| 1. |
- Silver, Lars, et al.
(författare)
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Uncertainty in cooperation between service buyers and sellers
- 1998
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Ingår i: <em>Working paper series, Uppsala university</em>. - Uppsala : Företagsekonomiska institutionen.
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- The realization of relationship marketing requires cooperative exchangebetween buyers and sellers. A key determinant of cooperative exchange isuncertainty perceived by the cooperating parties. This study investigates howcooperation is affected by decision makers’ perception of uncertainties in theenvironmental context, in relationships, and in decision-making routines. Asample of 135 branch managers from banks is used in a LISREL model. Theresults show that uncertainty regarding relationship and decision-making havestrong direct effects on relationship cooperation. An important finding is thatcontextual uncertainty causes relationship cooperation indirectly. The resultshighlight the importance of organization in firms that aim to facilitatecooperation between buyer and seller. In addition, they set an agenda forfuture research.
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| 2. |
- Ahlm, Clas, 1956-, et al.
(författare)
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Prevalence of antibodies specific to Puumala virus among farmers in Sweden
- 1998
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 24:2, s. 104-108
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Tidskriftsartikel (refereegranskat)abstract
- Serological evidence confirmed that the exposure of humans to Puumala virus is firmly restricted to the northern and central parts of Sweden. In addition the evidence indicated that, in this region, farming is associated with an increased risk of contracting hantavirus infection.
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| 3. |
- Klefbeck, B, et al.
(författare)
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Obstructive sleep apneas in relation to severity of cervical spinal cord injury.
- 1998
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 36:9, s. 611-628
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Tidskriftsartikel (refereegranskat)abstract
- Thirty-three subjects (28 men, five women) with complete or incomplete cervical cord injury representing a wide range of neurological impairment were investigated with regard to the prevalence of Obstructive Sleep Apnea (OSA). The relation between OSA and neurological function, respiratory capacity, body mass index and symptoms associated with OSA were studied. Overnight sleep recordings employed combined oximetry and respiratory movement monitoring. Pulmonary function tests included static and dynamic spirometry, maximal static inspiratory and expiratory pressures at the mouth. The subjects answered a questionnaire concerning sleep quality and tiredness. The prevalence of OSA was 15% (5/33) in this nonobese cervical cord injury study population. Nine percent of the subjects (3/33) fulfilled the criteria for obstructive sleep apnea syndrome, but daytime sleepiness or fatigue were also common in subjects without OSA. There was an inverse correlation between oxygen desaturation index and American Spinal Injury Association (ASIA) motor score in the subjects with complete injury, while there was no such correlation in the whole study group. There were significant correlations between maximal inspiratory and expiratory pressures and vital capacity and between ASIA motor score and vital capacity.
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| 4. |
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| 5. |
- Sköld, C, et al.
(författare)
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Simultaneous Ashworth measurements and electromyographic recordings in tetraplegic patients.
- 1998
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier. - 0003-9993 .- 1532-821X. ; 79:8, s. 959-965
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: A recent prevalence study of 353 spinal cord injured (SCI) individuals in the greater Stockholm area showed problematic spasticity in 30% of this population. To treat spasticity, the evaluation becomes crucial. The modified Ashworth scale (MAS) is the clinically most-used scale to grade degree of spasticity. This study evaluated whether the MAS correlated with electromyographic (EMG) recordings of muscle activity.STUDY DESIGN: This cross-sectional study was performed at an outpatient clinic that has the responsibility to do a standardized, yearly follow-up of all SCI patients in the greater Stockholm area. Thirty-eight SCI individuals met the inclusion criteria; 15 of the 38 were randomly selected for the study. They were all motor-complete tetraplegic men; mean age was 33 years and mean time since injury was 9 years. Spasticity evaluation was performed by flexing and extending the knees during simultaneous EMG recordings and MAS assessment of the thigh muscle activity.RESULTS: Eighty percent of the individual EMG recordings correlated significantly with the corresponding Ashworth measurements. The spastic resistance, as measured both clinically and electromyographically, was stronger and lasted longer during extension than flexion movements. Spearman coefficients for correlation of quantitative spasticity measures with MAS grades were calculated. EMG and clinical measures of spasticity were more closely correlated for flexion movements. Among EMG parameters, duration of movement-associated electrical activity invariably correlated significantly with the MAS grades (p < .05). Furthermore, Ashworth measurements of movement-associated spasticity showed a positive correlation with the EMG parameters mean, peak, and start to peak of electrical activity. Each increasing grade on the MAS corresponded to increasing myoelectric activity levels for each movement.CONCLUSION: EMG parameters were significantly positively correlated with simultaneous MAS measurements of the spastic muscle contraction. The Ashworth scale may therefore accurately reflect the movement-provoked spasticity in motor-complete tetraplegic patients.
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| 6. |
- Westgren, N, et al.
(författare)
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Quality of life and traumatic spinal cord injury.
- 1998
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Ingår i: Archives of Physical Medicine and Rehabilitation. - : Elsevier. - 0003-9993 .- 1532-821X. ; 79:11, s. 1433-1439
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine associations between major outcome variables after traumatic spinal cord injury (SCI) and quality of life (QL).SUBJECTS: Of a total population of 353 SCI patients, 320 participated, 261 men and 59 women living in the greater Stockholm area: 124 were tetraplegic, 176 were paraplegic, and 20 had no classified level. Mean age was 42 years (range, 17 to 78).METHOD: The Swedish SF-36 Health Survey was used to assess QL. The SF-36 is a self-administered questionnaire containing 36 items, divided into 8 multi-item dimensions, covering physical function, physical and emotional role function, social function, bodily pain, mental health, vitality and overall evaluation of health. Neurologic, general medical, and psychosocial variables were obtained from the Stockholm Spinal Cord Injury Study (SSCIS) data base. QL indices were analyzed for the SCI group as a whole, as well as for subgroups. Descriptors for subgroups were demographic variables, presence or absence of common medical problems, and subjective evaluation of the degree of impact of the medical problem on well-being/daily activities.RESULTS: QL in individuals with SCI was significantly lower in all subscales as compared with a normative population. No difference in QL was seen in subgroups according to extent of lesion, with the exception of physical functioning. Several medical complications such as neurogenic pain, spasticity, and neurogenic bladder and bowel problems were associated with lower QL scores.SUMMARY: QL, as defined by SF-36, is better in persons injured many years ago, as compared with those recently injured, suggesting an adaptive process operating over a long period. The presence of complicating medical problems, such as severe pain, problematic spasticity, and incontinence, seem to have more negative effects on QL than the extent of SCI as such.
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| 7. |
- Blomquist, Tomas, 1963-, et al.
(författare)
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Ekonomisk styrning för förändring : en studie av ekonomiska styrinitiativ i hälso- och sjukvården
- 1998
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Since the end of the 1980’s Swedish county council managers has been preoccupied with planning and implementing organisational change in order to alleviate the financial problems and to create more efficient production systems. Many of these efforts to change have implied changing the systems for management accounting and control, changes that have been inspired both by market-oriented ideologies and by the governance principles of large corporations in the private sector. Literature on management accounting and control indicates however, that management is unintentionally contributing to the creation of organisational inertia and conservatism. This contradiction is formulated as a change dilemma; ”How can managerial principles that make organizations subject to bureaucratization and inertia be used as important strategies for organizational change?” The purpose of the study is thus to analyze the use of management control systems as organizational change strategies in health care, employing a change perspective on management control.When used as a change strategy, management accounting and control becomes manifest as management control initiatives. Actors handle these control inititatives by organising themselves around the issue at hand. This organising process ends or fades away when there are no need for further attention to the control initiative.Empirical studies were made in the councils of Västerbotten, Sörmland and Uppsala counties. Management control initiatives investigated were performance-related pay, quality improvement work, systematic planning procedures, provider/purchaser-models, downsizing projects and profit center systems.The systems for management accounting and control appeared to structure health care organisations in terms of spatial structuring temporal structuring and actor categorization. The management control initiatives introduced were structured as extraordinary organising processes delimited in terms of space, time and involved actors. Actors in the administrative norm system participated with the intention to change the organisation, while those in the medical norm system aimed at just handling the initiative.Management control initiatives can therefore be seen as passing opportunities to change, passing in the sense that the organising processes are temporary by nature, opportunities in the sense that temporary re-coupling can be used to achieve long-term change. One such opportunity is the formulation of control initiatives; the possibility of using simple and standardized change strategies can be useful, but only if they are also linked to the medical norm system. A second opportunity is the temporary organising processes; if the project form of organising change can also be conveyed to the medical norm system, management control initiatives could result in short, intense courses of events that actually change things. The third opportunity s the recurrent cyc ica pro perties of management accounting and control systems, enabling recurrent activities around the same themes, thereby keeping them alive.
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| 8. |
- Chotai, Jayanti, et al.
(författare)
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CSF monoamine metabolites in relation to the diagnostic interview for borderline patients (DIB)
- 1998
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Ingår i: Neuropsychobiology. - : S. Karger AG. - 0302-282X .- 1423-0224. ; 38:4, s. 207-212
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Tidskriftsartikel (refereegranskat)abstract
- The cerebrospinal fluid concentrations of the monoamine metabolites 5-hydroxyindoleacetic acid (5-HIAA), homovanillic acid (HVA), 3-methoxy-4-hydroxyphenylglycol, and their ratios were studied in relation to the Diagnostic Interview for Borderline patients (DIB) evaluated retrospectively from hospital records for a sample of 202 patients participating in psychobiological programs on mood disorders. No correlations with the total DIB score were significant. Patients with borderline personality disorder (BPD) defined by a total DIB score of at least 7 or 6, respectively, did not differ significantly from non-BPD regarding the metabolites. However, for section II (impulse action pattern) of the DIB, those with an intermediate value of the section score had significantly higher levels of 5-HIAA and HVA, suggesting that such higher than normal concentrations may be protective against impulsive or suicidal behavior generated by an underlying psychiatric morbidity due to other risk factors.
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| 9. |
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| 10. |
- Hellzén, Ove, et al.
(författare)
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From optimism to pessimism : A case study of a psychiatric patient
- 1998
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 7:4, s. 360-370
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Tidskriftsartikel (refereegranskat)abstract
- This article focuses on the results of a single case study which illuminates an understanding of phases in nursing care for a patient in a psychiatric setting in Sweden. The focus of this study is a fifty year old man who showed progressive deterioration from increased motor activity to oral, sexual, destructive and aggressive actions. The data collection using five methods occurred during a 21 months period. Results of the content analyses processes identified four distinct but indiscreet phases of the patient’s complex condition. The medical and nursing care was categorised in three approaches: optimistic, strategic and resigned. The results raise the question whether there is action that is without any meaning as an expression of the patient´s wishes, thoughts and feelings. It seems clear that the patient in this study felt really angry and in despair. However, during moments of lucidity, he also indicated that he felt this was not an authentic expression of his "real" self. His experience was that of a splintered world.
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