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- Cronemyr, Peter, 1963-
(författare)
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Six Sigma management. Action research with some contributions to theories and methods.
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Many companies around the world have implemented Six Sigma as a problem solving methodology especially useful for dealing with recurring problems in business processes. Since the 1980s when it was developed at Motorola, many companies have tried to implement Six Sigma to fit their own company’s culture and goals. This thesis presents a longitudinal case study describing the evolution of ‘Six Sigma Management’ at Siemens in Sweden. The success of the programme was to a large degree built on previous failures, confirming Juran’s old saying ‘Failure is a gold mine’. From the case study, success factors for implementing Six Sigma at Siemens are identified and compared to those given in the literature. Some of the most critical success factors identified at Siemens had not been mentioned as such in the literature before. The main conclusion of the study is that, in order to succeed and get sustainable results from a Six Sigma programme, Six Sigma should be integrated with Process Management, instead of just running Six Sigma as a separate initiative in an organisation. Furthermore, the thesis includes papers presenting methods and tools to be used in a Six Sigma programme or in Six Sigma projects. They deal with: how to identify suitable Six Sigma projects, how to select which Six Sigma methodology to use, how to find hidden misunderstandings between people from different knowledge domains, and how to simulate the impact of improvements to iterative processes. All these methods and tools have been developed and tested at Siemens. This has been an action research project, where the author has been employed by the company under investigation for eleven years and has actively influenced the changes in the company based on knowledge gained at the company as well as on research studies conducted at universities. In action research the change initiative under investigation is conducted and analysed in a single context. The readers are invited to draw their own conclusions on the applicability of the results to their own specific cases. In addition to this, some conclusions derived using analytical generalisation, applicable to a more general case, are presented in the thesis.
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| 2. |
- Ekblom Bak, Elin, 1981-, et al.
(författare)
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Accelerometer derived physical activity patterns in 27.890 middle‐aged adults : The SCAPIS cohort study
- 2022
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : John Wiley & Sons. - 0905-7188 .- 1600-0838. ; 32:5, s. 866-880
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Tidskriftsartikel (refereegranskat)abstract
- The present study aims to describe accelerometer-assessed physical activity (PA) patterns and fulfillment of PA recommendations in a large sample of middle-aged men and women, and to study differences between subgroups of socio-demographic, socio-economic, and lifestyle-related variables. A total of 27 890 (92.5% of total participants, 52% women, aged 50–64 years) middle-aged men and women with at least four days of valid hip-worn accelerometer data (Actigraph GT3X+, wGT3X+ and wGT3X-BT) from the Swedish CArdioPulmonary bioImage Study, SCAPIS, were included. In total, 54.5% of daily wear time was spent sedentary, 39.1% in low, 5.4% in moderate, and only 0.1% in vigorous PA. Male sex, higher education, low financial strain, born in Sweden, and sedentary/light working situation were related to higher sedentary time, but also higher levels of vigorous PA. High BMI and having multiple chronic diseases associated strongly with higher sedentary time and less time in all three PA intensities. All-year physically active commuters had an overall more active PA pattern. The proportion fulfilling current PA recommendations varied substantially (1.4% to 92.2%) depending on data handling procedures and definition used. Twenty-eight percent was defined as having an “at-risk” behavior, which included both high sedentary time and low vigorous PA. In this large population-based sample, a majority of time was spent sedentary and only a fraction in vigorous PA, with clinically important variations between subgroups. This study provides important reference material and emphasizes the importance of a comprehensive assessment of all aspects of the individual PA pattern in future research and clinical practice.
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| 3. |
- Lange, Anna, 1975-
(författare)
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SLPI and soluble BTLA as immunological markers in severe bacterial infections
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Clinical presentation, and outcome of infections are affected by host-, and etiology- (focus of infection and pathogen) related factors. The immune response is controlled by a network of regulating pathways.This thesis focuses on Secretory Leukocyte Protease Inhibitor (SLPI), a protease inhibitor with anti-inflammatory properties, and the previously non-studied soluble isoform of B and T lymphocyte attenuator (sBTLA), a membrane-associated regulatory protein. Plasma concentrations of SLPI and sBTLA were assessed in relation to etiology, severity, mortality, and markers of inflammation and immunosuppression, in i) community-acquired pneumonia (CAP) (SLPI), ii) intensive care unit (ICU) treated severe sepsis and septic shock (sBTLA), and iii) dynamically in BSI (SLPI and sBTLA).Main findings were: higher expression of SLPI in pneumonia, compared to other sources, higher initial concentrations in Streptococcus pneumoniae, and Staphylococcus aureus BSI, compared to Escherichia coli BSI, and higher SLPI concentrations in sepsis compared to non-septic BSI. Interestingly, men with pneumonia had higher plasma levels of SLPI, both in CAP and BSI. Likewise, sBTLA was associated with severity, but preferentially at higher organ failure scores. High sBTLA was associated with increased risk of early death (28 days) in ICU-treated septic patients, and with mortality at 90 days and one year in BSI. In particular, failure to normalize sBTLA on day 7, was indicative of worse long-term outcome. SLPI was associated with decreased monocytic HLA-DR expression, and sBTLA with decreased lymphocyte count, which might indicate a connection to sepsis-associated immunosuppression.In conclusion, SLPI and sBTLA show association with severity, and markers of immune dysfunction, in sepsis and BSI. SLPI differs depending on etiology, while sBTLA may have prognostic implications. Our results propose that the pathobiological role of sBTLA, and the possible utility of SLPI and sBTLA in sepsis immune-profiling, should be further addressed in future studies.
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| 4. |
- Rasmussen, Gunlög, 1973-
(författare)
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Staphylococcus aureus bacteremia, molecular epidemiology and host immune response
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Staphylococcus aureus is a major pathogen responsible for a considerable disease burden worldwide. It may cause a wide array of infections, from superficial skin infections to invasive bacteremia and complications such as infective endocarditis (IE) and osteomyelitis. This thesis aimed to investigate aspects of the molecular epidemiology of S. aureus and host immune response in relation to disease manifestation, severity, and over time during S. aureus bacteremia (SAB).Genotypic characteristics in isolates causing colonization, bacteremia, and bacteremia with IE were studied. The S. aureus population was genetically diverse and certain clones with their set of often lineage-specific virulence genes were associated with invasive disease. Characterization of the long-term molecular epidemiology of MSSA bacteremia showed an increased prevalence of CC5 and CC15, while CC8, CC25 and CC30 declined. Antibiotic resistance pattern was favorable and unaffected.Further, different aspects of host immune response were explored in patients with SAB during the acute phase of bacteremia. When investigating the NLRP3 inflammasome signaling, induced caspase-1 activity was found, with a great inter-individual variation between patients, and subsequent release of IL-18, indicating inflammasome activity. Finally, the dynamics of MHC class II related genes HLA-DRA and CD74 were analyzed as markers of immunosuppression. Patients with complicated SAB had significantly lower HLA-DRA expression than patients with uncomplicated bacteremia, demonstrating an association between complicated SAB and impaired immune function.In conclusion, the S. aureus genotype, as well as host factors reflected by inter-individual variations in inflammasome signaling and immune function, may all contribute to disease manifestation and outcome during SAB. An ability to measure the immune response early and continuously during the hospital stay and course of bacteremia could offer a way to tailor patient management and treatment in an individualized way.
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