Real options in a Ramsey style growth model

This paper studies the aggregate implications of microeconomic investment irreversibility and idiosyncratic uncertainty in a simple growth model by highlighting real option effects. We endogenize the drift rate of real option by connecting it to the state of the economy. Thereby, we extend the analysis of the optimal capital accumulation policy in the firm sector and show the different implications of idiosyncratic and aggregate uncertainty on growth dynamics

State or Private ownership - The impact on performance and dividend payout

Masteroppgave(MSc) in Master of Science in Business, Finance - Handelshøyskolen BI, 2018This paper explores the impact state and private ownership have on return on assets and dividend payouts on a large sample of private and public limited liability companies in Norway. We test the impact using random-effects models on data for the time period 2002-2015. Our results are consistent with theory, which suggests that state ownership offers lower profitability and dividend payouts. We find that state-owned enterprises offer an average return on assets of 4.3192% while private-owned enterprises offer an average return on assets of 8.4738%. State-owned enterprises yield an average dividend payout ratio of 10.8798% while privately owned enterprises yield 24.4069%. By controlling for other factors, we find that state ownership negatively impacts return on assets and dividend payouts

Les enjeux du foncier : autorité, pouvoir et identité. Le cas de l'investissement de Green Resources dans la réserve forestière de Bukaleba, en Ouganda

Étude de cas de l'entreprise Green Ressources et de ses enjeux fonciers dans la réserve forestière de Bukaleba, en Ouganda

Assessing an Educational Program to Improve Documentation and Reduce Pain in Hospitalized Patients

Few experimental studies have evaluated the efficacy of continuing educational programs aimed at the improvement of nurses’ pain-management skills. This study assessed whether a standardized educational program aimed at nurses could increase the use of the Numeric Rating Scale-11 in both documenting and reducing postoperative pain-intensity levels in hospitalized surgical patients. The study had a quasi-experimental pre- and post-intervention design. Data were collected from records of surgical patients prior to and after the standardized educational program was completed. There were no significant differences between pre- and post-intervention groups in terms of either pain-documentation frequency or pain-intensity level. The study showed no increase in the frequency of postoperative pain documentation and no reduction of surgical patients’ postoperative pain-intensity level. This finding indicates that the standardized educational program on postoperative pain management was insufficient to bring about changes in clinical practice

Intensive care nurses’ experiences using volatile anaesthetics in the intensive care unit: An exploratory study

Objective: To explore the experiences intensive care nurses have with volatile anaesthetics in the intensive care unit. Research methodology and design: A qualitative exploratory and descriptive design was used. Data were collected in 2019 from individual interviews with nine intensive care nurses, who were recruited using purposive sampling. Data were analysed using systematic text condensation. Setting: The study was undertaken in two general intensive care units from different university hospitals in Norway where volatile anaesthetics were utilised. Findings: Three categories emerged from the data analysis: experiencing the benefits of volatile anaesthetics; coping with unfamiliarity in handling volatile anaesthetics; and meeting challenges related to volatile anaesthetics in practice. Conclusion: The intensive care nurses had positive experiences related to administering volatile anaesthetics in the intensive care unit and responded positively to the prospect of using it more often. Because volatile anaesthetics were rarely used in their units, the participants felt uncertain regarding its use due to unfamiliarity. Collegial support and guidelines were perceived as pivotal in helping them cope with this uncertainty. The participants also experienced several challenges in using volatile anaesthetics in the intensive care unit, with ambient pollution being regarded as the main challenge.acceptedVersio

Development of a Management Algorithm for Post-operative Pain (MAPP) after total knee and total hip replacement: study rationale and design.

BACKGROUND: Evidence from clinical practice and the extant literature suggests that post-operative pain assessment and treatment is often suboptimal. Poor pain management is likely to persist until pain management practices become consistent with guidelines developed from the best available scientific evidence. This work will address the priority in healthcare of improving the quality of pain management by standardising evidence-based care processes through the incorporation of an algorithm derived from best evidence into clinical practice. In this paper, the methodology for the creation and implementation of such an algorithm that will focus, in the first instance, on patients who have undergone total hip or knee replacement is described. METHODS: In partnership with clinicians, and based on best available evidence, the aim of the Management Algorithm for Post-operative Pain (MAPP) project is to develop, implement, and evaluate an algorithm designed to support pain management decision-making for patients after orthopaedic surgery. The algorithm will provide guidance for the prescription and administration of multimodal analgesics in the post-operative period, and the treatment of breakthrough pain. The MAPP project is a multisite study with one coordinating hospital and two supporting (rollout) hospitals. The design of this project is a pre-implementation-post-implementation evaluation and will be conducted over three phases. The Promoting Action on Research Implementation in Health Services (PARiHS) framework will be used to guide implementation. Outcome measurements will be taken 10 weeks post-implementation of the MAPP. The primary outcomes are: proportion of patients prescribed multimodal analgesics in accordance with the MAPP; and proportion of patients with moderate to severe pain intensity at rest. These data will be compared to the pre-implementation analgesic prescribing practices and pain outcome measures. A secondary outcome, the efficacy of the MAPP, will be measured by comparing pain intensity scores of patients where the MAPP guidelines were or were not followed. DISCUSSION: The outcomes of this study have relevance for nursing and medical professionals as well as informing health service evaluation. In establishing a framework for the sustainable implementation and evaluation of a standardised approach to post-operative pain management, the findings have implications for clinicians and patients within multiple surgical contexts

Validation of the surgical fear questionnaire in adult patients waiting for elective surgery

Objectives: Because existing instruments for assessing surgical fear seem either too general or too limited, the Surgical Fear Questionnaire (SFQ) was developed. The aim of this study is to assess the validity and reliability of the SFQ. Methods: Based on existing literature and expert consultation the ten-item SFQ was composed. Data on the SFQ were obtained from 5 prospective studies (N = 3233) in inpatient or day surgery patients. These data were used for exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability analysis and validity analysis. Results: EFA in Study 1 and 2 revealed a two-factor structure with one factor associated with fear of the short-term consequences of surgery (SFQ-s, item 1-4) and the other factor with fear of the long-term consequences of surgery (SFQ-l, item 5-10). However, in both studies two items of the SFQ-l had low factor loadings. Therefore in Study 3 and 4 the 2-factor structure was tested and confirmed by CFA in an eight-item version of the SFQ. Across all studies significant correlations of the SFQ with pain catastrophizing, state anxiety, and preoperative pain intensity indicated good convergent validity. Internal consistency (Cronbach's alpha) was between 0.765-0.920 (SFQ-total), 0.766-0.877 (SFQ-s), and 0.628-0.899 (SFQ-l). The SFQ proved to be sensitive to detect differences based on age, sex, education level, employment status and preoperative pain intensity. Discussion: The SFQ is a valid and reliable eight-item index of surgical fear consisting of two subscales: fear of the short-term consequences of surgery and fear of the long-term consequences.This study was conducted with departmental funding and supported by a grant from The Netherlands Organisation for Scientific Research (Zon-MW, http://www.zonmw.nl/en/), grant no. 110000007. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Patients' experiences with a welfare technology application for remote home care: A longitudinal study

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Aims and Objectives: To explore the longitudinal experiences using an application named remote home care for remote palliative care among patients with cancer living at home. Background: Introducing welfare technology in home-based care for patients with cancer in the palliative phase is internationally suggested as a measure to remotely support palliative care needs. However, little is known about the experiences of patients utilising welfare technology applications to receive home-based care from healthcare professionals in a community care context. Although living with cancer in the palliative phase often presents rapidly changing ailments, emotions and challenges with patients' needs changing accordingly, no studies exploring the longitudinal experiences of patients were found. Design: A qualitative study with a longitudinal, exploratory design. Methods: Data were collected through individual interviews with 11 patients over 16 weeks. The data were analysed using qualitative content analysis. The COREQ checklist guided the reporting of the study. Results: Three themes were identified: (1) potential to facilitate self-governance of life-limiting illness in daily life, (2) need for interpersonal relationships and connections, and (3) experiences of increased responsibility and unclear utility of the Remote Home Care. Conclusion: The results showed that remote home care facilitated patients' daily routines, symptom control and improved illness-management at home. Interpersonal relationships with healthcare professionals were considered pivotal for satisfactory follow-up. Infrastructural glitches regarding data access, information sharing and lack of continuous adjustments of the application represented major challenges, with the potential to impose a burden on patients with cancer in the palliative phase Relevance to Clinical Practice: By exploring the experiences of patients in palliative care over time as the disease progresses, this study provides constructive insights for the design and development of welfare technology applications and optimal care strategies. Patient or Public Contribution: The remote home care was developed by interdisciplinary healthcare professionals.publishedVersio

Uhøflighet på operasjonsstua – anestesisykepleieres erfaringer

Bakgrunn. Anestesisykepleiere jobber daglig tett på andre yrkes grupper i et høyteknologisk miljø og under tidvis krevende omstendigheter. Godt teamarbeid er essensielt for å gjennom føre arbeidet inne på en operasjonsstue. En arbeidssituasjon som i utgangspunktet opp leves som stressende, vil kunne få negative konsekvenser. Arbeidsmiljø, arbeidsglede, kommunikasjon og samarbeid blir markant redusert av uhøflig oppførsel. Hensikt. Hensikten med denne studien var å få kunnskap om hvilke erfaringer og opplevelser anestesisykepleiere har vedrørende uhøflighet og samarbeidsklima på operasjonsstuene. Metode. I studien er det benyttet kvalitativ metode med et deskriptivt, utforskende design. Data er samlet inn via to fokusgruppe intervjuer med totalt 8 anestesisykepleiere. Datamaterialet ble analysert ved hjelp av kvalitativ innholds analyse. Resultater. Fire temaer ble identifisert: ‘varierende høflighet blant medarbeidere’, ‘uhøflighet ødelegger arbeidsgleden’, ‘uhøflig kommunikasjon skaper konflikter’ og ‘mestrings strategier ved uhøflighet’. Samtlige informanter hadde rike beskrivelser av egne erfaringer med uhøflig het. Når de ble stående i slike situasjoner, følte de ubehag og reagerte med sjokk, apati, sinne og et ønske om å komme seg videre med arbeidet. Flere mente at slike situasjoner ble hengende igjen i en tid etterpå. Informantene beskrev det som et sjokk å være ny ut dannet eller student da de som ferske i faget oftere opp levde uhøflig oppførsel på jobb. Konklusjon. Resultatene tyder på at anestesi sykepleiere er velkjent med temaet uhøflighet på operasjonsstua. Det er indikasjoner for at det er et røft arbeidsmiljø, men informantene mener kulturen er i endring. Uhøflighet oppleves som ubehagelig og anestesi sykepleiere stiller spørsmålstegn ved hvorfor det må være slik på jobb. Informantene var samstemte i at dette er noe de blir vant til etterhvert, men at dette likevel er problematisk.publishedVersio