En dynamisk agenda for ICE-sesjoner

An increasing number of companies in the construction industry are adopting the VDC fram- ework. VDC is a framework of existing methods, theories, and practices that support the use of multi-disciplinary, virtual models of product, and process to achieve the project’s business objectives. Effective collaboration among project stakeholders is a fundamental part of the VDC framework. The framework utilizes the ICE methodology to enhance collaboration. The ICE methodology is a systematic approach to collaboratively identify, and solve project challenges. The starting point for achieving a successful ICE session is establishing an agen- da. Therefore, qualitative research through interviews, observations, and literature search has been conducted, in order to establish how the project team can create a dynamic agenda for ICE sessions. To achieve this, the master thesis will examine how companies can derive inspiration from various Agile methodologies in order to create a dynamic agenda. Like the VDC framework, Agile methods share the principle of involving multiple stakeholders in the development process, but Agile methods differentiate themselves from VDC through a greater focus on flexibility and adaptation. This thesis follows a construction project in Oslo that has recently initiated its first VDC pilot project. The research question was developed through initial observations of the project. Upon initial observations, it became apparent that the project management team exclusively determined the agenda for the ICE sessions, and the agenda itself was planned well in advance of the actual session. The study’s main findings suggest that the project management team should facilitate increased collaboration when defining the agenda of the session. It is also important to ensure good communication, in order to improve the group’s preparatory work and ensure that the group has a sufficient understanding of the VDC framework. The use of a Hybrid method between Kanban and Scrum has been suggested as a possible solution to handling the challenges discovered in this thesis. The Scrumban board visualizes project tasks and enables the team members to categorize, prioritize, and distribute the assignments. The-ICE agenda becomes its own section on the Scrumban board by creating a sprint backlog that is reset after each ICE session, drawing elements from the Scrum methodology

Global eller regional jihad? Foreign fighters og al-Qaida-retorik i al-Shabaabs nationalistiske oprørskamp

Foreign fighters bliver set som en massiv sikkerhedstrussel for vestlige lande. Især Syrienskrigerne har senest været i fokus, men debatten startede langt tidligere, særligt med henvisninger til truslen som siges at udgå fra den somaliske oprørsgruppe al-Shabaab. Hvad er det empiriske grundlag for den påståede kobling mellem regionale konflikter, jihadgrupper og en stigende og massiv trussel mod Vesten? Er der entydige eksempler på, at al-Shabaab organiserer angreb eller rekrutterer og træner fighters til at vende tilbage til Vesten med henblik på at udføre terrorisme? Empiri fra åbne kilder og analyse af al-Shabaab indikerer, at denne påståede sammenhæng mangler empirisk grundlag men ikke desto mindre bliver brugt som legitimerende begrundelse for at udvide støtte til antiterrorismeinitiativer og øge ressourcer og beføjelser til efterretningstjenester

Performance of hunting statistics as spatiotemporal density indices of moose (Alces alces) in Norway

Wildlife managers are often asking for reliable information of population density across larger spatial scales. In this study, we examined the spatiotemporal relationships between moose density as estimated by cohort analysis and the density indices (1) harvest density (HD; hunter kills per km2), (2) moose seen per unit effort (SPUE), seen moose density (SMD; seen moose per km2), and density of moosevehicle accidents (MVA density; e.g., traffic kills per km2) in 16 areas in Norway with 13–42 years of data. HD showed a close positive relationship with moose density both within and between regions. However, the temporal variation in HD was best explained as a delayed reflection of moose density and tended to overestimate its growth and decline. Conversely, SMD and SPUE were unable to predict the spatial variation in moose density with high precision, though both indices were relatively precise temporal reflectors of moose density. However, the SPUE tended to underestimate population growth, probably because of a decrease in searching efficiency with increasing moose density. Compared to the other indices, MVA density performed poor as an index of moose density within regions, and not at all among regions, but may, because of its independent source of data, be used to cross-check population trends suggested by other indices. Our study shows that the temporal trends in moose density can be surveyed over large areas by the use of cheap indices based on data collected by hunters and local managers, and supports the general assumption that the number of moose killed per km2 provides a precise and isometric index of the variation in moose density at the spatial scale of our study. cohort analysis; isometric index; management; monitoring; population reconstruction; precision; saturation; seen per unit effort (SPUE).Performance of hunting statistics as spatiotemporal density indices of moose (Alces alces) in NorwaypublishedVersio

Inflammatory cytokines in alcohol use disorder patients are lower in smokers and users of smokeless tobacco

Background - Smoking and alcohol use often co-occur, and the use of nicotine-containing products is particularly common among persons with alcohol use disorder (AUD). Recent evidence shows that chronic alcohol use leads to inflammation through increased gut permeability and dysregulated cytokine levels. While cigarette smoking also has detrimental health effects, nicotine has immune dampening effects in some settings. Preclinical evidence demonstrates that nicotine can dampen alcohol-induced inflammation, but inflammatory responses after nicotine use has not been studied in persons with AUD. This study compared the level of circulating cytokines in abstinent AUD inpatients who were non-tobacco users, smokers, users of Swedish snus, or dual tobacco users. Methods - We collected blood samples and information about somatic and mental health and tobacco habits from 111 patients in residential treatment for AUD and 69 healthy controls. Levels of interferon (IFN)-γ, interleukin (IL)-10, tumor necrosis factor (TNF)-α, IL-17a, IL-1β, IL-6, IL-8, IL-1 receptor antagonist (ra), and monocyte chemoattractant protein (MCP)-1 were examined using a multiplex assay. Results - Patients with AUD had higher levels of seven cytokines than healthy controls. Among the AUD patients, nicotine users had lower levels of IL-10, TNF-α, IL-17a, IL-1β, IL-8, and MCP-1 (all p  Conclusions - Our findings may indicate that nicotine has anti-inflammatory effects in patients with AUD. Nonetheless, nicotine use cannot be recommended as a viable therapeutic option to reduce alcohol-induced inflammation because of its other adverse effects. Additional studies of the effects of tobacco or nicotine products on cytokine patterns in relation to mental or somatic health conditions are warranted

History of Delirium Tremens in AUD Patients in Treatment: Relationship to AUD Severity and Other Factors

Delirium tremens (DT) occurs after stopping prolonged, high alcohol intake and may be life-threatening if untreated. We need to know about clinical correlates of DT to provide the best clinical care. At admission to inpatient treatment a cohort of 114 alcohol use disorder (AUD) patients were interviewed and examined concerning psychiatric diagnosis and symptoms, trauma experiences and alcohol related measures and if they had experienced DT. Results: Twenty-four percent of the patients reported a life-time experience of DT. These patients were predominantly males and had lower educational level. More of the patients in the DT than the non-DT group reported at least one suicide attempt, were diagnosed with PTSD, and dropped out of treatment. Also, having parents with alcohol problems was more common among these patients, and they reported a longer duration of problematic drinking and a higher number of drinks needed to feel an effect of drinking. In the multivariable adjusted analysis only a diagnosis of PTSD (OR=5.71; 95% confidence interval (CI): 1.34–24.31) and duration of problematic drinking with a 6% increase in risk for every year (OR=1.06; 95% CI: 1.01–1.11) remained significant risk factors for having DT experience. Having experienced DT was more prevalent in the current investigation than in earlier studies. Patients that had experienced DT seemed to have more serious AUD, especially signified by a longer duration of drinking. These patients seemed to have many clinical disadvantages including more drop-out and higher suicide rate. PTSD could be a risk factor for DT but may also follow the DT experience.publishedVersio

Fatty acid reference intervals in red blood cells among pregnant women in Norway–Cross sectional data from the ‘Little in Norway’ cohort

There is a growing interest in determining fatty acid reference intervals from pregnancy cohort, especially considering the lack of reference values for pregnant women in the literature and the generalized misconception of equating reference intervals for nonpregnant women as equivalent to pregnant women. Seafood and supplements are important dietary sources for the omega-3 long-chain polyunsaturated fatty acids (ω-3 LCPUFA), such as eicosapentaenoic acid (EPA, 20:5ω-3), docosapentaenoic acid (DPA, 22:55ω-3), and docosahexaenoic acid (DHA, 22:6ω-3). Sufficient intake of EPA and DHA is vital during pregnancy for the development of the fetus, as well as for maintaining adequate levels for the mother. This study describes the fatty acid status and suggests reference values and cut-offs for fatty acids in red blood cells (RBC) from pregnant women (n = 247). An electronic food frequency questionnaire (e-FFQ) mapped the dietary habits of the participants, and gas chromatography was used to determine the fatty acid levels in RBC. The association between e-FFQ variables and fatty acid concentrations was established using a principal component analysis (PCA). Twenty-nine-point-one percent (29.1%) of the participants reported eating seafood as dinner according to the Norwegian recommendations, and they added in their diet as well a high percentage (76.9%) intake of ω-3 supplements. The concentration levels of fatty acids in RBC were in agreement with those reported in similar populations from different countries. The reference interval 2.5/97.5 percentiles for EPA, DPA, DHA were 0.23/2.12, 0.56/2.80, 3.76/10.12 in relative concentration units (%), and 5.99/51.25, 11.08/61.97, 64.25/218.08 in absolute concentration units (µg/g), respectively. The number of participants and their selection from all over Norway vouch for the representativeness of the study and the validity of the proposed reference values, and therefore, the study may be a useful tool when studying associations between fatty acid status and health outcome in future studies. To the best of our knowledge, this is the first PCA study reporting a direct association between ω-3 LCPUFA and intake of seafood and ω-3 supplements in a pregnancy cohort.publishedVersio

Impact of multi-professional, scenario-based training on postpartum hemorrhage in Tanzania: A quasi-experimental, pre- vs. post-intervention study

Background Tanzania has a relatively high maternal mortality ratio of 410 per 100,000 live births. Severe postpartum hemorrhage (PPH) is a major cause of maternal deaths, but in most cases, it is preventable. However, most pregnant women that develop PPH, have no known risk factors. Therefore, preventive measures must be offered to all pregnant women. This study investigated the effects of multi-professional, scenario-based training on the prevention and management of PPH at a Tanzanian zonal consultant hospital. We hypothesized that scenario-based training could contribute to improved competence on PPH-management, which would result in improved team efficiency and patient outcome. Methods This quasi-experimental, pre-vs. post-interventional study involved on-site multi-professional, scenario-based PPH training, conducted in a two-week period in October 2013 and another 2 weeks in November 2014. Training teams included nurses, midwives, doctors, and medical attendants in the Department of Obstetrics and Gynecology. After technical skill training on the birthing simulator MamaNatalie®, the teams practiced in realistic scenarios on PPH. Each scenario was followed by debriefing and repeated scenario. Afterwards, the group swapped roles and the observers became the participants. To evaluate the effects of training, we measured patient outcomes by determining blood transfusion rates. Patient data were collected by randomly sampling Medical birth registry files from the pre-training and post-training study periods (n = 1667 and 1641 files, respectively). Data were analyzed with the Chi-square test, Mann-Whitney U-test, and binary logistic regression. Results The random patient samples (n = 3308) showed that, compared to pre-training, post-training patients had a 47% drop in whole blood transfusion rates and significant increases in cesarean section rates, birth weights, and vacuum deliveries. The logistic regression analysis showed that transfusion rates were significantly associated with the time period (pre- vs. post-training), cesarean section, patients tranferred from other hospitals, maternal age, and female genital mutilation and cutting. Conclusions We found that multi-professional, scenario-based training was associated with a significant, 47% reduction in whole blood transfusion rates. These results suggested that training that included all levels of maternity staff, repeated sessions with realistic scenarios, and debriefing may have contributed to reduced blood transfusion rates in this high-risk maternity setting.publishedVersio

The Multiple Determinants of Maternal Parenting Stress 12 Months After Birth: The Contribution of Antenatal Attachment Style, Adverse Childhood Experiences, and Infant Temperament

Parenting stress can influence caregiving behavior negatively, which in turn may harm children’s development. Identifying precursors of parenting stress, preferably beginning during pregnancy and throughout the first year of life, is therefore important. The present study aims to provide novel knowledge on this issue through a detailed examination of the association between maternal attachment style and later parenting stress. Moreover, we examine the role of several additional risk factors, specificially the mothers’ own adverse childhood experiences (ACE), as well as infants’ temperamental characteristics. Data from a community based longitudinal study of 1,036 Norwegian mothers, collected during pregnancy and 12 months after childbirth, were used. Results showed that attachment style in pregnancy predicted parenting stress 1 year after birth. In addition, it was demonstrated that the mothers’ own ACEs predicted postnatal parenting stress, and that attachment style operated as a mediator of this association. A significant association between perceived infant temperament and parenting stress was also found. The study illustrates the importance of understanding the multifactorial antecedents of parenting stress. The results may inform early intervention efforts aimed at supporting mothers and their partners in the potentially difficult transition period around childbirth

Resilience Thinking in Reindeer Husbandry

Resilience expresses the capacity of a social-ecological system to adapt to, absorb, or withstand perturbations and other stressors so that the system remains. Reindeer nomadic husbandry is a coupled social-ecological system that sustains resilience by interacting with the animals and environment: either the herders adjust their actions to animal behavior or change this behavior in ways that suit the herd and pastures. Stressors and shocks affecting Sámi reindeer husbandry are, for instance, sudden warm air temperatures with subsequent snow melting and freezing in winter, bad grazing conditions, loss of grazing lands, and even socio-economic reforms. All these are sudden, unprepared, or forced changes. Climate change resilience includes using reindeer herders’ Indigenous knowledge of selective breeding by maintaining different phenotypes of reindeer such as non-productive and castrated animals in the herd. Nevertheless, in Sámi reindeer husbandry in Norway today, low numbers of male reindeer and the absence of castrated animals challenge the herders’ resilience coping strategies. This chapter discusses factors that constrain resilience in herding societies, contribute to the transformation of reindeer husbandry and the erosion of resilience in the herding society