The Interventional Centre http://www.ivs.no/ The Interventional Centre's Webpages EBA-News 2.0.0 Member of OMT

]]> Karl Tue, 08 Jun 2010 09:05:59 +0200http://www.ivs.no/blog/member-of/ http://www.ivs.no/blog/member-of/ http://www.ivs.no/blog/member-of/#commentsHøyre kolonne World's first reported laparoscopic single-port distal pancreatic surgery A team of abdominal surgeons at The Interventional Centre, led by Bjørn Edwin MD,PhD, has performed a laparoscopic distal pancreatic tumor removal and splenectomy using only one single incision. The team was the first in the world to report on use of this particular minimally invasive surgical access for this type of complex laparoscopy. The new, specially designed quad-port trocar device used for surgical intruments access was placed in the patients umbilicus. Customized, curved laparoscopic instruments were used to perform the surgery in a surgical procedure normally requiring at least 4 to 5 separate instrument trocars. By this technique the patient is left with less surgical scars, and the postoperative pain will be reduced due to less surgical trauma caused by the procedure. On the image the single trocar and the curved instruments (on the video screen) can be seen. An image of the post-operative surgical scar and the quad-port trocar can be seen in the Read More>> section. single portA team of abdominal surgeons at The Interventional Centre, led by Bjørn Edwin MD,PhD, has performed a laparoscopic distal pancreatic tumor removal and splenectomy using only one single incision. The team was the first in the world to report on use of this particular minimally invasive surgical access for this type of complex laparoscopy. The new, specially designed quad-port trocar device used for surgical intruments access was placed in the patients umbilicus. Customized, curved laparoscopic instruments were used to perform the surgery in a surgical procedure normally requiring at least 4 to 5 separate instrument trocars. By this technique the patient is left with less surgical scars, and the postoperative pain will be reduced due to less surgical trauma caused by the procedure. On the image the single trocar and the curved instruments (on the video screen) can be seen. An image of the post-operative surgical scar and the quad-port trocar can be seen in the Read More>> section.

Post-operative scar

]]> Karl Wed, 19 May 2010 16:54:57 +0200http://www.ivs.no/blog/the-worlds-first-single-port-distal-pancreatic-tumour-surgery/ http://www.ivs.no/blog/the-worlds-first-single-port-distal-pancreatic-tumour-surgery/ http://www.ivs.no/blog/the-worlds-first-single-port-distal-pancreatic-tumour-surgery/#commentsHovednyheter Article from The Interventional Centre in Physiological Measurements 2009 Highlights Physiological Measurements has made a special collection of top rated papers that represents the excellence of the work published in 2009. Among the 13 papers selected for the presentation of outstanding new research was the article Validation of cardiac accelerometer sensor measurements written by Espen W Remme1, Lars Hoff2, Per Steinar Halvorsen1, Edvard Nærum1, Helge Skulstad3, Lars A Fleischer2, Ole Jakob Elle1 and Erik Fosse1. Author affiliations 1: The Interventional Centre, Oslo University Hospital, Oslo, Norway. 2:Vestfold University College, Tønserg, Norway. 3: Department of Cardiology, Oslo University Hospital, Oslo, Norway. The full text paper may be freely downloaded. The article describes a study where the group of researchers has investigated the accuracy of an accelerometer sensor designed for the measurement of cardiac motion and automatic detection of motion abnormalities caused by myocardial ischaemia. The video shows a robot arm attached next to the sensor. In this setup, both the robot and the sensor recorded the motion of the heart, which facilitated comparison of the sensor measurements with the robot. Physiological Measurements has made a special collection of top rated papers that represents the excellence of the work published in 2009. Among the 13 papers selected for the presentation of outstanding new research was the article Validation of cardiac accelerometer sensor measurements written by Espen W Remme1, Lars Hoff2, Per Steinar Halvorsen1, Edvard Nærum1, Helge Skulstad3, Lars A Fleischer2, Ole Jakob Elle1 and Erik Fosse1. Author affiliations 1: The Interventional Centre, Oslo University Hospital, Oslo, Norway. 2:Vestfold University College, Tønserg, Norway. 3: Department of Cardiology, Oslo University Hospital, Oslo, Norway. The full text paper may be freely downloaded. The article describes a study where the group of researchers has investigated the accuracy of an accelerometer sensor designed for the measurement of cardiac motion and automatic detection of motion abnormalities caused by myocardial ischaemia. The video shows a robot arm attached next to the sensor. In this setup, both the robot and the sensor recorded the motion of the heart, which facilitated comparison of the sensor measurements with the robot.

]]> Karl Mon, 03 May 2010 17:20:19 +0200http://www.ivs.no/blog/article-from-the-interventional-centre-in-highlights-of-2009/ http://www.ivs.no/blog/article-from-the-interventional-centre-in-highlights-of-2009/ http://www.ivs.no/blog/article-from-the-interventional-centre-in-highlights-of-2009/#commentsHovednyheter BWSN 2 Project final demo This is a video from the final demo of the BWSN2 (Biomedical Wireless Sensor Network) Project. The project objective was to implement wireless sensors from multiple vendors on a commercial software platform. The 802.15.4 Wireless Personal Area Network radio frequency standard operating in the 2.4 GHz ISM band was used in the project. The Scandinavian BWSN2 Consortium consisted of sensor developers, research institutes and the clinical test facilities at The Interventional Centre. MemsCap as, SINTEF IKT and Novelda as came from Norway. From Finland VTT participated. From Sweden Novosense AB, Imego and Millicore AB participated, and from Denmark Delta.  The sensor portfolio was implemented on software from the Norwegian company Imatis as. The project was funded by SNN and NICe This is a video from the final demo of the BWSN2 (Biomedical Wireless Sensor Network) Project. The project objective was to implement wireless sensors from multiple vendors on a commercial software platform. The 802.15.4 Wireless Personal Area Network radio frequency standard operating in the 2.4 GHz ISM band was used in the project. The Scandinavian BWSN2 Consortium consisted of sensor developers, research institutes and the clinical test facilities at The Interventional Centre. MemsCap as, SINTEF IKT and Novelda as came from Norway. From Finland VTT participated. From Sweden Novosense AB, Imego and Millicore AB participated, and from Denmark Delta.  The sensor portfolio was implemented on software from the Norwegian company Imatis as. The project was funded by SNN and NICe

]]> Karl Wed, 07 Apr 2010 11:30:21 +0200http://www.ivs.no/blog/bwsn-2-project-final-demo/ http://www.ivs.no/blog/bwsn-2-project-final-demo/ http://www.ivs.no/blog/bwsn-2-project-final-demo/#commentsHovednyheter Local organiser of School-of-MRI from the Interventional Centre ESMRMB - European Society for Magnetic Resonance in Medicine and Biology has placed its School-of-MRI in Oslo from June 3-5th 2010. More information and online registration is available from the course website. The cource topics are Advanced Neuro Imaging - Diffusion, Perfusion, Spectroscopy. Local Organiser is professor Atle Bjørnerud from the Interventional Centre, and the course venue is Oslo Univerity Hospital. The aim of this course is to convey in-depth knowledge about advanced functional MR techniques for imaging of the central nervous system. The combination of MR physics (at a level for radiologists) and clinical applications in this course provides an excellent opportunity to improve the understanding as well as the clinical interpretation of diffusion-and perfusion-MRI and MR spectroscopy. ESMRMBESMRMB - European Society for Magnetic Resonance in Medicine and Biology has placed its School-of-MRI in Oslo from June 3-5th 2010. More information and online registration is available from the course website. The cource topics are Advanced Neuro Imaging - Diffusion, Perfusion, Spectroscopy. Local Organiser is professor Atle Bjørnerud from the Interventional Centre, and the course venue is Oslo Univerity Hospital. The aim of this course is to convey in-depth knowledge about advanced functional MR techniques for imaging of the central nervous system. The combination of MR physics (at a level for radiologists) and clinical applications in this course provides an excellent opportunity to improve the understanding as well as the clinical interpretation of diffusion-and perfusion-MRI and MR spectroscopy.

]]> Karl Tue, 16 Mar 2010 16:17:40 +0100http://www.ivs.no/blog/local-organizer-of-school-of-mri-from-the-interventional-centre/ http://www.ivs.no/blog/local-organizer-of-school-of-mri-from-the-interventional-centre/ http://www.ivs.no/blog/local-organizer-of-school-of-mri-from-the-interventional-centre/#commentsHovednyheter New PhD on Patient-reported outcomes after on-pump and off-pump coronary artery bypass surgery On January 20th 2010 Lars Mathisen defended his thesis from the Interventional Centre and Dept. of Thorasic and Cardiovascular Surgery, Oslo University Hospital, Rikshospitalet and Faculty of Medicine, University of Oslo. The evaluation committee consisted of 1.opponent professor, Emerita Judy Watt-Watson, Centre for Advanced Studies in Professional Practice, University of Torointo, Canada, 2. opponent professor Rune Haaverstad, Dept. of Thorasic Surgery, Haukeland University Hospital and committee leader profesor Theis Tønnessen, Dept. of Thorasic Surgery, Institute for Hospital Medicine, University of Oslo. The dissertation was lead by the University representative professor Lars Gullestad from Department of Cardiology, Institute for Hospital Medicine, University of Oslo. The quality of life studies performed by Lars Mathisen was based on follow-up studies of patients enrolled in the Off-pump project, a randomized clinical trial comparing off-pump and on-pump coronary artery bypass surgery. So far 5 PhD's has been produced by this project material. Abstact; ”Patient-reported outcomes after on-pump and off-pump coronary artery bypass surgery” Patients’ self-report of symptoms, health status and overall quality of life reflects the experience of ischemic heart disease, as well as the impact of coronary artery bypass surgery (CABG). lmOn January 20th 2010 Lars Mathisen defended his thesis from the Interventional Centre and Dept. of Thorasic and Cardiovascular Surgery, Oslo University Hospital, Rikshospitalet and Faculty of Medicine, University of Oslo. The evaluation committee consisted of 1.opponent professor, Emerita Judy Watt-Watson, Centre for Advanced Studies in Professional Practice, University of Torointo, Canada, 2. opponent professor Rune Haaverstad, Dept. of Thorasic Surgery, Haukeland University Hospital and committee leader profesor Theis Tønnessen, Dept. of Thorasic Surgery, Institute for Hospital Medicine, University of Oslo. The dissertation was lead by the University representative professor Lars Gullestad from Department of Cardiology, Institute for Hospital Medicine, University of Oslo. The quality of life studies performed by Lars Mathisen was based on follow-up studies of patients enrolled in the Off-pump project, a randomized clinical trial comparing off-pump and on-pump coronary artery bypass surgery. So far 5 PhD's has been produced by this project material. Abstact; ”Patient-reported outcomes after on-pump and off-pump coronary artery bypass surgery” Patients’ self-report of symptoms, health status and overall quality of life reflects the experience of ischemic heart disease, as well as the impact of coronary artery bypass surgery (CABG).

Conventionally, in order to immobilize the surgical field and to protect the heart, a heart-lung machine is used to oxygenate and transport blood during cardioplegic arrest. ‘Beating heart’ CABG may have a potential for improved patient-reported outcomes, possibly due to a lower incidence of neurological adverse effects believed to be associated with extracorporeal circulation. Between 1999 and 2002, 120 patients were randomly assigned to on-pump or off-pump CABG, and the patients responded to questionnaires before and 3, 6 and 12 months after surgery. Additionally, measurements of cardiac and cognitive function, and magnetic resonance imaging of the brain were entered in regression analyses with patient-reported outcomes. The experimental study demonstrated a benefit of surgical intervention but no significant difference in favour of on- or off-pump surgery. In descriptive and predictive studies, change in physical health was associated with separate contributions from change in exercise capacity and symptom relief, while mental health was associated with preoperative and change in cognitive function. A disadvantage to physical health at three months after surgery was suggested for on-pump patients with preoperative evidence of cerebral ischemic lesions. A methodological study supported that overall quality of life may be a cause as well as a consequence of general health perceptions. This thesis is significant for patient counselling before and after surgery, both in selection of surgical method and for understanding the variation in individual outcomes after CABG. Furthermore, common and unidirectional models appear inadequate to study the causal relationships between cardiac surgery and overall quality of life.

References:

Dissertation:
1) "Patient-reported outcomes after on-pump and off-pump coronary artery bypass surgery", avhandling for graden ph.d. (philosophiae doctor) ved Institutt for sykehusmedisin, Medisinsk fakultet, Universitetet I Oslo, januar 2010.

Published articles:
2) Mathisen L, Lingaas PS, Andersen MH, Hol PK, Fredriksen PM, Sundet K, Rokne B, Wahl AK, Fosse E. Changes in cardiac and cognitive function and self-reported outcomes at one year after coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2009 Dec 15. [Epub ahead of print]

3) Mathisen L, Andersen MH, Veenstra M, Wahl AK, Hanestad BR, Fosse E. Quality of life can both influence and be an outcome of general health perceptions after heart surgery. Health Qual Life Outcomes. 2007 May 24;5:27.

4) Mathisen L, Andersen MH, Hol PK, Tennøe B, Lund C, Russell D, Lundblad R, Halvorsen S, Wahl AK, Hanestad BR, Fosse E. Preoperative cerebral ischemic lesions predict physical health status after on-pump coronary artery bypass surgery. J Thorac Cardiovasc Surg. 2005 Dec;130(6):1691-7.

Mathisen L, Andersen MH, Hol PK, Lingaas PS, Lundblad R, Rein KA, Tønnessen TI, Mørk BE, Svennevig JL, Wahl AK, Hanestad BR, Fosse E. Patient-reported outcome after randomization to on-pump versus off-pump coronary artery surgery. Ann Thorac Surg. 2005 May;79(5):1584-9.

]]> Karl Wed, 20 Jan 2010 16:03:05 +0100http://www.ivs.no/blog/new-phd-on-patient-reported-outcomes-after-on-pump-and-off-pump-coronary-artery-bypass-surgery/ http://www.ivs.no/blog/new-phd-on-patient-reported-outcomes-after-on-pump-and-off-pump-coronary-artery-bypass-surgery/ http://www.ivs.no/blog/new-phd-on-patient-reported-outcomes-after-on-pump-and-off-pump-coronary-artery-bypass-surgery/#commentsHovednyheter New PhD on "QoS Provisioning for Wireless Sensor Networks: Algorithms, Protocols and Modeling" Xuedong Liang defended his thesis in a dissertation originating from the Interventional Centre, Oslo Univerity Hospital Rikshospitalet and the Precice Modeling Group, Department of Informatics at University of Oslo on December 21st 2009. The first opponent was Professor Xiaoming Fu, Institute of Computer Science, Georg-August-University of Goettingen, the second opponent was Research Scientist Yan Zhang, Simula Research Laboratory and the commision leader was Associate Professor Martin Steffen, Department of Informatics, University of Oslo. The main superviser was Ilangko Balasingham, and co-advisers were Olaf Owe og Einar Broch Johnsen. The university representative at the dissertation was Dag Langmyhr. Xuedong Liang's work included 10 scientific papers (authored and/or co-authored) rated as not trivial by one of the opponents, but rather as improtant contributions on the QoS field. The topic of the trial lecture was Localization in Wireless Networks. xuedongXuedong Liang defended his thesis in a dissertation originating from the Interventional Centre, Oslo Univerity Hospital Rikshospitalet and the Precice Modeling Group, Department of Informatics at University of Oslo on December 21st 2009. The first opponent was Professor Xiaoming Fu, Institute of Computer Science, Georg-August-University of Goettingen, the second opponent was Research Scientist Yan Zhang, Simula Research Laboratory and the commision leader was Associate Professor Martin Steffen, Department of Informatics, University of Oslo. The main superviser was Ilangko Balasingham, and co-advisers were Olaf Owe og Einar Broch Johnsen. The university representative at the dissertation was Dag Langmyhr. Xuedong Liang's work included 10 scientific papers (authored and/or co-authored) rated as not trivial by one of the opponents, but rather as improtant contributions on the QoS field. The topic of the trial lecture was Localization in Wireless Networks.

]]> Karl Mon, 21 Dec 2009 15:36:05 +0100http://www.ivs.no/blog/new-phd-on-qos-provisioning-for-wireless-sensor-networks-algorithms-protocols-and-modeling/ http://www.ivs.no/blog/new-phd-on-qos-provisioning-for-wireless-sensor-networks-algorithms-protocols-and-modeling/ http://www.ivs.no/blog/new-phd-on-qos-provisioning-for-wireless-sensor-networks-algorithms-protocols-and-modeling/#commentsHovednyheter Minister of Research and Higher Education visited the Interventional Centre Tora Aasland, Minister of Reserach and Higher Education from Ministry of Education and Higher Research visited the Interventional Centre after a 3 hour meeting at Rikshospitalet Oslo University Hospital (OUS). The Minister met with leaders from Pharmaceutical industry including Karita Bekkemellem (The Association of the Norwegian Pharmaceuitical Industry-LMI), Gunnar Sæther (MSD), Erlend B. Smeland, leader of Research and Innnovation at OUS, Steinar Aamdal, MD, leader of the Clinical Research and Test Unit at Radiumhospitalet OUS and professor Erik Fosse from the Interventional Centre. Among topics discussed were how to improve collaboration between pharmaceutical industy and Norwegian hospitals and what role the government could play. One of the objectives of LMI is to increase the pharmaceutical research in Norway. After the meeting the Minister visited the clinical facilities at the Interventional Centre and was guided through the specialized operating rooms by research nurse Karl Øyri. See the LMI website for more information (in Norwegian) >>>. Photo: Marianne H Aandahl, Federation of Norwegian Industries. VisitorsTora Aasland, Minister of Reserach and Higher Education from Ministry of Education and Higher Research visited the Interventional Centre after a 3 hour meeting at Rikshospitalet Oslo University Hospital (OUS). The Minister met with leaders from Pharmaceutical industry including Karita Bekkemellem (The Association of the Norwegian Pharmaceuitical Industry-LMI), Gunnar Sæther (MSD), Erlend B. Smeland, leader of Research and Innnovation at OUS, Steinar Aamdal, MD, leader of the Clinical Research and Test Unit at Radiumhospitalet OUS and professor Erik Fosse from the Interventional Centre. Among topics discussed were how to improve collaboration between pharmaceutical industy and Norwegian hospitals and what role the government could play. One of the objectives of LMI is to increase the pharmaceutical research in Norway. After the meeting the Minister visited the clinical facilities at the Interventional Centre and was guided through the specialized operating rooms by research nurse Karl Øyri. See the LMI website for more information (in Norwegian) >>>. Photo: Marianne H Aandahl, Federation of Norwegian Industries.

]]> Karl Tue, 08 Dec 2009 16:42:10 +0100http://www.ivs.no/blog/minister-of-research-and-higher-education-visited-the-interventional-centre/ http://www.ivs.no/blog/minister-of-research-and-higher-education-visited-the-interventional-centre/ http://www.ivs.no/blog/minister-of-research-and-higher-education-visited-the-interventional-centre/#commentsHovednyheter Best Abstract Price to researcher from the Interventional Centre Anesthesiologist and PhD student Søren Pischke was awarded an Abstract Price at the 2009 Autumn Meeting of the Norwegian Anesthesiology Society. The abstract describes researh work performed at the Interventional Centre and is presented here: Hepatic and intestinal PCO2 measurement for real-time detection of hepatic artery and/or portal vein occlusion. Liver ischemia is a potentially life-threatening condition occurring in the course of liver transplantation, liver surgery and circulatory shock. Following liver transplantation hepatic artery (HA) stenosis and portal vein (PV) obstruction occur in 3 – 12 % of the patients, and more frequently in children than adults. Today, standard of care is Doppler ultrasound and liver enzyme assessment daily. Accordingly, detection of severe hypoperfusion may be delayed. Continuous monitoring of intrahepatic and intestinal PCO2 may be an opportunity for early detection of ischemia as tissue CO2 increases during ischemia by HCO3 buffering anaerobically produced lactic acid.Blood flow reduction in either HA, PV or both leads to alterations in intermediary metabolism in the liver. Intrahepatic and intestinal CO2 measurement as a marker for anaerobic metabolism detects these changes and enables correct diagnosis of the affected vessel. Søren Pischke, MDAnesthesiologist and PhD student Søren Pischke was awarded an Abstract Price at the 2009 Autumn Meeting of the Norwegian Anesthesiology Society. The abstract describes researh work performed at the Interventional Centre and is presented here: Hepatic and intestinal PCO2 measurement for real-time detection of hepatic artery and/or portal vein occlusion.
Liver ischemia is a potentially life-threatening condition occurring in the course of liver transplantation, liver surgery and circulatory shock. Following liver transplantation hepatic artery (HA) stenosis and portal vein (PV) obstruction occur in 3 – 12 % of the patients, and more frequently in children than adults. Today, standard of care is Doppler ultrasound and liver enzyme assessment daily. Accordingly, detection of severe hypoperfusion may be delayed. Continuous monitoring of intrahepatic and intestinal PCO2 may be an opportunity for early detection of ischemia as tissue CO2 increases during ischemia by HCO3 buffering anaerobically produced lactic acid.
Blood flow reduction in either HA, PV or both leads to alterations in intermediary metabolism in the liver. Intrahepatic and intestinal CO2 measurement as a marker for anaerobic metabolism detects these changes and enables correct diagnosis of the affected vessel.

In ten pigs inflatable vascular occluders and ultrasound devices measuring blood flow were placed around the HA and PV. Blood sampling catheters were placed in the PV, hepatic vein and carotid artery. IscAlert™ (diameter < 1 mm) and Neurotrend® sensors measuring real-time PCO2 conductimetrically and PCO2, PO2 and pH optically, respectively, as well as microdialysis probes were placed in the liver. IscAlert™ sensors were placed between loops of small intestine reflecting intestinal PCO2 and microdialysis probes in the intestinal lumen. Subjects were assigned to either full occlusion of the HA and PV followed by gradual occlusion of both or to gradual occlusion of HA and PV followed by total occlusion of both.

Gradual as well as full occlusion of HA and PV led to significant increases of intrahepatic PCO2. This was accompanied by a significant decrease of PO2 and pH both intrahepatically and in the hepatic vein, but not in arterial blood. Microdialysis revealed minor elevation of lactate and glycerol during HA occlusion and significant elevation during occlusion of the PV or both. Intestinal PCO2 rose significantly upon occlusion of the PV accompanied by a significant rise of lactate and glycerol in the intestinal lumen.

Even a gradual occlusion of one vessel leads to detectable changes in liver metabolism. Intrahepatic PCO2 measurement reliably identifies these changes. Intestinal PCO2 increases only during PV occlusion, likely reflecting venous ischemia in the intestine. A combination of intrahepatic and intestinal PCO2 measurement reliably diagnoses the affected vessel, depicts the severity of the occlusion and emerges as a clinical tool enabling early intervention.

]]> Karl Fri, 04 Dec 2009 15:03:42 +0100http://www.ivs.no/blog/abstract-price-to-resercher-from-the-interventional-centre/ http://www.ivs.no/blog/abstract-price-to-resercher-from-the-interventional-centre/ http://www.ivs.no/blog/abstract-price-to-resercher-from-the-interventional-centre/#commentsHovednyheter New PhD Thesis from the Interventional Centre Bjørn Erik Mørk defended his thesis Changing practices- A practice based study of cross-diciplinary technology development in hospitals from the Interventional Centre, Oslo University Hospital, Rikshospitalet, Faculty of Medicine at University of Oslo, Department of Leadership and Organizational Management, BI Norwegian School of Management, Oslo and Institute of Health Management and Health Economics at University of Oslo. This study examined why breakthroughs in knowledge may fail to be translated into medical practice. These novel practices often lack alignment with existing practices, or they cut across established professional boundaries and power structures. Despite this, we know that establishing practices across heterogeneous groups of actors, i.e. science, politics and industry, can facilitate interactive innovations. This project investigated how this was accomplished in practice in the context of cross-disciplinary technology development in hospitals. The dissertation is based on a longitudinal study of the Interventional Centre, Oslo University Hospital, Rikshospitalet, Norway. bemBjørn Erik Mørk defended his thesis Changing practices- A practice based study of cross-diciplinary technology development in hospitals from the Interventional Centre, Oslo University Hospital, Rikshospitalet, Faculty of Medicine at University of Oslo, Department of Leadership and Organizational Management, BI Norwegian School of Management, Oslo and Institute of Health Management and Health Economics at University of Oslo. This study examined why breakthroughs in knowledge may fail to be translated into medical practice. These novel practices often lack alignment with existing practices, or they cut across established professional boundaries and power structures. Despite this, we know that establishing practices across heterogeneous groups of actors, i.e. science, politics and industry, can facilitate interactive innovations. This project investigated how this was accomplished in practice in the context of cross-disciplinary technology development in hospitals. The dissertation is based on a longitudinal study of the Interventional Centre, Oslo University Hospital, Rikshospitalet, Norway.

The study contributes to our understanding of organising, learning, change and innovation. The specific contributions are developed in the five papers which drew from different theoretical approaches. Several of the papers critically addressed the role of communities of practice in innovation, which is an area that thus far has been under-researched. Specifically, they underscore how power relations both within and across communities of practice become challenged during innovation. In fact, it is argued that during radical innovation, it is no longer given who the master and the apprentice is. In general, the papers emphasise the ongoing, multilevel activities that are important for overcoming different boundaries to develop and stabilise new medical knowing in practice. A major and important challenge is that it is insufficient to establish links between different practices if the organizational and institutional context reinforces the tendency to distinguish between these practices. It also pointed out that the linear approach to innovation is highly problematic, since these processes are not linear or rational, and an innovation is not a "thing" with a constant characteristic that can easily be moved from one context to another. Instead, innovations are very dynamic, contingent and political.
1. opponent was Professor Maxine Robertson, Queen Mary University of London, School of Business and Management, London, England. 2. opponent was Professor Odd Nordhaug, Dept. of Strategy and Management, University of Bergen.
3. member of the Committee was Associated Professor Lars Erik Kjekshus, Health Management and Health Economics at University of Oslo. Leader of the dissertation was Professor Jan Ludvig Svennevig, Dept. of Thorasic Surgery, Faculty Division Rikshospitalet, University of Oslo.

]]> Karl Thu, 19 Nov 2009 14:50:10 +0100http://www.ivs.no/blog/new-phd-thesis-at-the-interventional-centre/ http://www.ivs.no/blog/new-phd-thesis-at-the-interventional-centre/ http://www.ivs.no/blog/new-phd-thesis-at-the-interventional-centre/#commentsHovednyheter