Postoperativ smärta hos barn : En kvantitativ studie

Detta examensarbete behandlar postoperativ smärta hos barn. Syftet med denna studie är att sjukskötare lättare ska kunna förstå och bemöta barn med postoperativa smärtor, hur man bedömer samt hur man lindrar barns postoperativa smärta. Våra frågeställningar var: Hur bemöter man barn med postoperativ smärta? Hur gör man smärtbedömning hos barn med postoperativ smärta? Hur kan man lindra barns postoperativa smärtor? Undersökningen utgår från Erikssons teori om lidande (1994) och Lindbergs doktorsavhandling om lekens betydelse (2013). Vi valde att använda oss av enkät som undersökningsmetod. Enkäterna delades ut till tre olika sjukhus och där svarade 26 barnsjukskötare på dem. Enkäten bestod av både öppna och slutna frågor. Resultatet visade att i bemötandet är det viktigt att föräldrarna är delaktiga i vården, att bemöta barnet på rätt sätt och på barnets nivå. Det är viktigt att göra en ordentlig smärtskattning, att använda smärtskattningsskalor men också att iaktta barnet och se på deras kroppsspråk, utgående från det kan man göra en rätt smärtbedömning. Angående smärtlindringen kom det tydligt fram att paracetamol används mest och att i de flesta fall så är smärtlindringen god.This thesis deals with post-operative pain in children. The purpose of this study is that nurses better understand and respond to children with postoperative pain, how to assess and how to alleviate children's postoperative pain. Our questions were: How do you treat children with postoperative pain? How do you make pain assessment in children with postoperative pain? How to relieve the child's postoperative pain? The survey is based on Erikson's theory of suffering (1994) and Lindberg's doctoral of the importance of play (2013). We chose to use the questionnaire survey method. The questionnaires were distributed to three different hospitals and 26 child nurses answered the questions. The questionnaire consisted of both open and closed questions. The results showed that in the response it is important that parents are involved in health care, to respond to the child in the right way and at the child's level. It is important to do a proper pain assessment, the use of pain assessment scales but also to observe the child and watch their body language, based on this you can make a correct assessment of pain. Regarding pain relief showed clearly that paracetamol is used the most and that in most cases is the pain relief good.Tämä opinnäytetyö käsittelee lasten postoperatiivista kipua. Tutkimuksen tarkoitus on sitä, että sairaanhoitajat helpommin voi ymmärtää ja kohdella lapsia, joilla on postoperatiivista kipua ja miten he voivat arvioida ja lieventää lasten kipua. Kysymyksenasettelujamme olivat: Miten kohdellaan lasta postoperatiivisella kivulla? Miten tehdään kipuarviointi lapsille, joilla on postoperatiivista kipua? Miten voidaan lieventää lasten postoperatiivista kipua? Tutkimus perustuu Eriksonin teoriaan kärsimystä (1994) ja Lindbergin jatkokoulutus leikin tarkoituksesta (2013). Tutkimusmenetelmänä olemme käyttäneet kyselyä. Kyselylomakkeita jaettiin kolmeen sairaalaan, ja 26 lastensairaanhoitajaa vastasivat kysymyksiin. Kysely sisälsi sekä avoimia että suljettuja kysymyksiä. Tulokset osoittivat että on tärkeää ottaa vanhemmat mukaan hoitoon, kohdata lapsia oikealla tavalla ja olla lasten tasoilla. On tärkeää tehdä oikean kipuarvioinnin, käyttää mittakaavoja mutta myös tarkkailla lapsia ja heidän kehonkieltä, ja sen perusteella voidaan tehdä oikean kipuarvioinnin. Kivunlievitystä tuli esille, että parasetamoli käytetään eniten, ja useimmissa tapauksissa kivunlievitys on hyvä

Family Ownership and Returns on Investment – Founders, Heirs, and External Managers

This paper investigates how family ownership, control, and management affect firms’ investment performance. We use the identity of Chief Executive Officer (CEO) and Chairman of the Board (COB) to establish under what management the firm is: founder, descendant, or external management. The results show that founder management has no effect on investment performance in family firms, whereas descendant management has a negative impact on returns on investment. Having an externally hired manager significantly improves investment performance. The results also indicate that the separation of voting right from cash flow right has a negative impact on investment performance in both family and non-family firms, but the negative effect is larger in family firms.Ownership; Control; Management; Family Firms; Returns on Investments

The Bankruptcy-Law Safe Harbor for Derivatives: A Path-Dependence Analysis

U.S. bankruptcy law grants special rights and immunities to creditors in derivatives transactions, including virtually unlimited enforcement rights. This article argues that these rights and immunities result from a form of path dependence, a sequence of industry-lobbied legislative steps, each incremental and in turn serving as apparent justification for the next step, without a rigorous and systematic vetting of the consequences. Because the resulting “safe harbor” has not been fully vetted, its significance and utility should not be taken for granted; and thus regulators, legislators, and other policymakers—whether in the United States or abroad—should not automatically assume, based on its existence, that the safe harbor necessarily reflects the most appropriate treatment of derivatives transactions under bankruptcy and insolvency law or the treatment most likely to minimize systemic risk

Plan S and academic publishing empires : response to Burgman et al. 2018

Non peer reviewe

Setting priorities for conservation : protected area effectiveness, management, and quality of governance

Protected areas are a key tool for conserving biodiversity and an increase in their coverage has long been the aim of international conventions and initiatives. With progress to achieve target 11 of the Convention on Biological Diversity of protecting 17 % of terrestrial areas, the focus has now shifted towards assessing the protected area effectiveness in maintaining species or avoiding land conversions. In my doctoral thesis I develop a novel way of assessing PA effectiveness, based on the counterfactual thinking, and use this to link it to different management and ecological factors. I link different aspects of PA effectiveness conceptually to the quality of governance and show how spatial prioritizations can change with the inclusion of these socio-political factors. Using Madagascar as a case study, and in line with other studies elsewhere, I find that the protected area network is effective to some extent in mitigating the pressure of deforestation. I show the importance of considering the temporal dimension of protected area effectiveness measures and how protected area effectiveness changes over time due to increasing or decreasing pressures. These results link directly to considerations of vulnerability and irreplaceability in Systematic conservation planning and I show that accounting for governance factors in a global spatial prioritization analysis change the identification of areas. My thesis shows the relative nature of protected area effectiveness measures and how important it is to get the assessments right, especially because of the massive focus on protected area effectiveness as a panacea to stopping biodiversity declines. Improving protected area effectiveness needs to be linked to governance factors affecting not only the management but also the drivers of threat, something that previous studies have overlooked. With my thesis I make an attempt to bridge the themes of protected area effectiveness, considerations of quality of governance, and how it all links to conservation prioritizations. Our methodology has been developed with the aim to be computationally efficient and conceptually more robust than existing matching methods, with the potential to be scaled up for larger studies. However, how the two methods perform needs to be tested in the future. My dissertation has clear practical implications for the conservation of Madagascar s biodiversity and the results are of potential interest for both NGOs and the Madagascar National Park administration. The conceptual contribution of this thesis should be incorporated into mainstream thinking and the discourse of setting global priorities for biodiversity conservation, such as by the International Union for Conservation of Nature and Natural Resources (IUCN), the World Parks Congress (WPC) and ultimately the Convention on Biological Diversity (CBD).Grundandet av naturskyddsområden är den ledande strategin för att skydda den biologiska mångfalden både lokalt och globalt. Stora framsteg har gjorts i frågan om att öka naturskyddsområdenas antal och areal och Biodiversitetskonventionens Aichi målsättning att skydda 17 % av jordens terrestra yta ligger inom räckhåll. Detta har gjort att fokus nu har skiftat till att man försöker evaluera naturskyddsområdenas effekt ifråga om att skydda de arter samt naturtyper som finns representerade. Analytiskt utgör detta ett intressant problem inom vetenskapen: det kräver en evaluering av vad som skulle ha hänt, om dessa områden inte grundats: det kontrafaktiska (från engelskans counterfactual). I min doktorsavhandling har vi utvecklat en ny metod för detta. Jag använder denna metod för att evaluera naturskyddsområdeseffektivitet och undersöker förhållandet mellan detta och olika aspekter på naturskyddsområdesledning, förvaltningsfaktorer samt ekologiska faktorer. Konceptuellt utvecklar jag ett ramverk som linkar olika aspekter av naturskyddsområdeseffektivitet till förvaltningens kvalitet (quality of governance) och visar hur spatiala prioriteringar beträffande var naturskyddsområden borde grundas kan ändras då dessa socio-politiska faktorer beaktas. Genom att använda Madagaskar som fallstudie, och i enlighet med andra studier från andra länder, visar mina analyser att nätverket av naturskyddsområden har en effekt, det vill säga de minskar skogsskövlingen inom områdenas gränser. Dock påvisar jag vikten av att beakta den temporala aspekten av effektivitet, och hur den effekt områdena har varierar över tid och i förhållande till ett minskat eller ökat tryck på att skövla skog. Min avhandling påvisar således den relativa karaktären av mått på naturskyddsområdeseffektivitet och hur betydande det är att genomföra dessa bedömningar rätt, samt hur resultaten skall tolkas. Detta framstår för tillfället som ytterst aktuellt på grund av det massiva fokus naturskyddsområdeseffektivitet har fått som ett universalmedel för att eliminera nedgångar i den biologiska mångfalden. Förbättrad naturskyddsområdeseffektivitet måste kopplas till förvaltningsfaktorer som påverkar inte bara den lokala ledningen utan även drivkrafterna bakom flera av hotbilderna mot biodiversiteten, något som tidigare studier har förbisett. Med min avhandling gör jag ett försök att syntetisera tematiken kring naturskyddsområdeseffektivitet och kvaliteten på samhällsstyrningen, och hur det hela länkar till hur man kan prioritera olika områden samt tillvägagångssätt inom bevarandebiologin. Vår nya metod har utvecklats med målsättningen att vara beräkningsmässigt effektiv och konceptuellt mer robust än befintliga metoder, och att därmed ha potential att skalas upp för större studier. Hur de två metoderna utfaller kräver testning i framtiden. Min avhandling har praktiska tillämpningsmöjligheter för bevarandet av Madagaskars biologiska mångfald och resultaten är av potentiellt intresse för både medborgarorganisationer och administrationen för Madagaskars nationalparker. Det konceptuella bidrag denna avhandling medför bör införlivas i diskussionen kring hur man borde fastställa globala prioriteringar för bevarandet av biologisk mångfald, såsom genom de rekommendationer och mål som utges av den internationella naturvårdsunionen IUCN, världsparkkongressen World Parks Congress samt biodiversitetskonventionen CBD

Quality of governance and effectiveness of protected areas: crucial concepts for conservation planning

Protected areas (PAs) are a key tool for biodiversity conservation and play a central role in the Convention on Biological Diversity. Recently, the effectiveness of PAs has been questioned, and assessing how effective they are in enabling the future persistence of biodiversity is not trivial. Here, we focus on terrestrial PAs and clarify the terminology related to PA effectiveness, distinguishing between management and ecological aspects. We suggest that the quality of governance affects both aspects of effectiveness but recognize a lack of synthetic understanding of the topic. We present a conceptual framework linking the underlying mechanisms by which the quality of governance affects conservation outcomes in PAs and how this relates to conservation planning. We show that it is crucial to separate pressure and response and how these together will lead to the observed conservation outcomes. We urge for more focused attention on governance factors and in particular more empirical research on how to address causality and how to account for the quality of governance when prioritizing actions. Our framework is linked to the classic concepts of systematic conservation planning and clarifies the strategies available to achieve a comprehensive and effective network of PAs.Peer reviewe

Governance factors in the identification of global conservation priorities for mammals

Global conservation priorities have often been identified based on the combination of species richness and threat information. With the development of the field of systematic conservation planning, more attention has been given to conservation costs. This leads to prioritizing developing countries, where costs are generally low and biodiversity is high. But many of these countries have poor governance, which may result in ineffective conservation or in larger costs than initially expected. We explore how the consideration of governance affects the selection of global conservation priorities for the world's mammals in a complementarity-based conservation prioritization. We use data on Control of Corruption (Worldwide Governance Indicators project) as an indicator of governance effectiveness, and gross domestic product per capita as an indicator of cost. We show that, while core areas with high levels of endemism are always selected as important regardless of governance and cost values, there are clear regional differences in selected sites when biodiversity, cost or governance are taken into account separately. Overall, the analysis supports the concentration of conservation efforts in most of the regions generally considered of high priority, but stresses the need for different conservation approaches in different continents owing to spatial patterns of governance and economic development

Statistical matching for conservation science

The awareness of the need for robust impact evaluations in conservation is growing and statistical matching techniques are increasingly being used to assess the impacts of conservation interventions. Used appropriately matching approaches are powerful tools, but they also pose potential pitfalls. We outlined important considerations and best practice when using matching in conservation science. We identified 3 steps in a matching analysis. First, develop a clear theory of change to inform selection of treatment and controls and that accounts for real‐world complexities and potential spillover effects. Second, select the appropriate covariates and matching approach. Third, assess the quality of the matching by carrying out a series of checks. The second and third steps can be repeated and should be finalized before outcomes are explored. Future conservation impact evaluations could be improved by increased planning of evaluations alongside the intervention, better integration of qualitative methods, considering spillover effects at larger spatial scales, and more publication of preanalysis plans. Implementing these improvements will require more serious engagement of conservation scientists, practitioners, and funders to mainstream robust impact evaluations into conservation. We hope this article will improve the quality of evaluations and help direct future research to continue to improve the approaches on offer.Peer reviewe