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Sökning: hsv:(SAMHÄLLSVETENSKAP) > Högskolan i Skövde > Doktorsavhandling

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1.
  • Lundin, Anette (författare)
  • Rättfärdigade prioriteringar : en kvalitativ analys av hur personal i äldreomsorgen hanterar motstridiga verksamhetslogiker
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This dissertation aims at contributing to social scientific knowledge about prevailing prioritizations in eldercarepractice by looking at an economic and a caring logic, and how these logics are overlapping, contradictory or comein conflict with each other. A more concrete aim is to understand how the personnel describe their work with orfor balance between the logics and their justifications prioritizations made in the care of older persons. The researchquestion is: How do personnel and care unit manager at a public nursing home understand and handle the twologics that govern care work for facilitating wellbeing of the residents. The aim and research question led to threesub-aims: 1) to analyze the personnel’s experiences of and meaning making about the care work they carry out, 2)to illuminate and problematize the two logics above, and 3)to analyze how the personnel justify their prioritizationsin prevailing context, and how their accountability have an effect on their professional identities.Empirical material was gathered through 13 individual interviews with care personnel and their care unitmanager at a public nursing home in Sweden. These interviews were complemented by a group interview. Thematerial was analyzed by the use of three methods: phenomenology (Paper I and II), reflexive analysis (Paper III),and a positioning analysis (Paper IV). Paper I found that the personnel understands the residents’ well-being asbeing characterized by feeling of being existentially touched. This essence is constituted by feeling freedom ofchoice, pleasure, and closeness to someone or something. In Paper II, the work for facilitating this kind of wellbeingwas characterized by three ambiguities: (i) freedom of choice for the older persons vs. institutionalconstraints, (ii) the residents' need for activation vs. wanting not to be activated, and (iii) the residents' need forroutine vs. the eldercarers' not being able to know what the residents need. Paper III showed that the care unitmanager created a hybrid of the two logics (economy is care and vice versa) and that the personnel oppose thishybrid. The opposition is shaped as the personnel divides their work in care and “those other things”. Thesefindings showed how interaction between the logics expresses itself in practice and that it is the personnel who hasto handle contradictions between the logics in their everyday care work. The positioning analysis in Paper IV hadthree levels. The first level showed how the carers align with their peers and that they find the organizationalframe, within which they have agency, changed due to increased workload. This change led to an order of priorities.The second level showed that the carers relate to three aspects when making accounts: the care itself, the olderpersons, and the media. The third level showed that the carers share a view of administration, cleaning, servingmeals, and filling up supplies, as not being parts of caring.The dissertation’s theoretical framework focused on theories on logics, accountability, and professionalidentity. The conclusion is that both logics are needed in order to facilitate the well-being of the older persons. Therelationships between the two logics are not always clear and if their contradictions are not illuminated, there is arisk for a care practice that does not facilitate the well-being of their residents. An important theoreticalcontribution is that logics of activities should be understood vertically (form political, through management, anddown to the level of practice) instead of horizontally. The practical implications emphasize the importance ofsupporting the personnel’s professional identity on the one hand, and discussing the logics on the other. Byunderstanding differences between definitions on management-level and practice level, a homogeneity can bereached.
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2.
  • Dahl, Anna, 1975- (författare)
  • Body mass index, cognitive ability, and dementia : prospective associations and methodological issues in late life
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aims of the present study were to investigate the association between overweight and cognitive ability and dementia, and to evaluate the usefulness of self-reported body mass index (BMI) in late life and various data sources commonly used in epidemiological studies to identify persons with dementia. Data were drawn from three population-based studies: the Swedish Adoption/Twin Study of Aging (SATSA), Aging in Women and Men: A Longitudinal Study of Gender Differences in Health Behaviour and Health among Elderly (the Gender Study), and the Finnish Lieto Study. In Study I, the agreement between self-reported and measured BMI over time was evaluated among 774 men and women, ages 40 to 88 years at baseline (mean age 63.9) participating in both the questionnaire phase and in-person testing of SATSA. Latent growth curve (LGC) modeling showed a small but significant increase between self-reported and measured BMI (0.02 kg/m2/y) over time, which would probably not affect the results if self-reported BMI were used as a continuous variable in longitudinal research. In Study II, the agreement between dementia diagnoses from various sources and dementia diagnoses set at a consensus conference was evaluated. Among the 498 elderly people ages 70 to 81 at baseline (mean age 74.5) enrolled in the Gender Study, 87 were diagnosed with dementia during an eight-year period. Review of medical records and nurse evaluations yielded the highest sensitivity (0.83 and 0.80, respectively) and a high specificity (0.98 and 0.96), indicating that these sources might be good proxies of dementia, while data extraction from the Swedish Inpatient Discharge Registry underestimated the prevalence of dementia (sensitivity 0.26). In Study III, the association between being overweight in midlife and cognitive ability in late life was examined in SATSA. The 781 participants ages 25 to 63 at baseline (mean age 41.6) in 1963 or 1973 self-reported their height and weight. From 1986 until 2002, they were assessed five times using a cognitive test battery. LGC models showed that people with higher midlife BMI scores had significantly lower cognitive ability and a significantly steeper decline than their thinner counterparts, an association that persisted when those who developed dementia during the study period were excluded from the analysis. This finding indicates that being overweight might affect cognitive ability independently of dementia. In Study IV, the association between BMI and dementia risk in older persons was described among 605 persons without dementia and ages 65 to 92 at baseline (mean age 70.8) in the Lieto Study. Among these, 86 persons were diagnosed with dementia during eight years of follow-up. Cox regression analyses indicated that for each unit increase in BMI score, the risk of dementia decreased 8% (hazard ratio = 0.92, 95% confidence interval = 0.87–0.97) and the association remained significant when individuals who developed dementia during the first four years of follow-up were excluded from the analyses. This result suggests that low BMI scores are present almost a decade before clinical dementia onset.
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3.
  • Johannesson, Krister, 1970- (författare)
  • I främsta rummet : planerandet av en högskolebiblioteksbyggnad med studenters arbete i fokus
  • 2009
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The purpose of the thesis is to investigate planning processes for academic library buildings and the outcomes of such processes. This is accomplished through a case study utilising discourse analysis. The main question is: How is a vision of an academic library implemented in and through a building? The case study is retrospective and focused on the building of a new library at Kalmar University, Sweden, at the end of the 1990s. During this period, technological and educational developments and general societal change transformed the context of library planning and made way for renegotiations of the librarian profession. A critical realist approach characterises the study of visions, processes and the analysis of the various functions of the building. Results reveal the proactive nature of the activities of the library director in Kalmar. Early in the process he formulated a vision in which he presents the library as an information resource, a meeting place between different user groups and a workplace intended to promote learning and knowledge. From a professional point of view, the vision implied a dehierarchisation of relations both within the library staff and between library staff and visitors. The vision was based on an interpretation of Swedish national educational policy, and architecturally manifested by an ambition to reduce the physical and psychological boundaries between library staff and visitors. The early formulation of the vision together with the clients’ use of architectural expertise facilitated the choice of architects. However during the process a need arose to anchor the decision in the library field. Efforts were made to address library expertise and to collect user comments from a broader academic field. Discourses concerning the university library as a workplace and a meeting place were especially evident in the strategies of the leading agents. The discourses uncovered in the study correspond to more general discourses which became prominent in society and higher education during the period in question. The library itself has met growing appreciation by users both from within and outside the university. The proactive leadership demonstrated by the library director in Kalmar was based on hegemony rather than coercion. This corresponds to contemporary tendencies. Hegemonic consent may persist even after changes in leadership. In Kalmar however, architectural solutions with insufficient support from the library staff have been reconstructed after changes in leadership. Future research on architectural planning processes may pay further attention to different discursive resources, social fields and the positions within them.
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4.
  • Ståhl, Tomas (författare)
  • Determinants of Fairness-based and Favorability-based Reactions to Authorities' Decisions
  • 2006
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The present thesis focuses on the causal role of the people’s relationship to the authority in reactions to allocation decisions. A series of experiments investigating the effects of the authority’s group membership on reactions to allocation decisions are reported. In addition, psychological processes that may contribute to differences in responses to ingroup versus outgroup authorities’ decisions are examined. Because resource allocations across group boundaries may be particularly challenging for authorities, and because the psychological processes guiding reactions to outgroup authorities’ decisions have received very little attention, a primary aim is to examine the psychology of reactions to outgroup authorities’ decisions. Results demonstrate that people react more strongly to the favourability of procedures and outcomes when the authority is from an outgroup (vs. ingroup). By contrast, people generally react more strongly to the fairness of procedures when the authority is from an ingroup (vs. outgroup). Notably, direct activation of relational (ingroup) versus instrumental (outgroup) concerns produces the same response patterns as manipulating the authority’s group membership. Results further suggest that responses to outgroup authorities’ decisions in part can be explained by expectations that the authority is biased of members of his/her own group
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5.
  • Bank, Sakarias Einar Sefik (författare)
  • Promoting Air Quality Policy Adoption and Change
  • 2021
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Air pollution is a localised issue but negatively influences health and finance globally. Conurbations and regional governments struggle to find the best policy solutions to meet air quality limit levels while competing over resources and attempting to secure growth. As such, methods to increase the adoption of effective pollution-focused policies are warranted. This thesis has set out to create a framework for understanding the relationship between behaviour change of policy makers and the adoption of new air quality policies at regional levels of government. Chapter four of this thesis looked into the quality and results of previous literature through a systematic review (study 1), investigating how previous interventions have attempted to promote policy adoption. Within chapter five, a vignette study with policy practitioners (study 2; n = 15) was conducted to evaluate the use of intervention functions. Alongside the vignette study, an online questionnaire looked at perceived barriers to policy adoption. Data from both were amalgamated using thematic analysis. Finally, in chapter six, the use of interventions to promote air quality policy and the state of current UK air quality policy was reviewed (study 3). Collectively these studies have contributed to the understanding of how intervention functions influence policy intention formation and policy adoption. The combined outcomes of these studies suggest a) a need for increased education of policymakers and b) for councils to share learning and take inspiration from each other. Throughout the studies, key barriers to policy intentions and policy adoption were investigated, the most prominent being economic and administrative barriers. Within chapter seven, results are summarised and directions for future research and practice are suggested.
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6.
  • Andersson, Erik (författare)
  • Det politiska rummet : villkor för situationspolitisk socialisation i en nätgemenskap av och för ungdomar
  • 2012
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • The aim is to analyse the institutional character of, and the on-going communication in, a net community organised by and for young people. This is achieved using terms of conditions for situational political socialisation – a situation in a specific context in which the participants, within the battle between different groups attempting to organise society through interaction and action, adopt political preferences and skills. The thesis builds on agonism, a political theory in which controversy and struggle are viewed as prerequisites for human life that uses language as a political act. The net community, as an institution, contingently depends on political rebirth via action and communication. The use of language creates places that give the institution meaning while at the same time the institution claims the participants and their creation of meaning. Black Heart, the analysed net community, is a quasi-public space for and by young people aged between 14 and 28 years. It is a cultural community where political conversations take place among other kinds of communication. The institutional character of Black Heart and ten politically controversial conversations are analysed, using a case study method that applies web content analysis and computer mediated discourse analysis. There is a strong institutional framework operating in the political text conversations of Black Heart, the participants are governed by the institution and the participants govern each other. The political communication is characterised by revealing and arguing for political interest. To challenge is the dominant category of political action which constitutes political subjects that are offensive, argumentative and polemic. Political communication and the on-going interaction generate an educational situation in which the participants are expected to be content oriented, argumentative, expressive, communicative and polemic.  
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7.
  • Andersson, Martin, 1981- (författare)
  • A bilevel approach to parameter tuning of optimization algorithms using evolutionary computing : Understanding optimization algorithms through optimization
  • 2018
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Most optimization problems found in the real world cannot be solved using analytical methods. For these types of difficult optimization problems, an alternative approach is needed. Metaheuristics are a category of optimization algorithms that do not guarantee that an optimal solution will be found, but instead search for the best solutions using some general heuristics. Metaheuristics have been shown to be effective at finding “good-enough” solutions to a wide variety of difficult problems. Most metaheuristics involve control parameters that can be used to modify how the heuristics perform its search. This is necessary because different problems may require different search strategies to be solved effectively. The control parameters allow for the optimization algorithm to be adapted to the problem at hand. It is, however, difficult to predict what the optimal control parameters are for any given problem. The problem of finding these optimal control parameter values is known as parameter tuning and is the main topic of this thesis. This thesis uses a bilevel optimization approach to solve parameter tuning problems. In this approach, the parameter tuning problem itself is formulated as an optimization problem and solved with an optimization algorithm. The parameter tuning problem formulated as a bilevel optimization problem is challenging because of nonlinear objective functions, interacting variables, multiple local optima, and noise. However, it is in precisely this kind of difficult optimization problem that evolutionary algorithms, which are a subclass of metaheuristics, have been shown to be effective. That is the motivation for using evolutionary algorithms for the upper-level optimization (i.e. tuning algorithm) of the bilevel optimization approach. Solving the parameter tuning problem using a bilevel optimization approach is also computationally expensive, since a complete optimization run has to be completed for every evaluation of a set of control parameter values. It is therefore important that the tuning algorithm be as efficient as possible, so that the parameter tuning problem can be solved to a satisfactory level with relatively few evaluations. Even so, bilevel optimization experiments can take a long time to run on a single computer. There is, however, considerable parallelization potential in the bilevel optimization approach, since many of the optimizations are independent of one another. This thesis has three primary aims: first, to present a bilevel optimization framework and software architecture for parallel parameter tuning; second, to use this framework and software architecture to evaluate and configure evolutionary algorithms as tuners and compare them with other parameter tuning methods; and, finally, to use parameter tuning experiments to gain new insights into and understanding of how optimization algorithms work and how they can used be to their maximum potential. The proposed framework and software architecture have been implemented and deployed in more than one hundred computers running many thousands of parameter tuning experiments for many millions of optimizations. This illustrates that this design and implementation approach can handle large parameter tuning experiments. Two types of evolutionary algorithms, i.e. differential evolution (DE) and a genetic algorithm (GA), have been evaluated as tuners against the parameter tuning algorithm irace. The as pects of algorithm configuration and noise handling for DE and the GA as related to the parameter tuning problem were also investigated. The results indicate that dynamic resampling strategies outperform static resampling strategies. It was also shown that the GA needs an explicit exploration and exploitation strategy in order not become stuck in local optima. The comparison with irace shows that both DE and the GA can significantly outperform it in a variety of different tuning problems.
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8.
  • Cäker, Mikael, 1972- (författare)
  • Management accounting as constructing and opposing customer focus : three case studies on management accounting and customer relations
  • 2005
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • This thesis is on the relation between management accounting and customer focus and relates to discussions about how internal managing processes in organizations are interrelated with interorganizational relations, specifically constructions of customers. Both a normative and a descriptive perspective on the relation are taken within the different parts of the thesis, which consists of a licentiate thesis, three articles and a synthesizing text. The purpose is to understand the interaction between management accounting and customer focus on operative levels in industrial organizations, where focus on customer has a central place. The results are also discussed with respect to its possible importance in the development of managing processes of organizations. The thesis is based on three cases, which have been studied with mainly a qualitative approach.In the licentiate thesis, traditional accounting models, originally developed to provide information for analyzing products, are revisited under the assumption that customers and products are equally interesting to analyze. The three articles explore the role of management accounting in interpreting customers and the interface to customers. In the first article, strong customer accountability is found to override the intentions from managers, as communicated through the accounting system. Arguments of how management accounting can be perceived as inaccurate then have a central place in motivating how customers are prioritized in a way not favored by managers. Furthermore, in the second article, customers are experienced as both catalysts and frustrators to change processes and changes in management accounting are found in eo-development with the different customer relations and how different customers prefer to communicate. The third article explores how coordination mechanisms operate in relation to each other in coordination of customer-supplier relationships. A strong market mechanism creates space for bureaucratic control and use of management accounting. However, the use of bureaucratic control in turn relies on social coordination between actors in order to function.These four parts are revisited and related to each other in a synthesizing part of the thesis. The relation between management accounting and customer focus is approached in two ways. Management accounting may construct customer focus, making it impossible to distinguish between the two. However, another interpretation of the relation is management accounting and customer focus as opposing logics, where management accounting represents hierarchical influence, homogeneous control processes and cost efficient operations, and customer focus represents customer influence, control processes adapted to the customer and customized operations.
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9.
  • Eriksson, Nomie, 1955 (författare)
  • Friska vindar i sjukvården. Stöd och hinder vid förändringar i professionella organisationer
  • 2005
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Implementation of decisions in professional organisations is characterized by the board making decisions for the professions to perform. In this thesis a decision concerning how process directed method of working in medical service is studied. The implementation was studied at two hospitals and units with similar medical alignment. Earlier research shows that medical service is hard to change. The aim with this study is to identify what supports and what hinders the professions’ implementation of a new working method and to explain why. The professions are registered nurses and physicians. They have good knowledge of the medical service and a great interest in good performance for patients as well as themselves. Characteristic is that they carry out decisions if they correspond with their norms and values which describe how medical service is to be performed, i.e. the institutions of medical service. Process directed method of working diverts from the traditional working methods in medical service. The activities in medical service are synchronized into a logical chain without repetitions. It gives a standardized medical service for all the patients included in one group of patients or one diagnosis. The new way of working changes what medical service is offered, where it is performed and by whom. The working method gives medical, as well as administrative, changes. Medically, questioning and changing alters the contents of medical service. Administratively, the medical service directing and organisation is changed. The overall view on medical service is developed with this working method, whether it is performed in one or several units. Established facts for the implementation of the working method is development of the dialogue, which is held between the professions, by real enthusiasts and offers from each hospital management respectively about education and stimuli. The professions’ satisfaction with the new working method also supports the change. Hindering the implementation of the method are activities such as rounds, reports and documentation and they are hard to adapt into the processes since they have developed into ceremonies that could wear traces of path dependence. On top of this there is a general expressed conception of lack of time, which also has developed into a ceremony. Despite that the study showed that existing institutions agree with the decided working method and the implementation is strong when it comes to available bases, the grade of implementation varies and problems of implementation are identified. If the organisation is marked by contentment, the existing working method will be preserved. If the decision is forced upon the professions they will re-form it or re-interpret it. If path dependent activities exist, only parts of the working method are changed which the professions’ experience as frustrating. However, if the professions participate in the implementation of process directed working method through dialogue, real enthusiasts and education and stimuli, the traditional working method will change.
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10.
  • Gadolin, Christian (författare)
  • The Logics of Healthcare - In Quality Improvement Work
  • 2017
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Quality improvement (QI) has become a cornerstone in contemporary healthcare organizations with the aim of enabling management that facilitates efficiency and effectiveness, while providing a consistent correlation between health spending and indicators of access to and quality of care. However, despite years of reform which have attempted to change healthcare professionals’ practice, traditional professional modes of working remain relatively stable and entrenched. Previous research has highlighted the fact that healthcare professionals’ active involvement in quality improvement work (QIW) is often lacking. Such a lack is often explained by professionals’ scepticism towards management, managers, and organizationally related improvement initiatives.  Yet, there is a shortage of studies which focus on analysis at the level of the actor when studying healthcare professionals’ involvement in QIW.This dissertation presents a qualitative case study of the QIW undertaken by a multi-professional diabetes care team. It enables a description and analysis of healthcare professionals’ involvement in QIW at the actor level of analysis. A theoretical framework, consisting of the combination of institutional logics and institutional work, is applied in order to focus on varied and complementary aspects of institutional dynamics while simultaneously emphasizing the embeddedness of actors’ actions and interactions.The study shows that healthcare professionals’ identification with and adherence to the professional logic in general impairs their involvement in QIW. Adherence entails perceiving professional judgments and discretion as legitimate in guiding practice and work. However, the study emphasizes that adherence to the professional logic varies amongst professionals representing different professions. This means that healthcare professionals’ acceptance of the bureaucratic control of work as legitimate differs - enabling diverse approaches and practices in QIW. Furthermore, the study illustrates that the physicians’ relative dominance hinders the utilization of multiple perspectives in the multi-professional team. This finding elucidates how dominance and hierarchization of logics enable healthcare professionals’ practice to remain relatively stable, despite managerial attempts to change and alter it. Finally, the study delineates the interactions needed in order to bridge institutional logics at the actor level of analysis. Such interactions are characterized by reciprocal acts of claiming and granting influence that constitute creative/disruptive institutional work, enabling actors to find new approaches to each other and further facilitate healthcare professionals’ involvement in QIW.
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