Variasjon i investerings- og LCC-kostnader for skolebygg

De siste årene har det vært befolkningsvekst i Norge. Dette har ført til elevvekst i flere kommuner, noe som igjen medfører økt fokus på utbygging av skolebygg. Oslo kommune alene skal frem mot 2022 bruke 25 milliarder kroner på utbygging av skolebygg. Oslo vil få mellom 18 000 og 20 000 nye elever frem til år 2022. Dette er store investeringskostnader for Oslo kommune, og tilhørende fremtidige budsjettbindinger for forvaltnings-, drifts- og vedlikeholdskostnader (FDV-kostnader) for disse bygningene. Derfor er det viktig for Oslo kommune å se på den totale kostnaden de får i løpet av levetiden til bygningene (Aftenposten, 2012-03-14). Faget «prosjektledelse og -styring» har fanget vår interesse for å se nærmere på kommunens prosjektgjennomføring. Vi ønsker spesielt å se på variasjonene i investerings - og levetidskostnader. I tillegg er valg av entrepriseformer og måleparametere kommunene bruker, forhold vi ønsker å se på

A Rare Case of Foreign Body Ingestion, Mimicking as Mesenteric Cyst. "Case Report"

Background: Foreign body ingestion by children is a commonly encountered problem and accounts for a significant emergency visits among pediatric population. Although these ingested foreign bodies pass spontaneously and uneventfully, a subset of such bodies may become trapped in the digestive tract, eventually leading to significant injury. Most of these bodies are radio-opaque and detectable radiologically, but some radio-lucent may become a diagnostic dilemma and subtle management issue. Case Report: We report a case of a one-year girl who presented after accidental ingestion of foreign body with signs and symptoms of acute intestinal obstruction. Initially we were unable to diagnose the cause, but later the radiological investigation suspected a mesenteric cyst. After failure to respond to conservative measures she underwent exploratory laparotomy, and a jelly ball was removed from the gut. The patient had uneventful post-operative recovery and was kept on follow-up for three months without any complication. Conclusion: These patients do not respond to conservative measures and need surgery on an emergency basis. It is likely that if left untreated may have caused Intestinal perforation and irreversible shock. Radiolucent foreign bodies are difficult to diagnose and need high level of suspicion. Need of the hour is to educate the parents to be extra vigilant as “prevention is better than cure”

Cost of primary health care in Pakistan

Background: Detailed cost analysis is an important tool for review of health policy and reforms. We provide an estimate of cost of service and its detailed breakup on out-door patient visits (OPV) to basic health units (BHU) in Pakistan. Method: Six BHUs were randomly selected from each of the five districts in Khyber Pukhtonkhawa (KPK) and two agencies in Federally Administered Tribal Areas (FATA) of Pakistan for this study. Actual expenditure data and utilization data in the year 2005 –06 of 42 BHUs was collected from selected district health offices in KPK and FATA. Costs were estimated for outpatient visits to BHUs. Perspective on cost estimates was district-based health planning and management of BHUs. Results:Average recurring cost was PKR. 245 (USD4.1) per OPV to BHU. Staff salaries constituted 90% of recurrent cost. On the average there were 16 OPV per day to the BHUs. Conclusion: Recurrent cost per OPV has doubled from the previous estimates of cost of OPV in Baluchistan. The estimated recurrent cost was six times higher than average consultation charges with the private general practitioner (GP) in the country (i.e.,PKR 50/ GP consultation). Performance of majority of the BHUs was much lower than the performance target (50 patients per day) set in the sixth five - year plan of the government of Pakistan. The Government of Pakistan may use these analyses to revisit the performance target, staffing and location of BHUs

Epilepsy in pakistan: national guidelines for clinicians

Epilepsy is one of the most common chronic neurological disorders requiring prolonged treatments and drugs. According to The World Health Organization (WHO), epilepsy is one of those serious brain disorders that affect not only the individual but has a deep impact on the family and society in general. Approximately 50 million people are affected with epilepsy around the world36, though proper epidemiological studies do not exist for Pakistan it is estimated that the prevalence of epilepsy is 9.99/1000. Highest prevalence is seen in people younger than 30 years of age, i.e. about 2 million people and 1/10th of the world burden of epilepsy is in Pakistan! The guidelines available in developed countries are gauged in a setting where epilepsy care is provided by epileptologists/neurologists. In Pakistan the scenario is different, there is only one neurologist for 1.4 million (14lac) population contrast to US where one neurologist for 26 thousand people 29. So there is a desperate need to adapt to alternate guidelines with strategies to provide epilepsy management at a primary care level and to standardize epilepsy care on a National level

Epilepsy in Pakistan: national guidelines for clinicians (part 2)

In 2013 an international taskforce of the ILAE shaped out a communal definition of Epilepsy.(2) This definition is useful for all or most practical purposes, thus more helpful in management. Epilepsy was defined as recurrent unprovoked seizures i.e 2 or more at least 24 hours apart. The revised practical definition implies that Epilepsy can be considered even after a single seizure in individuals who have other factors predictive of a second unprovoked seizure, a risk set at 60%. The factors include the diagnosis of an epilepsy syndrome, structural lesions like stroke, CNS infections, intraparenchymal contusions after trauma, as well as reflex seizures such as photosensitive seizures

Factors affecting the organisational adoption of blockchain technology in australia : a mixed-methods approach

Blockchain (BCT) is an emerging technology that promises many benefits for organisations, such as disintermediation, data security, data transparency, a single version of the truth, and trust among trading partners. Despite its multiple benefits, the adoption rate of BCT among organisations has not reached a significantly high level worldwide. The present thesis addresses this issue in the Australian context. There is a knowledge gap in what specific factors, among the plethora of factors reported in the extant scholarly and commercial literature, affect Australian organisations while deciding to adopt BCT. To fill this gap, this thesis uses a mixed-methods approach known as sequential exploratory mixed methods. In this approach, the research starts with a qualitative phase as an initial phase followed by a quantitative phase. During the qualitative phase, data were collected through semi-structured interviews of the BCT experts and decision-makers working with the ifferent Australian organisations that adopted or were in the process of adopting BCT. The Technology, Organisation, Environment (TOE) framework, based on the qualitative interpretative approach, was used as a theoretical lens during the qualitative phase. The qualitative data were analyzed using the thematic analysis technique with the SQR NVivo software. The analysis shows that the different factors, belonging to the technological, organisational, and environmental contexts, affect the organisational decision to adopt BCT in Australia. The technological factors include perceived benefits, perceived computability, perceived complexity, perceived disintermediation, and perceived information transparency; organisational factors are organisational innovativeness, organisational learning capability, top management support; environmental factors consist of government support, standards uncertainty, competition intensity, and trading partners readiness. The qualitative analysis also shows the direct and moderating effect of the perceived risks between the relationship of the identified factors and organisational adoption of BCT. Based on the findings of the qualitative phase, the thesis develops a theoretical conceptual model, which shows the relationship between the factors and the organisational adoption of BCT. To increase the external validity of the developed conceptual model, the thesis started a quantitative phase with the administration of an online survey for data collection. Certain criteria were set to screen out the irrelevant participants in the survey. During this phase, hypotheses were proposed for the relationship of the factors identified in the qualitative phase and the organisational adoption of BCT. The survey data was analyzed using the PLS Structural Equation Modelling (SEM) technique with the SmartPLS 3 software. The quantitative analysis confirms the findings of the qualitative phase that the perceived benefits, perceived compatibility, perceived information transparency, perceived disintermediation, organisational innovativeness, organisational learning capability, top management support, competitive intensity, government support, and trading partner readiness have a positive effect on the organisational adoption of BCT. Whereas the perceived complexity, standards uncertainty, and perceived risks have a negative effect. The analysis also shows that the moderating effects of perceived risks are significant in the relationship of perceived compatibility, perceived information transparency, perceived disintermediation, organisational innovativeness, organisation innovativeness, competition intensity, and organisational adoption of BCT. Contrary to the qualitative findings, ‘perceived risks’ has no moderating effects on the relationship of perceived benefits, organisational learning capability, top management support, government support, trading partner readiness, and the adoption of BCT. The thesis has both theoretical and practical contributions, which are useful both for theory development and decision-making for the adoption of BCT in Australia. Theoretically, this thesis contributes to the existing IT adoption literature in several ways. Firstly, the thesis provides empirical evidence about the factors affecting organisational adoption of BCT in Australia. This is the first in-depth sequential exploratory mixed methods research that bridges this knowledge gap in the extant literature. The identification of such factors is important, particularly for the Australian government and organisations interested in the value creation of BCT. Second, the thesis reports the effect of new factors, namely, perceived information transparency, perceived disintermediation, organisational innovativeness, organisational learning capability, standards uncertainty, trading partner readiness, and competition intensity on BCT adoption that are exclusively identified in this research. Third, this thesis confirms the findings of the past studies that the factors of perceived benefits and perceived compatibility, perceived complexity, and top management support have an effect on the organisational adoption of BCT. Fourth, according to the best of the authors' knowledge, this is the first research that has used the qualitative interpretive research approach to investigate the organisational adoption of BCT. Therefore, the thesis confirms the suitability of the qualitative interpretive research approach for BCT adoption. Lastly, most of the researchers have used the TOE framework in either in qualitative or quantitative research. This thesis proves its validity in mixed methods research as well. The thesis's practical contributions are discussed in chapter 7.Doctor of Philosoph

The health seeking behaviour of elderly population in a poor-urban community of Karachi, Pakistan

OBJECTIVES: To presents socio-demographic characteristics and health seeking behaviour of elderly and to determine frequency of Diabetes Mellitus and Hypertension in elderly population of a poor peri-urban community in Karachi, Pakistan. METHODS: A cross-sectional study was conducted, targeting population aged 65 or above. A total of 438 respondents were interviewed after taking informed consent, between November 2005 and December 2005. Frequencies and Chi square values were calculated for different variables using SPSS 13.0. RESULTS: Total population surveyed comprised of 438 elderly, 158 (36%) women and 280 (63.9%) men. Mean age for the population was 71.44 +/- 7.74. A total of 238 (54.3%) elderly were found to be economically active. More than half (n = 269, 61.4%) of the elderly were found to be illiterate. Only 72 (16.4%) of the elderly population were Diabetic and 132 (30.1%) were Hypertensive. Common symptoms that prompted elderly of Azam Basti to seek health care were fever (61.2%), generalized body aches (43.4%) and cough (40.4%). Over half of the (n = 269, 61.4%) responders reported factors which deterred them from seeking health care, out of which 62% reported financial constraint as the commonest factor. Deterrence from seeking health care was associated with illiteracy (p = 0.001) and living alone (p = 0.06). CONCLUSION: The elderly population of this peri-urban community has financial constraints in seeking health care. Hypertension was found to be more prevalent among women as compared to men, ratio being 1:2. Less number of people knew they were diabetics; this might be attributed to ignorance and non-availability of investigations and screening

The Impact of Psychological Empowerment of Project-Oriented Employees on Project Success: A Moderated Mediation Model

In the current era of accelerated economic growth, project success – successful completion of the final product for which the project was initiated – is the ultimate goal of every organisation. It is essential for organisations to keep project-based employees motivated and focused on successfully accomplishing the project objectives. This research examined the association between psychological empowerment of project-based employees and project success. We explored the mediating role of knowledge sharing to explain the intervening mechanism between psychological empowerment and project success. We also tested the moderating role of employee creativity along with conditional indirect effects by performing a moderated mediation analysis. Using a time-lagged research design, multiple-source field data (N¼327) were collected from employees of project-based organisations in Pakistan. The findings of the study showed a positive association between psychological empowerment and project success and significant mediation of knowledge sharing. Project employees with high creativity are likely to achieve project success when they possess higher psychological empowerment too. Results concluded that psychological empowerment is positively associated with project success directly as well as indirectly through its impact on knowledge sharing. The study has its importance and implications for management specialists and project employees at all levels

Poetry and Nationalism: Comparative analysis of Emerson and Mehjoor

Poets are the nation builders. Poets have always fueled the nationalistic movements all over the world from ancient times. Whatever be the nativity of the poets, they use the same motifs, themes and the historical representations in order to proclaim the nationalistic fervor. I have chosen two representative poets of the east and the west and under different political conditions to argue their similarities on the subject of nationalism. Ralph Waldo Emerson from America and Gulam Ahmad Mehjoor from Kashmir are the subject of my analysis. Both these poets are great in their own field. But they have the same nationalistic zeal. Both these poets advice and entreat both leaders and the common men to stand and defend their nation with courage, proper dedication and spirit. The focus of my study is to compare the two great poets on the theme of nationalism. There are many things common between the two poets such as veneration for nature, mysticism, belief in communal harmony and fraternity, and above all zeal of nationalism. Although they lived in different times and situations they deal with the subject of national consciousness in the same manner and brevity

Factors affecting the organizational adoption of blockchain technology : an Australian perspective

Blockchain Technology (BCT) is a novel innovation that has the potential to transform industries, for instance, supply chain, energy, finance, and healthcare. However, despite the potential and the wide range of benefits reported, organizational adoption of BCT is low in several countries including Australia. Some studies investigated the adoption of BCT in different countries, however, there is a lack of research that examines the organizational adoption of BCT in Australia. This study fills this gap by exploring the factors, which influence BCT adoption among Australian organizations. To achieve this, we used an interpretative qualitative research approach based on the Technology, Organization, and Environment (TOE) framework and the Institutional Theory. The findings show that organizational adoption of BCT in Australia is influenced by perceived novelty, complexity, cost, and disintermediation feature of BCT; top management knowledge and support; government support, customer pressure, trading partner readiness, and consensus among trading partners. © 2021 IEEE Computer Society. All rights reserved