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Empowering students’ agentive engagement through formative assessment in online learning environment
Get PDFThis study investigated empowering students to engage agentively in formative assessment of their English writing. To this end, student agentic engagement was explored drawing on multiple data collection. A Digitalized Engagement Enhancement Tool (DEET) was utilized to encourage students to record, unpack, plan for actions, and reflect on the feedback they received from the teacher and their peers. A series of content analyses was conducted to codify and track students’ engagement dimensions and practices in multiple writing samples, DEET, and student-revised sample writings. The analysis of the frequency of student engagement codes and their writing performances indicated a significant increase in student engagement at all dimensions. Further Chi-square analysis indicated that student agentic engagement was characterized by reciprocal and proactive practices in the critical assessment of their writing. The analyses indicated significant increase in the quality of student writing performances as well. Thematic analysis of students’ evaluation of self-perceived efficacy of DEET provided insights for teaching practitioners to build on the formative purpose of student engagement enhancement practices. The implications for teaching practitioners were discussed.publishedVersio
Between patient participation and healthcare standardization - The ordering of work in managing hand osteoarthritis
Get PDFIn this dissertation, I have explored the ordering of healthcare work in managing and coping with chronic illness, hand osteoarthritis, at the intersection of patient participation and healthcare standardization. The rising burden from chronic illness calls for new models of care. Care pathways and task shifting strategies are considered relevant responses in developing sustainable healthcare. These new healthcare models, when implemented, contribute to blurring the boundaries between patients and health professional in responding to chronic illness. Transforming working relationships between patients and health professionals from that of cure-and caregiving to partnering and co-creation alters actor positioning and responsibilities, and subsequently, decision-making. Healthcare standardization in tandem with stronger calls for patient participation also contributes to the shaping of healthcare working processes. Consequently, the boundaries between who should do what, when, where, how, and with what knowledge and skills become increasingly flexible as more responsibilities are shifted from health professionals and healthcare institutions to the chronically ill at home. Although healthcare work has been explored and understood from various academic disciplines, positions, and perspectives, the focus on healthcare organizations or healthcare professions often excludes patients from the activities that are involved in the healthcare working processes. At the same time, the literature on the work of patients highlights patient efforts in managing chronic illness. However, exploring the work of patients in combination with the work of health professionals and how those healthcare practices are shaped by patient participation and healthcare standardization, has been less explicitly studied. Against that backdrop, and in conceptualizing work as actions of patients and health professionals in negotiating order and change in the hospital, combined with activities involved in coping with a chronic hand condition at home, this dissertation explores the ordering of work in coping with and managing chronic illness. The dissertation is based on interviews with patients and health professionals, and observations in clinical consultations in two Norwegian hospitals specializing in rheumatology. The results presented in this dissertation are threefold. First, taken-for-granted ideas regarding hand osteoarthritis as ordinary and expected with age shape patient actions. Prior to, during and after clinical encounters, they make efforts to cope with, prioritize, and self-manage a chronic illness that does not warrant healthcare attention. The unacknowledged characteristics of patient work render it invisible despite considerable efforts in everyday life and illustrates how the interconnectedness of patient and health professional working processes are underpinned by negotiations, power, and dependency, which not only shape decision-making but also contribute to keeping the work of patients out of sight. Nonetheless, this articulation work of patients in managing chronic illness contributes substantially to seamless and coherent healthcare. Second, hospital working processes are shaped by a hierarchical ordering that impacts negotiations and decision-making. The diagnostic organization of tasks preserves rheumatologist authority and control over the direction of the trajectory, which in turn sets in motion the work of occupational therapists who enhance their responsibilities through evidence-based recommendations in rheumatology. In this process, occupational therapists align their clinical tasks with the tasks of rheumatologists, which contributes to establishing the necessary congruence to keep the trajectory on course. Although this work is central, the tinkering of occupational therapists is often taken for granted. Third, knowledge about hand OA was constructed from various sources of knowledge that were brought into consultations through a polyphony of ideas to make sense of chronic illness. Reaching new understandings conjointly serves as a catalyst for the activation of subsequent tasks when power is shared to make decisions that are understandable and acceptable to both patients and health professionals. In this process, health professionals use standards as tools rather than rigidly following pre-planned protocols and pathways, which enables the bringing together of relevant tasks into working arrangements. Similarly, in trusting health professionals to set the agenda, patients articulate work and bring tasks together when they make efforts to connect their own lifeworld with the healthcare world of standards. These working processes that are made into being through interaction, highlight the centrality of managing tensions and show how the work that is enacted along the illness trajectory is a complex process of negotiation where the actors depend on each other in ameliorating discontinuous elements to construct a coherent whole. These efforts of patients and health professionals in maneuvering the space between patient participation and healthcare standardization are not tasks that are formalized and assigned to particular actors. On the contrary, they are taken for granted by all stakeholders. Consequently, articulation work gets secondary value rather than being acknowledged as the supra-type of work that enables other work to function and get things accomplished in locally negotiated orders. In this everchanging healthcare environment, it is not just about preparing health systems and health professionals for the major ongoing shift in managing chronic illness through the restructuring of healthcare systems. Equally important is ensuring that patients are adequately equipped to cope with and manage their chronic conditions at home.
Denne avhandlingen utforsker organiseringen av helsearbeid i håndteringen av håndartrose i skjæringspunktet mellom pasienters deltakelse og helsetjenestens standardisering. Med økende sykdomsbyrde fra kronisk sykdom etterspørres nye måter å organisere helsetjenesten på. Pakkeforløp og oppgavedeling ansees som relevante strategier for mer bærekraftige helsetjenester. Dagens helsetjenester påvirkes også i stigende grad av standardiseringsprosesser sammen med økende krav om aktiv deltakelse fra pasienter. Samtidig endres forholdet mellom pasienter og helsepersonell når samarbeidet går fra å kurere sykdom og gi omsorg til å omhandle partnerskap og samskaping. Slike forandringer har betydning for aktørenes posisjonering og ansvarsområder når beslutninger skal tas rundt håndteringen av kronisk sykdom. Som en følge blir grensene for hvem som skal gjøre hva, når, hvor, hvordan og med hvilken kunnskap og ferdigheter stadig mer usikre og flytende når ansvar skiftes fra helseinstitusjoner og helsepersonell til kroniske syke hjemme. Arbeidsprosesser i helsetjenestene har blitt utforsket og forstått fra ulike fagdisipliner, posisjoner og perspektiver. Et særlig fokus på helseorganisasjoner og helseprofesjoner har ofte utelatt pasienter fra de aktivitetene som er involvert i arbeidsprosesser. Samtidig fokuserer litteraturen om pasienters arbeid på pasientens egeninnsats i håndteringen av kronisk sykdom. Imidlertid har det vært mindre fokus på hvordan pasienters og helsepersonells arbeid er sammenvevd og hvordan disse felles arbeidsprosessene formes av forventninger om pasienters deltakelse og standardisering av helsetjenester. Mot denne bakgrunnen utforsker denne avhandlingen forholdet mellom pasientdeltakelse og standardisering av helsetjenester i organiseringen av arbeidet med å håndtere kronisk sykdom. Avhandlingen er basert på intervjuer med pasienter og helsepersonell, samt observasjoner i kliniske konsultasjoner ved to norske sykehus spesialisert innen revmatologi. Ved å konseptualisere arbeid som handlinger fra pasienter og helsepersonell i forhandlinger om orden og endring på sykehuset, kombinert med aktiviteter knyttet til håndtering av en kronisk sykdom, søker denne avhandlingen å forstå noe av kompleksiteten som moderne helsearbeidsprosesser innebærer. Resultatene presentert i denne avhandlingen er tredelt. For det første formes pasienters handlinger før, under og etter kliniske konsultasjoner av tatt-for-gitt-ideer om håndartrose som noe som er vanlig og forventet med alderen. Dette gjør pasientens arbeid usynlig til tross for betydelige anstrengelser i dagliglivet, og illustrerer hvordan samspillet mellom pasienters og helsepersonells arbeid er forankret i forhandlinger, makt og avhengighet, som ikke bare påvirker beslutningstaking, men også bidrar til å holde pasientenes arbeid uten a syne. Likevel bidrar arbeidet som pasientene gjør med å håndtere kronisk sykdom i betydelig grad til å forbedre sammenhengen mellom de ulike oppgavene og aktørene gjennom sykdomsforløpet. For det andre er sykehusets arbeidsprosesser formet av en hierarkisk orden som påvirker forhandlinger og beslutningstaking. Den diagnostiske organiseringen av oppgaver bevarer revmatologens autoritet og kontroll over retningen på sykdomsforløpet, noe som setter i gang arbeidet til ergoterapeuter som øker sitt ansvar gjennom evidensbaserte anbefalinger innen revmatologi. I denne konteksten tilpasser ergoterapeuter egne terapeutiske oppgaver til revmatologenes medisinske oppgaver, noe som bidrar til å etablere den nødvendige sammenhengen for å holde behandlingsforløpet på rett kurs. Selv om dette arbeidet er sentralt, blir ofte ergoterapeutenes tilpasninger tatt for gitt. For det tredje er kunnskap om håndartrose konstruert fra ulike kunnskapskilder som bringes inn i konsultasjoner gjennom en polyfoni av ideer for å forstå kronisk sykdom. Det å nå nye forståelser i fellesskap fungerer som en katalysator for aktivering av påfølgende oppgaver når makt deles for å ta beslutninger som er forståelige og akseptable for både pasienter og helsepersonell. I denne prosessen bruker helsepersonell standarder som verktøy i stedet for å følge dem fullt ut, noe som gjør det mulig å samle relevante oppgaver til fungerende arbeidsprosesser. På samme måte og ved å stole på helsepersonell som setter dagsordenen, artikulerer pasienter arbeid og bringer oppgaver sammen når de gjør anstrengelser for å koble sin egen livsverden med helsetjenestens verden av standarder. Slike arbeidsprosesser som blir til gjennom samhandling, understreker viktigheten av å håndtere spenninger og viser hvordan arbeidet som blir utført gjennom sykdomsforløpet er en kompleks forhandlingsprosess der aktørene er avhengige av hverandre for å utjevne ujevnheter og konstruere en sammenhengende helhet. Dette sammenføyningsarbeidet fra pasienter og helsepersonell i å manøvrere mellom pasientdeltakelse og standardisering av helsetjenester er ikke oppgaver som er formalisert og tildelt bestemte aktører. Tvert imot blir de tatt for gitt av alle interessenter. Som en følge, får dette artikulasjonsarbeidet sekundær verdi i stedet for å bli anerkjent og opphevet som overordnet arbeid som muliggjør annet arbeid og gir resultater når pasienter og helsepersonell forhandler i lokale situasjoner. I en helsetjeneste i stadig forandring handler det ikke bare om å forberede helsesystemer og helsepersonell på den store pågående endringen i håndtering av kroniske sykdommer. Like viktig er det å sikre at pasienter er tilstrekkelig rustet til å håndtere sin kroniske sykdom i eget hjemmemiljø.publishedVersio
Self-perceived barriers to returning to work among employees with a low educational level on long-term sick leave: the “NOW WHAT” large-scale interview study
Get PDFObjective: Because employees with low educational levels have the highest rates of sick leave, this study aimed to identify the self-perceived return-to-work barriers of employees with low educational levels on long-term sick leave.
Methods: Employees on long-term sick leave with primary/secondary educational attainment were included from the NOW WHAT large-scale interview study (n=122). The World Health Organization’s system of classifying functioning, disability, and health guided the deductive content analysis.
Results: 1,942 meaning units describing return-to-work barriers across all classifications were identified. The most frequent components were body functions (n=552, 28%, mean=4.5), with mental functions (e.g., sleep, tiredness, emotional and cognitive functioning) the most frequent barriers; environmental factors (n=414, 21%, mean=3.4), with services, systems ,and policies (e.g., social security, healthcare system) the most prevalent barriers; activity limitations (n=352, 18%, mean=2.9); and personal factors (n=323, 17%, mean=2.6).
Conclusion: Employees with low educational levels on long-term sick leave described a wide range of return-to-work barriers and combinations thereof. In addition to health-related functional barriers, identifying environmental, activity-limitation, and personal barriers is important to enhance understanding of this group’s potential determinants of absence from work.publishedVersio
Payment Problems and Suicide: Life under Financial Strain
Get PDFAims: Suicide deaths are often linked to impulsivity during moments of crisis, such as financial difficulties, relationship
breakdowns and poor health. For individuals experiencing financial problems, risk factors for suicide can commonly include
circumstances surrounding payment problems, including unemployment, divorce, low education and low income mediated by debt.
Methods: In this study, we investigate the impact of payment problems on suicide in Norway using a spline-based parametric survival analysis, with suicide as the outcome variable. With access to high quality Norwegian register data and unique information on payment problems, defined as deductions in wages or benefits, we investigated suicide amongst the entire adult Norwegian population over an 11-year period (2008–2018).
Results: We found that the prevalence of payment problems among the Norwegian population between 2009 and 2018 was associated with a higher risk of suicide for both males and females. Despite the greater proportion of suicide occurring amongst males both globally and in Norway, we found that women experiencing financial hardship had a relatively higher suicide risk when adjusted for demographic variables than their male counterparts.
Conclusions: These findings highlight the need for stronger protections for individuals struggling with financial difficulties and emphasise the importance of further research on the relationship between payment problems and suicide, with the aim of informing and enhancing national suicide prevention strategies.publishedVersio
Negotiating digital traces. The epistemic power of recorded police data
Get PDFDrawing on two empirical cases in different Norwegian police units, we explore how the increasing data gathering, recording, sorting, standardizing, and integration required by the Norwegian police's Intelligence Doctrine is experienced by users. Inspired by domestication theory, we provide new insights into police officers’ varied perceptions, interpretations, and use of data. Our main finding is that digital traces were not necessarily used as the steered and managed intelligence process envisioned in the Intelligence Doctrine, and that this led to various adverse outcomes. Police officers engaged with recorded and digital traces in varied ways—rejecting, resisting, ignoring, supporting, adopting, or negotiating them. The intelligence process was constrained by bias inherent to the system, which resulted from focusing information gathering on what was already available, and from connecting it to recurrent individuals and problems. In the processes of turning analogue objects into digital ones, police officers’ gut feeling and intuition still mattered, for example when information was selected for the crime intelligence system. The way the police related to the epistemic power of the data varied, but officers were obliged to relate to this uncertain element. Despite the standardized framework for how data should be applied, differences in practical routines, the digital tools used, symbolic work and learning processes revealed that its domestication in the police organization was messy. We found gaps between policy and practice, which can be seen both in unexpected workarounds and in solutions for organizing routines and everyday work. These reciprocal processes influenced and were influenced by police culture. As police intelligence evolves, the interpretation and utilization of recorded data may change, especially with the use of algorithms and artificial intelligence. Future research will show how police navigate between data-driven and observation-based narratives, and how this affects their social identity within a continuum of “datafied” and “contextual” police culture.publishedVersio
Erfaringer med å kombinere arbeid og omsorg når partneren er alvorlig kreftsyk
Get PDFBakgrunn: Forskning viser at det kan være utfordrende for partnere til personer med alvorlig kreftsykdom å delta i yrkeslivet og/eller utføre arbeidsoppgavene tilfredsstillende fordi denne omsorgsrollen gir økt ansvar hjemme. Det er mangel på kvalitativ forskning som belyser pårørendes egne erfaringer med balansen mellom omsorgsansvar og yrkesaktivitet.
Hensikt: Vi ønsket å utforske erfaringene til pårørende som har hatt en partner med alvorlig kreftsykdom. Det mest interessante var hvordan de opplevde å ha en omsorgsrolle og samtidig være yrkesaktiv.
Metode: Vi benyttet et kvalitativt design og utførte elleve individuelle dybdeintervjuer med respondenter fra Kreftforeningens brukerpanel. De inkluderte respondentene var gjenlevende partnere som hadde hatt en samboer eller ektefelle som hadde dødd av kreft, og som var yrkesaktive under partnerens sykdomsperiode. Som metodeverktøy brukte vi tematisk analyse – en metode for å identifisere, analysere og skildre mønstre i kvalitative data.
Resultater: Tre hovedtemaer ble identifisert: 1) «Begrensninger i arbeidsdeltakelse», 2) «Glede ved å opprettholde eget arbeid» og 3) «Omsorg for partneren i arbeidshverdagen». Deltakerne møtte ulike begrensninger som gjorde det utfordrende å delta fullt i arbeidslivet. Samtidig poengterte de at det var viktig å kunne jobbe for å få energi og et pusterom. Få omtalte økonomiske vanskeligheter, men flere beskrev innvendinger mot dagens økonomiske og ikke-økonomiske støtteordninger. De understreket hvor viktig det var å kunne yte omsorg og støtte partneren sin, både praktisk, psykososialt og i møte med helsevesenet.
Konklusjon: Utsagnene i studien vår samsvarer godt med det som er rapportert tidligere: at det er komplisert å stå i arbeid samtidig som man har en omsorgsrolle. Selv om det er viktig å ha en jobb å gå til, opplevde mange det som enda mer verdifullt å kunne stille opp for partneren. Mange hadde imidlertid hatt en vanskelig tid etter partnerens død, og flere etterlyste støtteordninger som ikke var tilgjengelige.publishedVersio
Understanding and assessing CBAM: vulnerability and impacts in the EU. SPES Working Paper no. 7.2, SPES project – Sustainability Performances, Evidence and Scenarios.
Get PDFThe European Union (EU) has made significant progress in reducing CO2 emissions in recent decades, partly due to the implementation of the EU Emissions Trading System (EU ETS). However, the decline in emissions has not been matched by an equally substantial reduction in the continent's carbon footprint. In addition, some European companies, in order not to be subject to EU climate regulation, could have relocated production abroad, thus confirming the risk of the so-called carbon leakage. To remedy this problem, the EU has proposed a Carbon Border Adjustment Mechanism (CBAM), through which a carbon quasi-tariff, determined based on the embodied emissions of the good and priced according to EU ETS criteria, would be imposed on imports of non-EU products from specific sectors. The measure, scheduled to enter into force in 2026, is expected to be compatible with WTO regulation. It should limit carbon leakage effectively, indirectly support European competitiveness, and stimulate other jurisdictions to implement their own carbon markets. At the same time, it poses some critical issues regarding adherence to the Common But Differentiated Responsibilities and Respective Capabilities (CBDR-RC) principle. Also, it has a possible negative socio-economic impact on vulnerable countries inside and outside the EU. At the European level, the 2021 European Commission's impact assessment and subsequent CBAM-covered goods trade data do not show a relevant CBAM negative effect on the European economy. However, the mechanism may hit the Mediterranean Member States and some in Eastern Europe the hardest. Considering this, the new Commission proposed to amend the CBAM with some revisions during the European Clean Industrial Deal presentation in February 2025. The revisions aim to support the European small, medium and large enterprises most exposed to CBAM, with the hope that this will not translate into a reduction in continental climate ambitions.publishedVersio
A note on the NOR-RETIN survey: Data and methodology
Get PDFAppendix to NIBR policy brief 2025:1 - Reception, integration and future prospects of Ukrainian refugees in the Nordic countriespublishedVersio
The Bumblebee Project: Systems Thinking About the Environment
Get PDFLearning about organisms that are familiar to young students can be a fruitful way to engage in biological diversity and may create an opportunity for the teacher to link the organism to the ecosystem. In this chapter, we investigate how using picturebooks and trips outside, while focusing on bumblebees and their place in the ecosystem, promote systems thinking, critical thinking, and eco-citizenship.publishedVersio
Undersøkelser av årsaker til høy tidsbruk i plansaker og forslag om mer effektive planprosesser
Get PDFKommunal- og distriktsdepartementet ba om en undersøkelse av årsaker til høy tidsbruk i plansaker og forslag om tiltak for å sikre mer effektive planprosesser.
Det er gjennomført en kartlegging av årsaker til tidsbruk gjennom statistisk analyse og casestudier. Det er undersøkt om det er trekk ved plansakene (pressområder, fortetting osv.), trekk ved selve planprosessene (særskilte hensyn, klager osv.) eller trekk ved kommunal organisering som gjør at plansaker tar lang tid. Det er i tillegg studert 10 case i 5 kommuner nærmere gjennom intervju med utbygger og kommune. Det er i tillegg drøftet foreløpige funn i en referansegruppe der bransjeaktører har vært representert. På bakgrunn av kartleggingen er det gitt en del anbefalinger for å redusere tidsbruken i planprosesserpublishedVersio