| 1. |
- Ekström, Magnus Pär, et al.
(författare)
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The association of body mass index, weight gain and central obesity with activity-related breathlessness : the Swedish Cardiopulmonary Bioimage Study
- 2019
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Ingår i: Thorax. - : BMJ Publishing Group Ltd. - 0040-6376 .- 1468-3296. ; 74:10, s. 958-964
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Breathlessness is common in the population, especially in women and associated with adverse health outcomes. Obesity (body mass index (BMI) >30 kg/m(2)) is rapidly increasing globally and its impact on breathlessness is unclear.Methods: This population-based study aimed primarily to evaluate the association of current BMI and self-reported change in BMI since age 20 with breathlessness (modified Research Council score >= 1) in the middle-aged population. Secondary aims were to evaluate factors that contribute to breathlessness in obesity, including the interaction with spirometric lung volume and sex.Results: We included 13 437 individuals; mean age 57.5 years; 52.5% women; mean BMI 26.8 (SD 4.3); mean BMI increase since age 20 was 5.0 kg/m(2); and 1283 (9.6%) reported breathlessness. Obesity was strongly associated with increased breathlessness, OR 3.54 (95% CI, 3.03 to 4.13) independent of age, sex, smoking, airflow obstruction, exercise level and the presence of comorbidities. The association between BMI and breathlessness was modified by lung volume; the increase in breathlessness prevalence with higher BMI was steeper for individuals with lower forced vital capacity (FVC). The higher breathlessness prevalence in obese women than men (27.4% vs 12.5%; p<0.001) was related to their lower FVC. Irrespective of current BMI and confounders, individuals who had increased in BMI since age 20 had more breathlessness.Conclusion: Breathlessness is independently associated with obesity and with weight gain in adult life, and the association is stronger for individuals with lower lung volumes.
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| 2. |
- Söderberg, Stefan, et al.
(författare)
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MEASURES OF WAIST AND HIP MODIFY SEX-SPECIFIC ASSOCIATIONS BETWEEN BODY MASS INDEX AND PREVALENCE OF CORONARY ARTERY CALCIFICATION IN OPPOSITE DIRECTIONS
- 2019
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Ingår i: Journal of the American College of Cardiology. - : ELSEVIER SCIENCE INC. - 0735-1097 .- 1558-3597. ; 73:9, s. 13-13
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Obesity is associated with increased risk of cardiovascular disease. However, there is still a debate whether accumulation of fat in certain depots modifies this risk. Using data from the CArdioPulmonary bioImage Study (SCAPIS), we investigated if anthropometric measurements of obesity (waist and hip) modifies the risk of coronary artery calcification. Methods: In the first 15,810 participants in SCAPIS (mean age 58 years, 52% women), data on coronary artery calcification score (CACS) and anthropometry were recorded and traditional cardiovascular risk factors were measured. Body mass index (BMI) was categorized as; <25, 25-30, 30-35 and >35 kg/m2 , quartiles of waist and hip circumferences were constructed within each BMI category and compared using the lowest quartile as reference. Results were adjusted for site, age, smoking and diabetes status. Results: Obesity (BMI >30 kg/m2 ) was found in 21.9% of men and in 20.5% of women. In both sexes the odds ratio (OR) for CACS >0 increased with increasing BMI categories: comparing <25 and >35 kg/m2 , OR = 2.1 (95% CI: 1.6-2.7) for men and OR = 1.4 (1.2-1.8) for women. In addition, increasing quartiles of waist significantly increased the prevalence of CACS >0 for men [p = 0.05; OR = 1.2 (1.0-1.4) for highest quartile] and women [p = 0.005; OR = 1.3 (1.1-1.5)] while increasing quartiles of hip significantly decreased the prevalence for men [p = 0.005; OR = 0.8 (0.6-0.9)] and women [p = 0.04; OR = 0.8 (0.7-0.9)]. Data on education level and physical activity did not affect the model. Conclusion: Increased BMI is associated with increased prevalence of coronary artery calcification and the distribution of fat modifies this risk. Our results suggest that gluteofemoral adipose tissue (hip) counteracts the negative effects associated with BMI and abdominal adipose tissue (waist).
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| 3. |
- Blomquist, Bo, 1958, et al.
(författare)
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Revising the Present Administrative Codification of Organisations at Hand Within Four Hospitals in Sweden. Empirical evidence regarding some research questions in relation our earlier research and development work within the automobile and manufacturing industry
- 2016
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- The two authors have in this article (preprint not yet completed due to the retirement of one of the authors) gathered some experiences and insights dealing with so-called co-worker's questionnaires surveys concerning work and work environment matters, as have been and still are practised within e.g. all Swedish public hospital (as well as also within some other private and public sectors). This understanding is brought forward to substantiate some deductions on how such questionnaire surveys ought to be organised to make them more valuable for practitioners as well as for scientists (some examples from the author's world are confirming this argumentation). Particular so about research results gained from work within Skaraborgs Sjukhus, i.e. the four hospitals that are located in Falköping, Lidköping, Mariestad and Skövde with approximate 4 500 employees. To exemplify, his particular research and development work gradually, more or less, forced us to scrutinise the organisation of these four hospitals in some specific ways. Such scrutinising was inescapable necessary for us. Thereby are this article replicating on the authors' experiences to organise such questionnaire surveys within both the automobile and health-care sectors which in turn have lead us to suggest how some particular aspects on the four hospitals ought to be organised. This while we are focusing on the some of the administrative codification and routines. In fact, a far more rational way to organise the operations (by no means, yet not fully recognised by the practitioners involved) will thereby be possible to implement in practice (to a delimited extent has the already been carried out) For example, annoying for us was the lack of a so-called consistent semantic network (the denotations found in various administrative information systems used were featuring several inconsistencies like abbreviations, shortenings, synonyms etc.) (such facts became obvious for us really ought to be remedied). This fact was proved and further substantiated by our practices (all-pervading analyse approach) of combine data-collection and data-analyses approach, i.e. cross-reference procedures by computer technique and various manual efforts like re-configuration of customised print-outs on paper, which were cut up and reorganised manually by e.g. glue and scissors. However, some constructive remedies are also illustrated in this article. A comment (in order to be explicit): Note that by means of this specific method to organize questionnaire surveys (including complementary data collection) it is feasible to couple (softer) questionnaire data to (harder) technical data (i.e. the operators perception of work and work conditions to parameters like product flow patterns and buffer functions and positions) (see e.g. other publications registered in Chalmers Public Library CPL).
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| 4. |
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| 5. |
- Engström, Joakim, et al.
(författare)
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Lung complications are common in intensive care treated patients with pelvis fractures : a retrospective cohort study
- 2016
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Ingår i: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - : BioMed Central. - 1757-7241. ; 24
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Tidskriftsartikel (refereegranskat)abstract
- Background: The incidence of severe respiratory complications in patients with pelvis fractures needing intensive care have not previously been studied. Therefore, the aims of this registry study were to 1) determine the number of ICU patients with pelvis fractures who had severe respiratory complications 2) whether the surgical intervention in these patients is associated with the pulmonary condition and 3) whether there is an association between lung complications and mortality. We hypothesized that acute hypoxic failure (AHF) and acute respiratory distress syndrome (ARDS) 1) are common in ICU treated patients with pelvis fractures, 2) are not related to the reconstructive surgery, or to 3) to mortality.Methods: All patients in the database cohort (n = 112), scheduled for surgical stabilization of pelvis ring and/or acetabulum fractures, admitted to the general ICU at Uppsala University Hospital between 2007 and 2014 for intensive care were included.Results: The incidence of AHF/ARDS was 67 % (75/112 patients), i.e., the percentage of patients that at any period during the ICU stay fulfilled the AHF/ARDS criteria. The incidence of AHF was 44 % and incidence of ARDS was 23 %. The patients with AHF/ARDS had more lung contusions and pneumonia than the patients without AHF/ARDS. Overall, there were no significant changes in oxygenation variables associated with surgery. However, 23 patients with pre-operative normal lung status developed AHF/ARDS in relation to the surgical procedure, whereas 12 patients with AHF/ARDS normalized their lung condition. The patients who developed AHF/ARDS had a higher incidence of lung contusion (P = 0.04) and the surgical stabilization was performed earlier (5 versus 10 days) in these patients (P = 0.03).Conclusions: We found that the incidence of respiratory failure in ICU treated patients with pelvis fractures was high, that the procedure around surgical stabilization seems to be associated with a worsening in the respiratory function in patients with lung contusion, and that mortality was low and was probably not related to the respiratory condition.
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| 6. |
- Engström, Tomas, 1950, et al.
(författare)
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A Specific Method Developed for Carrying Questionnaire Surveys. Or, how to amalgamate operators’ perception with production system design and to organisational units within hospitals. Explanations and some short examples
- 2017
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This article (or preprint not yet completed due to the retirement of one of the authors) is a more universally orientated compilation (with some short examples) of some of the authors' research and development work, than what has been published before. The content is based on some specially designed questionnaire surveys carried out by the authors during almost three decades. Thus, we explain a specific method, which has been judged necessary to make public since it makes questionnaire studies more scientifically valuable in particular senses. This method was developed and practised in the automotive and manufacturing industry, and after that refined further for yet another sector of the society (the health-care sector). This approach means that at first (1992–2006), were a number plants/production systems (mainly Volvo operations) evaluated dealing with blue-collar employees (however, the two most recent questionnaire surveys within this sector of the society were also embracing the category of white-collar employees included). Note that all of these questionnaire surveys comprised all of the employees within the categories studied (i.e. not just a sample of operators) (the most extensive comprised 1100 blue-collar employees). Secondly (2011–2015), was Skaraborgs Sjukhus in focus for the authors' interest. In this case, were we initially dealing with yearly questionnaire surveys dispatched to all employees regarding work and work conditions, this means that the so-called co-workers' questionnaires surveys were paid interest, as have been and still are practised within e.g. all Swedish public hospital, as well as within many other private and public sectors. After that was quite other matter within this hospital of a more geographical and organisational nature tickling our awareness. Specifically, this means, that for the automotive cases were we already from the beginning especially competent because one of the authors had earlier (1976–1984) been involved in automotive matters, while his research colleagues and he intensified this research and development work after that (1985–1992). During the latter period, where they systematically disassembling several products and compared these findings with the content in the information systems used (as a part of theirs earlier long-time research and development work to design several production systems mainly for both the Volvo Automobile and Truck Corporations). During this particular phase where the involved in, e.g., complementation and reconfiguration of the so-called product information for the products disassembled. Thereby were the physical products, as well as the less obvious anomalies of various information systems, possible to be mastered in ways that were and still are quite uncommon for most practitioners as well as scientists. A deeper understanding of some different aspects implied being of interest were thereby gained before the method for questionnaires studies at all became important for us. They were therefore in these automotive cases, already from the very beginning, possessing a "sort of reference" for the work to understand e.g. both the product and the functions of the production systems in question (this feat was thereby achieved long before questionnaire surveys proved to be attention-grabbing). In contrast, for the Skaraborgs Sjukhus, were such "sort of reference" not initially at hand for both of the two authors of this of this article (this sector of the society was unfamiliar for us). That is, we were (as novices) instead, in this case, required to as before for the automotive industry, cross-refer information from various sources of information using some different methods that will be clarified it this article. And, to after that compare these results with results from particular inventories of the building facilities (which thus, in this case, served as a "sort of reference" for us). The specific method to carry out questionnaire studies requires precise control out of each operator's work and workplace. Also, it is, therefore, a matter of taking advantage of auxiliary information like (1) both real-life and schematic layouts, (2) individuals and workgroups geographical positions therein. That is, all of the different questionnaire forms comprised specially constructed questions concerning where and with what the individual operator (respondent) were working (one key question was thereby how to design such questions for the two different sectors of the society). As partly already hinted, such achievements require that we must gain an in-depth, understanding of each particular plant/production system (or acquire a similar knowledge of all medical operations). One merit (or the increased scientific value) is that we were able to link subjective information with more hard facts, i.e. it has thereby proved possible for us to amalgamate operators' perception with e.g. the production system design. A comment: Note that by means of this specific method to organize questionnaire surveys (including complementary data collection) it is feasible to couple (softer) questionnaire data to (harder) technical data like the operators perception of work and work conditions to parameters like product flow patterns and buffer functions and positions.
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| 7. |
- Engström, Tomas, 1950
(författare)
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Assembly-Oriented Product Structures and Assembly Work Instructions for Extensively Long Work Cycle Times. Insights and experiences from assembly of automobiles and heavy truck chassis
- 2017
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This article (or preprint not yet completed due to the retirement of one of the authors) deals with the research area of extensively long work cycle times performed by small parallel workgroups. As was carried out in two of the most socio-technically advanced assembly plants (namely, the Volvo automobile plant in Uddevalla and the so-called assembly docks in the heavy truck chassis plant in Tuve). The author will elucidate (1) how the assembly-oriented product structure was designed for the former assembly plant, (2) how the assembly work instruction was edited and organised within the same assembly plant. Moreover, will also (3) the theoretical frames of references thereby prospected be brought forward. Some interesting explanatory examples fetched from both these two (real-life) assembly systems will also be explicated. The reason for these efforts is that some of the author's colleagues, as well as the author, were heavily involved the births and lives of these two (real-life) assembly systems. Especially was this the case for the automobile plant (which with some time delay feed insights and experiences to the heavy truck chassis plant). Both companies were taking advantages of the author's experimental workshop in Gothenburg, and these two automotive companies were stationing employees to work within this workshop during the period of it's more than eight years life (1985–1993). Since mastering of the product architecture and product variation (as was defined by the product information) proved to be the crucial insight for making extensively long work cycle time possible for full-scale production purposes. That is, the author was in fact enforced to decompose both these (physical) products methodically. However, this approach was in coherence with the author's earlier research and development work regarding such assembly system designs, which were predating the experiences and insights reported here by more than twelve years. This work had previously (i.e. before we got heavily involved) underlined the fact that the content concealed in various information system was deceiving. This anomaly meant that the only way to earlier get correct information regarding components within single physical products proved to be inventories of materials located along some assembly lines (implying that disassembly of products had to be carried out). The work within the experimental workshop, as well as our examination of the present information systems, soon proved that the design-oriented product structure used within Volvo companies was not (for some different reasons) suitable to use as a point of departure for this type of assembly work discussed. The practitioners' misconception during this, as well as during earlier period just mentioned, was that the products in question were so complicated that they were impossible to comprehend by any human being and featuring an immense number of components that in turn were composed of an enormously number of different product variants. A myth that had to be addressed by us, and which in fact proved to emanate from the information systems. Among other things, designing assembly work instructions for long work cycle time work was considered to be almost impossible. Making assembly work instruction for extensively long work cycle time work was usually considered impossible (just the sheer size of such work instructions would make them unreadable for any blue-collar employee). ¬ In conclusion, recognition of the correct product architecture and product variation was, therefore, a necessity. That is, the present (central) design-oriented product structure, used to communicate product information to all Volvo assembly plants on an international level, had to be complemented by an assembly-oriented product structure valid for the (local) shop floor work. In other words, the physical product assembled must indisputably be the point of departure this type of assembly work (i.e. dissections of products were necessary). This insight was attended to by systematically disassembling both several automobiles and one heavy truck chassis in the experimental workshop, while the removed components were spread out on the shop floor. These spread out components were compared with the content in some information systems, which were represented by various paper printouts that were positioned on large elbow-high tables. A large puzzle was thereby at hand that the author's colleagues and the author, in fact, more or less were forced to make sense out of through moving components around on the shop floor and by cutting and pasting in the paper printouts. A process that was e.g. substantiated using e.g. textbooks on automotive matters as well as various other aids from the two automotive companies. This approach was our overarching methodology to deal with the research question already hinted above. This overarching methodology gave birth to two assembly-oriented product structures, this in turn also gave birth to the assembly work instruction.
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| 8. |
- Engström, Tomas, 1950
(författare)
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Division of Labour Within Two Diametrically Different Assembly System Designs. The measure of the intra-workgroup pattern as has been practised for the design of the socio-technically most advanced (real-life) assembly systems
- 2017
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This article (or preprint not yet completed due to the retirement of one of the authors) treats the division of labour within two diametrically different assembly system designs. One hand, are parallel flow assembly system designs discussed and, on the other hand, are also serial product flow assembly system designs considered (in more general terminology, dock assembly work versus assembly line work). This discussion is based on the so-called intra-workgroup pattern. The recognition of such work patterns (or measure to define the division of labour) will, in many aspects, help the reader out to understand why the extensively long work cycle times practised earlier in two Swedish (real-life) assembly systems differed from less advanced and orthodox assembly systems. These two (real-life) assembly systems featured group work in parallel product flows with extensively long work cycle times. And, this, in turn, will help the reader to grasp why the more advanced and unorthodox designs proved to be successful, and thus used for full-scale production purposes. The author will treat the Volvo Automobile Corporation's assembly plant located in Uddevalla and the Volvo Truck Corporation's so-called assembly docks within the Tuve plant based in Gothenburg. Albeit these two (real-life) assembly system are now both closed down (in 1992 and 2002, respectively), are still such knowledge necessary be aware of for both practitioners and scientist. Among other things, is this the case because these intra-group work patterns are one key measure for more advanced and unorthodox assembly system designs (nevertheless note that according to the author's insights were many of the less advanced and unorthodox designs practised within the Swedish automotive industry, not correctly designed). In contrast to the sometimes more public understanding, were these two (real-life) assembly systems by no means experiments. Instead, they were both based on solid engineering, which to some extent were and still are considered uncommon for the automobile industry. Both were based on e.g. particular established and training principles fetched from the scientific field of vocational learning featuring among other things advanced materials feeding techniques utilising materials kits. (In fact, a selected number of senior research competencies were engaged in the design, running-in and full-scale manufacturing phases of the assembly plant in Uddevalla, which with some slight time delay in parallel feed knowledge to the assembly docks in Tuve.) More theoretical speaking, and to connect to for a long time established theoretical frames of references, the experiences and insights reported may very well be perceived representing some of the final efforts to in practice to prove the sociotechnical research approach. This feat was achieved in a more engineering-wise manner than what usually has been practised before. As was the case for the author's and his co-workers, who gradually became responsible for the design of these two so-called most socio-technically advanced (real-life) assembly systems. These two (real-life) assembly systems were internationally unique and thereby needs these experiences and insights to be reported. Consequently, to connect to what is hinted initially, presenting the meaning of the intra-workgroup pattern, while at the same time referring to selected theoretical frames of references within vocational learning. As well as some frames of references from operation management will most certainly make the different versions assembly line work questionable (there among other things, the product architecture and product variation have a specific meaning in the last-mentioned assembly systems than what are the case for the two advanced and unorthodox cases). To be even more precise, we will exemplify all this using the intra-workgroup patterns from the two (real-life) assembly systems, and relate this to the advanced materials feeding technique. But we will also report on how these work patterns were related to the product architecture and product variation of the two different products assembled (automobiles and heavy truck chassis). As will become apparent, recognition of the more correct (shop floor) product architecture and product variation was the (unique) key innovation for these assembly system designs (i.e. from an assembly point of departure). That is, the present design-oriented product structure had to be complemented by an assembly-oriented product structure valid for the local shop floor work in question (relying solely on the still all-pervading fragmented and inconsistent product information communicated by the design-oriented product structure is by no means an option). Or in other words, the logic of the product manufactured must incontrovertibly become the logic of the small parallel workgroups assembly work. How such a feat has proved to be achievable for e.g. the author is something that will be explained.
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| 9. |
- Engström, Tomas, 1950, et al.
(författare)
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Engström, T. and Jonsson, D. (2016). Development and Application of (Certain) Principles for Work Structuring
- 2015
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This manuscript is an extensive book (or preprint not yet finished to due to one the author’s retirement) summaries four decades research and development work dealing with development work of alternatives to assembly lines and assembly line work, as have been the case for one of the two authors from a technical point of departure (he is a senior research competency in mechanical engineering). On the other hand, the other authors have an even longer time perspective, but he has a social science background (he is a senior research competency within sociology for more than four decades). That is, they have been working at Chalmers University of Technology respectively at Gothenburg University all throughout their professional life. This while they both are belonging to a normative sociotechnical research tradition earlier at hand in the Gothenburg area, which actually has emanated from specific precursors at Gothenburg University (i.e. mainly professor Edmund Dalhström at the Department of Sociology), this research tradition was later on brought over to Chalmers by professor Ulf Karlsson responsible for operation management at the same university. It is fair to state that this research area required the amalgamation of technical as well as social science aspects. Efforts that during the passing years have been substantiated by extensive help and support from the Swedish automotive industry (Saab Scania and Volvo companies, as well as other parts of the industry) and also from several governmental research foundations. In fact, a truer cross and multi-science research approach than what usually is at hand has always been required. The extensive book manuscript is exceeding more than 600 pages. Twelve chapters exists as well as also a number of freestanding appendixes and the necessary (all-pervading) definitions of primary concepts and term in combination with explaining various synonyms and homonyms (a particular dilemma for cross and multi-science approaches) (i.e. are we in agreement with the text it alone, or are we eventually together understanding the underlying meaning). Moreover, the text is scrutinized by word process programs in form of Word as well as by the professional English check-up program Grammarly) and all of the necessary figures are completed. i.e. several revisions of this manuscript have been iterated first between the authors and later on against other parties. Most notable are external revisions by two senior research competencies (professor David Bennet responsible for operation management at Aston Business School, Birmingham and professor Lennart Nilsson responsible for vocational learning and training at Gothenburg University, Gothenburg). The authoring just described (involving the initiated hinted just above) have occupied our minds for more than one decade (our co-authoring and work with specific Japanese research colleagues, have most certainly underlined a need for careful writing, since among other things just nicking the practitioners’ nomenclature will be misleading, as is also the case while relaying on one or a few scientific research areas) (see some of the other publications registrated in Chalmers Public Library CLP) (it is most certainly an extensive research area, and the skills needed to be mastered in order to understand are indeed wide). The underlying principles of any (real-life) assembly system must, according to our understanding, are inventible required to be explained. Thus, it is important for the analyst to grasp whether or not the principle applied is correct or if the practice is questionable. This means, metaphorically speaking, is the original drawings accurate or have the execution (practice) faulty. The two most sociotechnically advanced (real-life) assembly systems both proved to be successful (more efficient and flexible in relation to comparable assembly lines, and work and work conditions were far better). They were both based on correct principles (i.e. the nowadays defunct Volvo Uddevalla plant and the so-called assembly docks at the Volvo Tuve heavy truck chassis plant located in Gothenburg). As will become evident by the content brought forward in this extensive book manuscript. A comment. The most socio-technically advanced assembly system designs inventible requires reformed/reconfigured information systems dealing with product data (which in turn defines the product architecture and product variation). In fact, no any such (real-life) plant or assembly system would work as anticipated otherwise. And this publication is to some extent describing some selected aspects of this (very) dilemma (changing information systems are usually not something considered than designing assembly systems) (thus are totally new plants – and in turn totally new information systems – most often the real practical change to create something unorthodox) (however, which scientist will gain such opportunities, this is really rare, i.e. the projection of the Volvo Uddevalla plant was thus an exception and the trust given by the industry – by Volvo Uddevalla project organisation – was appreciated by some of the authors).
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| 10. |
- Engström, Tomas, 1950, et al.
(författare)
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Examples of Various Observed Anomalies Identified Within the Public Swedish Health-Care Sector – A more commonly orientated summary of a five years research and development work regarding information systems and organisation
- 2017
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- This article (or preprint not yet completed due to the retirement of one of the authors) is a more commonly orientated summary of some of the two authors' findings during a five years engagement (or research and development work) within the public Swedish health-care sector. Particular so about research results from Skaraborgs Sjukhus, i.e. the four hospitals that are located in Falköping, Lidköping, Mariestad and Skövde with approximate 4 500 employees. Our engagement, in this case, was at first concerning the yearly questionnaire surveys remitted to all employees regarding work and work conditions. That is, the so-called co-workers' questionnaire surveys, as have been and still, are practised within e.g. all Swedish public hospital (as well as also within many other private and public sectors). This research and development work gradually, more or less, forced us to scrutinise the organisation of these four hospitals in some specific ways. Such scrutinising was necessary for at least two reasons. Firstly, this was needed due to one of the authors more than forty years experiences within the automotive and manufacturing industry. Among other things, we had already developed and used a specific method for some questionnaires surveys, which required detailed control out of each operator's work and workplace, as well as taking advantage of auxiliary information like e.g. both real-life and schematic layouts, individuals and workgroups geographical positions therein. This approach was needed to, gain an in-depth, understanding of each particular production system. For example, one merit is that we have earlier, using this specific method, been able to link subjective information with more hard facts, i.e. it has been proved possible to for us to amalgamate operators' perception with the e.g. production system design (i.e. a particular sort of complementary data collection have been at hand for all og our questionnaire surveys). Secondly, this was also needed to make sense out of our similar efforts to apply this specific method for the public health-care sector (albeit, modified to suit Skaraborgs Sjukhus). And, while we were carrying out preliminary interviews as well as collecting auxiliary information, we had already (during the very initiation of the engagement dealt with here) started to be somewhat perplexed by some various anomalies gradually identified. Especially so for how the information regarding the organisation was differing between the information found in various information systems that were practised and also by anomalies with the information identified by quite other sources. Since one of our overarching aims was to, so to say, grasp the geographical aspects of Skaraborgs Sjukhus. That is, to relate organisational issues to already established information to gain a proper overarching understanding that made sense for our analytical purposes. This independent on if such information happened to be hiding in an information system or if such information eventually was more or less evident using e.g. sings and naming of various parts of the building facilities (as a help for both of the employees as well as to the patients). Our earlier experiences, from the automotive and manufacturing industry, had most certainly underlined the importance of trying to establish what may be denoted as a "consistent semantic network". At least was such a network needed for our analytical purposes. In fact, it proved necessary to carry out extensive inventories of all of the rooms (respectively room numbers, room denotation, etc.) for all of the approximately 35 000 rooms used. It was necessary for us to compare these particular findings with the information found in some information systems. Information systems that were used for e.g. administration of salaries within the four hospitals, calling of patients, the health-care region of Västra Götaland with numerous hospitals used for managing of information to patients in a more overarching (domestic) perspective and thus overarching sense, etc. For example, the nomenclature practised within the four hospitals proved to be fragmented, inconsistent, incompatible, not well thought-out, etc. Moreover, the core medical health-care services managed by one public service (by Skaraborg Sjukhus) was not at all congruent with another public service, which was responsible for the building facilities (Västfastigheter) (two incompatible logics). It was, as a consequence, e.g. impossible to provide us with any list of names and number of employees the organisational units. In fact, it was even impossible to designate the parts of the appropriate building facilitates to the responsible organisational unit. Among other things, because the rent for the premises was invoiced as a lump sum on a yearly base between these two public services, this without any such information (such information was as said just non-existent). It is such anomalies, and partly the necessary measures suggested as remedies, that this article will address. A comment: Note that a, for us and rather obviously for others, annoying was the above mentioned lack of a so-called consistent semantic network (the denotations in various administrative information systems used were featuring several inconsistencies like, abbreviations, shortenings, synonyms etc.) (such facts became obvious for us, and these anomalies ought to be remedied in the future). However, some constructive remedies are also illustrated, as was proved possible to bring forward by means of our practices of a combine data-collection and data-analyze approach (i.e. cross-reference procedures by computer technique and various manual efforts like re-configuration of customized print-outs on paper, which were cut up and reorganized manually by e.g. glue and scissors).
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