Informasjonskampanjer og miljøvennlig adferd: En utredning for klimakampanjen Klimaløftet

Denne rapporten er skrevet på oppdrag for prosjektledelsen for klimakampanjen Klimaløftet, som er opprettet av Miljøverndepartementet. Oppdraget bestod i å sammenstille faktakunnskap om effekter av informasjonskampanjer med adferdsendring som mål, rettet mot husholdninger, kommuner, industri og næringsliv (på områdene stasjonær energi og transport), identifisere kunnskapshull og å komme med anbefalinger. Denne rapporten inneholder imidlertid bare områdene husholdninger og kommuner. (Innspill fra Enova skal dekke industri og næringsliv). Det finnes store muligheter til redusere klimagassutslipp gjennom reduksjon av energiforbruket og omlegging til andre energikilder hos husholdninger og kommuner i Norge. Vi vet at den norske befolkningen er mer motivert enn før til å gjøre tiltak for å redusere sitt energiforbruk, men at de mangler kunnskap om hvordan. Vi vet mindre om interne og eksterne barrierer for de konkrete tiltakene. Dersom det eksisterer eksterne barrierer, bør en vurdere å kombinere informasjon med andre virkemidler (som økonomiske, fysiske osv.). En informasjonskampanje bør ha definerte og operasjonaliserbare mål, som er en forutsetning for styring og kontroll av arbeidet. Kommunene er nærmere befolkningen enn det statlige nivået, har større kunnskap om målgruppene og mulige tiltak, og kan derfor være en viktig bidragsyter for å endre adferd også på klimaområdet. I tillegg kan de gjennom en miljøvennlig egen drift være en inspirator for annen næringsvirksomhet

Supervision im Prozess der Veränderungen beruflicher Arbeit im Allgemeinen Sozialen Dienst (ASD)

In den letzten beiden Jahren habe ich mich bei den Überlegungen zu meiner und der Biografie anderer mit dem "Erinnern" beschäftigt. Ich habe nachgelesen, was der Stand der Biografieforschung ist, und habe mich mit Erkenntnissen der Hirnforschung auseinandergesetzt Dabei ist mir im Bezug auf das Erinnern eine Unterscheidung wichtig geworden: Es gibt qualitative Unterschiede zwischen dem Abspeichem und Wiedererinnern von Wissen und Wissenssystemen und dem Abspeichern und Wiedererinnern von Erfahrungen, Erlebnissen und Episoden. Wissensinhalte können gleichsam "unverändert" gehoben werden, während Erfahrungsinhalte, die vorgängigen Erlebnisse beim Vorgang des Erinnems ständig neu gestaltet werden, d. h. in einen dem Subjekt sinnvoll erscheinenden Zusammenhang gebracht werden. Markowitsch und Welzer (2006) sprechen in diesem Zusammenhang von einem Wandlungskontinuum des biografischen Gedächtnisses

A Tool to Ensure Appropriate Drug Use and Maintain Patient Safety When Administering Pro Re Nata Medications: Healthcare Providers’ Experiences With Medicine Lists in Sheltered Housing for Older People

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'To give or not to give medication, that is the question.’ Healthcare personnel’s perceptions of factors affecting pro re nata medication in sheltered housing for older adults — a focus-group interview study

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Older Adults Living in Sheltered Housing’s Experiences of Involvement in Pro Re Nata Decisions. A Narrative Positioning Analysis

Decisions regarding pro re nata medications might be challenging due to the complex nature of the practice. The aim of this study was to expand our understanding of the experiences of older people living in sheltered housings with regard to shared decision-making concerning pro re nata medications. In this study, we conducted in-depth interviews with residents living in Norwegian sheltered housings. The analysis was inductive, based on a narrative positioning analysis. Twelve residents were interviewed, and three narratives representing participants’ variation are presented. People take different positions in shared decision-making of pro re nata medication, and they position themselves variously at different levels and situations. Prevailing master narratives affect the residents’ positions in shared decision-making. Contrasts in older adults’ experiences indicate that shared decision-making is not straightforward and is highly reliant on the context. Seemingly, they wish to be involved and not involved at the same time, a contradiction that healthcare providers need to consider

The role of goal-setting in urban climate governance

This article argues that goal-setting is an important, albeit understudied, part of urban climate governance scholarship. By using goal-setting theory, the article introduces concepts and perspectives capable of shedding new light on the political aspect of cities' climate strategic work. Climate goal-setting is studied within a wider urban governance context, as a way to activate a multitude of internal and external actors for shared goals and purposes. The article analyses levels of ambiguities of urban climate goals, and in light of different politico-institutional settings it explores possible contextual implications for cities’ climate governance. Through a comparative analysis of four cities – Copenhagen, Cape Town, Oslo and Gothenburg, the article identifies two distinct approaches. An inclusive approach containing ambiguous all-encompassing climate goals, consensus-oriented political decision-making, a broad administrative entity with weak mandate and close and long-term stakeholder collaboration. An efficiency-oriented approach including clear and problem focused climate goals, instrumental political decision-making, a special-purpose administrative entity with a wide and clear mandate and targeted and temporary stakeholder collaboration. The article concludes by posing some key questions that should guide further research on the exact relationship between these variables

Designing a future eHealth service for posthospitalization self-management support in long-term illness: Qualitative interview study

Background: For patients with noncommunicable diseases (NCDs; eg, heart failure [HF] and colorectal cancer [CRC]), eHealth interventions could meet their posthospital discharge needs and strengthen their ability to self-manage. However, inconclusive evidence exists regarding how to design eHealth services to meet the complex needs of patients. To foster patient acceptability and ensure the successful development and implementation of eHealth solutions, it is beneficial to include different stakeholders (ie, patients and health care professionals) in the design and development phase of such services. The involvement of different stakeholders could contribute to ensuring feasible, acceptable, and usable solutions and that eHealth services are developed in response to users’ supportive care needs when transitioning to home after hospitalization. This study is the first step of a larger complex intervention study aimed at meeting the postdischarge needs of 2 NCD populations. Objective: This study aimed to explore the perspectives of patients with HF and CRC and health care professionals on patient self-management needs following hospital discharge and investigate how a future nurse-assisted eHealth service could be best designed to foster patient acceptability, support self-management, and smooth the transition from hospital to home. Methods: A qualitative, explorative, and descriptive approach was used. We conducted 38 semistructured interviews with 10 patients with HF, 9 patients surgically treated for CRC with curative intent, 6 registered nurses recruited as nurse navigators of a planned eHealth service, and 13 general practitioners experienced in HF and CRC treatment and follow-up care. Patients were recruited conveniently from HF and CRC outpatient clinics, and the nurses were recruited from the cardiology and gastro-surgical departments at a university hospital in the southwest of Norway. The general practitioners were recruited from primary care in surrounding municipalities. Semistructured interview guides were used for data collection, and the data were analyzed using thematic analysis. Results: In total, 3 main themes were derived from the data analysis: expecting information, reassurance, and guidance when using eHealth for HF and CRC self-management; expecting eHealth to be comprehensible, supportive, and knowledge promoting; and recognizing both the advantages and disadvantages of eHealth for HF and CRC self-management. The data generated from this interview study depicted the diverse needs for self-management support of patients with CRC and HF after hospital discharge. In addition, valuable suggestions were identified regarding the design and content of the eHealth service. However, participants described both possible advantages and disadvantages of a remote eHealth service. Conclusions: This study is the first step in the development of an eHealth service for posthospitalization self-management support for long-term illnesses. It concerns patients’ supportive care needs and user requirements of an eHealth service. The findings of this study may add value to the planning and development of eHealth interventions for patients with NCDs.publishedVersio

Kan organisering av omsorgsboliger for eldre påvirke praksis i forbindelse med legemidler som gis ved behov?

Bakgrunn: Parallelt med at legemidler utgjør en stadig større del av dagens pasientbehandling, skjer en økning i risiko for uønskede hendelser og alvorlige feil i legemiddelbehandlingen. Dersom vi skal nå de helsepolitiske målene om sikker legemiddelbruk i helse- og omsorgstjenesten, er det viktig med kunnskap om legemiddelhåndtering i alle deler av tjenestene. Denne studien hadde til hensikt å utvikle kunnskap om hvordan organisering av omsorgsboliger for eldre kan påvirke behovsmedisinering, og med dette påvirke pasientsikkerheten. Metode: Det ble gjennomført fem fokusgruppeintervjuer med helsepersonell (N=22) ansatt i fem omsorgsboliger i Midt-Norge. Data ble analysert ved bruk av systematisk tekstkondensering. Resultat: Tre hovedtema med tilhørende åtte undertema sa noe om organisatoriske forhold som kan påvirke behovsmedisinering i omsorgsboliger. Dette handlet om strukturer for informasjonsdeling, fysisk organisering og organisering av personell. Konklusjon: Flere av studiens resultater er i tråd med tidligere forskning fra andre deler av helsetjenesten, men tilfører ny kunnskap fra konteksten omsorgsboliger. Organiseringen av omsorgsboliger kan mulig påvirke praksis i forbindelse med behovsmedisinering, og kan dermed utgjøre en risiko for pasientsikkerheten i tjenesten.publishedVersio

Comprehensive analysis of MHC class I genes from the U-, S-, and Z-lineages in Atlantic salmon

<p>Abstract</p> <p>Background</p> <p>We have previously sequenced more than 500 kb of the duplicated MHC class I regions in Atlantic salmon. In the IA region we identified the loci for the MHC class I gene <it>Sasa-UBA </it>in addition to a soluble MHC class I molecule, <it>Sasa-ULA</it>. A pseudolocus for <it>Sasa-UCA </it>was identified in the nonclassical IB region. Both regions contained genes for antigen presentation, as wells as orthologues to other genes residing in the human MHC region.</p> <p>Results</p> <p>The genomic localisation of two MHC class I lineages (Z and S) has been resolved. 7 BACs were sequenced using a combination of standard Sanger and 454 sequencing. The new sequence data extended the IA region with 150 kb identifying the location of one Z-lineage locus, <it>ZAA</it>. The IB region was extended with 350 kb including three new Z-lineage loci, <it>ZBA</it>, <it>ZCA </it>and <it>ZDA </it>in addition to a <it>UGA </it>locus. An allelic version of the IB region contained a functional <it>UDA </it>locus in addition to the <it>UCA </it>pseudolocus. Additionally a BAC harbouring two MHC class I genes (UHA) was placed on linkage group 14, while a BAC containing the S-lineage locus <it>SAA </it>(previously known as <it>UAA</it>) was placed on LG10. Gene expression studies showed limited expression range for all class I genes with exception of <it>UBA </it>being dominantly expressed in gut, spleen and gills, and <it>ZAA </it>with high expression in blood.</p> <p>Conclusion</p> <p>Here we describe the genomic organization of MHC class I loci from the U-, Z-, and S-lineages in Atlantic salmon. Nine of the described class I genes are located in the extension of the duplicated IA and IB regions, while three class I genes are found on two separate linkage groups. The gene organization of the two regions indicates that the IB region is evolving at a different pace than the IA region. Expression profiling, polymorphic content, peptide binding properties and phylogenetic relationship show that Atlantic salmon has only one MHC class Ia gene (<it>UBA</it>), in addition to a multitude of nonclassical MHC class I genes from the U-, S- and Z-lineages.</p