Global best practices for sludge management relevant for the Indian context

Denne rapporten gir en oversikt over teknologier og systemer for slambehandling som brukes med gode erfaringer rundt om i verden i dag, samt forurensinger som kan forekomme i slam. Vi går også gjennom de mest brukte regulative rammeverkene for slamhåndtering, spesielt EUs slamdirektiv og den amerikanske standarden kjent som US EPA “Part 503 Rule”. Hensikten med rapporten er å gi et kunnskapsgrunnlag for forbedringer av håndtering av slam (behandling og disponering) i det urbane India.This report provides an overview over technologies and systems for sewage sludge management used successfully globally as well as contaminants – both well-known and emerging – which commonly occur in sludge. We present a couple of the most influential regulative frameworks for sludge management, in particular, the European Sludge directive and the US EPA “Part 503 Rule”. The objective of the report is to provide knowledge for decision support for improving sludge management (treatment and disposal) in urban India.publishedVersio

EDB-senteret som arbeidsplass : en intern spørreskjemaundersøkelse.

EDB-senteret har vært plaget med en ustabil personalsituasjon i det siste. Denne undersøkelsen tar sikte på å kartlegge årsakene til dette og foreslå tiltak for å bedre stabiliteten. bedring av terminalarbeidsplassene og den interne kommunikasjonen kolleger imellom samt omorganisering av kontakten med brukerne er tiltak som de ansatte prioriterer. Lønn og avansemuligheter er imidlertid fortsatt viktige faktorer for å holde på arbeidskraften

Global best practices for sludge management relevant for the Indian context

Denne rapporten gir en oversikt over teknologier og systemer for slambehandling som brukes med gode erfaringer rundt om i verden i dag, samt forurensinger som kan forekomme i slam. Vi går også gjennom de mest brukte regulative rammeverkene for slamhåndtering, spesielt EUs slamdirektiv og den amerikanske standarden kjent som US EPA “Part 503 Rule”. Hensikten med rapporten er å gi et kunnskapsgrunnlag for forbedringer av håndtering av slam (behandling og disponering) i det urbane India

Radiographic classifications in Perthes disease: Interobserver agreement and association with femoral head sphericity at 5-year follow-up

Background and purpose — Different radiographic classifications have been proposed for prediction of outcome in Perthes disease. We assessed whether the modified lateral pillar classification would provide more reliable interobserver agreement and prognostic value compared with the original lateral pillar classification and the Catterall classification. Patients and methods — 42 patients (38 boys) with Perthes disease were included in the interobserver study. Their mean age at diagnosis was 6.5 (3–11) years. 5 observers classified the radiographs in 2 separate sessions according to the Catterall classification, the original and the modified lateral pillar classifications. Interobserver agreement was analysed using weighted kappa statistics. We assessed the associations between the classifications and femoral head sphericity at 5-year follow-up in 37 non-operatively treated patients in a crosstable analysis (Gamma statistics for ordinal variables, γ). Results — The original lateral pillar and Catterall classifications showed moderate interobserver agreement (kappa 0.49 and 0.43, respectively) while the modified lateral pillar classification had fair agreement (kappa 0.40). The original lateral pillar classification was strongly associated with the 5-year radiographic outcome, with a mean γ correlation coefficient of 0.75 (95% CI: 0.61–0.95) among the 5 observers. The modified lateral pillar and Catterall classifications showed moderate associations (mean γ correlation coefficient 0.55 [95% CI: 0.38–0.66] and 0.64 [95% CI: 0.57–0.72], respectively). Interpretation — The Catterall classification and the original lateral pillar classification had sufficient interobserver agreement and association to late radiographic outcome to be suitable for clinical use. Adding the borderline B/C group did not increase the interobserver agreement or prognostic value of the original lateral pillar classification

Prehospital naloxone administration – what influences choice of dose and route of administration?

Background Amidst the ongoing opioid crisis there are debates regarding the optimal route of administration and dosages of naloxone. This applies both for lay people administration and emergency medical services, and in the development of new naloxone products. We examined the characteristics of naloxone administration, including predictors of dosages and multiple doses during patient treatment by emergency medical service staff in order to enlighten this debate. Methods This was a prospective observational study of patients administered naloxone by the Oslo City Center emergency medical service, Norway (2014–2018). Cases were linked to The National Cause of Death Registry. We investigated the route of administration and dosage of naloxone, clinical and demographic variables relating to initial naloxone dose and use of multiple naloxone doses and one-week mortality. Results Overall, 2215 cases were included, and the majority (91.9%) were administered intramuscular naloxone. Initial doses were 0.4 or 0.8 mg, and 15% of patients received multiple dosages. Unconscious patients or those in respiratory arrest were more likely to be treated with 0.8 mg naloxone and to receive multiple doses. The one-week mortality from drug-related deaths was 4.1 per 1000 episodes, with no deaths due to rebound opioid toxicity. Conclusions Intramuscular naloxone doses of 0.4 and 0.8 mg were effective and safe in the treatment of opioid overdose in the prehospital setting. Emergency medical staff appear to titrate naloxone based on clinical presentation