| 1. |
- Dalin, Martin, 1982, et al.
(författare)
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Massive parallel sequencing questions the pathogenic role of missense variants in dilated cardiomyopathy
- 2017
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Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 228, s. 742-748
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Tidskriftsartikel (refereegranskat)abstract
- Background: Germline genetic variants are an important cause of dilated cardiomyopathy (DCM). However, recent sequencing studies have revealed rare variants in DCM-associated genes also in individuals without known heart disease. In this study, we investigate variant prevalence and genotype-phenotype correlations in Swedish DCM patients, and compare their genetic variants to those detected in reference cohorts. Methods and results: We sequenced the coding regions of 41 DCM-associated genes in 176 unrelated patients with idiopathic DCM and found 102 protein-altering variants with an allele frequency of <0.04% in reference cohorts; the majority were missense variants not previously described in DCM. Fifty-five (31%) patients had one variant, and 24 (14%) patients had two or more variants in the analysed genes. Detection of genetic variants in any gene, and in LMNA, MYII7 or TTN alone, was associated with early onset disease and reduced transplant-free survival. As expected, nonsense and frameshift variants were more common in DCM patients than in healthy individuals of the reference cohort 1000 Genomes Europeans. Surprisingly however, the prevalence, conservation and pathogenicity scores, and localization of missense variants were similar in DCM patients and healthy reference individuals. Conclusion: To our knowledge, this is the first study to identify correlations between genotype and prognosis when sequencing a large number of genes in unselected DCM patients. The similar distribution of missense variants in DCM patients and healthy reference individuals questions the pathogenic role of many variants, and suggests that results from genetic testing of DCM patients should be interpreted with caution.
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| 2. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Clinicians' psychological empowerment to engage in management as part of their daily work
- 2022
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Ingår i: Journal of Health Organization & Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 36:9, s. 272-287
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of the article is to analyze how physicians and nurses, as the two major health care professions, experience psychological empowerment for managerial work. Design/methodology/approach: The study was designed as a qualitative interview study at four primary care centers (PCCs) in Sweden. In total, 47 interviews were conducted, mainly with physicians and nurses. The first inductive analysis led us to the concept of psychological empowerment, which was used in the next deductive step of the analysis. Findings: The study showed that both professions experienced self-determination for managerial work, but that nurses were more dependent on structural empowerment. Nurses experienced that they had competence for managerial work, whereas physicians were more ignorant of such competence. Nurses used managerial work to create impact on the conditions for their clinical work, whereas physicians experienced impact independently. Both nurses and physicians experienced managerial work as meaningful, but less meaningful than nurses and physicians' clinical work. Practical implications: For an effective health care system, structural changes in terms of positions, roles, and responsibilities can be an important route for especially nurses' psychological empowerment. Originality/value: The qualitative method provided a complementary understanding of psychological empowerment on how psychological empowerment interacted with other factors. One such aspect was nurses' higher dependence on structural empowerment, but the most important aspect was that both physicians and nurses experienced that managerial work was less meaningful than clinical work. This implies that psychological empowerment for managerial work may only make a difference if psychological empowerment does not compete with physicians' and nurses' clinical work.
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| 3. |
- Gadolin, Christian, 1987-, et al.
(författare)
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Providing healthcare through “value shops” : impact on professional fulfilment for physicians and nurses
- 2020
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Ingår i: International Journal of Health Governance. - : Emerald Group Publishing Limited. - 2059-4631 .- 2059-464X. ; 25:2, s. 127-136
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this paper is to empirically explore and demonstrate the ability of healthcare professionals to attain professional fulfilment when providing healthcare inspired by “value shops”. Design/methodology/approach: A qualitative case study incorporating interviews and observations was conducted. Findings: The empirical data suggest that the professional fulfilment of both physicians and nurses is facilitated when care is organized through “value shops”. Both groups of professionals state that they are able to return to their “professional core”. Originality/value: The beneficial outcomes of organizing healthcare inspired by the “value shop” have previously been explored in terms of efficiency and quality. However, the professional fulfilment of healthcare professionals when providing such care has not been explicitly addressed. Professional fulfilment is vital in order to safeguard high-quality care, as well as healthcare professionals' involvement and engagement in implementing quality improvements. This paper highlights the fact that care provision inspired by the “value shop” may facilitate professional fulfilment, which further strengthens the potential positive outcomes of the “value shop” when utilized in a healthcare setting.
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| 4. |
- Pistone, Isabella, 1987, et al.
(författare)
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We Need to Talk about Knowledge! Rethinking Management and Evidence-Based Practice in Welfare
- 2023
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Ingår i: Scandinavian Journal of Public Administration. - : University of Gothenburg School of Public Administration. - 2001-7405 .- 2001-7413 .- 2000-8058. ; 27:3, s. 37-56
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Tidskriftsartikel (refereegranskat)abstract
- New Public Management (NPM) and Evidence-Based Practice (EBP) are two fundamental concepts within welfare professions. Both NPM and EBP are central to many debates within welfare, and often criticised as posing simplified or positivist approaches to management and knowledge utilization. Epistemologically, both are manifestations of modernity, with its emphases on standardization, control, simple causality and measurability. These epistemological similarities have not been explored as potential doorways for making modifications to NPM and EBP. The purpose of this paper is to contribute to new ways of thinking and doing management and EBP of complex welfare issues by increasing the epistemological understanding of these concepts. NPM and EBP are taken here as subjects for joint conceptual analysis. The paper is guided by the following question: What is an appropriate epistemology for professionals involved in EBP and managing? Literature on NPM and EBP are analyzed together with theoretical insights from scholarship on formalization and heterogeneity of expertise, and analyzed in light of empirical examples taken from a case of a subregional social sustainability/public health initiative. Drawing on the development of post-NPM and more complex versions of EBP, the paper ends by introducing the notion post-EBP, and concludes by outlining some implications of this concept for the working professions.
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| 5. |
- Andersson, Stefanie, 1989, et al.
(författare)
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Genome-wide imaging screen uncovers molecular determinants of arsenite-induced protein aggregation and toxicity
- 2021
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Ingår i: Journal of Cell Science. - : The Company of Biologists. - 0021-9533 .- 1477-9137. ; 134:11
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Tidskriftsartikel (refereegranskat)abstract
- The toxic metalloid arsenic causes widespread misfolding and aggregation of cellular proteins. How these protein aggregates are formed in vivo, the mechanisms by which they affect cells and how cells prevent their accumulation is not fully understood. To find components involved in these processes, we performed a genome-wide imaging screen and identified Saccharomyces cerevisiae deletion mutants with either enhanced or reduced protein aggregation levels during arsenite exposure. We show that many of the identified factors are crucial to safeguard protein homeostasis (proteostasis) and to protect cells against arsenite toxicity. The hits were enriched for various functions including protein biosynthesis and transcription, and dedicated follow-up experiments highlight the importance of accurate transcriptional and translational control for mitigating protein aggregation and toxicity during arsenite stress. Some of the hits are associated with pathological conditions, suggesting that arsenite-induced protein aggregation may affect disease processes. The broad network of cellular systems that impinge on proteostasis during arsenic stress identified in this current study provides a valuable resource and a framework for further elucidation of the mechanistic details of metalloid toxicity and pathogenesis. This article has an associated First Person interview with the first authors of the paper.
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| 6. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Nurturing innovative culture in a healthcare organisation : Lessons from a Swedish case study
- 2022
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Ingår i: Journal of Health Organization & Management. - : Emerald Publishing. - 1477-7266 .- 1758-7247. ; 37:9, s. 17-33
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Healthcare organisations are often described as less innovative than other organisations, since organisational culture works against innovations. In this paper, the authors ask whether it has to be that way or whether is possible to nurture an innovative culture in a healthcare organisation. The aim of this paper is to describe and analyse nurturing an innovative culture within a healthcare organisation and how culture can support innovations in such a healthcare organisation. Design/methodology/approach: Based on a qualitative case study of a healthcare unit that changed, within a few years, from having no innovations to repeatedly generating innovations, the authors describe important aspects of how innovative culture can be nurtured in healthcare. Data were analysed using inductive and deductive analysis steps. Findings: The study shows that it is possible to nurture an innovative culture in a healthcare organisation. Relationships and competences beyond healthcare, empowering structures and signalling the importance of innovation work with resources all proved to be important. All are aspects that a manager can influence. In this case, the manager's role in nurturing innovative culture was very important. Practical implications: This study highlights that an innovative culture can be nurtured in healthcare organisations and that managers can play a key role in such a process. Originality/value: The paper describes and analyses an innovative culture in a healthcare unit and identifies important conditions and strategies for nurturing innovative culture in healthcare organisations.
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| 7. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Patients' perceptions of quality in Swedish primary care - a study of differences between private and public ownership
- 2021
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Ingår i: Journal of Health Organization & Management. - : Emerald Group Publishing Limited. - 1477-7266 .- 1758-7247. ; 35:9, s. 85-100
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The purpose of the paper is to describe and analyze differences in patients' quality perceptions of private and public primary care centers in Sweden.DESIGN/METHODOLOGY/APPROACH: The article explores the differences in quality perceptions between patients of public and private primary care centers based on data from a large patient survey in Sweden. The survey covers seven dimensions, and in this paper the measure Overall impression was used for the comparison. With more than 80,000 valid responses, the survey covers all primary care centers in Sweden which allowed for a detailed analysis of differences in quality perceptions among patients from the different categories of owners.FINDINGS: The article contributes with a detailed description of different types of private owners: not-for-profit and for profit, as well as corporate groups and independent care centers. The results show a higher quality perception for independent centers compared to both public and corporate groups.RESEARCH LIMITATIONS/IMPLICATIONS: The small number of not-for-profit centers (21 out of 1,117 centers) does not allow for clear conclusions for this group. The results, however, indicate an even higher patient quality perception for not-for-profit centers. The study focus on describing differences in quality perceptions between the owner categories. Future research can contribute with explanations to why independent care centers receive higher patient satisfaction.SOCIAL IMPLICATIONS: The results from the study have policy implications both in a Swedish as well as international perspective. The differentiation between different types of private owners made in this paper opens up for interesting discussions on privatization of healthcare and how it affects patient satisfaction.ORIGINALITY/VALUE: The main contribution of the paper is the detailed comparison of different categories of private owners and the public owners.
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| 8. |
- Andersson, Thomas, 1970-, et al.
(författare)
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Understanding institutional work through social interaction in highly institutionalized settings : Lessons from public healthcare organizations
- 2020
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Ingår i: Scandinavian Journal of Management. - : Elsevier BV. - 0956-5221 .- 1873-3387. ; 36:2
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Tidskriftsartikel (refereegranskat)abstract
- The present study describes and analyses how social interactions between individual actors form institutional work in the highly institutionalized setting of healthcare organizations. Based on a qualitative case study, we affirm that social interactions mainly form maintaining institutional work, thus primarily upholding the rigidity of healthcare organizations. Social interactions either preserve distance between different actors or prevent their mutual influence, which decreases the effects of institutional complexity. However, when institutional work goes beyond maintaining, social interaction is characterized by processes of claiming influence and granting influence between individual actors who adhere to different institutional logics, which allows effects of institutional complexity. Such institutional work is contingent upon physicians' strong power position, and granting influence is likely to precede claiming influence.
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| 9. |
- Eriksson, Erik, 1977, et al.
(författare)
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Post-New Public Management in Public Healthcare: Recycled, Hybridized, Paradigmatic?
- 2019
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Ingår i: British Academy of Management (BAM) 2019 Conference. - : British Academy of Management.
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Konferensbidrag (refereegranskat)abstract
- New Public Management (NPM) is increasingly used pejoratively and claimed unfit for the complex challenges in contemporary societies, for example aging population structures and, as a result, increased number of cancer patients. Consequently, post-NPM gains increased attention. Drawing from a longitudinal case in Swedish cancer care, the present article seeks to pinpoint post-NPM in public healthcare practice. It is revealed that some post-NPM aspects are recycled by combining traditional public administration (pre-NPM) and NPM aspects: the former’s re-professionalisation is combined with the latter’s foci on performance measures, decentralisation, and accountability. Other post-NPM aspects are hybridizing typical NPM aspects with new (post-NPM) aspects: for instance, customer-focus is taken further to include the patient’s active participation in co-designing services, and standardization is reinterpreted to concern meeting-places rather than efficiency. Yet other aspects are replacing NPM shortcomings: for instance, trust is replacing control, and a systems approach is replacing the intra-organisational focus
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| 10. |
- Eriksson, Erik, 1977-, et al.
(författare)
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Value Propositions in Public Collaborations : Regaining Organizational Focus Through Value Configurations
- 2022
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Ingår i: British Journal of Management. - : John Wiley & Sons. - 1045-3172 .- 1467-8551. ; 33:4, s. 2070-2085
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Tidskriftsartikel (refereegranskat)abstract
- There is consensus that complex problems of contemporary society call for public service collaborations. So-called public service logic (PSL) focuses on joint value creation among a multiplicity of actors in service ecosystems. Despite recognizing various actors, this logic is essentially user-centric, with the service user being the one realizing the value. Consequently, single and collaborating organizations cannot deliver value, only potential value, or so-called value propositions. The elusive public service logic takes a network value conguration for granted and as a starting point. Drawing from two cases in Swedish healthcare, this paper argues that two other value congurations (chain and shop) are also relevant for understanding the development of value propositions – and that these may be related to both intra- and inter-organizational processes. Theoretically, we conclude that just like public service logic, other collaborative public management theories need to recognize the importance of a multiplicity of value congurations and that these are often related to both intra- and inter-organizational processes. We conclude that managers should not adopt the latest network trends without first reflecting on the relevance of existing internal processes.
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