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- Ekblom, Robert, et al.
(författare)
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Spatial pattern of MHC class II variation in the great snipe (Gallinago media)
- 2007
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Ingår i: Molecular Ecology. - 0962-1083 .- 1365-294X. ; 16:7, s. 1439-1451
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Tidskriftsartikel (refereegranskat)abstract
- The genes of the major histocompatibility complex (MHC) code for proteins involved in antigen recognition and triggering of the adaptive immune response, and are therefore likely to be under selection from parasites. These selection regimes may vary in space and time. Here we report a strong geographical structure in MHC class II B genes of a migrating bird, the great snipe (Gallinago media). Genetic differentiation in the MHC between two ecologically distinct distributional regions (Scandinavian mountain populations vs. East European lowland populations) was still present after statistically controlling for the effect of selectively neutral variation (microsatellites) using partial Mantel tests. This suggests a role for selection in generating this spatial structure and that it represents local adaptation to different environments. Differentiation between populations within the two regions was negligible. Overall, we found a high number of MHC alleles (50, from 175 individuals). This, together with a tendency for a higher rate of nonsynonymous than synonymous substitutions in the peptide binding sites, and high Tajima's D in certain regions of the gene, suggests a history of balancing selection. MHC variation is often thought to be maintained by some form of balancing selection, but the nature of this selection remains unclear. Our results support the hypothesis that spatial variation in selection regimes contributes to the high polymorphism.
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- Jacobsson, Torbjörn, 1971, et al.
(författare)
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Factors that hinder the implementation of process flow solutions in healthcare - Empirical findings from four emergency departments
- 2010
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Ingår i: Proceedings of the 17th International Annual EurOMA Conference – Managing Operations in Service Economies, 6-9 June 2010, Catholic University, Porto, Portugal..
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Konferensbidrag (refereegranskat)abstract
- This paper investigates factors that hinder the implementation of process flow solutions in healthcare. Empirical findings are based on case studies from four emergency departments. A qualitative research method was used. The main factors can be categorized into following areas: management on strategic and operational level, professional hierarchies and traditions, existing knowledge paradigm. These areas are connected to a multifaceted customer conception with differing perceptions on what are value-creating activities which lead to insufficient patient focus in the implementation.
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- Jacobsson, Torbjörn, 1971, et al.
(författare)
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Factors that hinder the implementation of process flow solutions related to the existing knowledge paradigm in healthcare
- 2010
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Ingår i: Proceedings of APMS 2010 - International Conference on Advances in Production Management Systems. - 9788864930077 ; , s. NS.5.1; id 195-
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Konferensbidrag (refereegranskat)abstract
- This paper investigates factors that hinder the implementation of process flow solutions related to the existing knowledge paradigm in healthcare. There is a prevailing view of the knowledge areas that healthcare should master. Medical science is, of course, in focus but in order to create efficiency in production of care, there is a need of widening the traditional approach and being open to knowledge from the operations management field.Physicians play a significant role when implementing process flow solutions and they have a severe impact on how knowledge in operations management is developed and established in healthcare organizations. There is a challenge in having both physicians and nurses involved in patient flow improvement projects that are not explicitly connected to their research or specialist areas.
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- Jacobsson, Torbjörn, 1971, et al.
(författare)
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IMPLEMENTING PROCESS FLOW SOLUTIONS IN HEALTHCARE:A CASE STUDY AT A DERMATOLOGY CLINIC
- 2007
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Ingår i: 14th International Annual Euroma Conference. - 9789756090237 ; , s. 10-
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Konferensbidrag (refereegranskat)abstract
- Today, many healthcare organizations are confronting queues of patients who need treatment. Implementing process flow improvements, derived from the operations management field is a promising way to meet these challenges. Although literature exists on how practices born out of manufacturing can be applied in healthcare, the study of the implementation of these practices is not that common. Based on an in-depth case study of the implementation of process flow solutions in a Swedish dermatology clinic, we identify several factors that played a significant role when implementing the process flow solutions. The contribution of this paper is foremost to increase awareness of factors that have impact on the implementation process.
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- Jacobsson, Torbjörn, 1971, et al.
(författare)
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REDUCING THE QUEUE OF REFERRALS USING OPERATIONS MANAGEMENT - –A CASE STUDY OF A DERMATOLOGY CLINIC
- 2005
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Ingår i: International Conference on the Management of Healthcare & Medical Technology 25-26 August 2005, Aalborg, Denmark. - 8791200482 ; , s. 136-147
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Konferensbidrag (refereegranskat)abstract
- We performed a study during a six month period at a dermatology clinic at a large teaching hospital. Our task was to analyse the patient flow and suggest ways to reduce the queue of referrals, through better utilization of existing recourses. To this aim, we applied manufacturing-based operations management techniques in three areas: capacity management, operations focus and reduction of variation. Our analysis revealed that the existing queue of referrals could be reduced with current resources after having implemented the suggested actions. Theoretically, itshould be possible to eliminate the queue of referrals in a seven to eight month period depending on how the clinic handle the follow-up visits created by the new first-time visits. Our conclusions focus on the reactions of medical staff to the usage of manufacturing-based improvement methods. We found that the usage of manufacturing concepts in a health care setting can create critical reaction byemployees. Explaining the purpose in a pedagogical way is one approach to reduce this criticism.
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- Jacobsson, Torbjörn, 1971, et al.
(författare)
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The challenge of collecting data in healthcare settings: experiences from clinical case research
- 2007
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Ingår i: 6th annual Conference of the Association for Healthcare Technology and Management (HCTM). ; , s. 10-
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Konferensbidrag (refereegranskat)abstract
- This paper gives advice on how to gain access to data in healthcare organizations. The paper is based on clinical research in Swedish healthcare organizations, where the concern was both with generating new knowledge andcontributing to the practical concerns of the organization. In conducting the research, we experienced difficulties in gaining access to appropriate data andneeded to develop practices to gain access. Among these practices were the manner in which the research project was introduced, the building of rapport and the way data were collected.
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