Skriftserien
https://skriftserien.oslomet.no/index.php/skriftserien
<p><img class="forside" alt="" src="/plugins/themes/skriftserien/skriftserien_4_farger.jpg"></p> <p>Skriftserien publiserer avhandlinger, temahefter, småskrifter og rapporter som er skrevet ved Høgskolen i Oslo og Akershus.</p> <p>Alle titler kan også <a href="http://www.hioa.no/Om-HiOA/Skriftserien-publikasjoner-fra-HiOA">kjøpes trykt</a>.</p> <h3>ISSN:</h3> <ul> <li class="show">HiOA Avhandling: 1893-0476</li> <li class="show">HiOA Rapport: 1892-9648</li> <li class="show">HiOA Tema: 1893-0425</li> <li class="show">HiOA Småskrift: 1893-4609</li> </ul>OsloMet - storbyuniversitetetnb-NOSkriftserienInstapoetry as a post-digital phenomenon
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/907
<p>This article-based dissertation investigates the cultural phenomenon of instapoetry as platformized pop poetry. This involves investigating exactly how and in what way instapoetry is bound to the digital social media platform Instagram by approaching the platform as a media ecology for instapoetry, as well as how it is interlocking, overlapping, and interacting with other media ecologies. This provides an opportunity to study both the effects of the platform’s infrastructure and the platform as infrastructure. The study applies a mixed methods digital humanities approach to answer the main research question: How can we understand instapoetry as a post-digital cultural phenomenon? Instapoetry is situated in the post-digital. Platformization is a particular articulation of the postdigital, and much research has gone into investigating the platformization of contemporary cultural production. At the same time, the distributional turn in the humanities, an infrastructuralist and materialist re-orientation in the study of the storage, transmission, and interpretation of culture, has shown the need to account for the effects which media infrastructures, as they are what position and shape agents, objects and processes in media ecosystems of cultural production. Supported by an extensive data collection of Scandinavian instapoetry in the form of ca. 35 000 Instagram posts and their metadata, the dissertation provides a new entry point into the phenomenon. The first article of the dissertation analyses the materials found in the tagged platform archives of the well-known Norwegian instapoet Trygve Skaug. In accounting for how instapoetry is bound to Instagram, the article contributes with a conceptualization of the post-digital distribution process of instapoetry as a defining trait of how instapoetry moves on, off, and through the platform. The article contributes by outlining a particular genre of instapoetry: the instalyric. This is a lyric made for the type of repetition activated by the distributional processes of Instagram. The second article, co-written with Dr. Eleonora Ravizza, concerns curation, canonization, and access to data. We argue that algorithmic curation on social media platforms makes specific works more visible than others by a different selection process than what is the case for literature and other types of art in other cultural ecosystems. This influences the choice of objects to study. We argue that a fruitful way to bypass this is to collect and investigate large data sets. However, when this is stopped by the platform companies, this has severe implications for studying phenomena that exist digitally on these platforms. The third article is an exploration of the phenomenon through the extensive collected data collection scraped from Instagram. Here, aggregated patterns are made manifest, and a visual network analysis of a hashtag co-occurrence network provides knowledge on topics and themes, as well as where instapoetry exists on Instagram. The findings from this article provide a basis for the selection of the instapoet accounts examined in the fourth article. The fourth article investigates the platformed practices related to instapoetry by asking when a poet is an instapoet. Socio-technical processes are investigated to provide a basis for understanding what platformed relations exist between the poet, platform, and audience. The article argues for understanding the instapoet as a specific role a poet can have that goes beyond using Instagram as a marketing tool and instead place it in closer connection with platformed participatory culture. Combined, the articles demonstrate that instapoetry is a particular articulation of the post-digital in the form of platformized poetry. The different articulations of platform dependency and platform specificity that come with being platformized are used to develop a theorization of instapoetry as pop poetry, which relies on Instagram for distribution and circulation. This dissertation contributes to the study of contemporary pop poetry and to the important field of culture organization, where the study of how something is organized also means accounting for how it shapes what it organizes.</p>Camilla Holm Soelseth
Copyright (c) 2025 Camilla Holm Soelseth
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2025-01-312025-01-31Group Recommendation Systems With Pairwise Preference Data
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/904
<p>Bakgrunn og Motivasjon: Gruppeanbefalingssystemer (GRS) er utviklet for å finne ut hva en gruppe mennesker liker og til å foreslå ting de vil ha glede av sammen. Disse systemene har som mål å matche de kombinerte preferansene til alle i gruppen. GRS er nyttig for sosiale aktiviteter som å se på film, spise ute og planlegge turer, hvor beslutninger gi et best mulig resultat for flere med ulike preferanser. Den største utfordringen er å kombinere de ulike preferansene til én anbefaling som gjør alle fornøyde. Denne forskningen fokuserer på å forstå hvordan grupper tar beslutninger og å utvikle algoritmer som nøyaktig kan forutsi hva en gruppe vil sette pris på. Å lykkes med å løse denne utfordringen kan gjøre gruppeaktiviteter mer hyggelige og harmoniske.</p> <p>Målsetninger: Hovedmålet med denne forskningen er å foreslå nye metoder for gruppeanbefalinger som er rettferdige og presise. For å oppnå dette målet er seks forskningsspørsmål (RQs) formulert: [RQ1] Hvordan kan bruk av parvise preferansedata løse begrensningene ved enkeltratingsdata for å øke effektiviteten til GRS? [RQ2] Hvordan bidrar klynging av brukere basert på lignende preferanser til å forbedre rettferdigheten i anbefalingssystemer? [RQ3] Hvordan kan prediksjon av manglende data i parvise preferansedatasett effektivt håndtere kaldstartproblemet i GDM og GRS? [RQ4] Hvordan kan vi utvikle modeller for å bedre forstå og inkorporere påvirkningene blant medlemmers preferanser, og dermed forbedre gruppeanbefalinger? [RQ5] Hvordan kan utnyttelse av mangfoldige likhetsegenskaper hos brukere overkomme begrensningene til tradisjonelle gruppeanbefalingssystemer for å forbedre anbefalingsnøyaktigheten? [RQ6] Hvordan kan aggregasjons- og konsensusmekanismer forbedre gruppeanbefalingssystemer?</p> <p>Metoder: Denne forskningen foreslo og anvendte metodologier som kan klassifiseres i tre hovedkategorier: Først benyttet vi parvise preferansedata og forutså manglende verdier. For det andre utforsket vi brukergruppering gjennom introduksjon av klyngingsteknikker som GcPp, MFP-basert mangfoldsklynging og GCN-basert mangfoldsklynging. I denne sammenhengen undersøkte vi forskjellige metoder for å beregne brukersimilaritet, hvorav noen ble foreslått for første gang. For det tredjeutviklet vi konsensus- eller aggregeringsmetoder som kombinerer individuelle brukerpreferanser for å danne en helhetlig gruppepreferanseprofil, som er essensielt for å konstruere gruppeanbefalingsmodellen.</p> <p>Bidrag: Hovedbidragene fra denne studien inkluderer:</p> <p>• Introduksjon av en entropibasert matrisefaktoriseringsteknikk for å forutsi manglende verdier i parvise preferansedatasett, som har bred anvendelse i gruppeanbefalingssystemer og gruppedynamikk.</p> <p>• Forslag til flere metoder for å forutsi brukersimilaritet ved bruk av parvise preferansedata, som viser høyere nøyaktighet sammenlignet med enkeltratingsdata.</p> <p>Disse similaritetsscorene ble beregnet ved hjelp av ulike metoder:</p> <p>1. Brukersimilaritet basert på preferansegraf og grafkonvolusjonsnettverk (GCN).</p> <p>2. Brukersimilaritet basert på brukervektorer hentet fra: a) Bruker-itemscores oppnådd fra matrisefaktorisering (MF). b) Brukerinnleiringsvektorer fra en trent matrisefaktoreringsmodell. c) Brukerinnleiringsvektorer fra vektene til et trent grafnevralnettverk.</p> <p>• Utvikling av klyngemetoder for å gruppere brukere med lignende preferanser for å fasilitere generering av rettferdige gruppeanbefalinger, som:</p> <p>1. Dominant set klynging.</p> <p>2. Mangfoldsbasert klynging, som minimerer brukermangfoldsscorer innenfor grupper.</p> <p>• Introduksjon av en konsensusmetode basert på brukerpersonligheter, som reflekterer virkelige scenarioer hvor brukerens bidrag til gruppebeslutninger avhenger av deres personlighetstrekk.</p> <p>• Utvikling av aggregeringsmetoder som tar hensyn til bidragene fra individuelle brukere i den endelige gruppedynamikken. Disse bidragene beregnes ved hjelp av konsepter som Shapley-verdi og Wonderful Life Utility.</p>Roza Abolghasemi
Copyright (c) 2025 Roza Abolghasemi
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2025-01-312025-01-31Between patient participation and healthcare standardization
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/911
<p>In 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.</p>Hege Johanne Magnussen
Copyright (c) 2025 Hege Johanne Magnussen
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2025-02-042025-02-04The Impact of Dry Eye Disease before and after cataract surgery
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/920
<p>The outcomes of modern cataract surgery are generally very good. About 80% of patients achieve the intended refractive precision within 0.5 diopters. Only a few patients experience refractive errors of more than 0.75 or 1.0 diopters, which may be a considerable source of dissatisfaction for these patients. Especially when patients choose advanced IOLs to amend refractive errors. Dry eye disease (DED) is one factor that can result in an undesired refractive outcome when using a reflection-based keratometry. Additionally, cataract surgery can contribute to or worsen dry eye conditions post-surgery. The main aim of this thesis was to investigate whether dry eyes could affect the outcome of cataract surgery. Our first and second studies aimed to determine whether the variability of keratometry was affected by dry eyes and if dry eye treatment could improve this variability and, consequently, improve refractive precision. The results showed that subjects with either instability (reduced break-up time) or hyperosmolarity of the tear film had a statistically significantly higher mean variability of keratometry or proportions of outliers (difference > 0.25 D) when measured with reflection-based keratometry. There was no statistically significant difference in the variability of keratometry for patients with the combined signs of DED from baseline to the time of cataract surgery. There were no statistically significant differences in refractive predictability for dry eye subjects (treated with artificial tears or untreated) versus non-dry eye subjects. The aim of our third study was to explore differences in osmolarity between the two eyes as a diagnostic criterion for dry eye disease (DEWS II recommendations). Chi-square analyses were performed to compare this criterion to other criteria for DED. The results revealed that the inter-eye difference did not correlate with any other dry eye tests, suggesting that an intereye difference of 8 mOsmol/L is not a useful cut-off for diagnosing dry eyes. In the fourth and the last of our studies, we aimed to evaluate the effects of preservative-free NSAIDs, corticosteroids, and trehalose/hyaluronic acid eye drops versus NSAIDS and corticosteroids with preservative benzalkonium chloride for patients with dry eyes and nondry eyes after cataract surgery. We discovered that subjects with dry eyes before surgery (signs and symptoms) improved six weeks after cataract surgery. The effect of the steroids could explain this improvement. In contrast, subjects without dry eyes became worse. We concluded that preservative-free eye drops and artificial tears had no beneficial effects. Our research in the first study found that the signs of hyperosmolarity and instability of the tear film associated with DED can affect reflection-based keratometry, potentially affecting refractive precision. However, the combined criteria of DED appear to be insufficient to assess if patients are at risk for uncertain keratometry measurements. Our results showed that lubrication and preservative-free eye drops are insufficient to improve refractive predictability. Further research on different DED treatments is required. However, we suggest that patients with reduced break-up time should have repeated biometric measurements and that IOL calculations can be based on averaged keratometry. An inter-eye difference in osmolarity of more than 8 mOsmol/L seems unsuitable for diagnosing DED and requires re-evaluation (third study). Finally, our fourth study found no positive effects of preservative-free eye drops and twoweek treatment with lubricants in a cohort of patients scheduled for cataract surgery.</p>Christian Nilsen
Copyright (c) 2025 Christian Nilsen
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2025-03-102025-03-10Generation of full-length mRNA transcriptome and miRNA target prediction resources utilized in the study of miRNAs associated with response to Moritella viscosa infection in Atlantic salmon
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/909
<p>Atlantic salmon (salmo salar) is an important aquaculture species around the world. Infectious diseases, including the bacterial pathogen Moritella viscosa, which causes Winter Ulcer disease, remains a significant issue for salmon aquaculture. As part of the efforts to counter these problems, researchers have studied the genetic component of the Atlantic salmon’s disease response to viral and bacterial pathogens. MicroRNAs (miRNAs) are regulatory non-coding RNAs that play important roles across many species in fine-tuning the expression levels of proteins through targeted binding to mRNA transcripts. Included among the transcripts they regulate are many which encode immune-pathway proteins. The study of which genes are post-transcriptionally regulated by miRNAs in Atlantic salmon has, however, been hampered by the lack of access to 3’UTRs from full-length (FL) sequenced mRNA transcripts. An evolutionarily recent whole-genome duplication event in salmonids makes the short-read sequencing methods less reliable at producing such information, as these methods are less capable at differentiating between transcripts that are splice variants of each other or are from highly similar paralogs. We developed a generalized bioinformatics pipeline for the generation and functional annotation of full-length transcriptomes based on hybrid-corrected PacBio long-read SMRT sequencing to address the lack of full-length resources. This pipeline was employed to produce a de novo transcriptome for Atlantic salmon consisting of 71 461 FL sequenced mRNAs from 23 071 loci. Comparisons to the existing transcriptome resources revealed that the FL-transcriptome verified many of the predicted transcripts in the refseq database (25% of reference). However, the majority of the transcripts (70% of the FL-transcriptome) were novel splice variants or from uncharacterized paralogs. All transcripts in the FL-transcriptome unambiguously tied the UTR sequences to the CDS of the specific isoform or paralog variants. Capitalizing on this, all the unique 3’UTR sequences from the mRNA transcriptome were extracted in silico and used in miRNA target gene prediction analysis. The target prediction analysis utilized a weighted hybrid verification approach where each predicted target transcript had to be supported by the RNAHybrid algorithm as well as at least two of three other common target prediction tools. The complete set of target gene predictions, published as the MicroSalmon database, allowed users to search for the predicted targets of each of the Atlantic salmon miRNA along with their functional annotations. Known and putative novel cis-regulatory motifs present in the 3’UTR of each of the FL-transcripts were also characterized and may be searched for in the database. Differential expression studies of miRNAs (small RNA sequencing) and mRNAs (microarrays) identified 52 guide miRNAs and ~4500 protein coding transcripts associated with M. viscosa infection. The observation of concurrent changes in expression levels (both miRNAs and mRNAs) helped identify input lists for MicroSalmon, and predicted target genes of the disease responding guide miRNAs were identified among the differentially expressed protein coding transcripts. These functionally annotated target genes were subsequently used in enrichment analyses. These revealed that target transcripts of the disease-associated miRNAs were significantly overrepresented in gene networks associated with immune response, response to bleeding, wound healing, cell cycle control and response to stress. The distribution of enriched biological functions seemed to be partially tissue-specific, with headkidney materials expressing genes related to haemostasis and general immune responses, while the lesion site materials showed enrichment of genes related to death and breakdown of infected cells and the growth of new cells. Several orthologs of the conserved disease responding miRNAs displayed similar disease-related responses in other species, supporting them having the same roles in Atlantic salmon. These miRNAs also included teleost-specific immune miRNAs like miR-2188 and miR-7132. In conclusion, this study provided important new knowledge suggesting that certain miRNAs have important functions in response to bacterial infections. The findings may be utilized in future studies investigating whether the disease responding miRNAs have potential as infection biomarkers, as therapeutic tools, or as biomarkers in marker assisted breeding.</p>Sigmund Ramberg
Copyright (c) 2025 Sigmund Ramberg
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2025-01-312025-01-31Hand hygiene, infection prevention and antibiotic use in nursing homes
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/906
<p>Background: Healthcare-associated infections (HAIs) pose a major threat to patient safety. Nursing home residents are particularly vulnerable to severe consequences of infections, including hospital admission and death, due to the likelihood of reduced immunity, chronic disease, polypharmacy, and cognitive impairment. Many HAIs can be prevented, with good hand hygiene being the most cost-effective preventive measure. Infections are often treated with antibiotics, although unnecessary use can increase antimicrobial resistance, which is a global public health problem. Few studies have explored how to improve hand hygiene in nursing homes and if doing so can reduce infection and antibiotic use rates, and none in Norway.</p> <p>Aims: This study sought to test new methods to achieve a long-lasting behavior change in terms of hand hygiene practices among healthcare workers in nursing homes. Thus, it explored healthcare workers’ hand hygiene practices (Paper I), infections and antibiotic use among residents (Paper II), and the effect of interventions on both hand hygiene practices and infection and antibiotic use rates (Paper III).</p> <p>Method: This quasi-experimental study involved 22 nursing home wards. The wards reported on infections and antibiotic use weekly for 18 months (February 2021 to August 2022). Hand hygiene adherence was measured in February and March 2021 and September and October 2022 using the World Health Organization’s (WHO’s) validated observation tool. After six months, three wards with mean values for hand hygiene adherence and infection rates were chosen to implement interventions based on Bandura’s behavior change theory. The remaining 19 wards served as control wards and continued usual practices. The interventions were designed by three groups: education nurses and managers, “bedside” healthcare workers, and researchers collaborating with nursing students. The interventions were based on social cognitive theory and the WHO’s multimodal model, and they consisted of education, posters, ultraviolet-light boxes, and interviews.</p> <p>Results:In the first study (Paper I), hand hygiene practices were investigated in 20 nursing home wards during the COVID-19 pandemic. Nursing students on clinical placement conducted the observations. A total of 7316 indications were observed, and hand hygiene was performed in 58.3% of them. Hand hygiene adherence decreased from February to March (65.8–51.4%), with large variations between wards (26.4–83.1%). In addition, there were differences between different occupations, locations where hand hygiene was conducted, and types of indications. Moreover, hand hygiene adherence was only 35.3% when gloves were used. In the second study (Paper II), infections and antibiotic use were investigated over the initial six months in 21 nursing home wards. There were 495 reported infections, 53 hospital admissions, and 11 deaths related to infections. The total infection rate was 5.37 per 1000 bed days. While the data collection was performed during the COVID-19 pandemic, urinary tract infections were the most common infection type. Of the reported infections, 97.6% were treated with antibiotics. Regression analyses revealed that the short-term wards had the highest infection rates. The final study (Paper III) included all 22 nursing home wards. Three received interventions to improve hand hygiene adherence. Adherence increased in the intervention wards from 54.7% to 60.9%, while it decreased in the control wards from 59.5% to 51.3%. The highest adherence was observed in relation to “after indications,” which also saw the greatest post-intervention increase. Hand hygiene adherence when using gloves remained low at 38.9%.</p> <p>Conclusion: Hand hygiene adherence in nursing homes is too low to prevent all infections. Infection rates in Norwegian nursing homes tend toward being high compared with other countries. These findings highlight the need to improve hand hygiene among healthcare workers. Interventions based on the WHO’s multimodal model and a focus on behavior change may increase adherence.</p>Ida Hellum Sandbekken
Copyright (c) 2025 Ida Hellum Sandbekken
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2025-01-312025-01-31Between patient participation and healthcare standardization
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/914
<p>In 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.</p>Hege Johanne Magnussen
Copyright (c) 2025 Hege Johanne Magnussen
https://creativecommons.org/licenses/by-sa/4.0
2025-02-112025-02-11Et rkesdidaktisk aksjonsforskningsprosjekt om ungdom som har falt ut av skolen, men som velger lærekandidatordningen mot fagbrev i salgsfaget gjennom et læringssenter
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/922
<p>Students dropping out of vocational upper secondary education has been an issue in Norway for many years and there is a great need to attain knowledge about the causes and to provide appropriate examples in order to support the affected students with the most fitting follow-up and training for the individual. My background for starting a practical action research project was 17 years as a teacher at upper secondary school as well as in the position of youth worker in a voluntary organization. It has been central to elucidate which societal obligations the education system has in terms of differentiated instruction and inclusion to meet the needs of students in vocational education. I have used Goodlad's (1986) theory of curriculum analysis and Bronfenbrenner's system theory (1979) to describe the systems around the students who are connected to the learning center. The dissertation's contribution to knowledge is a synthesis of a model and theory of a learning center, and a proposal for a learning center didactics. This dissertation's research aim is to contribute new, research-based knowledge of a learning centre, apprenticeship training agency (opplæringskontor) and the training candidate scheme (lærekandidatordningen) as an alternative learning and competence development arena for vocational students who are at risk of dropping out of the educational system, within the sales module and more generally in society.. The theoretical basis is strongly grounded in the vocational didactics and the didactics relationship model (Hiim & Hippe, 2001), and experiential learning (Dewey, 1938) through comprehensive vocational training (Sund, 2005; Haaland & Nilsen, 2020). In order to create motivation and commitment, it was necessary to use a new approach in relation to learning and methods. The target group was young people between the ages of 18 and 23. Through training in the sales profession, basic key competences and psychosocial support, the goal for the students was to achieve a career in the sales profession. Freire's (2005) liberating pedagogy and critical theory from action research contribute to guidance for participation, reflection and democratic processes (Carr & Kemmis, 1986). The problem statement for the PhD thesis is: Which vocational didactic, psychosocial and organizational conditions are needed to develop and run a learning center adapted to students who have dropped out of school, aimed at giving them the opportunity to become apprentice candidates in the sales profession? Based on this problem statement, there are three research questions I attempt to answer: 1. Which central vocational didactic conditions must be met in order to achieve meaningful, experience-based and relevant training in sales at the learning center, apprenticeship training agency and in the relevant training establishment? 2. What are the psychosocial conditions needed in a development process for young people who have dropped out of school to participate in vocational training aimed at giving them the opportunity to become apprentices? 3. How can the learning center organize cooperation with the relevant parties such as the apprenticeship training agency, participating establishments, NAV, voluntary organizations and various support systems to create good learning conditions for young people who have dropped out of school? My research approach is educational action research inspired by Educational Action Research in the UK, as well as practitioner research (Hiim, 2010). The approach is based on a desire to develop knowledge about educational activity in collaboration with those involved in the activity, through a form of practical "experiments". The action researcher, with his professional expertise, participates in the process himself in dialogue with the users and others who are active in the research area. The project's issues are wide-ranging, and the research questions concern participants with diverse roles: the learning centre, the participating establishments and the young people themselves as well as other supportive participants involved. In addition, inputs from schools, health institutions and Nav, and the collaboration between these are included. It is important to emphasize the system perspective in order to make society's responsibility visible. It is also central to show what role the organization has in ensuring that young people's opinions are taken seriously through their active participation in the process of personal agency (Shier, 2001; Bandura, 2006). Inclusion features strongly in the Education Act, for example through practice-based adapted education (Kunnskapsdepartementet, 2017). The data collection was done in the form of logs and notes from observations and conversations in the learning center and the training establishments. In addition, results from student assignments, group discussions with the students and minutes from meetings of companies constituted important material. By combining these methods, it became possible through the researcher’s own presence, observation and participation in the actions to gain an insight into how the work and training in the learning center and the training establishments actually took place, and to find justifications for the choice of measures. My main finding demonstrate that there is a need for a learning center. The organizational framework for a learning center must facilitate long-term follow-up with smaller groups, professional vocational didactics training, a workshop, and close cooperation with training establishments and voluntary organizations. My research also highlights the necessity for a new learning center didactics that focuses on social support, psychosocial challenges, work inclusion and vocational didactics. The practical organization is proposed to be carried out through four phases which was carried out in the project. The first phase provides an opportunity to get to know each other and gain an interesting and meaningful view of learning through exercises that bring joy, inspired by play and exploration. At the same time, through autonomous choices, we try to turn the motivation for further education from a forced, extrinsic motivation to an intrinsic motivation, by letting the students work on hobbies or professional tasks they are interested in (Ryan & Deci, 2000), and by developing self-efficacy in several different areas through mastery experiences, model learning, imitation learning and guidance (Bandura, 2006) together with practical exercises in the sales profession. The second phase, through interest differentiation, focusing on the importance of social competences and knowledge of the sales profession must be present in order to get a job. If the content is geared towards holistic learning processes in collaboration with an organization, students will see that the subject is not fragmented exercises without context. The third phase focuses on close cooperation with the practice establishments to achieve a work practice that is relevant and meaningful for all parties. With such close cooperation, the young people become a resource instead of a burden. The fourth phase can be carried out in various ways, but must be based on the young people's wishes, further plans for their lives, and the opportunities that have been created in the interprofessional collaboration. Through the learning center didactics, a learning center will also work with training in coping with life and provide help with psychosocial problems. The didactics must contain a breadth and variety of tools, which must be individually adapted to meet the individual young person. Important concepts such as resilience, learning resistance and awareness of daily life challanges can help to find focus and put into words some challenges and opportunities (Rutter, 2006; Illeris, 2012). The main aim of the project has been that the pupils should strengthen their independence, and that through vocational didactics training the students can develop a basic, overall vocational competence in sales (Sund, 2005; Haaland & Nilsen, 2020; Hiim, 2013).</p>Ragnvald Holst-Larsen
Copyright (c) 2025 Ragnvald Holst-Larsen
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2025-03-122025-03-12Attending Behavior in Matching-to-Sample Procedures
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/910
<p>This dissertation consists of three published studies that have an overarching objective to evaluate various environmental variables' effects on restrictive stimulus control and observing responses, which are behaviors often characterized as attention. Studies 1 and 2 investigated restricted stimulus control in matching-to-sample (MTS) procedures with compound stimuli. In both studies, participants established responses in the presence of compound stimuli of color and shape. The conditional discrimination procedures were followed with a test where the two elements of the compound stimuli were separated and tested individually to examine which part of the stimuli participants attended to or exerted control of the participants’ responses. In Study 1, restrictive stimulus control was investigated in two experiments in an identity MTS procedure. Restricted stimulus control was demonstrated in Experiment 1. In Experiment 2, two groups of participants were compared regarding different lengths of delay (0 and 3s.) between the sample and comparison stimuli presentation in training. Results showed more participants showing restricted stimulus control when trained with a 0s delay. In Study 2, an arbitrary MTS procedure was arranged with compound and abstract stimuli trained as a stimulus class. A one-to-many and many-to-one training structure was used to teach twelve conditional discriminations to each of the two groups of participants. Restricted stimulus control was tested by separating the compound stimuli and testing the elements individually. Individual elements were also tested as part of a stimulus equivalence class. Participants who showed restricted stimulus control responded correctly only to color stimuli when trained with a many-to-one training structure. Whereas those trained with one-to-many, had errors to both elements of the compound stimuli. Study 3 analyzed the effect meaningful stimuli have on eye movements in an MTS procedure and a test for stimulus equivalence relations. In this experiment, eye movements were measured using a head-mounted eyetracker, and fixation durations to different stimuli, along with the number of transitions and trials with repeated gaze to the sample stimulus, were measured. Several measures showed that meaningful stimuli affect eye movements by reducing fixation time and the number of transitions between stimuli.</p>Live Fay Braaten
Copyright (c) 2025 Live Fay Braaten
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2025-01-312025-01-31Vulvodynia in heterosexual relationships
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/918
<p>Vulvodynia, a chronic genital pain disorder affecting about 15% of women, is linked to health issues like anxiety, depression, sexual dysfunction, distress, and other pain conditions. Often invisible beyond the woman's partner and overlooked, it can affect the male partner's sexual and mental health. Partner responses to pain, one of the most studied interpersonal factors influencing vulvodynia, can influence emotional regulation and relationship outcomes. Despite increased focus, vulvodynia remains under-researched, particularly its impact on partners and relationships. The thesis investigates the relational aspects of vulvodynia, exploring how the condition affects not only the women but also their partners, providing insights into the role of partners in the treatment and management of vulvodynia. In Study I, we explored the experiences of eight couples, focusing on how contextual factors influenced the women’s pain-coping strategies. In Study II, we explored the ambivalence and distress of the same male partners about conflicting masculine ideals. In Study III, we explored the associations between different partner responses (facilitative, solicitous, and negative) and demographic and psychosexual variables, as well as differences between men who reported being currently sexually active versus inactive. The three studies reveal that vulvodynia presents numerous challenges for couples, including understanding the condition, facing social exclusion, and navigating complex sexual norms. Male partners experience significant distress managing conflicting masculinity ideals and sexual expectations. The findings also highlight the link between partner responses and psychosexual health outcomes, relationship satisfaction, and the importance of mental health in managing vulvodynia. The couples’ experiences highlight the need for increased public awareness of vulvodynia, improved healthcare, and more open communication between partners. Based on our findings, we propose that the inclusion of both partners in the treatment of vulvodynia may be beneficial for improving relational dynamics, especially related to partner responses to pain and validation.</p>Linn Myrtveit-Stensrud
Copyright (c) 2025 Linn Myrtveit-Stensrud
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2025-03-052025-03-05Rom for lesing og utforsking
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/915
<p>SK 25-1 "Rom for lesing og utforsking: Skolebibliotekets muligheter" av Idunn Bøyum og Åse Kristine Tveit (red.). </p> <p><strong><em><a href="https://skriftserien.oslomet.no/index.php/skriftserien/article/view/812">Digital utgave</a> inkluderer kapitel 2, 3, 7, 8, 10, 13 og 16. For trykt utgave med alle kapitler, kontakt Akademika Pilestredet. </em></strong></p> <p>Hvilke muligheter kan skolebiblioteket gi elevene i deres utforsking, lesing og sosiale miljø?<br />Gjennom hele historien og på alle utdanningsnivå - fra antikken til i dag – har bibliotek vært en viktig del av skoleelevers og studenters læringsmiljø. Slik er det fortsatt, selv om både skolen, elevene og samfunnet forandres. Tjenestene i skolebibliotekene må svare til disse forandringene. Boka formidler ny forskning og praksisbaserte bidrag som er aktuelle for skolebibliotek i grunn- og videregående skole, og som alle bidrar til kunnskapsutvikling på feltet.<br />Boka gir nyere perspektiver på sentrale sider ved skolebibliotekene: litteraturformidling, informasjonskompetanse, samarbeid, det sosiale rommet og organisering av samlingene. I tillegg settes skolebibliotekene inn i en historisk og utdanningspolitisk sammenheng, og viser, med basis i et bredt kunnskapsgrunnlag hvilken positiv innvirkning et godt skolebibliotek har på læring – for alle skolefag.<br />Boka har bidrag fra forskere i bibliotekfag og pedagogikk og fra praktikere som arbeider i eller med skolebibliotek. Den er aktuell for studenter i bibliotekfag og ved lærerutdanningene, og for skolebibliotekarer som vil oppdatere sin kunnskap.</p>Idunn BøyumÅse Kristine Tveit
Copyright (c) 2025 Idunn Bøyum, Åse Kristine Tveit
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2025-02-252025-02-25Pulsed Ultrasonic Fields
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/923
<p>This report is a summary of the medical ultrasound activity at Oslomet over several years. The modelling of pulsed field propagation and generation is based on the method of the spatial impulse response method. A novel numeric algorithm for calculating the spatial impulse response has been developed and tested. The novel algorithm uses weighted binning to reduce the numeric noise in the calculation and the computation time can therefore be reduced. The method can be used for any source function. The method has been tested by comparison to piecewise analytic solutions and measurements. The measurements have been done in a water tank with several transducers as sources. Some of the transducer’s impulse responses were modified by digital inverse filtering. Measurements of pulse responses and beam profiles have verified the calculation method. Measurements of harmonic generation and propagation has been demonstrated, showing a narrower beam profile. Depth resolution was measured by applying deconvolution and the theoretical minimum of one-half period was achieved.</p>Nils Sponheim
Copyright (c) 2025 Nils Sponheim
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2025-03-192025-03-19Evaluering av faggruppeorganiseringen ved Handelshøyskolen og Institutt for sosialfag, OsloMet
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/916
<p>Senter for profesjonsforskning har på oppdrag fra fakultetsledelsen (kontrakt datert 02.10.2024) evaluert faggruppeorganiseringen av Handelshøyskolen (HHS) og Institutt for Sosialfag (SF) ved Fakultet for Samfunnsvitenskap, OsloMet. Denne organisasjonsmodellen ble iverksatt på Handelshøyskolen fra 1.8.2019, og på Institutt for sosialfag fra 01.01.2020. Omorganiseringen ble beskrevet som en omlegging fra en utdanningsbasert modell til en faggruppemodell. Formålet, slik det kom til uttrykk i dokumentene, var å åpne for bedre prioritering og ressursbruk på tvers av studieprogrammer og å styrke integrasjonen av forskning og utdanning.</p> <p>Begge instituttene har fem faggrupper ledet av faggruppeledere med personalansvar. På evalueringstidspunktet, høsten 2024, er faggruppelederstillingene inne i sin andre åremålsperiode. For begge instituttene har det vært stabilitet i faggruppenes inndeling og titler. På begge instituttene har det vært stor utskiftning i hvem som har hatt stillingene som faggruppeledere.</p> <p>Datakildene i evalueringen har vært en elektronisk spørreskjemaundersøkelse til ansatte ved de to instituttene og ansatte i studieadministrasjonen ved fakultetet (svarprosent 43,6%), intervjuer med faggruppeledere og instituttledelsen (18 intervjuer), samt bakgrunnsdokumenter og informasjon fra fakultetsadministrasjonen om faggruppelederstillingene, generell stillingsutvikling, utviklingen i publikasjonspoeng, studentenes gjennomføringsprosent og studiepoengproduksjon.</p> <p>Evalueringen viser at det ikke er noen endringer i det store bildet når det gjelder stillingsutvikling, utviklingen i publisering, studentenes gjennomføring eller studiepoengproduksjonen som kan tilskrives endring av organisasjonsmodell.</p> <p>Spørreundersøkelsen viser at ansatte på Handelshøyskolen jevnt over er mer positive til faggruppeorganiseringen enn ansatte på Institutt for Sosialfag. Generelt er de som er ansatt etter omorganiseringen til en faggruppemodell, mer positive enn de som ble ansatt før omorganiseringen og dermed har erfaring med den tidligere såkalte utdanningsbaserte modellen.</p> <p>Både på Handelshøyskolen og Institutt for Sosialfag rapporteres det mest positivt om at faggruppeorganiseringen legger til rette for god personalledelse, at man vet hvor man skal gå med spørsmål og problemer, godt forskningssamarbeid innen faggruppa og godt arbeidsmiljø på instituttet.</p> <p>Både på Handelshøyskolen og Institutt for Sosialfag rapporteres det mest negativt om at faggruppeorganiseringen legger til rette for godt forskningssamarbeid på tvers av eller utenfor faggruppene, og godt undervisningssamarbeid på tvers av eller utenfor faggruppene. På Sosialfag rapporteres det også i stor grad negativt om hvorvidt faggruppeorganiseringen legger til rette for god utnyttelse av forskningsressurser og personale.</p> <p>De områdene der det er størst forskjeller mellom de som ble ansatt før og etter omorganiseringen, er om man er helt enig i at faggruppeorganisering legger til rette for godt forskningssamarbeid innen faggruppene (21 og 44%), og om man er helt enig i at faggruppeorganiseringen legger til rette for godt arbeidsmiljø på instituttet (23 mot 39%). Derimot er det færre blant de som ble ansatt etter omorganiseringen som er helt enige i at de vet hvor de skal gå med spørsmål og problemer.</p> <p>Både på Handelshøyskolen og på Institutt for Sosialfag er det variasjoner mellom faggruppene når det gjelder de ansattes vurderinger av faggruppeorganiseringen.</p> <p>En forskjell mellom instituttene er at faggruppene på Handelshøyskolen i større grad er organisert etter fag (disipliner), mens faggruppene på Sosialfag er organisert tematisk, noe som gjør det mindre tydelig hvorfor medlemmene tilhører den gruppen de er organisert i.</p> <p>Hvorvidt faggruppeorganiseringen har ført instituttene nærmere de ønskede målene lar seg ikke uten videre besvare, både fordi det er relativt store forskjeller mellom implementeringen på de to instituttene og de rapporterte erfaringene med organisasjonsmodellen, fordi det innad på hvert institutt er relativt store forskjeller mellom faggruppene, og fordi omorganiseringer trenger tid til å virke, særlig fordi modellen og stillingene var nye og praksis måtte utvikles underveis.</p> <p>Faggruppeorganiseringen har ført til at de faglige ressursene kan brukes og brukes mer på tvers av studieprogrammene. Faglige ansatte underviser på tvers av nivåer og på ulike bachelorprogram. Særlig fra Handelshøyskolen rapporteres det positivt om dette. At faggruppeorganisering legger til rette for god utnyttelse av forskningsressurser og – personale er nesten halvparten av de ansatte på Handelshøyskolen enige i, nærmere 20 prosent svarer verken-eller, mens 32 prosent er uenige.</p> <p>At faggruppeorganiseringen legger til rette for god utnyttelse av undervisningsressurser og –personale er 60 prosent på Handelshøyskolen enige i, 14 prosent svarer verken eller mens 26 prosent er uenige. På Sosialfag er flertallet uenige i at dette er god ressursutnyttelse både når det gjelder forskningsressurser og utdanningsressurser.</p> <p>At faggruppeorganiseringen legger til rette for styrket integrasjon av forskning og utdanning, er flertallet på Handelshøyskolen, ca 60%, enige i og selv om det er variasjon mellom gruppene, ligger de fleste på den positive siden av skalaen. På Sosialfag er flertallet uenige, og selv om det også her er variasjon mellom gruppene, er det ingen faggrupper som er enige. Det kan være et uttrykk for at det ikke er en nødvendig kobling mellom faggrupper og integrasjon av forskning og utdanning.</p> <p>Faggruppeorganiseringen har noen problematiske sider, særlig at den har medført en oppsplitting av utdanningene. Mindre helhet og mer fragmentering rundt utdanningene er svakheten ved faggruppeorganiseringen som framheves i svarene på spørreskjemaets åpne spørsmål og i intervjuene. Fragmentering av utdanningene knyttes til at utdanningsprogrammene bemannes av ansatte som er spredt på flere faggrupper (og ledere), og til at det mangler velfungerende arenaer for å drøfte utdanningsfaglige temaer. Det skaper koordineringsutfordringer og arbeidskrevende «kabaler» for å bemanne undervisningsoppgavene. Dette gjelder for begge instituttene, men synes likevel spesielt krevende på Sosialfag, noe som blant annet kan ha sammenheng med mindre overlapp mellom hvilke faggrupper personer tilhører, og hvilket program de underviser på, at flere personer er involvert i hvert enkelt emne, slik at planleggingen av hvert enkelt emne typisk krever at flere personalledere er involvert, og at det er mindre overlapp mellom programkoordinatoransvar og personalansvar.</p> <p>Faggruppeorganiseringen beskrives som en matriseorganisering, men det er i noen grad utydelig hva som er prinsippet bak den vertikale ansvarslinjen – faget som faggruppen er organisert etter, særlig på Sosialfag. Videre synes det ikke som den horisontale ansvarslinjen har tilstrekkelig velfungerende struktur. Det synes behov for å klargjøre ansvarsforholdene når det gjelder undervisning og undervisningsplanlegging, se på studieadministrasjonens rolle i undervisningsplanleggingen, og ettersom faggruppelederstillingene er åremålsstillinger, å sikre institusjonell hukommelse i undervisningsplanleggingen.</p> <p> </p> <p> </p>Tone Alm AndreassenBeate ElvebakkHåvard HellandOskar Grannæs Olsen
Copyright (c) 2025 Tone Alm Andreassen, Beate Elvebakk, Håvard Helland, Oskar Grannæs Olsen
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2025-02-272025-02-27Kvinners arbeidsmiljø og arbeidshelse
https://skriftserien.oslomet.no/index.php/skriftserien/article/view/924
<h1><a name="_Toc174441990"></a><a name="_Toc176876769"></a><a name="_Toc191297865"></a></h1> <h1><a name="_Toc174441990"></a><a name="_Toc176876769"></a><a name="_Toc191297865"></a>Sammendrag</h1> <p style="font-weight: 400;">Formålet med dette notatet er å gjennomgå tidligere forskning og presentere nye upubliserte analyser av kvinners arbeidsmiljø og arbeidshelse basert på analyser av to validerte jobbeksponeringsmatriser og registerdata. I første del av notatet gir vi en beskrivelse av bakgrunnen for og formålet med notatet “Kvinners arbeidsmiljø og arbeidshelse – analyser av registerdata”. Videre gir vi en utfyllende beskrivelse av datamaterialet som benyttes og hvordan notatet er organisert, og vi presenterer en mekanisk og en psykososial jobbeksponeringsmatrise (JEM) med tilhørende indekser som er konstruert og validert for bruk i analyser av norske registerdata (Hermansen og Dahl 2022; Le, Hermansen og Dahl 2023a).</p> <h2><a name="_Toc191297866"></a>Omfanget av dobbelt eksponering</h2> <p style="font-weight: 400;">I del to undersøker vi, med utgangspunkt i den mekaniske og den psykososiale eksponeringsindeksen, hvordan jobbeksponeringer fordeler seg mellom kvinner og menn i hele den sysselsatte befolkningen. I disse analysene tar vi utgangspunkt i de minst og de mest eksponerte gruppene. Resultatene viser at av de om lag 560 000 sysselsatte med det laveste omfanget av “dobbelt eksponering” i 2021 var 75,7 prosent menn. Til sammenligning var 72 prosent av de sysselsatte med det høyeste omfanget av “dobbelt eksponering” kvinner. Kvinner står dermed i langt større grad enn menn i yrker med en “dobbelt eksponering” av både mekaniske og psykososiale eksponeringer.</p> <h2><a name="_Toc191297867"></a>Betydningen av jobbeksponeringer for sysselsetting og ulike helseutfall</h2> <p style="font-weight: 400;">I del tre av notatet undersøker vi betydningen av fysiske og psykososiale eksponeringer for sysselsetting og ulike helseutfall. I denne delen oppsummerer vi tidligere forskning og presenterer nye analyser, som ikke er publisert i vitenskapelige tidsskrifter.</p> <p style="font-weight: 400;">Tidligere internasjonale studier viser at kvinner og menn utsettes for ulikt omfang av mekaniske og psykososiale eksponeringer. Menn er i større utstrekning utsatt for mekaniske eksponeringer i arbeidet, mens kvinner er mer utsatt for psykososiale eksponeringer. Det er også studier som viser at menn og kvinner, innen samme yrke, utsettes for ulike typer eksponeringer.</p> <p style="font-weight: 400;">I del tre oppsummerer vi også fire publiserte studier, som undersøker betydningen av den validerte mekaniske og psykososiale eksponeringsindeksen for sysselsetting og ulike helseutfall. Hovedfunnene i disse studiene er som følger:</p> <h2><a name="_Toc191297868"></a>Retur til arbeid etter kreft – betydningen av jobbeksponeringer</h2> <p style="font-weight: 400;">Resultatene viser at både mekaniske og psykososiale eksponeringer har en negativ innvirkning på sysselsettingen over tid for både kvinner og menn, uavhengig av om de er kreftoverlevere eller ikke. Kvinner har en dobbelt så høy risiko for redusert sysselsetting som følge av mekaniske eksponeringer sammenlignet med menn. Menn har derimot en over tre ganger høyere risiko for redusert sysselsetting når de utsettes for psykososiale eksponeringer, sammenlignet med kvinner.</p> <p style="font-weight: 400;">Blant kreftoverlevere er risikoen for redusert sysselsetting spesielt høy for menn med høyere omfang av mekaniske eksponeringer, sammenlignet med menn som ikke har hatt kreft. Dette kan tyde på at kreftoverlevere er mer sårbare for et fysisk krevende arbeidsmiljø, og at belastningene kan forverre utfordringene knyttet til tilbakevending til arbeidslivet etter sykdom.</p> <h2><a name="_Toc191297869"></a>Arbeidsbelastning og sykefravær blant mødre</h2> <p style="font-weight: 400;">Psykososiale og mekaniske arbeidseksponeringer er hver for seg assosiert med et høyere antall sykefraværsdager blant mødre, uavhengig av om barnet har funksjonsnedsettelser eller ikke. Når begge typer eksponeringer vurderes sammen, er det de mekaniske eksponeringene som har størst innvirkning på sykefraværet.</p> <h2><a name="_Toc191297870"></a>Retur til arbeid etter fødsel</h2> <p style="font-weight: 400;">Førstegangsfødende opplever en betydelig lavere sannsynlighet for å returnere til arbeid etter fødsel når de utsettes for psykososiale eller mekaniske eksponeringer i jobben. Dette peker på at krevende arbeidsforhold i kombinasjon med omsorgsforpliktelser kan hindre kvinners reintegrering i arbeidslivet etter fødselspermisjon.</p> <h2><a name="_Toc191297871"></a>Kjønnsforskjeller i risiko for langtidssykefravær og uførhet</h2> <p style="font-weight: 400;">Kvinner som arbeider i yrker med høy mekanisk eksponering har høyere risiko for langtidssykefravær og uførhet sammenlignet med menn. På den annen side har menn høyere risiko for langtidssykefravær i yrker med høy psykososial eksponering, ved samme nivå av eksponeringer som kvinner.</p> <p style="font-weight: 400;">I nye analyser, som tidligere ikke er publisert, undersøker vi betydningen av “dobbelt eksponering” for sysselsetting og helseutfall blant kvinner og menn. Hovedfunnene i disse analysene er som følger:</p> <h2><a name="_Toc191297872"></a>Dobbelt eksponering og sysselsetting</h2> <p style="font-weight: 400;">I analysen av sysselsetting identifiserer vi fire ulike forløp, hvor sannsynligheten for å ha en årlig yrkesinntekt på over 3.5G varierer i perioden 2007 til 2020. Ved å benytte en årlig yrkesinntekt på over 3.5G inkluderer vi både de som jobber i store deltidsstillinger og heltidsansatte i vårt mål på sysselsetting. De fire ulike forløpene kaller vi “stabil høy sysselsetting”, “lav til fallende sysselsetting”, “høy til fallende sysselsetting” og “stabil lav sysselsetting”. Sysselsatte som står i yrker med “høy” og “svært høy” grad av “dobbelt eksponering” dominerer alle forløp som innebærer fallende sysselsetting over tid. Den viktigste kjønnsforskjellen synes å være at for kvinner i de mest eksponerte yrkene skjer fallet over flere år og begynner tidligere enn for menn, mens for menn kommer fallet senere og er kraftigere. Disse forskjellene kan forklares av at kvinner i de mest eksponerte yrkene både reduserer stillingsstørrelsen over tid og går over på helserelaterte ytelser, mens det virker rimelig å anta det bratte fallet blant menn representerer en økende overgang til helserelaterte ytelser.</p> <h2><a name="_Toc191297873"></a>Dobbelt eksponering og status som arbeidssøker</h2> <p style="font-weight: 400;">I analysen av arbeidssøkerstatus identifiserer vi fire ulike forløp, hvor sannsynligheten for å være arbeidssøker en eller flere måneder i løpet av årene 2007 til 2020 varierer. De fire ulike forløpene kaller vi “ikke arbeidssøker”, “tiltagende arbeidssøker”, “tiltagende og raskt fallende arbeidssøker” og “tiltagende og fallende arbeidssøker”.</p> <p style="font-weight: 400;">Forskjellene mellom kvinner og menn er små, og i en analyse hvor vi tar høyde for ulike bakgrunnskjennetegn, finner vi at både kvinner og menn i yrker med “høy” og “svært høy” grad av “dobbelteksponering” har betydelig høyere sannsynlighet for å tilhøre forløpet “tiltagende og fallende arbeidssøker”. Status som arbeidssøker kan gi en indikasjon på sysselsettingsutfordringer, og disse utfordringene kan bestå i at den enkelte har mistet jobben, ønsker å komme over i en annen stilling eller jobber ufrivillig deltid og søker derfor på større stillinger. Generelt viser resultatene at både kvinner og menn i de mest eksponerte yrkene, langt oftere enn sysselsatte i mindre eksponerte yrker, er jobbsøkere. Dersom vi bruker status som arbeidssøker som et sammensatt mål på sysselsettingsutfordringer, er det utvilsomt at disse utfordringene i langt større omfang treffer dem som står i de mest eksponerte yrkene, uavhengig av kjønn.</p> <h2><a name="_Toc191297874"></a>Dobbelt eksponering og sykdomsrelatert fravær</h2> <p style="font-weight: 400;">I analysen av sykdomsrelatert fravær identifiserer vi fire ulike forløp, hvor sannsynligheten for å være registrertmed langtidssykefravær, AAP eller uføretrygd en eller flere måneder varierer i perioden 2010 til 2020.</p> <p style="font-weight: 400;">Ett flertall, eller 56 prosent, tilhører forløpet “lavt sykdomsrelatert fravær”. Dette forløpet fanger opp alle som i løpet av disse årene har hatt ingen eller noen langtidssykefravær, men som aldri har gått ut sykemeldingsperioden og deretter gått over på AAP.</p> <p style="font-weight: 400;">Av de tre mindre forløpene tilhører 27,8 prosent “stabilt og fallende fravær”. Det virker rimelig å anta at dette er en gruppe som har mer eller mindre vedvarende helseplager, som innebærer at de med ujevne mellomrom går ut i langtidssykefravær, men hvor ingen går ut sykemeldingsperioden i løpet av årene vi undersøker. Av sysselsatte i alderen 45 til 50 år i 2010 er det 10,6 prosent som følger forløpet “stabilt og høyt sykdomsrelatert fravær”, og har allerede første observasjonsår i 2010 rundt 80 prosent sannsynlighet for å være registrert med langtidssykefravær, AAP eller uføretrygd. Gjennom hele perioden har så og si alle sysselsatte som følger dette forløpet et sykdomsrelatert fravær.</p> <p style="font-weight: 400;">Det minste forløpet har vi kalt “tiltagende sykdomsrelatert fravær”, og i alt 5,8 prosent av alle sysselsatte mellom 45 og 50 år i 2010 følger dette forløpet. Til tross for at dette forløpet er det minste, er det også det mest interessante i den forstand at det aller tydeligst viser helsemessig utstøtning i perioden vi undersøker. I motsetning til de andre forløpene har dette forløpet en klar utvikling mot et sterkt økende omfang av sykdomsrelatert fravær.</p> <p style="font-weight: 400;">Resultatene viser at både kvinner og menn i yrkene med høyere grad av “dobbelt eksponering” i langt større grad enn sysselsatte i mindre eksponerte yrker oftere har sykdomsrelatert fravær. Samtidig er betydningen av “dobbelt eksponering” for kvinners og menns fravær relativt lik når vi tar høyde for andre forhold som kan ha betydning for fraværet.</p> <h2><a name="_Toc191297875"></a>Dobbelt eksponering, omsorgsforpliktelser og sykdomsrelatert fravær</h2> <p style="font-weight: 400;">For å undersøke hvorvidt betydningen av omsorgsforpliktelser, målt som antall barn, er ulik for kvinner og menn som står i yrker med ulik grad av “dobbelt eksponering”, har vi sett på antall perioder med langtidssykefravær og måneder med AAP i perioden 2010 til 2020, samt sannsynligheten for å være ufør i 2020.</p> <p style="font-weight: 400;">Samlet sett viser resultatene at betydningen av “dobbelt eksponering” for kvinner og menn er relativt lik når det gjelder antall perioder med langtidssykefravær og måneder på AAP i perioden 2010 til 2020. Omfanget av omsorgsforpliktelser ser ikke ut til å øke forskjellene i sykdomsrelatert fravær mellom menn og kvinner. Tvert imot bidrar omsorg for barn til at menn i de mest eksponerte yrkene “nærmer seg” samme nivå av sykdomsrelatert fravær som kvinner.</p> <p style="font-weight: 400;">I analysen av uførestatus i 2020 finner vi, som i de to foregående analysene, at betydningen av “dobbelt eksponering” er relativt lik for kvinner og menn. Uførerisikoen er betydelig høyere for sysselsatte i yrker med høyere grad av “dobbelt eksponering”, og denne risikoen varierer ikke med “antall barn”.</p> <h2><a name="_Toc191297876"></a>Dobbelt eksponering og diagnosebasert uførhet</h2> <p style="font-weight: 400;">Avslutningsvis undersøker vi betydningen av jobbeksponeringer for diagnosebasert uførhet. Både kvinner og menn som står i yrker med høyere grad av “dobbelt eksponering” har økt risiko for å bli uføretrygdet, basert på en muskel- og skjelettdiagnose. Risikoen er noe høyere for menn enn for kvinner. I denne analysen har vi også skilt på mekaniske og psykososiale eksponeringer, og resultatene viser at det særlig er graden av mekaniske eksponeringer som bidrar til denne økte risikoen, og ikke minst at den til dels er betydelig høyere blant menn enn blant kvinner. Høyere grad av “dobbelt eksponering” øker også risikoen for å bli uføretrygdet, basert på en psykisk diagnose, og risikoen er noe høyere for kvinner enn for menn.</p> <h2><a name="_Toc191297877"></a>Betydningen av dobbelt eksponering – oppsummert</h2> <p style="font-weight: 400;">De ulike analysene vi presenterer i dette notatet avdekker kjønnsforskjeller, men gjennomgående er disse relativt små. Både kvinner og menn som står i yrker med høyere grad av "dobbelt eksponering" har betydelig høyere sannsynlighet for å oppleve fallende sysselsetting, økende jobbsøkning og sykdomsrelatert fravær over tid. Den mest slående kjønnsforskjellen er at kvinner, uavhengig av hvordan vi definerer analysepopulasjonene, utgjør et stort flertall av de sysselsatte med den aller høyeste graden av "dobbelt eksponering". For sysselsatte med det laveste nivået av "dobbelt eksponering" finner vi gjennomgående at menn utgjør mellom sju og åtte av ti i denne gruppen.</p> <p style="font-weight: 400;">Samlet sett viser resultatene i dette notatet at langt flere kvinner enn menn står i yrker med en høy grad av "dobbelt eksponering", og dermed er langt flere kvinner enn menn utsatt for arbeid som over tid kan innebære utfordringer med å forbli sysselsatt, samt ha helsemessige konsekvenser. Et viktig forbehold er at vi i de fleste av våre analyser har studert sysselsatte som befinner seg midt i yrkeskarrieren. Det er grunn til å tro at frafallet fra de mest eksponerte yrkene er betydelig tidligere i yrkeskarrieren. De sysselsatte vi inkluderer i våre analyser, og særlig de som står i de mest eksponerte yrkene, er dermed trolig en mer positivt selektert gruppe når det gjelder helse, enn tilfellet ville vært dersom vi hadde utvidet observasjonsperiodene i tid og aldersspenn. I kommende studier bør det derfor undersøkes hvordan ulike jobbeksponeringer og graden av "dobbelt eksponering" påvirker frafallet fra arbeidslivet tidligere i yrkeskarrieren.</p>Åsmund HermansenCedrik Andersen LyngrothTherese Saltkjel
Copyright (c) 2025 Åsmund Hermansen, Cedrik Andersen Lyngroth, Therese Saltkjel
https://creativecommons.org/licenses/by-sa/4.0
2025-04-022025-04-02