The importance of reliable information exchange in emergency practices: a misunderstanding that was uncovered before it was too late

Background: Many medical emergency practices are regulated by written procedures that normally provide reliable guidelines for action. In some cases, however, the consequences of following rule-based instructions can have unintended negative consequences. The article discusses a case - described on a type level - where the consequences of following a rule formulation could have been fatal. Case presentation: A weak and elderly patient has cardiac arrest, and a Do Not Resuscitate (DNR) clause is written in the patient’s medical record. Paramedics at the scene cannot see that the patient’s general appearance match conditions which would indicate the DNR clause, so they start cardiopulmonary resuscitation (CPR), and the patient survives. This turns out to be a crucial decision. The DNR clause is from an earlier bout with serious disease from which the patient has recovered, against all odds, and someone has forgotten to remove the clause from the medical record. Analysis: In order to be able to interpret the validity of written guidelines, paramedics and other health workers need to develop personal skills that transcend the ability simply to follow written instructions. Within traditional virtue ethics, personal judgment is conceived of as crucial for being able to make ‘good’ autonomous decisions. Virtue ethical analyses, decision-making abilities and non-technical communication skills are important as conceptual tools when health workers need to make difficult clinical decisions. Conclusion: The case study accentuates the significance of prudent judgment in medical practice. In the case described, the consequence of trusting the written advance directive could have been fatal, but the point is general: for the purpose of achieving excellent organizational performance, it is insufficient for health workers to rely uncritically on rules and procedures. Even the clearest rule formulations must be interpreted contextually in order to determine ethically correct behavior and avoid potential negative consequences that are not in the patient’s best interests

”Motives and Meaning for Long-Term Indoor Exercise"

English abstract: This qualitative study was designed to explore the motives and what gives meaning (is pleasure something meaningful) to Norwegian people who maintain for a long time regular indoor exercise regime. There are few studies on this phenomenon in Norway. The theory of hedonism in exercise informed this study. Six long-term adhering exercisers (three men and three women) were interviewed about their exercise experiences and feelings of pleasure and displeasure when exercising indoor. A phenomenological approach was used for designing and implementing the study and a thematic analysis was performed to analyze the information gathered. Several elements about a regular exerciser’s motives and meaning were identified and organized within five themes: one’s exercise habits, ways to overcome barriers, choosing own exercise, the exercise environment, and the exercise induced affect. All participants had a goal that helped them exercise on a regular basis; with health and fitness level goal or high performance goal, yet the goal was there. All participants also had developed a high level of self-awareness regarding their bodies and of knowledge regarding exercise types and intensities. Concerning the meaning of the experience and the role of pleasure in it, five of the six participants in this study highlighted the important of pleasure during exercise. To experience the desired pleasure the exercisers select on their own the exercise intensity considering their mental and physical state for the day and time being. Earlier exercise experiences appear to play a positive role for the adherence the exercisers experience today. Last but not least, the participant shared that while they feel pleasure in the exercise environment, sometimes social pressure pushed them to do things differently like increase their exercise intensity in the presence of others. These findings are discussed in relation to the recommendations for physical activity levels provided by the Norwegian government, which are clear and suggest that people need to get more physically active. While this is a qualitative study and its findings should be generalized, as people come into the fitness centers with different experiences and goals, some suggestions are offered for the fitness practitioner who ought to help clients find pleasure in the act of exercise in order to achieve exercise adherence

Radical design processes for systemic change

To enable radical design in safety-critical collaborative workplaces, there is a need to engage a wide range of stakeholders. This paper reports on three design presentations carried out with the purpose of enabling systemic changes necessary to carry out a complete redesign of current ship bridges for advanced marine operations. The presentations showed possible future bridge designs developed from an extensive design-driven research and development project. The presentations were held inside the company commissioning the innovations and publicly at industrial meeting places where customers, sub-suppliers and regulatory authorities meet. We present the objectives, target groups, our strategy, the means of presentation and the results. Our preliminary work suggests there is a close relation between the presentations and the research and development project's ability to introduce radical innovations to marine industry. The presentations have aligned stakeholder expectations of future bridge development and as such prepared the community for systemic changes. We suggest the three presentations are examples of how design presentations can serve as systemic interventions that prime social systems so as to more easily accept and support radical innovation processes

Can price reversals on Oslo Stock Exchange be exploited?

We investigate if price reversals on the Oslo Stock Exchange can be exploited using a twofold method. Our method includes stock selection based on variance ratios and simulation of portfolio performance using a contrarian trading strategy. Existing evidence of mean reversion from major stock exchanges motivate our approach. Our results show consistently better performance for portfolios sorted by desirable variance ratios than for portfolios with undesirable variance ratios. However, most of these portfolios fail to produce excess profits after transaction costs

Poesi og lingvistiske kontraster: språklig oppmerksomhet i klasserommet

I denne artikkelen analyserer vi et flerspråklig diktprosjekt ut fra mulighetene det gir for metaspråklige samtaler og dermed metaspråklig bevissthet hos elevene. Spørsmålet vi stiller er: Hvordan kan poesi benyttes didaktisk for å fremme metaspråklig bevissthet i en språkheterogen klasse? Prosjektet er prøvd ut i en sjetteklasse i Oslo. Poesi på mange språk – lesing og skriving av dikt – er i analysen brukt for å belyse det Bialystok (2001) og andre har omtalt som språklig oppmerksomhet, en oppmerksomhet rettet mot språklige fenomener. En slik språklig oppmerksomhet er en forutsetning for å sette i gang prosesser for å øke det som av forskere helt siden tidlig litterasitetsforskning og andrespråksforskning er omtalt som metaspråklig bevissthet (blant annet Birdsong 1989, Yaden & Templeton 1986)

«Man må regne med å dø når man er over 60 år». En KLoK-oppgave om utfylling av dødsattest og unaturlige dødsfall

Gruppen har valgt utfylling av Legeerklæring om dødsfall/Melding om unaturlig dødsfall (dødsattest) som tema i denne prosjektoppgaven, nærmere bestemt delen som omhandler registrering og melding av unaturlige dødsfall. Problemstillingen lyder som følger: Hvordan endre dødsattesten for å forbedre registrering ,og melding til politiet, av unaturlige dødsfall? Kunnskapsgrunnlaget for oppgaven baseres i stor grad på det norske lovverket, i tillegg også publiserte forskningsresultater fra Akershus Universitetssykehus (Ahus). Kvalitetsforbedringsprosjektet finner sted på Ahus og skal gjennomføres ved å gjøre endringer i dødsattestskjemaet i DIPS. Gruppen planlegger å benytte seg av en resultatindikator der man sammenligner andel unaturlige dødsfall som blir registrert og meldt til politiet før og etter prosjektperioden. Vi vurderer vårt tiltak til å være gjennomførbart. Hvis tiltaket fungerer på Ahus, bør det også innføres på nasjonalt plan

Between the tag and the screen : redesigning short-range RFID as design material

Article-based thesis. Article 3 has been excluded from this digital version due to copyright restrictions.Industrial and interaction designers are increasingly faced with new computational technologies that may be used as materials in designing. Such materials are important in design practices because they offer conditions for conceptualisation and production of new designs. However, new computational technologies are often very complex and not presented with the intention of supporting design practices. This study explores such a problem by way of a study of Short-Range RFID (SR-RFID) as design material. SR-RFID is a new computational technology that enables a transaction of information between a radio transmitter and an RFID tag when the two are within a very short range (2-5 cm). As a design material, SR-RFID crosses the traditional boundaries between industrial and interaction design by offering temporal and spatial properties that may be shaped by both disciplines. In investigating SR-RFID as a design material, we are faced with two important challenges. First, the available information concerning SR-RFID in relation to industrial and interaction design is limited and often oriented toward finished solutions rather than exposing potentials for designing. Second, it is difficult to find frameworks that show how to analyse such a technology so as to present it as a material specifically oriented toward industrial and interaction design. I meet this challenge by applying a process of research by design. In this process, a series of explorative design probes has been carried out with the purpose of exposing design-related properties of SR-RFID. The design research has been conducted by a multidisciplinary team of researchers and designers as part of a larger research project called Touch. Central to my study is the use of activity theory in building a conceptual framework that allows the analysis of computational technology as design material. This framework has been applied to SR-RFID in order to re-conceptualise it for designing. The study has found that in order to understand SR-RFID in relation to industrial and interaction design it is useful to reinterpret it as a design material. I offer three main reflections on SR-RFID as design material. First, I argue that SR-RFID may be seen as near-field material. This material is specifically oriented toward industrial and interaction designers' form-making. Second, I present how SR-RFID may be seen as a conceptual material that helps us focus on material properties that have special significance in the creation of forms. Third, I argue that when creating design materials for industrial and interaction design, we should pay particular attention to the concept of motive. Motives may help us understand what SR-RFID means in designers' activity. The results of this study offer one example of how activity theory could be used in interaction and industrial design research to understand materials. Furthermore, it expands upon current research that investigates computational technology as materials. In addition, new insights into the makeup of SR-RFID are offered that may be further appropriated and used in design and design teaching

The Mongolian's peoples republic, 1924-1928, and the right deviation

The thesis examines the history of the MPR between 1924 and 1928, establishes a chronology of events and identifies the personalities involved. It describes the creation of political structures after Soviet models; the transfer of the Mongolian economy from the Chinese to the Soviet system; the growth of secular education; and the attempt to subject the organization and economic power of the Buddhist church to state control. These developments were strongly influenced by the Mongols' desire to remain independent of China and to assume the form and characteristics of powerful nation-states. However the heavy demands of allegiance to the USSR and the Comintern distorted native aspirations and compelled Mongols to give up ideas of Pan-Mongolism, Buddhist reform and an independent foreign policy. Until the end of 1926 modernization and the integration of the MPR into the Soviet system was gradual but from 1927 the Comintern ordered stricter measures of class discrimination, harsher religious policies and a more rapid construction of state capitalism. Some Mongolian leaders believed the demands unsuitable to Mongolian conditions. The Comintern fomented differences among the leadership and in 1928 most former MPRP leaders were ousted on the charge of Right Deviation. The USSR's deteriorating foreign relationships and Stalin's plan for the rapid industrialization of the USSR were root causes of this development. Unquestioning loyalty of the MPR to the USSR was required for strategic reasons. Cooperative and state forms of capitalism would facilitate the transfer of more Mongolian products to the Siberian industries. The thesis draws the conclusion that the MPRP submitted to Comintern demands in 1928 through conviction, coercion and because there was no alternative ally prepared to guarantee Mongolian independence. It also points to the experience of the MPR as a suitable development model for nomadic, pre-industrial societies. The MPR may also be compared with other states traditionally linked with China but now closely associated with the USSR