Search

Aims: The Tromsø Study is an ongoing population-based health study in Tromsø, Norway, initiated in 1974. The purpose of the seventh survey (Tromsø7) 2015–2016 was to advance the population risk factor surveillance and to collect new types of data. We present the study design, data collection, attendance, and prevalence of risk factors and disease. Methods: All inhabitants in Tromsø municipality, Norway, aged 40 years and older ( N=32,591) were invited to a health screening including extensive questionnaires, face-to-face interviews, biological sampling (blood, urine, saliva, nasal/throat swabs, faeces), measurements (anthropometry, blood pressure, pulse, pulse oximetry) and clinical examinations (pain sensitivity, echocardiography, cognitive, physical, and lung function, accelerometer measurements, eye examinations, carotid ultrasound, electrocardiography, dual-energy X-ray absorptiometry, and heart, lung and carotid auscultation). New research areas in this round were dental and oral health examinations, collection of faecal samples for studies of normal bacterial flora and antibiotic resistance, and 24-hour urine samples for examination of sodium and iodine intakes. Results: Attendance was 65% ( N=21,083), and was higher in women, age group 50–79 years, previous attenders, and Norwegian-born individuals. Cardiovascular risk factor levels and prevalence of chronic obstructive lung disease decreased since the last survey, while the prevalence of obesity and diabetes increased. Conclusions: Attendance was stable from the sixth survey. Interaction with participants might be key to maintain participation. Favourable trends in risk factors continue, except for a continued increase in obesity. Both new data collection technology and traditional physical examinations will be crucial for the impact of future population studies.

Four corner fusion (4CF) is a limited wrist arthrodesis offered to patients with painful wrists due to scaphoid non-union advanced collapse (SNAC) or scapho-lunate advanced collapse (SLAC). A retrospective study of 42 wrists (in 36 patients), operated with 4CF using K-wires and autologous bone graft followed up after 11 (4-19) years was performed, 25 were male and mean age at surgery was 51 (22-71) years. During the follow-up period, 13 wrists were converted to total wrist arthrodesis or wrist arthroplasty, and one is scheduled for conversion (14/42, 33%) due to non-union (3), DISI and progressing arthrosis (7) or progressing arthrosis (4). Non-union was seen in 3/42 (93%) wrists, all were later converted. At the final follow-up, the patients reported residual pain, VAS = 15 and 36 at rest and activity, respectively, and QDASH/PRWHE = 32 and 31, respectively. Active range of motion (AROM) was 38% and grip-strength was 76% compared to the uninjured side. Degenerative changes were seen in 88% on CT scans at follow-up. 4CF renders an acceptable pain reduction and function in the majority of patients, but increased degeneration and a high number of conversions after a longer follow-up time is concerning.

Objective We developed a peer-led group program for Veterans called Taking Charge of My Life and Health (TCMLH) that emphasizes patient education, goal setting, shared decision making, and whole person care. Our aim was to conduct an evaluation of a facilitator training course to deliver TCMLH in VA sites. Methods Repeated measures ANOVA models were used to examine change over three timepoints (pre-test, post-test, and two-month follow-up) in outcomes of attitudes, knowledge, skills, and self-efficacy related to patient empowerment, skills acquisition, self-care strategies, and curriculum facilitation. Qualitative data analysis of participant feedback was used to identify potential training adaptations and barriers to TCMLH delivery. Results Our sample comprised 70 trainees who completed all three assessments. Participants reported high levels of training satisfaction, quality, and utility, and sustained improvements in knowledge of Whole Health, self-efficacy for group facilitation, and self-efficacy for using Whole Health concepts and tools. Implementation barriers included challenges related to group management and site logistics. Conclusion The facilitator training course improved knowledge and self-efficacy associated with successful peer-led program delivery and identified opportunities to improve the training course and TCMLH dissemination. Practice Implications: Findings provide insights on the design and implementation of training models to support peer-led programs.

Background The European Working Group on Sarcopenia in Older People (EWGSOP2) recommends grip strength and chair stand tests to be used as primary defining measures. It is unclear how either test affects prevalence estimates. Methods This cross-sectional study involved 3498 community-dwelling participants (40–84 years) from the 7th Tromsø Study survey (2015–2016). We used grip strength, five-repetition chair stands, four-meter Walk Speed Test, Timed-Up-and-Go (TUG) and Dual-Energy X-ray Absorptiometry measurements. Data were analyzed using multiple linear regression models and ROC-curves. Results Probable and confirmed sarcopenia prevalence was 1.3 and 4.4% based on grip strength and chair stands, respectively. There was very low agreement between grip strength and chair stand cut-offs (κ = 0.07), with only 4.3% of participants defined as having probable sarcopenia overlapping in the two criteria. Participants with grip strength-based sarcopenia had lower mean height, weight, waist circumference, and appendicular lean mass relative to body height (ALMheight2) than non-sarcopenic participants (all p p Conclusions Using chair stands instead of grip strength more than doubled probable sarcopenia prevalence across all ages. The two measures defined individuals of contradictory anthropometrics, body composition, and dissimilar physical function to have probable sarcopenia. Researchers should further evaluate the consequences of using different strength measures in the EWGSOP2 definition to classify sarcopenia.

Funder: Universitetet i Tromsø; doi: http://dx.doi.org/10.13039/100007465, Background. Reference values for visceral adipose tissue (VAT) are needed and it has been advocated that body composition measures depend on both the technique and methods applied, as well as the population of interest. We aimed to develop reference values for VAT in absolute grams (VATg), percent (VAT%), and as a kilogram-per-meters-squared index (VATindex) for women and men, and investigate potential differences between these measures and their associations with cardiometabolic risk factors (including metabolic syndrome (MetS)). Methods. In the seventh survey of the population-based Tromsø Study, 3675 participants (aged 40–84, 59% women) attended whole-body DXA scans (Lunar Prodigy GE) from where VAT was derived. We used descriptive analysis, correlations, receiver operating characteristics (ROC), and logistic regression to propose reference values for VAT and investigated VAT’s association with cardiometabolic risk factors, MetS and single MetS components. Further, Youden’s index was used to suggest threshold values for VAT. Results. VATg and VATindex increased until age 70 and then decreased, while VAT% increased with age across all age groups. VAT (all measurement units) was moderate to highly correlated and significantly associated with all cardiometabolic risk factors, except for total cholesterol. Associations between MetS, single MetS components, and VATg and VATindex were similar, and VAT% did not contribute any further to this association. Conclusion. These VAT reference values and thresholds, developed in a sample of adults of Norwegian origin, could be applied to other studies with similar populations using the same DXA device and protocols. The associations between VAT and cardiometabolic risk factors were similar across different measurement units of VAT.

Scapholunate ligament (SLL) injury represents a hazard to the wrist and the treatment of these injuries has been the focus of much debate. We performed a long-term follow (10 years) of triscaphoid arthrodesis for symptomatic chronic SLL injuries in 10 (8 men) patients 37 (22-49) years of age. All arthrodesis healed. One patient was converted to total wrist arthrodesis during the follow-up period, and three had minor additional surgeries. At final follow-up, the patients had reduced active range of motion (AROM, 55%) and grip strength (85%) compared to the opposite side, but reported low Quick Disability of Arm, Shoulder and Hand (QDASH) (11), Patient-Rated Wrist and Hand Evaluation (PRWHE) (25) and visual analog scale (VAS) pain scores (0 and 10 at rest and activity). Radiographs found minimal degenerative changes in four patients, while CT scans demonstrated changes in seven patients, in three of these scaphoid was subluxed on the rim of the radius. The patients working prior to surgery were working at follow-up. A triscaphoid arthrodesis for SLL renders a functional wrist function in most patients for many years and has postponed more extensive surgery like total wrist arthrodesis or wrist arthroplasty. The patients are still young, and the degenerative changes seen especially on CT scans warrants attention.

Master i IKT i læring, Institutt for pedagogikk, religion og samfunnsfag Høsten 2020 ble Læreplanverket for Kunnskapsløftet, LK20, gjort gjeldende for alle norske skoler. I den forbindelse har programmering og algoritmisk tenkning blitt innført i flere fag, og flere lærere skal nå drive med dette i undervisningen. Målet med denne studien har vært og sett på et utvalg av læreres profesjonsfaglige digitale kompetanse i programmering og algoritmisk tenkning etter innføring av dette i LK20. Studien har hatt fokus læreres kompetanse rundt det tosidige siktet i PfDK, profesjonsutøvelse og profesjonsutvikling. Studien er gjennomført med semistrukturerte intervjuer av fem lærere som jobber på barnetrinnet og som alle har kommet i gang med programmering og algoritmisk tenkning som en del av LK20. Det teoretiske rammeverket jeg har valgt er sosiokulturelle synet på læring med fokus på perspektivene læringsfellesskapet og den proksimale utviklingssonen hvor hovedfokuset er på lærerrollen og hvordan lærere knytter dette opp i undervisningen. I tillegg har jeg valg å benytte meg av rammeverket for profesjonsfaglig digital kompetanse, PfDK, og TPACK som utgangspunkt for å kunne analysere og drøfte funnene om læreres digitale kompetanse i programmering og algoritmisk tenkning. Analysen i av funnene forteller oss at lærere opplever å få lite informasjon om mulige kurs og videreutdanninger selv om dette er noe de ønsker å delta på. Kompetansen de har opparbeidet i programmering og algoritmisk tenkning, er utviklet på eget initiativ på grunnlag av egeninteresse innenfor temaet. Informantene er fremdeles usikre på hvordan de skal koble programmering og algoritmisk tenkning inn i fagene og driver det derfor som et eget element og ikke som en del av fagene, slik det er tenkt i LK20. Konklusjonen i denne studien handler om at lærere er kommet i gang med programmering og algoritmisk tekning i undervisningen, og er kommet langt på vei til å utvikle en profesjonsfaglig digital kompetanse. Lærerne som bruker den algoritmiske tenkeren fra UDIR klarer i større grad å legge til rette for elever som tenker algoritmisk, enn hva lærere som ikke bruker denne modellen. Det finnes også flere kompetanseutviklingsmuligheter i programmering og algoritmisk tekning for lærere, men at dette ikke er lett tilgjengelig og det er vanskelig å finne. Det er også store forskjeller mellom de to kommunene informantene er ansatt i, og det er lite systematisk arbeid når det kommer til kompetanseutvikling av programmering og algoritmisk tenkning hos lærere. MASIKT-OPG

Supplemental material, sj-docx-2-sjp-10.1177_14034948221092294 for The seventh survey of the Tromsø Study (Tromsø7) 2015–2016: study design, data collection, attendance, and prevalence of risk factors and disease in a multipurpose population-based health survey by Laila A. Hopstock, Sameline Grimsgaard, Heidi Johansen, Kristin Kanstad, Tom Wilsgaard and Anne Elise Eggen in Scandinavian Journal of Public Health

Supplemental material, sj-docx-5-sjp-10.1177_14034948221092294 for The seventh survey of the Tromsø Study (Tromsø7) 2015–2016: study design, data collection, attendance, and prevalence of risk factors and disease in a multipurpose population-based health survey by Laila A. Hopstock, Sameline Grimsgaard, Heidi Johansen, Kristin Kanstad, Tom Wilsgaard and Anne Elise Eggen in Scandinavian Journal of Public Health

Supplemental material, sj-docx-1-sjp-10.1177_14034948221092294 for The seventh survey of the Tromsø Study (Tromsø7) 2015–2016: study design, data collection, attendance, and prevalence of risk factors and disease in a multipurpose population-based health survey by Laila A. Hopstock, Sameline Grimsgaard, Heidi Johansen, Kristin Kanstad, Tom Wilsgaard and Anne Elise Eggen in Scandinavian Journal of Public Health

Supplemental material, sj-docx-4-sjp-10.1177_14034948221092294 for The seventh survey of the Tromsø Study (Tromsø7) 2015–2016: study design, data collection, attendance, and prevalence of risk factors and disease in a multipurpose population-based health survey by Laila A. Hopstock, Sameline Grimsgaard, Heidi Johansen, Kristin Kanstad, Tom Wilsgaard and Anne Elise Eggen in Scandinavian Journal of Public Health

Supplemental material, sj-docx-3-sjp-10.1177_14034948221092294 for The seventh survey of the Tromsø Study (Tromsø7) 2015–2016: study design, data collection, attendance, and prevalence of risk factors and disease in a multipurpose population-based health survey by Laila A. Hopstock, Sameline Grimsgaard, Heidi Johansen, Kristin Kanstad, Tom Wilsgaard and Anne Elise Eggen in Scandinavian Journal of Public Health

The chapter gives priority to children’s voices as ‘counter-conduct’. This is done by analyzing a narrative that describes an event, which takes place in a conversation group for children who have mentally ill and/or addicted parents. A central topic in the interpretation is how children who refuse to take part in activities organized by the professional group leaders, are to be understood. The claim is that the refusal should not be interpreted as a sign of immatureness or developmental disorder, but rather that the children convey a richer variety of life experiences than professionals normally are aware of. The article concludes that the ‘counter – conduct’ found in children’s voices, can reveal knowledge about children’s being in the world, that is usually hidden from adults.

Masteroppgave i psykologi MAPSYK360 INTL-MED MAPS-PSYK INTL-SV INTL-PSYK INTL-KMD INTL-HF INTL-MN INTL-JUS

It remains unclear which blood pressure (BP) characteristics best predict cardiovascular risk in different age groups and between sexes. We leveraged data from the MORGAM (MONICA [Monitoring of Trends and Determinants in Cardiovascular Disease], Risk, Genetics, Archiving and Monograph) Project to investigate determinants of BP characteristics and their prognostic importance, in younger and older (P interaction P P P P =0.03), enhanced continuous net reclassification improvement (0.150 [95% CI, 0.087–0.215]) and improved the prognostic value of the European Society of Cardiology/European Society of Hypertension hypertension definition (categorical net reclassification improvement=0.0255, P =0.005). In conclusion, diastolic BP may provide additional prognostic utility beyond systolic BP, in predicting composite cardiovascular events among younger individuals.

Background Physical inactivity and obesity are global public health challenges. Older adults are important to target for prevention and management of disease and chronic conditions. However, many individuals struggle with maintaining increased physical activity (PA) and improved diet. This feasibility study provides the foundation for the RESTART trial, a randomized controlled trial (RCT) to test a complex intervention to facilitate favourable lifestyle changes older adults can sustain. The primary objective of this study was to investigate study feasibility (recruitment, adherence, side-effects, and logistics) using an interdisciplinary approach. Methods This 1-year prospective mixed-method single-arm feasibility study was conducted in Tromsø, Norway, from September 2017. We invited by mail randomly selected participants from the seventh survey of the Tromsø Study (2015–2016) aged 55–75 years with sedentary lifestyle, obesity, and elevated cardiovascular risk. Participants attended a 6-month complex lifestyle intervention program, comprising instructor-led high-intensive exercise and nutritionist- and psychologist-led counselling, followed by a 6-month follow-up. All participants used a Polar activity tracker for daily activity monitoring during the intervention. Participants were interviewed three times throughout the study. Primary outcome was study feasibility measures. Results We invited potential participants (n=75) by mail of which 27 % (n=20) agreed to participate. Telephone screening excluded four participants, and altogether 16 participants completed baseline screening. The intervention and test procedures of primary and secondary outcomes were feasible and acceptable for the participants. There were no exercise-induced injuries, indicating that the intervention program is safe. Participants experienced that the dietary and psychological counselling were delivered too early in the intervention and in too close proximity to the start of the exercise program. Minor logistic improvements were implemented throughout the intervention period. Conclusion This study indicates that it is feasible to conduct a full-scale RCT of a multi-component randomized intervention trial, based on the model of the present study. No dropouts due to exercise-induced injury indicates that the exercises were safe. While minor improvements in logistics were implemented during the intervention, we will improve recruitment and adherence strategies, rearrange schedule of intervention contents (exercise, diet, and psychology), as well as improve the content of the dietary and behavioural counselling to maximize outcome effects in the RESTART protocol. Trial registration ClinicalTrials.gov Identifier: NCT03807323 Registered 16 January 2019 – retrospectively registered.

Pragmatic clinical trials are based on data from unselected patients recruited from common clinical practice. These trials therefore bridge the gap between evidence-based medicine and clinical practice.

Objective - Overweight, defined as excessive fat mass, is a long-standing worldwide public health challenge. Traditional anthropometric measures used to identify overweight and obesity do not assess body composition. The aim of this study was to examine population trends in general and abdominal fat mass during the past two decades. Methods - This study included participants from one or more consecutive surveys of the population-based Tromsø Study, including Tromsø 5 (conducted in 2001, n = 1,662, age 40-84 years), Tromsø 6 (2007-2008, n = 901, age 40-88 years), and Tromsø 7 (2015-2016, n = 3,670, age 40-87 years), with total body dual-energy x-ray absorptiometry scans. Trends in total fat and visceral adipose tissue (VAT) were analyzed by generalized estimation equation models in strata of sex and age groups. Results - Total fat and VAT mass increased during 2001 to 2016, with a larger increase during 2007 to 2016 than from 2001 to 2007 and among the youngest age group (40-49 years), particularly in women. Women had higher total fat mass than men, whereas men had higher VAT mass than women. Conclusions - General and abdominal dual-energy x-ray absorptiometry-derived fat mass increased during the past two decades in this general population. Of particular concern is the more pronounced increase in the past decade and in the younger age groups.

Aims Plate and screw fixation has been the standard treatment for painful conditions of the wrist in non-rheumatoid patients in recent decades. We investigated the complications, re-operations, and final outcome in a consecutive series of patients who underwent wrist arthrodesis for non-inflammatory arthritis. Patients and Methods A total of 76 patients, including 53 men and 23 women, with a mean age of 50 years (21 to 79) underwent wrist arthrodesis. Complications and re-operations were recorded. At a mean follow-up of 11 years (2 to 18), 63 patients completed questionnaires, and 57 attended for clinical and radiological assessment. Results Of the 76 patients, 46 (60.5%) had complications, resulting in 65 re-operations, mainly related to the plate and screws. In the 63 patients who completed the questionnaires, the mean Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) score was 36 (0 to 91), the mean Patient-Rated Wrist and Hand Evaluation (PRWHE) score was 40 (0 to 96), and 14 patients (22%) reported no wrist pain. Grip strength, pinch strength, and pronation and supination were significantly reduced compared with the contralateral forearm. The outcome was worse in patients who had previously undergone surgery to the wrist, and those with complications. A total of 13 are awaiting further re-operations, giving a total re-operation rate of 63% (40/63). Conclusion We observed complications and re-operations throughout the follow-up period and therefore consider wrist arthrodesis to be more complicated than previously assumed. Many of the patients never got used to or accepted their stiff wrists and reported a substantial reduction in function and residual pain. Motion-sparing surgery should be offered prior to wrist arthrodesis. Cite this article: Bone Joint J 2019;101-B:852–859.

Background Consumer-based activity trackers are increasingly used in research, as they have the potential to promote increased physical activity and can be used for estimating physical activity among participants. However, the accuracy of newer consumer-based devices is mostly unknown, and validation studies are needed. Objective The objective of this study was to compare the Polar Vantage watch (Polar Electro Oy) and Oura ring (generation 2; Ōura Health Oy) activity trackers to research-based instruments for measuring physical activity, total energy expenditure, resting heart rate, and sleep duration in free-living adults. Methods A total of 21 participants wore 2 consumer-based activity trackers (Polar watch and Oura ring), an ActiGraph accelerometer (ActiGraph LLC), and an Actiheart accelerometer and heart rate monitor (CamNtech Ltd) and completed a sleep diary for up to 7 days. We assessed Polar watch and Oura ring validity and comparability for measuring physical activity, total energy expenditure, resting heart rate (Oura), and sleep duration. We analyzed repeated measures correlations, Bland-Altman plots, and mean absolute percentage errors. Results The Polar watch and Oura ring values strongly correlated (P Conclusions The Oura ring can potentially be used as an alternative to the Actiheart to measure resting heart rate. As for sleep duration, the Polar watch and Oura ring can potentially be used as replacements for a manual sleep diary, depending on the acceptable error. Neither the Polar watch nor the Oura ring can replace the ActiGraph when it comes to measuring steps, moderate-to-vigorous physical activity, and total energy expenditure, but they may be used as additional sources of physical activity measures in some settings. On average, the Polar Vantage watch reported higher outputs compared to those reported by the Oura ring for steps, moderate-to-vigorous physical activity, and total energy expenditure.

Aims To investigate European guideline treatment target achievement in cardiovascular risk factors, medication use, and lifestyle, after myocardial infarction (MI) or ischaemic stroke, in women and men living in Norway. Methods and results In the population-based Tromsø Study 2015–16 (attendance 65%), 904 participants had previous validated MI and/or stroke. Cross-sectionally, we investigated target achievement for blood pressure (sedentary, accelerometer-measured moderate-to-vigorous ≥150 min/week), diet (intake of fruits ≥200 g/day, vegetables ≥200 g/day, fish ≥200 g/week, saturated fat Conclusion Secondary prevention of cardiovascular disease was suboptimal. A negligible proportion achieved the treatment target for all risk factors. Improvement in follow-up care and treatment after MI and stroke is needed.

Glycemic traits are used to diagnose and monitor type 2 diabetes and cardiometabolic health. To date, most genetic studies of glycemic traits have focused on individuals of European ancestry. Here we aggregated genome-wide association studies comprising up to 281,416 individuals without diabetes (30% non-European ancestry) for whom fasting glucose, 2-h glucose after an oral glucose challenge, glycated hemoglobin and fasting insulin data were available. Trans-ancestry and single-ancestry meta-analyses identified 242 loci (99 novel; P-8), 80% of which had no significant evidence of between-ancestry heterogeneity. Analyses restricted to individuals of European ancestry with equivalent sample size would have led to 24 fewer new loci. Compared with single-ancestry analyses, equivalent-sized trans-ancestry fine-mapping reduced the number of estimated variants in 99% credible sets by a median of 37.5%. Genomic-feature, gene-expression and gene-set analyses revealed distinct biological signatures for each trait, highlighting different underlying biological pathways. Our results increase our understanding of diabetes pathophysiology by using trans-ancestry studies for improved power and resolution.A trans-ancestry meta-analysis of GWAS of glycemic traits in up to 281,416 individuals identifies 99 novel loci, of which one quarter was found due to the multi-ancestry approach, which also improves fine-mapping of credible variant sets.

BACKGROUND Consumer-based physical activity trackers have increased in popularity. The widespread use of these devices and the long-term nature of the recorded data provides a valuable source of physical activity data for epidemiological research. The challenges include the large heterogeneity between activity tracker models in terms of available data types, the accuracy of recorded data, and how this data can be shared between different providers and third-party systems. OBJECTIVE The aim of this study is to develop a system to record data on physical activity from different providers of consumer-based activity trackers and to examine its usability as a tool for physical activity monitoring in epidemiological research. The longitudinal nature of the data and the concurrent pandemic outbreak allowed us to show how the system can be used for surveillance of physical activity levels before, during, and after a COVID-19 lockdown. METHODS We developed a system (mSpider) for automatic recording of data on physical activity from participants wearing activity trackers from Apple, Fitbit, Garmin, Oura, Polar, Samsung, and Withings, as well as trackers storing data in Google Fit and Apple Health. To test the system throughout development, we recruited 35 volunteers to wear a provided activity tracker from early 2019 and onward. In addition, we recruited 113 participants with privately owned activity trackers worn before, during, and after the COVID-19 lockdown in Norway. We examined monthly changes in the number of steps, minutes of moderate-to-vigorous physical activity, and activity energy expenditure between 2019 and 2020 using bar plots and two-sided paired sample t tests and Wilcoxon signed-rank tests. RESULTS Compared to March 2019, there was a significant reduction in mean step count and mean activity energy expenditure during the March 2020 lockdown period. The reduction in steps and activity energy expenditure was temporary, and the following monthly comparisons showed no significant change between 2019 and 2020. A small significant increase in moderate-to-vigorous physical activity was observed for several monthly comparisons after the lockdown period and when comparing March-December 2019 with March-December 2020. CONCLUSIONS mSpider is a working prototype currently able to record physical activity data from providers of consumer-based activity trackers. The system was successfully used to examine changes in physical activity levels during the COVID-19 period.

BACKGROUND Consumer-based activity trackers are increasingly used in research, as they have the potential to promote increased physical activity and can be used for estimating physical activity among participants. However, the accuracy of newer consumer-based devices is mostly unknown, and validation studies are needed. OBJECTIVE The objective of this study was to compare the Polar Vantage watch (Polar Electro Oy) and Oura ring (generation 2; Ōura Health Oy) activity trackers to research-based instruments for measuring physical activity, total energy expenditure, resting heart rate, and sleep duration in free-living adults. METHODS A total of 21 participants wore 2 consumer-based activity trackers (Polar watch and Oura ring), an ActiGraph accelerometer (ActiGraph LLC), and an Actiheart accelerometer and heart rate monitor (CamNtech Ltd) and completed a sleep diary for up to 7 days. We assessed Polar watch and Oura ring validity and comparability for measuring physical activity, total energy expenditure, resting heart rate (Oura), and sleep duration. We analyzed repeated measures correlations, Bland-Altman plots, and mean absolute percentage errors. RESULTS The Polar watch and Oura ring values strongly correlated (Pr=0.75, 95% CI 0.54-0.92; Oura: r=0.77, 95% CI 0.62-0.87), moderate-to-vigorous physical activity (Polar: r=0.76, 95% CI 0.62-0.88; Oura: r=0.70, 95% CI 0.49-0.82), and total energy expenditure (Polar: r=0.69, 95% CI 0.48-0.88; Oura: r=0.70, 95% CI 0.51-0.83) and strongly or very strongly correlated (Pr=0.74, 95% CI 0.56-0.88; Oura: r=0.82, 95% CI 0.68-0.91). Oura ring–derived resting heart rates had a very strong correlation (Pr=0.9, 95% CI 0.85-0.96). However, the mean absolute percentage error was high for all variables except Oura ring–derived sleep duration (10%) and resting heart rate (3%), which the Oura ring underreported on average by 1 beat per minute. CONCLUSIONS The Oura ring can potentially be used as an alternative to the Actiheart to measure resting heart rate. As for sleep duration, the Polar watch and Oura ring can potentially be used as replacements for a manual sleep diary, depending on the acceptable error. Neither the Polar watch nor the Oura ring can replace the ActiGraph when it comes to measuring steps, moderate-to-vigorous physical activity, and total energy expenditure, but they may be used as additional sources of physical activity measures in some settings. On average, the Polar Vantage watch reported higher outputs compared to those reported by the Oura ring for steps, moderate-to-vigorous physical activity, and total energy expenditure.

Konseptet pragmatiske studier ble foreslått av Schwartz og Lellouch i 1967 og problematiserte to viktige aspekter ved utprøving av ny behandling, nemlig forståelse og beslutning (1). Tradisjonelle forklarende effektstudier (explanatory trials) har som mål å øke vår forståelse ved å vise om en behandling virker per se, ofte under optimale forhold med nøye utvalgte studiedeltakere og utfallsmål. Pragmatiske studier skal derimot vise om en behandling virker i den kliniske hverdagen, helst på alle typer av aktuelle pasienter. Større bredde i pasientutvalget kan potensielt gjøre det vanskeligere å påvise klinisk relevante forskjeller, og studiene må av denne grunn ofte inkludere et stort antall pasienter. Den ideelle pragmatiske studien inkluderer en uselektert pasientgruppe som er aktuell for en type klinisk behandling, med endepunkter og oppfølging som i størst mulig grad foregår i den kliniske rutinen. Resultatene gir oss virkelighetsdata som kan understøtte beslutningen om å innføre en ny behandlingsform på generelt grunnlag. Pragmatiske studier er av interesse for beslutningstakere, fordi denne studieformen også tar sikte på å besvare spørsmål om kostnadseffekt av ny behandling som skal benyttes i alle deler av helsetjenesten.

Masteroppgave i klinisk fysioterapi, Høgskulen på Vestlandet, campus Bergen Prosjektets formål er økt innsikt i hvordan psykomotoriske fysioterapeuter kan hjelpe mennesker som har opplevd belastende livshendelser. Det tar utgangspunkt i fortelling som en måte å forstå fortiden, finne mening i pågående situasjoner, og som formende for fremtidig handling. Prosjektet utforsker hvordan et felles narrativ kan utvikles gjennom en psykomotorisk behandlingsprosess, og ser nærmere på hvordan kroppslige og muntlige fortellinger kan bidra til ny forståelse av fortid, nåtid og fremtid. Prosjektet er forankret i teoretiske perspektiver på sammenhenger mellom livshistorie og kropp, innsikter fra psykomotorisk fysioterapi, fenomenologi og dialektisk relasjonsteori, samt narrative perspektiver på tid, intersubjektivitet og identitet. En kvalitativ forskningstilnærming er benyttet, og studien føyer seg inn i en fenomenologisk-hermeneutisk forskningstradisjon. Prosjektet er sentrert omkring en enkeltstående behandlingsprosess, og kan beskrives som en langsgående casestudie med en narrativ tilnærming. Datamateriale er innhentet gjennom observasjon og dyadisk dybdeintervju av fysioterapeut og pasient i samspill med hverandre. Materiale utviklet fra dybdeintervjuet har vært utgangspunkt for en narrativ analyse, inspirert av Ricoeurs trefoldige mimesis. En tidslinje er utformet gjennom å sette sammen de to informantenes retrospektive erfaringsbeskrivelser i en utviklingssammenheng. En helhetlig og meningsbærende fortelling om informantenes behandlingsprosess er analysert frem på grunnlag av tidslinjen. Fortellingen innledes fra informantenes første møte, og følger utviklingen i behandlingsprosessen deres over et år. Fortellingen belyser hvordan samhandlingen i psykomotorisk fysioterapibehandling gir mulighet for intersubjektiv meningsdannelse, og ny selvforståelse. Kroppslig handling og samhandling, anerkjennelse og meningsskapende dialog driver frem utvikling i behandlingsprosessen, og varsomhet fremtrer som et avgjørende element. En bevegelse fra tilbakeholdelse til selvutfoldelse, fra omsorg til egenomsorg, og mot økt selvstendighet preger hendelsesforløpet som beskrives. Fortiden og fremtiden flettes inn i handlingsforløpet på ulike måter, og behandlingsforløpet kan beskrives som en bevegelse gjennom tiden. Nye muligheter for livsutfoldelse skapes gjennom kroppslig og verbal samhandling mellom fysioterapeut og pasient. Min tolkning er at fortellingen fremhever potensialet i det mellommenneskelige aspektet ved samhandling i psykomotorisk fysioterapi. MAFYS603

Aim: To assess whether stroke diagnoses in national health registers are sufficiently correct and complete to replace manual collection of endpoint data for the Tromsø Study, a population-based epidemiological study. Method: Using the Tromsø Study Cardiovascular Disease Register for 2013–2014 as the gold standard, we calculated correctness (defined as positive predictive value, PPV) and completeness (defined as sensitivity) of stroke cases in four different data subsets derived from the Norwegian Patient Register and the Norwegian Stroke Register. We calculated the sensitivity and PPV with 95% confidence intervals (CIs) assuming a normal approximation of the binomial distribution. Results: In the Norwegian Stroke Register we found a sensitivity of 79.8% (95% CI 74.2–85.4) and a PPV of 97.5% (95% CI 95.1–99.9). In the Norwegian Patient Register the sensitivity was 86.4% (95% CI 81.6–91.1) and the PPV was 84.2% (95% CI 79.2–89.2). The overall highest levels were found in a subset based on a linkage between the Norwegian Stroke Register and the Norwegian Patient Register, with a sensitivity of 88.9% (95% CI 84.5–93.3), and a PPV of 89.3% (95% CI 85.0–93.6). Conclusions: Data from the Norwegian Patient Register and from the linked data set between the Norwegian Patient Register and the Norwegian Stroke Register had acceptable levels of correctness and completeness to be considered as endpoint sources for the Tromsø Study Cardiovascular Disease Register. The benefits of using data from national registers as endpoints in epidemiological studies must be weighed against the impact of potentially decreased data quality.

Denne oppgaven undersøker på hvilken måte Alan Turing strever med å forstå pragmatiske fenomener i spørsmål-svar-sekvenser hentet fra filmen «The Imitation Game». Oppgaven baserer seg på en kvalitativ undersøkelse, og bruker ulike teoretikere som Carston (2002), Wilson og Sperber (2002) og Kjøll (2014) i sin sammenligning og analyse av den innsamlede dataen. Her tas det en nærmere titt på relevansteorien, en teori om kommunikasjon, samt de pragmatiske fenomenene implikaturer og ironi. Oppgaven kommer fram til at det er spesielt to teorier og fenomener som det ser ut til at Alan Turing strever med å forstå innenfor kommunikasjon. For det første ser det ut til at han ikke har like god tilgang til det kommunikative relevansprinsippet, og for det andre ser det ut til at han har mangelfull tilgang på de kontekstuelle antagelsene som behøves for å utlede de nødvendige impliserte premissene som skal til for å forstå avsenders intenderte mening. This thesis examines the way in which Alan Turing strives to understand pragmatic phenomena in question-and-answer sequences taken from the film "The Imitation Game". The thesis is based on a qualitative research and uses various theorists such as Carston (2002), Wilson and Sperber (2002) and Kjøll (2014) in its comparison and analysis of the collected data. Here I take a closer look at the theory of relevance, which is a theory of communication, as well as the pragmatic phenomena of implicatures and irony. The thesis concludes that there are two theories and phenomena that it seems that Alan Turing strives to understand in communication. Firstly, it seems that he does not have as good access to the communicative relevance principle, and secondly, it seems that he has insufficient access to the contextual assumptions needed to derive the necessary implied premises needed to understand the sender's intended meaning.