| 1. |
- Myléus, Anna, 1978-, et al.
(författare)
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Celiac disease revealed in 3% of Swedish 12-year-olds born during an epidemic
- 2009
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Ingår i: Journal of Pediatric Gastroenterology and Nutrition - JPGN. - New York : Raven P. - 0277-2116 .- 1536-4801. ; 49:2, s. 170-176
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Tidskriftsartikel (refereegranskat)abstract
- Objetive: Sweden experienced a marked epidemic of celiac disease between 1984 and 1996 in children younger than 2 years of age, partly explained by changes in infant feeding. The objective of this study was to determine the prevalence of celiac disease in 12-year-olds born during the epidemic (1993), including both symptomatic and screening detected cases.Patients and methods: All sixth-grade children in participating schools were invited (n = 10,041). Symptomatic and, therefore, previously diagnosed celiac disease cases were ascertained through the National Swedish Childhood Celiac Disease Register and/or medical records. All serum samples were analyzed for antihuman tissue transglutaminase (tTG)-IgA (Celikey), and serum-IgA, and some for tTG-IgG and endomysial antibodies. A small intestinal biopsy was recommended for all children with suspected undiagnosed celiac disease.Results: Participation was accepted by 7567 families (75%). Previously diagnosed celiac disease was found in 67 children; 8.9/1000 (95% confidence interval [CI] 6.7-11). In another 192 children, a small intestinal biopsy was recommended and was performed in 180. Celiac disease was verified in 145 children, 20/1000 (95% CI 17-23). The total prevalence was 29/1000 (95% CI 25-33).Conclusions: The celiac disease prevalence of 29/1000 (3%)-with two thirds of cases undiagnosed before screening-is 3-fold higher than the usually suggested prevalence of 1%. When these 12-year-olds were infants, the prevailing feeding practice was to introduce gluten abruptly, often without ongoing breast-feeding, which might have contributed to this unexpectedly high prevalence.
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| 2. |
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| 3. |
- Albertsson-Wikland, Kerstin, 1947, et al.
(författare)
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Dose-dependent effect of growth hormone on final height in children with short stature without growth hormone deficiency
- 2008
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Ingår i: Journal of Clinical Endocrinology and Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 93:11, s. 4342-4350
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Tidskriftsartikel (refereegranskat)abstract
- CONTEXT: The effect of GH therapy in short non-GH-deficient children, especially those with idiopathic short stature (ISS), has not been clearly established owing to the lack of controlled trials continuing until final height (FH).OBJECTIVE: The aim of the study was to investigate the effect on growth to FH of two GH doses given to short children, mainly with ISS, compared with untreated controls.DESIGN AND SETTING: A randomized, controlled, long-term multicenter trial was conducted in Sweden.INTERVENTION: Two doses of GH (Genotropin) were administered, 33 or 67 microg/kg.d; control subjects were untreated.SUBJECTS: A total of 177 subjects with short stature were enrolled. Of these, 151 were included in the intent to treat (AllITT) population, and 108 in the per protocol (AllPP) population. Analysis of ISS subjects included 126 children in the ITT (ISSITT) population and 68 subjects in the PP (ISSPP) population.MAIN OUTCOME MEASURES: We measured FH sd score (SDS), difference in SDS to midparenteral height (diff MPHSDS), and gain in heightSDS.RESULTS: After 5.9+/-1.1 yr on GH therapy, the FHSDS in the AllPP population treated with GH vs. controls was -1.5+/-0.81 (33 microg/kg.d, -1.7+/-0.70; and 67 microg/kg.d, -1.4+/-0.86; P<0.032), vs. -2.4+/-0.85 (P<0.001); the diff MPHSDS was -0.2+/-1.0 vs. -1.0+/-0.74 (P<0.001); and the gain in heightSDS was 1.3+/-0.78 vs. 0.2+/-0.69 (P<0.001). GH therapy was safe and had no impact on time to onset of puberty. A dose-response relationship identified after 1 yr remained to FH for all growth outcome variables in all four populations.CONCLUSION: GH treatment significantly increased FH in ISS children in a dose-dependent manner, with a mean gain of 1.3 SDS (8 cm) and a broad range of response from no gain to 3 SDS compared to a mean gain of 0.2 SDS in the untreated controls.
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| 4. |
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| 5. |
- Hellström, Erik, et al.
(författare)
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Look-ahead control for heavy trucks to minimize trip time and fuel consumption
- 2009
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Ingår i: Control Engineering Practice. - : Elsevier BV. - 0967-0661 .- 1873-6939. ; 17:2, s. 245-254
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Tidskriftsartikel (refereegranskat)abstract
- The scenario studied is a drive mission for a heavy diesel truck. With aid of an on board road slope database in combination with a GPS unit, information about the road geometry ahead is extracted. This look-ahead information is used in an optimization of the velocity trajectory with respect to a criterion formulation that weighs trip time and fuel consumption. A dynamic programming algorithm is devised and used in a predictive control scheme by constantly feeding the conventional cruise controller with new set points. The algorithm is evaluated with a real truck on a highway, and the experimental results show that the fuel consumption is significantly reduced.
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| 6. |
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| 7. |
- Ivarsson, Andreas, 1979, et al.
(författare)
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Kunskapsöversikt över teorier och metoder för hantering av olyckor ur ett kommunalt perspektiv
- 2008
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Ingår i: Myndigheten för samhällsskydd och beredskap.
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten utgör en kunskapsöversikt över teorier och metoder för kommunalt säkerhetsarbete. I avsaknad av policyforskning på detta område rekonstrueras i rapporten et sådant område genom att studera närliggande områden, och relatera dessa till generella policyteorier samt kommunalt säkerhetsarbete.
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| 8. |
- Ivarsson, Lars, 1969-, et al.
(författare)
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Anställdas upplevelse av interaktionen med kunder/mottagare i tjänstesektorn
- 2008
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Ingår i: Arbetsmarknad & Arbetsliv. - Karlstad : Karlstads universitet. - 1400-9692 .- 2002-343X. ; 14:4, s. 43-61
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Tidskriftsartikel (refereegranskat)abstract
- I denna artikel görs dels en summering av forskning som uttalar sig om arbetsvillkor för anställda med hög grad av kundkontakt, dels påvisas utbredningen av dessa villkor i den svenska tjänstesektorn. Det visar sig att tjänstearbete präglas av rutinisering, krav på utseende samt styrning av känslor. Samtidigt är kundkontakter en källa till arbetstillfredsställelse och denna arbetstillfredsställelse är mer utbredd bland anställda som identifierar sig med verksamhetens kunder.
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| 9. |
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| 10. |
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| 11. |
- Ivarsson, Lars
(författare)
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Vad betyder kundfokus? : En studie av närhet, kompetens och teknik
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This is a dissertation about customer focus. Customer focus is a concept that can be understood in terms of giving the customer what the customer wants. It has been argued that the industrial society has transformed into a service society with the obvious consequence that services nowadays play a leading part, not at least in regard to customer focus. The customer of today is claimed to have lost interest in mass consumption and is much attracted to personalized and unique solutions, something that results in the fact that businesses must create or develop customer focus, i.e. listen to the customer’s wishes, needs, and demands. According to most researchers in this field, “service excellence” is the primary aspect one firm can use in order to successfully compete with other similar firms. According to Service Management, customer focus is much about developing a personal relationship between the service provider (employee) and the customer. In order to that, the service provider needs to adjust his or hers behaviour in accordance with the customer. This circumstance has a tendency to lead to a “master-and-servant” relation, in which the service provider must obey the various wishes, needs, and demands any customer may have. Most studies on customer focus have been undertaken in the context of low skill service work, but the results have often (implicitly) been generalized to comprise all service work in the whole service sector. As a consequence of this situation, my survey takes on high skill service work (banking and health care). The main purpose of the survey is to examine if the results and analyses, presented from service management apply when the services are not low skill. The results from this survey shows that Service Managements heavily emphasis of the personal relationship between employee and customer – in which the service provider in some meaning need to undertake the role of a servant – can be questioned. The results also show that there is a discrepancy between (bank customers’ and patients’) opinion on an abstract comprehensive level and a specific level where various situations and errands are defined. Further, the dissertation shows that the various factors that can be included in the conception of customer focus, need to be examine more carefully. Some factors integrate in a way that makes it difficult to separate them, and one specific factor can in fact hold a variety of essences.
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| 12. |
- Ivarsson, Maria, 1977-
(författare)
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Fuel Optimal Powertrain Control for Heavy Trucks Utilizing Look Ahead
- 2009
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The road topography in highways affects the powertrain control of a heavy truck substantially since the engine power is low in relation to the vehicle weight. In large road gradients constant speed is not possible to keep, which would have been beneficial otherwise, and in some uphills shifting gears becomes inevitable. If information about the road ahead, i.e. look ahead information, is available, then the powertrain can be controlled in a more fuel efficient way. Trial runs are performed, where the velocity trajectory that minimizes energy consumption, is calculated and communicated in real time as set points to the conventional cruise control. This look ahead control gives significant fuel consumption reductions compared to a standard cruise control, while keeping to the same mean speed. The results are the inspiration to further studies in how powertrain control can benefit from look ahead information. An engine with a non-linear fuel map is studied to understand its impact on fuel optimal speed. It is shown that for a significant fuel map non-linearity, quantified by a threshold value, constant speed in small road gradients is no longer optimal. Further, an automated manual transmission (AMT) optimal gear control is studied. It is shown that the reduced propulsion of a typical AMT gear-shifting process must be considered when choosing when to shift gears. Thus, additional reductions of fuel consumption are obtained with a look ahead control based on knowledge of engine and transmission characteristics.
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| 13. |
- Ivarsson, Maria, 1977-, et al.
(författare)
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Impacts of AMT Gear-Shifting on Fuel Optimal Look Ahead Control
- 2009
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Ingår i: SAE Technical Paper Series. - Linköping : Linköping University Electronic Press. - 0148-7191.
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- A fuel optimal gear shift control has been studied, when look ahead information is available, and the impact of the automated manual transmission (AMT) gear-shifting process is analayzed. For a standard discrete heavy truck transmission, answers are found on when to shift gears, prior to or when in an uphill slope. The gear-shifting process of a standard AMT is modeled, not considering the comfort details, in order to capture the fuel and time aspects of the gear shift. A numerical optimization is performed by dynamic programming, minimizing fuel consumption and time by controlling fuel injection and gear. Since a standard AMT does not have look ahead information, it sometimes gears down unnecessarily and thus gives a significantly higher fuel consumption compared to the optimal control. However, if gearing down is inevitable, the AMT gear-shifting strategy, based on engine thresholds, is a well-functioning gear control so that the optimal control only gives marginal additional savings. To attain the possible fuel reductions it is shown that the reduced propulsion of an AMT gear-shifting process, and the resulting vehicle retardation, must be considered. The point of shifting gears must be chosen to ensure an adequate engine speed in order to get a sufficient engine power after the gear shift, even as the truck is decelerated during gear shift.
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| 14. |
- Ivarsson, Maria, 1977-, et al.
(författare)
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Look Ahead Control - Consequences of a Non-Linear Fuel Map on Truck Fuel Consumption
- 2008
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Ingår i: The 17th IFAC World Congress.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Consequences of non-linearities in specific fuel consumption, sfc, of a heavy truck combustion engine are studied with focus on so small road gradients that constant speed is optimal if the engine torque has an affine relation to fueling. A quasi-static analysis gives valuable insights into the intrinsic properties of minimization of fuel consumption. Two objective functions are shown to give different optimal velocity trajectories on a constant road gradient, when the non-linearity in sfc is significant, a notation which is quantified. For a significant non-linearity, when a constraint is set to keep a final time, switching between two characteristic speeds is optimal. Alternatively, if consumed time, in addition to fuel consumption, is part of the objective function, then keeping to one constant speed is optimal also for significant non-linearities. However, the different optimal solutions still show similarities, since for a certain significant non-linearity a specific speed range determined by the characteristic velocities is shown to be unobtainable for both optimality criteria. Similar results are obtained for a full dynamic model including a realistic fuel map and other realistic constraints.
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| 15. |
- Ivarsson, Maria, 1977-, et al.
(författare)
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Look-ahead control – consequences of a non-linear fuel map on truck fuel consumption
- 2009
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Ingår i: Proceedings of the Institution of mechanical engineers. Part D, journal of automobile engineering. - London : Professional Engineering Publishing. - 0954-4070 .- 2041-2991. ; 223:10, s. 1223-1238
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Tidskriftsartikel (refereegranskat)abstract
- Consequences of non-linearities in specific fuel consumption (SFC) of a heavy truck combustion engine are studied with focus on such small road gradients that a constant speed is optimal if the engine torque has an affine relation to fuelling. A quasi-static analysis gives valuable insights into the intrinsic properties of minimization of fuel consumption. Two objective functions are shown to give different optimal velocity trajectories on a constant road gradient, when the non-linearity in SFC is significant, a notation which is quantified. For a significant non-linearity, when a constraint is set to keep a final time, switching between twocharacteristic speeds is optimal. Alternatively, if consumed time, in addition to fuel consumption, is part of the objective function, then keeping to one constant speed is optimal also for significant non-linearities. However, the different optimal solutions still show similarities, since for a certain significant non-linearity a specific speed range determined by the characteristic velocities is shown to be unobtainable for both optimality criteria. Similarresults are obtained for a full dynamic model including a realistic fuel map and other realistic constraints.
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| 16. |
- Ivarsson, Maria, et al.
(författare)
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Vehicle control using preview information
- 2006
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Konferensbidrag (refereegranskat)abstract
- The background and the aim of the project,“Vechicle control by using preview information - ’Look Ahead’ ” , are discussed. The project is raisedto explore the possibilities of reduction of fuel consumption and improvements in comfort and safety for heavy vehicles. In particular research will focus on improvements that can be made, in actual and future control systems, with knowledge of the road ahead. This paper describes the project and reports on initial findings as well as related research.
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| 17. |
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| 18. |
- Nyström, Monica E., et al.
(författare)
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The challenges of developing health promotion in health care – Investigating the process of learning and change
- 2009
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Ingår i: XIth European Conference on Organizational Psychology and Human Service Work.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Traditional views on the spread of knowledge and learning in health care have been criticized as being overly linear, simplified and rational, leading to a slow progress of clinical praxis. Accelerating change in health promotion is a special challenge. The objective of the study was to examine learning and change processes in a countywide multi-professional, multi-organizational health promoting program for children, named Salut. The involved county council facilitators used an improvement approach built on theory regarding how to accomplish change in complex systems. The program involved active cooperation between researchers, process facilitators and professionals in a pilot area process. Interviews, observations, survey and archival data were used in analyses of the program's progress (2004-2008) and the actors' views on the learning and change processes introduced. Results indicate differences in perspectives, focus, aims and understanding between groups of actors, and between steering and operational levels of the project organization. The facilitators' views differed most compared to the others regarding aspects of learning and process focus. The views on learning changed as the program progressed and were at the end of 2008 under new strategic consideration. A model of development and learning, from medical knowledge to health improvements, was developed, describing several sub-processes. It also illustrates different scientific focuses on health intervention and change. A main conclusion is the importance of including intermediate processes when designing health promoting programs and acknowledgement of relations between evidence based medical knowledge, the processes of producing and selecting interventions, intervention design, type of implementation process and its effects on sustainability; the learning-in-context by professionals and parent/child and its connection to sustainability; the cognitive processes involved in learning and behavioral change; life-style changes and their effects on health. A good pilot example can hardly spread without a strategic change plan and an understanding of the dynamics of context and processes over time. The model has become a central tool in continuing the process of the Salut program and might also be of aid to other development projects.
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| 19. |
- Palm, Lars, et al.
(författare)
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Acetabular revision with extensive allograft impaction and uncemented hydroxyapatite-coated implants. Results after 9 (7-11) years follow-up
- 2007
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Ingår i: The Journal of Arthroplasty. - : Elsevier BV. - 0883-5403 .- 1532-8406. ; 22:8, s. 1083-1091
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Tidskriftsartikel (refereegranskat)abstract
- This is a clinical and radiographic review of 87 hips in 79 patients 9 (7-11) years after acetabular revision with extensive use of morselized allograft firmly impacted into localized defects as well as the entire acetabular cavity, followed by insertion of an uncemented hydroxyapatite-coated cup with supplementary screw fixation. The 9-year survival rate for the acetabular implant was 90.5% (95% CI, 83.4%-97.6%) with revision for any reason as end point and 94% (95% CI, 89%-99.1%) with revision for aseptic loosening as end point. Acetabular revision with massive allograft impaction and hydroxyapatite-coated implants show very promising results. The limited contact between implant and host bone does not seem to compromise implant survival in the 7- to 11-year perspective.
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| 20. |
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| 21. |
- Palm, Lars, et al.
(författare)
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No difference in migration or wear between cemented low-profile cups and standard cups. A randomized radiostereographic study of 53 patients over 3 years
- 2007
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 78:4, s. 479-484
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Tidskriftsartikel (refereegranskat)abstract
- Background: Minor design changes may cause major changes in implant performance. Thus, as part of a stepwise introduction of a new low-profile cup, we performed a randomized trial comparing it to a well-docu-mented standard cup. Patients and methods: 60 patients, stratified according to sex, weight, and age, underwent cemented total hip arthroplasty using a Lubinus SP2 stem with ceramic head and were randomized to either the new low-profile Lubinus Flanged Anti-Luxation cup (FAL) or the Lubinus Standard Eccentric cup (Standard). 7 patients were excluded and 53 (28 FAL) were evaluated at 3, 6, 12, and 36 months postoperatively. Primary outcome variables, cup migration (MTPM), and wear (total 3-dimensional femoral head penetration) were measured with radiostereometry (RSA). Clinical outcome was evaluated with the western Ontario and McMaster osteoarthritis index (Womac) and the visual analog pain score (VAS). Results: We found no difference in migration between the FAL and Standard cups. There was no difference in wear between the two cups and there was no correlation between wear and migration. 3 cups (2 FAL and 1 Standard) showed continuous migration of a magnitude that indicated an increased risk of early loosening. Clinical outcome was excellent, without any difference between the 2 groups.
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| 22. |
- Palm, Lars, 1960-
(författare)
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On Fixation of Hip Prostheses
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis, comprising 5 separate studies, is concerned with fixation of prosthetic components in total hip arthroplasty. The results and conclusions of the studies fol-low;The initial stability of femoral revision components, the long cementless PCA stem and the Exeter standard stem cemented in a bed of impacted bone graft, was com-pared in an experimental study. The PCA stem was more stable than the Exeter stem. However, for both stems initial stability may not be sufficient to allow bone ingrowth. Initial fixation is especially vulnerable to torsion.Identical femoral stems with or without HA-coating were compared in a prospec-tive randomized clinical trial. The long-term stable fixation of a cementless Link RS femoral component was improved by application of hydroxyapatite coating to the femoral stem.In a clinical study the method of extensive impaction of morsellized bone allograft and a hydroxyapatite-coated cementless Mallory-Head acetabular component was found to be advantageous for acetabular revision in the presence of contained or acetabular wall defects. The limited contact between the HA-coated implant and living host bone did not seem to compromise long-term stable fixation.Two different cup designs were compared in a prospective randomized RSA study. At 3 years after implantation the cemented low profile Lubinus FAL cup performed as well as the cemented Lubinus Standard cup in terms of migration and polyethyl-ene wear.In a study of the relationship between radiolucent lines and migration the Lubinus FAL cup displayed more radiolucent lines in the cement bone interface than the Lubinus Standard cup but no difference in migration was found. Early appearance of such radiolucent lines represents an unspecific finding without reliable correla-tion to 3-year migration of the acetabular component.
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| 23. |
- Rosemar, Anders, 1958, et al.
(författare)
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Increased concentration of tissue-degrading matrix metalloproteinases and their inhibitor in complicated diverticular disease
- 2007
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Ingår i: Scandinavian journal of gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 42:2, s. 215-20
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Complicated diverticular disease is associated with extensive structural changes of the colonic wall. Turnover of extracellular matrix (ECM) plays a pivotal role in this process. Proteolytic enzymes, including matrix metalloproteinases (MMPs), are capable of degrading most components of ECM. Their activity is regulated by inhibitors, tissue inhibitors of metalloproteinases (TIMPs). Disturbances of the MMP-TIMP balance can cause tissue degradation or fibrosis. The aim of this study was to assess the concentration and distribution of MMPs and TIMPs in colonic biopsies. MATERIAL AND METHODS: Twenty-seven patients who had undergone sigmoid colectomy were included in the study. Full-thickness biopsies from affected and non-affected parts of each resected specimen were collected. Expressions of the proteins MMP-1, -2, -3, -9, TIMP-1 and TIMP-2 were quantified by ELISA and localized by immunohistochemistry. RESULTS: The concentrations of MMP-1, MMP-2 and TIMP-1 were significantly higher in affected tissue than concentrations in non-affected tissue (MMP-1 p=0.005, MMP-2 p=0.0003 and TIMP-1 p<0.0001). In affected segments in general, there was an increased expression in the entire bowel wall, predominantly for MMP-2, MMP-3 and TIMP-1. CONCLUSIONS: Concentrations of MMP-1, MMP-2 and TIMP-1 were increased in intestinal segments affected by complicated diverticular disease and distributed throughout the entire bowel wall, which may explain the structural changes.
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| 24. |
- Starck, Göran, et al.
(författare)
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A 1H magnetic resonance spectroscopy study in adults with obsessive compulsive disorder: relationship between metabolite concentrations and symptom severity.
- 2008
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Ingår i: Journal of neural transmission (Vienna, Austria : 1996). - : Springer Science and Business Media LLC. - 0300-9564 .- 1435-1463. ; 115:7, s. 1051-62
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Tidskriftsartikel (refereegranskat)abstract
- 1H magnetic resonance spectroscopy (1H MRS) studies exploring brain metabolites, especially glutamine + glutamate (Glx), in obsessive compulsive disorder (OCD) are of vital interest for trying to understand more about the pathophysiology of OCD. Therefore, we conducted the present 1H MRS study with the aims of (1) comparing MRS metabolites in a group of adult patients with OCD and a group of healthy controls, and (2) examining the relationship between MRS metabolite concentrations and symptom severity in the patient group. Three brain regions were studied, the right caudate nucleus, the anterior gyrus cinguli and the occipital cortex bilaterally. Since multivariate analysis is a highly useful tool for extraction of 1H MRS data, we applied principal component analysis (PCA) and partial least square projection to latent structures (PLS) to the MRS data. PLS disclosed a strong relationship between several of the metabolites and OCD symptom severity, as measured with Yale-Brown obsessive-compulsive scale (YBOCS): the YBOCS score was found to be positively correlated to caudate creatine, Glx, glutamate, and choline compounds as well as occipital cortex myoinositol, and negatively correlated to occipital cortex Glx. The negative correlation between occipital cortex Glx and YBOCS was the most impressive. PCA did not reveal any tendency for a separation between the patients with OCD and controls with respect to MRS metabolites. The results are discussed in relation to corticostriatothalamocortical feedback and previous observations of poor visuospatial ability in OCD.
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| 25. |
- Åberg, Annika
(författare)
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Tjänstemötet : Interaktionens kommersiella, byråkratiska och social logik
- 2007
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The subject of this thesis is interaction in the service encounter. The aim is to describe and explain the service encounter interaction with a special focus on the social and organisational context. The contextual focus is related to two overriding questions: What significance does the human interaction have for the service encounter? What significance does the organisational context have for the service encounter?The result show that even though the communication consists of four discerned phases – salutation, the subject of the call, concluding the subject, and rounding off the call, each phase also displays contradictions. Consequently, there are both relational and instrumental utterances, as well as symmetrical and asymmetrical aspects of the conversations.These contradictory results of the relational-instrumental and symmetrical-asymmetrical features are explained when interaction is viewed in terms of three different sets of logic – the commercial, the bureaucratic, and the social. Every logic is constituted by a number of characteristics, each contributing to the shape of the interaction and to the relationship between the customer and the employee.Analytically speaking, the three forms of logic can be described in terms of their respective field of action and rationality, that is, what the actors talk about and what the purpose of the talk is. It is shown that the actors must prioritise between economic, administrative and personal areas within a limited time of action. It is also clear that the disparate rationalities, that is, economic, executive and recognition, all exercise influence over the service encounter, which means that acts aiming at a specific goal are restricted by the objectives of the other logics. Therefore there is a certain self-regulating function in the antagonism between the logics. The positions of the employee in relation to the customer, the organisation and the so-called collective customer mean that there are demands made from three qualitatively different directions. There is, in other words, a three-bosses dilemma for employees. The different positions of the employee also entail three different asymmetrical relationships in which either the customer or the employee has the advantage. This position constructs the hierarchy of dominance between employee and customer.To conclude, the interaction constitutes a complex relationship between the characteristics of the logics and when these combine the interaction of the service encounter is shaped. The fact that the service encounter involves human interaction means that there is a counter balance against the organisational ascendancy.
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