
Abstract: Avhandlingen presenterer en kvalitativ studie av innføring og bruk av standarder i sykepleie og bygger på empiriske studier fra ulike sykehusmiljø. Standardisering er ofte ansett som en viktig forutsetning for å oppnå sømløs integrasjon ved bruk av informasjons – og kommunikasjonsteknologi (IKT) i helsesektoren. Terminologier og retningslinjer blir ofte utviklet av internasjonale organisasjoner som involverer omfattende prosesser for å ivareta faglige og helsepolitiske krav. Når standarder blir tatt i bruk blir de en del av en lokal arbeidspraksis som er preget av et dynamiske miljø som transformeres i takt med utvikling av ny kunnskap, teknologi og samarbeidsstrukturer. Fokuset for avhandlingen er i dette spenningsfeltet og gir først og fremst økt teoretisk og empirisk innsikt i de gjensidige tilpasningene mellom universelle standarder og lokal praksis (ko-konstruksjon). Videre gir studien innsikt i de koordinerende egenskaper ved bruk av standarder som en integrert del av arbeidspraksis og kan også ha betydning for design og utvikling av prosesstøttende EPR systemer. Description: The papers of this thesis are not available in Munin:
1. Meum, T. and G. Ellingsen: '‘Sound of silence’ – changing from an oral to a computer-mediated handover', Behaviour & Information Technology (2011), vol. 30(4):479-488. Available at http://dx.doi.org/10.1080/0144929X.2010.547221
2. Torbjørg Meum, Gro Wangensteen, Harald Igesund, Gunnar Ellingsen and Eric Monteiro: 'Standardization – the iron cage of nurses' work', in Studies in Health Technology and Informatics (2010), Volume 157: Information Technology in Health Care: Socio-Technical Approaches. Available at http://dx.doi.org/10.3233/978-1-60750-569-3-85
3. Torbjørg Meum, Eric Monteiro and Gunnar Ellingsen: 'The Pendulum of Standardization', ECSCW 2011: Proceedings of the 12th European Conference on Computer Supported Cooperative Work, 24-28 September 2011. Available at http://dx.doi.org/10.1007/978-0-85729-913-0_6
4. Meum, Torbjørg and Ellingsen, Gunnar: 'Standardization in nursing practice: Cross-contextual information sharing', ECIS 2011 Proceedings. Paper 139. Available at http://aisel.aisnet.org/ecis2011/139
5. Meum, T.: '“Lost in Translation”: The Challenges of Seamless Integration in Nursing Practices' (manuscript).
6. Torbjørg Meum: 'Electronic medication management: a socio - technical change process in clinical practice', CSCW '12 Proceedings of the ACM 2012 conference on Computer Supported Cooperative Work (2012), Pages 877-886. Available at http://dx.doi.org/10.1145/2145204.2145335URI: http://hdl.handle.net/10037/5082 File(s) in this item: 1
thesis.pdf (2.353Mb) -
Rismo, Renathe (Doctoral thesis; Doktorgradsavhandling, 11-Jan-2013)[+][-]
Abstract: Patogenesen ved inflammatorisk tarmsykdom (IBD) er fortsatt ikke fullstendig klarlagt. Mye forskning har blitt gjort de siste tjue årene for å kartlegge immunresponsen ved ulcerøs kolitt og Crohns sykdom. Man antar at et samspill mellom genetiske faktorer, miljøfaktorer og bakterier ligger bak utviklingen av sykdommen. Kartleggingen av immunresponsen i tarmen har vært grunnlaget for utviklingen av såkalt målrettet behandling, også kjent som anti-TNF behandling. I denne avhandlingen er sammenhengen mellom uttrykket av immunkomponenter i tarmslimhinnen, respons på behandling og sykdomsforløp undersøkt hos pasienter med IBD. Arbeidene er basert på innsamlet pasientmateriale ved gastromedisinsk avdeling UNN Tromsø i perioden 2003-2011. Det er gjort kliniske registreringer i tilegg til innsamling av vevsprøver fra tarmen under endoskopiske undersøkelser av disse pasientene. Vi har først undersøkt immunprofilen i tarmen hos IBD pasienter som er uten behandling og funnet at enkelte immunmarkører er assosiert med grad av sykdomsaktivitet. Deretter har vi sett på om nivået av genuttrykk av noen markører kan relateres til behandlingseffekten. Vi har funnet at det hos pasienter med ulcerøs kolitt ser ut til at et høyt uttrykk av enkelte mediatorer før oppstart av anti-TNF behandling kan forutsi en bedre effekt av behandlingen. Hos pasienter med Crohn har vi sett at anti-TNF behandling reduserer uttrykket av immunmarkører som er relatert til betennelsen, men ikke til normalisert nivå hos de fleste pasienter. Manglende normalisering av uttrykket av markører som medierer betennelsen hos Crohn-pasienter gir signifikant høyere risiko for raskt tilbakefall når anti-TNF behandlingen stoppes. Immunmarkører som relateres direkte til betennelsen i tarmslimhinnen hos IBD pasienter ser ut til å kunne utnyttes som biomarkører i klinisk sammenheng ved å forutsi både effekten av behandlingen og sannsynligheten for raskt tilbakefall etter behandlingen er stoppet. Videre kartlegging av immunrespons og identifisering av verdifulle biomarkører er viktig for å utvikle målrettet individuell behandling, og også definere kriterier for valg av behandlingsstrategi på lang sikt. Description: The papers of this thesis are not available in Munin:
1. Olsen T, Rismo R, Cui G, Goll R, Christiansen I, Florholmen J.: 'TH1 and TH17 interactions in untreated inflamed mucosa of inflammatory bowel disease, and their potential to mediate the inflammation',Cytokine (2011), vol. 56:633-40. Available at http://dx.doi.org/10.1016/j.cyto.2011.08.036
2. Rismo R, Olsen T, Cui G, Christiansen I, Florholmen J, Goll R.: 'Mucosal cytokine gene expression profiles as biomarkers of response to infliximab in ulcerative colitis', Scandinavian Journal of Gastroenterology (2012), vol. 47:538–547. Available at http://dx.doi.org/10.3109/00365521.2012.667146
3. Rismo R, Olsen T, Cui G, Paulssen EJ, Christiansen I, Florholmen J, Goll R.: 'The effect of adalimumab for induction of endoscopic healing and normalization of mucosal cytokine gene expression in Crohn’s disease', Scandinavian Journal of Gastroenterology (2012) (online before print). Available at http://dx.doi.org/10.3109/00365521.2012.711853
4. Rismo R, Olsen T, Cui G, Paulssen EJ, Christiansen I, Johnsen K, Florholmen J, Goll R.: 'Normalization of mucosal cytokine gene expression levels predict long-term remission after discontinuation of anti-TNF therapy in Crohn’s disease' (manuscript)URI: http://hdl.handle.net/10037/5075 File(s) in this item: 1
thesis.pdf (787.3Kb)
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