Resuscitation of term and near-term newborns in low-resourced settings : Studies of positive end-expiratory pressure and expired CO2 during bag-mask ventilation at birth

Background: An estimated 0.7 million newborns die due to perinatal asphyxia each year, most are born at or near term. The major burden of preventable newborn deaths occur in low-resourced settings. A self-inflating bag is the most used and available equipment to save newborn lives globally. To aerate the lungs is key to survival. Expired CO2 (ECO2) may be an indicator for lung aeration, and positive end-expiratory pressure (PEEP) may facilitate aeration of the lungs. Research aiming to improve ventilation in term and near-term newborns using a self-inflating bag is needed. Aims: To investigate interpretation of ECO2 measured during bag-mask ventilation in the immediate newborn period, and assess whether this can be used as a marker for lung aeration, effective ventilation technique and prognosis. To study the effects of PEEP during bag-mask ventilation at or near term. Methods: Two observational studies and one randomized clinical trial were performed at Haydom Lutheran Hospital in Tanzania. Data were collected using direct observation, side-stream CO2-monitoring, respiratory function monitoring and dry-electrode ECG. In the randomized trial, newborns in need of ventilation were assigned in blocks based on weeks to receive ventilations by self-inflating bag with or without a PEEP-valve. Results: ECO2 during bag-mask ventilation at birth was significantly associated with both ventilation factors and clinical factors. Tidal volumes of 10-14 ml/kg and a low ventilation frequency of around 30 inflations/minute were associated with the fastest rise and highest levels of ECO2. ECO2 increased before heart rate, and measured levels of ECO2 during resuscitation could, similar to heart rate, predict 24-hours survival. Adding a PEEP-valve to the self-inflating bag did not improve heart rate, ECO2 or outcomes in term and near-term newborns despite delivery of an adequate PEEP. Conclusions: ECO2 may be seen as a combined marker for lung aeration, airway patency and pulmonary circulation at birth. Tidal volumes of 10-14 ml/kg and ventilation frequencies of around 30 inflations/minute may be favorable to achieve a fast lung aeration. We found no clinical benefit of adding a PEEP-valve during bag-mask ventilation at birth in term and near-term newborns, and our study does not support routine use

Making occupational health and safety training relevant for farmers: Evaluation of an introductory course in occupational health and safety in Norway

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Agriculture in transition: New strategies for the promotion of occupational health and safety.

It is well documented that farming is a high-risk industry in terms of fatalities and injuries, and with numerous risk factors associated with operating the farm. It has also proved difficult to find evidence for the effectiveness of interventions. Moreover, farming is in transition, with ongoing technological transformations as well as becoming increasingly more globalized. Thus, new perspectives that allow for more systemic understandings in the management and promotion of occupational health and safety (OHS) are needed. Our main objective is to present an integrated theoretical understanding of the farm as an enterprise and an integrated element in the political-economic agricultural system. The main question is how can farmers organize and manage the farm, in order to simultaneously improve efficiency, quality and OHS based on systemic models for OHS and a systemic understanding of the political-economical system of Norwegian agriculture? The framework is adapted to the Norwegian agricultural context, with ongoing transformations both technologically and organizationally, including visions and plans set by Norwegian agriculture itself. However, the framework can be applied irrespective of national context.submittedVersio

Agriculture in transition: New strategies for the promotion of occupational health and safety.

It is well documented that farming is a high-risk industry in terms of fatalities and injuries, and with numerous risk factors associated with operating the farm. It has also proved difficult to find evidence for the effectiveness of interventions. Moreover, farming is in transition, with ongoing technological transformations as well as becoming increasingly more globalized. Thus, new perspectives that allow for more systemic understandings in the management and promotion of occupational health and safety (OHS) are needed. Our main objective is to present an integrated theoretical understanding of the farm as an enterprise and an integrated element in the political-economic agricultural system. The main question is how can farmers organize and manage the farm, in order to simultaneously improve efficiency, quality and OHS based on systemic models for OHS and a systemic understanding of the political-economical system of Norwegian agriculture? The framework is adapted to the Norwegian agricultural context, with ongoing transformations both technologically and organizationally, including visions and plans set by Norwegian agriculture itself. However, the framework can be applied irrespective of national context.submittedVersio

Work-Family Interference: Nurses in Norway and Finland

The aim of the study is to investigate the level of work–family inter-ference (WFI) for part-time nurses in Norway and Finland. Part-time work is usually cited as a desirable way in which to facilitate work and family harmony. However, the opportunity to work part-time in professions may be associated with greater difficulties and challenges than commonly presumed. Part-time professionals are often stigmatized as being less committed to work and report fewer job rewards than colleagues in full-time positions. This study challenges the notion of the desir-able consequences of work hour flexibility concerning the integration of work and family. Part-time nurses in Norway and Finland report an equal level or even higher levels of interference than nurses in full-time positions. A disproportional distri-bution of inconvenient work schedules appears to be a central explanation for the results reported by Norwegian nurses, but to a lesser degree by Finnish nurses

Utfordringer i implementeringsfasen av nytt ERP-system i DDV-kommunene

Masteroppgave ledelse - Universitetet i Agder 2016The approach to the problem in this master has been to take a look at the challenges that appears in the project with introducing a new economy-/salary/-HR system in a DDV municipality. The task is based on empirical investigation among employees who work in central staff- and supportfunctions within economy, salary/HR, who will get a new, equal economy- and salary/HR-system based on common structure in all DDV-municipalities. The study is based on an ongoing workprocess with organizing the implementation of a new economy- and salarysystem for 9 municipalities in DDV-cooperation. The purpose of the study has been to reveal the biggest challenges so far in the process, and what it will take to ensure the establishment of a successful foundation for a transfer from the old system to the new. The inquiry has been carried out based on a qualitative survey among 8 employees who has participated in the project, either in the workshop Economy, workshop Salary/HR, the competencenetwork or the QA-group, with equal number of respondents from agresso municipalities and visma municipalities, and equal numbers between economyfunctions and salaryfunctions. The main findings in this study indicates challenges in relation to management, and the process on lack of knowledge to the strategyfoundation for the process with the involved in the project. Lack of clear management and control of the process. Great challenges in the lack of understanding of the visma municipalities for the work beeing carried out in in the ongoing implemantation fase. The visma municipalities is struggling to understand structure and building in new systemsolutions. Great concern is beeing expressed for the quality of what is the foundation for the building of a new systemsolution from visma municipalities. Lack of competence is beeing revealed at Evry to convey new program solution simple and understandable. Technological circumstances reveals challenges when it comes to lack of recogniztion in the solution beeing demontrated and the solution beeing used in the implementation fase. The visma municipalities is experience bad userfriendliness in a new solution, and the user interface to a new solution is experienced as big compare to the relations in the solution they have today. 6 The main message in what it takes to secure the further success with the project is to carry out a fastworking competencedevelopmentproject to familierize the strategy foundation for the project and secure the visma municipalities understanding of a new systemsolution

Det skapende rom: betydningen av det ikke-målbare

I denne artikkelen rettes blikket mot selve opplevelsen i den skapende prosess, de ikke-målbare kvaliteter, spesielt i forhold til faget Kunst og håndverk. Artikkelens data består av tre ulike utøvergruppers arbeidsprosess i en bestemt type maleoppgave; maling med musikk som inspirasjon. De tre utøvergruppene hadde ulik alder, bakgrunn og skolering. Disse tre gruppene skal eksemplifisere hvilke opplevelser som kan oppstå i noen utvalgte skapende prosesser. Teorigrunnlaget er Czsikmyhalis flow-teori og Hans-Georg Gadamers hermeneutiske teori. Intensjonen er å bringe inn et perspektiv for å øke bevissthet og omtanke av enkelte forhold vedrørende tilrettelegging for skapende aktiviteter i skolen.publishedVersio

A System Perspective on Implementation and Usage of the Da Vinci Technology at a Large Norwegian Regional Hospital

The aim of this research paper is to identify advantages and barriers to implementation and usage of robotic-assisted surgery (RAS), specifically the Da Vinci robot, at a larger regional hospital in Norway and from a multiple stakeholder perspective. The identified advantages and barriers are connected to the socio-technical system framework SEIPS, thereby establishing a broader contextual system perspective on RAS implementation and usage. Our findings both align and extend upon existing human factors and ergonomics (HFE) knowledge on RAS in the operating room. In terms of specific future directions, we believe that a pressing concern for both management and current HFE research involving RAS implementation and usage relates to exploring and accounting for the close connections between the organization itself and the external stakeholders that exert a considerable influence on the internal work system and processes and the ability to achieve cost-efficiency and safety levels. We further conclude that the SEIPS framework can be a powerful tool in drawing or eliciting the larger contextual picture of RAS implementation and usage, and we encourage further HFE research to explore its application in different contexts to improve the current knowledge base.publishedVersio

Resultater fra utforskning av Dolley trallen ved UNN - NFR FORREGION prosjekt 333752

Innovasjonsprosjektet «Utvikling, testing og tilpasning av Dolley» omhandler utforskning av en tralle til oppbevaring av pasientenes personlige eiendeler og håndbagasje for enkel håndtering og forflytning på sykehus og/eller institusjoner. Prosjektet har en forskningsdel som utledes om i denne rapporten. Ideen funderes på at det ved dagens sykehus ikke finnes hjelpemidler som kan avhjelpe pasientene med de mest enkle oppgaver som å ha en plass å legge veske, klær, personlige eiendeler og lignende, og samtidig kunne frakte disse med seg rundt på avdelingen. Hovedmålsetning for prosjektet er å utvikle en protype av trallen til en endelig løsning for sykehusmiljøet som tar høyde for spekteret av tilpasningsbehov definert av samtlige involverte/berørte aktører med spenn fra pasienter/brukere via ansatte til ledelsen ved sykehuset.publishedVersio

Us and them. Faith-based organisations and street youths in Søndre Nordstrand. Kap. 7

I: I. Swart, A. Vähäkangas, M. Rabe and A. Leis-Peters (Red.), 2021, Stuck in the Margins? Young people and faith-based organisations in South African and Nordic localities (Kap. 7, s. 121-142). Vandenhoeck & Ruprecht, Brill. https://www.vr-elibrary.de/doi/abs/10.13109/9783666568558This book is the product of a South African - Nordic research collaboration that wanted to gain deeper insight into the role that faith-based organizations (FBOs) play in the lives of young people eking out a living from the margins of society. The book as such distinguishes itself as a first major international scholarly endeavor to explore the contemporary phenomenon of youth marginalization from a concerted interdisciplinary faith-based organizational interest. While the exploration of concepts such as NEET (an acronym for young people not in education, employment or training), social cohesion and FBOs constitutes an important point of departure, the book's essential contribution lies in the empirical work undertaken. In six case studies, conducted respectively in locations in South Africa, Finland and Norway, the authors make a deliberate attempt to give a voice to the young people with whom interviews were conducted. The result is a scholarly work that in its discussions and conclusions is both critical and appreciative of the involvement of FBOs in the lives of marginalized youths but also the research achievement itself. Perspectives that recognize the meaningful presence of FBOs in the lives and lived religion of many young people at the margins are presented, while authors do not shy away either from highlighting the shortcomings of FBOs to work more purposefully with young people in overcoming the conditions conducive to their marginalization. Ultimately, however, this book does not confine itself to a critical perspective on FBOs alone but through the contribution of some of its authors present illuminating insight into what may still be required from the point of view of academic research to participate in larger liberative practices involving young people but also FBOs at the margins of society.publishedVersio