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- Bojesson, Catarina
(författare)
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Enabling Dynamic Capability : Managing and Organizing for Change
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This doctoral thesis is based on a longitudinal single-case study conducted over five years within a product development context at a manufacturing company. In dynamic environments that demand flexibility and adaptability, it is essential to understand how organizations can improve dynamic capabilities to remain viable and competitive during periods of turbulence and change. This challenge is especially central to product development organizations offering customer-specific products as it tends to increase organizational complexity. An excessive focus on internal coordination and control to manage this complexity has led to inertia due to establishment of strict, rigid processes and hierarchical bureaucracies within organizational management and design.This study aims to contribute with new knowledge on how organizations operating in dynamic contexts can develop adaptability to changing needs. Specifically, it seeks to understand how to design and manage organizations to increase their preparedness for and adaptability to change. Investigating the factors and mechanisms that influence an organization's dynamic capability can provide insights into the sources of inertia and support the transition toward a more dynamic structure. The longitudinal study is based on data collected through an initial interview study followed by a questionnaire study, and finally through a concluding interview study. The research has been phenomenon-driven; as the organization’s circumstances have evolved, the focus of the study has shifted accordingly. Emerging from the aggregated results of the longitudinal study, the overall scope of the research is the change process, transitioning from a rigid to a more dynamic organization. Research findings are presented in five appended papers.Analysis from literature studies and the empirical study show that the primary focus on improving performance often centers on internal efficiency. However, within the case company, tension arose between the desire of strict control according to predefined processes and plans and the actual need for flexibility. Dynamic contexts require working processes that facilitate reactive problem-solving, creativity, and flexibility, as well as managers capable of going back and forth between management styles to benefit performance. Successful organizational reconfiguration depends on developing the conditions that enable the firm's dynamic capability in relation to its context. This involves identifying both the microfoundations that generate dynamic capability and the internal and external constraints to change.Considering the external environment is crucial for developing an understanding of how to best organize and manage resources and capabilities, which places demands on managerial capabilities. Managers must possess the skills to monitor the external environment and formulate strategies to respond to changing conditions, as their interpretation of the external environment will influence their decisions, which will subsequently enable or hinder possible actions. The design of organizations will impact the ability to rearrange resources and capabilities. Processes and working procedures must allow for reconfigurations to respond swiftly to changing constraints or opportunities. The use of multiple theoretical perspectives has been imperative in the analysis of the data, and the theoretical contribution extends to exploration of various factors and mechanisms that influence an organization's dynamic capability.
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| 3. |
- Lannergård, Anders, 1953-
(författare)
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Serum Amyloid A Protein (SAA) in Healthy and Infected Individuals
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Serum amyloid A protein (SAA) is an acute phase protein that has recently gained increasing interest as a potential marker for disease and treatment monitoring. We investigated SAA and CRP levels in (a) patients with various common infectious diseases (n=98), (b) patients with pyelonephritis (n=37) versus patients with cystitis (n=32), (c) healthy individuals of varying ages (n=231), (d) very immature newborn infants with or without nosocomial infections (NIs) (n=72) and (e) patients with bacterial infections treated with cefuroxime (n=81). SAA significantly correlated with CRP in viral as well as in bacterial infections (for the total group: r2=0.757, p<0.0001) and showed a systemic inflammatory response in 90% of the patients with cystitis as compared with 23% for CRP. Equally high efficiencies (0.96 and 0.94 for SAA and CRP, respectively) were observed in discriminating between pyelonephritis and cystitis. SAA and high sensitive (hs) CRP were lower in umbilical cords (p<0.0001) and higher in elderly adults (p<0.0001-0.03) than in the other age groups; higher in immature newborn infants than in term infants; and higher in the NI group than in the non-NI group. Interindividual variabilities of the time course of the biomarkers SAA and CRP were considerable. Because of the smoothed distribution of SAA and CRP (i.e. elevations were both essentially unchanged during the first 3 days of cefuroxime treatment), these markers were not useful when deciding parenteral-oral switch of therapy, which occurred within this time period in most cases.SAA is a sensitive systemic marker in cystitis. SAA and hsCRP in umbilical cord blood are close to the detection limit and increase with age. They increase in relation to NI in very immature newborn infants and might therefore be used in diagnosis and monitoring. Finally, SAA and CRP in adults with bacterial infections could not predict an early parenteral-oral switch of antimicrobial therapy.
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| 4. |
- Larsson, Anders, 1977-
(författare)
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Test Optimization for Core-based System-on-Chip
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The semiconductor technology has enabled the fabrication of integrated circuits (ICs), which may include billions of transistors and can contain all necessary electronic circuitry for a complete system, so-called System-on-Chip (SOC). In order to handle design complexity and to meet short time-to-market requirements, it is increasingly common to make use of a modular design approach where an SOC is composed of pre-designed and pre-verified blocks of logic, called cores.Due to imperfections in the fabrication process, each IC must be individually tested. A major problem is that the cost of test is increasing and is becoming a dominating part of the overall manufacturing cost. The cost of test is strongly related to the increasing test-data volumes, which lead to longer test application times and larger tester memory requirement. For ICs designed in a modular fashion, the high test cost can be addressed by adequate test planning, which includes test-architecture design, test scheduling, test-data compression, and test sharing techniques.In this thesis, we analyze and explore several design and optimization problems related to core-based SOC test planning. We perform optimization of test sharing and test-data compression. We explore the impact of test compression techniques on test application time and compression ratio. We make use of analysis to explore the optimization of test sharing and test-data compression in conjunction with test-architecture design and test scheduling. Extensive experiments, based on benchmarks and industrial designs, have been performed to demonstrate the significance of our techniques.
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| 5. |
- Larsson, Magnus, 1983-
(författare)
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National environmental evaluation systems : guiding towards sustainability?
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Dealing with environmental threats is one of the largest, if not the largest, challenge contemporary societies face. One way to better deal with this challenge would be to produce knowledge that can be used to improve environmental work and environmental policy and thus ultimately contribute to sustainable development. National environmental evaluations, which this thesis explores, could potentially fill this function because they are supposed to generate applicable and useful knowledge for improving environmental policy and practice for a sustainable transition. However, what different environmental actors view as useful knowledge varies, and needs to be empirically investigated. Against this background, the aim of this thesis is to investigate whether, and how, national environmental evaluation systems contribute to key actors’ environmental work and sustainable development. The thesis explores two national environmental evaluation systems in Sweden.Method: A mixed methods approach is applied that combines three methods. Firstly, a narrative synthesis is developed and applied to compile a list of sustainable development effects from national environmental evaluations. Secondly, a critical program theory is used to investigate the evaluation system’s underlying logic and to assess the likelihood of it achieving its intended effects. Thirdly, a directed content analysis is used to explore the usability and use of environmental evaluations and evaluation systems. The methods are applied to various documents, interviews with key actors, and observations at two environmental seminars.Results: The results show that, to contribute to sustainable development in the context of evaluation systems and network governance, environmental evaluations need to be of sufficient quality and meet different stakeholders’ knowledge needs. However, only some evaluations meet this demand. The main value of national environmental evaluations and evaluation systems is that they reinforce the national objectives, provide a recurrent report on achievement of objectives, and push actors to take responsibility to improve their environmental work.
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- Lipcsey, Miklós, 1975-
(författare)
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Pathophysiological, Inflammatory and Haemostatic Responses to Various Endotoxaemic Patterns : An Experimental Study in the Pig
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Septic shock is frequently seen in intensive care units and is associated with significant mortality. Endotoxin – a major mediator of the pathophysiologic responses – is released during lysis of Gram-negative bacteria. These responses can be mimicked in the endotoxaemic pig. This thesis focuses on the following topics: the inflammatory and pathophysiological responses to various endotoxin doses and infusion patterns; covariations between endotoxin induced inflammatory and pathophysiological responses; whether the biological effects of endotoxin can be modulated by clopidogrel and whether tobramycin or ceftazidime reduce plasma cytokine levels. Endotoxin induced linear log-log cytokine and F2-isoprostane responses. Leukocyte and platelet responses, pulmonary compliance, circulatory variables as well as indicators of plasma leakage and hypoperfusion exhibited log-linear responses to the endotoxin dose. Biological responses to endotoxaemia such as inflammation, hypotension, hypoperfusion and organ dysfunction were more expressed when the organism was exposed to endotoxin at a higher rate. These results may facilitate the possibility to choose relevant endotoxin administration, when experiments are set up in order to evaluate certain responses to endotoxaemia. Correlation studies between cytokines, leukocytes, platelets and the endotoxin dose were in agreement with the well-known ability of endotoxin to induce cytokine expression and to activate both primary haemostasis and leukocytes. Free radical mediated lipid peroxidation and COX-mediated inflammation correlated to cytokine expression and organ dysfunction in endotoxaemic shock. Endotoxaemic pigs pretreated with clopidogrel, exhibited a trend towards less expressed deterioration of renal function, although blocking of ADP-induced primary haemostasis is not a key mediator of endotoxin induced deterioration of renal function. Tobramycin did not neutralise the biological effects of endotoxin or the plasma levels of endotoxin, suggesting that these antibiotics do not bind to endotoxin. Reduction in IL-6 was greater in pigs treated with ceftazidime and tobramycin as compared with those given saline, indicating a possible anti-inflammatory effect of both antibiotics.
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| 7. |
- Olsson, Karl Wilhelm, 1985-
(författare)
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Persistent ductus arteriosus in extremely preterm infants
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Patent ductus arteriosus (PDA) is common in infants born <28 weeks gestational age (GA) and associated with significant morbidity. Despite extensive research efforts, the indications for PDA treatment remain controversial. The aims of these studies were to gain knowledge of factors affecting ductal closure during the early postnatal period and provide better means for identification of preterm infants that may benefit from PDA treatment.In Paper I, infants born <28 weeks GA and pharmacologically treated for PDA were retrospectively identified and their echocardiographic examinations were reviewed. Twenty-nine (52%) infants successfully closed and 27 (48%) infants failed to close PDA during treatment. High maximal ductal flow velocity (Vmax) was independently associated with closure (OR 3.04, p=0.049).Paper II prospectively included infants born <28 weeks GA and assessed early respiratory, circulatory and echocardiographic parameters. PDA was persistent in 18 (30%) and ultimately closed or insignificant in 42 (70%) infants. Echocardiographic criteria for hemodynamically significant PDA on days 2-7 did not predict persistent PDA (p=1.000). Mechanical ventilation (p=0.025), high mean airway pressure (p=0.020) and low Vmax (p=0.024) during day two were associated with future persistent PDA.Blood samples were obtained during the second day of life from 47 of the infants in Paper II and serum markers previously associated with PDA or factors affecting PDA were analyzed for Paper III. Inflammatory markers and erythropoietin (EPO) were elevated in infants with future persistent PDA. EPO levels were also higher in infants that did not close PDA during pharmacological treatment.In Paper IV, 44 infants born <28 weeks GA with surgically ligated PDA were retrospectively compared to non-surgically treated controls. Ligated infants had larger ductal diameter prior to, and lack of diameter decrease after pharmacological treatment for PDA (p=0.048 and p=0.022 respectively), and higher incidence of severe bronchopulmonary dysplasia (p=0.025). Longer periods with invasive ventilation was independently associated with ligation (OR 1.04, p=0.018).In conclusion, early hsPDA do not predict persistence of ductus arteriosus in extremely preterm infants, but Vmax and EPO are promising early markers for prediction of persistence and should be subjects of future studies.
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| 8. |
- Sjölander, Anders
(författare)
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Den naturliga ordningen : Makt och intressen i de svenska sparbankerna 1882-1968
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis has been to analyse how savings banks were integrated into the Swedish financial system from the end of the 19 th century until 1968. The study has focused on two questions. The fist deals with different viewpoints regarding the role of Savings banks in the credit market and which of these viewpoints had an impact on the regulation of savings banks. The second questions studied in this thesis concerns which actors had control over the savings banks and their regulation. In this thesis I have shown that the question of the role of savings banks in the financial system is complex. During the entire period being studied, savings banks were local organisations and the ideas that were put forward regarding their role on the credit market were greatly affected by how the credit market were organised on the local level. Sudden changes were rare within the savings banks' movement. As I have shown, during the period being studied, there were many different points of view regarding the role of savings banks in the financial system. Without outside pressure in the form of legislation, however, the savings banks themselves would hardly have succeeded in agreeing on and developing new operations. The slow but apparent changes in the position of savings banks on the Swedish financial market were closely connected to changes in power structures in Swedish society. Up until the inter-war period, the local elite - both economic and political - were closely involved with the development of savings banks. Gradually, however, national elite groups, that is political parties and the savings banks' central organisation, increased their control over local savings banks. At the same time as this change strengthened the role of savings banks as in some measure a public organisation, it also helped to expand their sphere of activity.
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| 9. |
- Sperber, Jesper
(författare)
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Protective Mechanical Ventilation in Inflammatory and Ventilator-Associated Pneumonia Models
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Severe infections, trauma or major surgery can each cause a state of systemic inflammation. These causes for systemic inflammation often coexist and complicate each other. Mechanical ventilation is commonly used during major surgical procedures and when respiratory functions are failing in the intensive care setting. Although necessary, the use of mechanical ventilation can cause injury to the lungs and other organs especially under states of systemic inflammation. Moreover, a course of mechanical ventilator therapy can be complicated by ventilator-associated pneumonia, a factor greatly influencing mortality. The efforts to avoid additional ventilator-induced injury to patients are embodied in the expression ‘protective ventilation’.With the use of pig models we have examined the impact of protective ventilation on systemic inflammation, on organ-specific inflammation and on bacterial growth during pneumonia. Additionally, with a 30-hour ventilator-associated pneumonia model we examined the influence of mechanical ventilation and systemic inflammation on bacterial growth. Systemic inflammation was initiated with surgery and enhanced with endotoxin. The bacterium used was Pseudomonas aeruginosa.We found that protective ventilation during systemic inflammation attenuated the systemic inflammatory cytokine responses and reduced secondary organ damage. Moreover, the attenuated inflammatory responses were seen on the organ specific level, most clearly as reduced counts of inflammatory cytokines from the liver. Protective ventilation entailed lower bacterial counts in lung tissue after 6 hours of pneumonia. Mechanical ventilation for 24 h, before a bacterial challenge into the lungs, increased bacterial counts in lung tissue after 6 h. The addition of systemic inflammation by endotoxin during 24 h increased the bacterial counts even more. For comparison, these experiments used control groups with clinically common ventilator settings.Summarily, these results support the use of protective ventilation as a means to reduce systemic inflammation and organ injury, and to optimize bacterial clearance in states of systemic inflammation and pneumonia.
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| 10. |
- Adolfsson, Annsofie, 1960-, et al.
(författare)
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Miscarriage : women’s experience and its cumulative incidence
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Many women experience miscarriage every year. Every fourth woman who has given birth reports that she has previous experience of miscarriage. In a study of all women in the Swedish Medical Birth Register 1983-2003, we found that the number of cases of self reported miscarriage had increased in Sweden during this 21 year period. This increase can be explained by the introduction of sensitive pregnancy tests around 1990, as well as an increase in the mean age of the mothers, by approximately 3 years, during the observation period. The risk of miscarriage is 13% with the first child. With subsequent pregnancies, the risk of miscarriage is 8%, 6% and 4% with the second, third and fourth child, respectively.Thirteen of these women who had suffered a recent miscarriage were interviewed four months later, and their feelings of guilt and emptiness were explored. Their experience was that they wanted their questions to be answered, and that they wanted others to treat them as the mothers to be that they felt themselves to be. They also experienced the need for time to grieve their loss.Measurement of grief by means of the Perinatal Grief Scale (PGS) is used in research but has also been proposed for clinical use. We have translated this psychological instrument to Swedish, back-translated and tested it in a small pilot study. In a randomized controlled study, women with early miscarriage were allocated, either to a structured visit (study group) or a regular visit (control group) to a midwife. The structured visit was conducted according to the Swanson caring theory. We could conclude that the structured visit had no significant effect on grief compared to the regular visit, as measured using the PGS. However, women with the sub-diagnosis missed abortion have significantly more grief four months after early miscarriage, regardless of visit type.We also performed a content analysis of the tape-recorded structured follow-up visit. The code-key used was Bonanno and Kaltman’s general grief categorization. Women’s expression of grief after miscarriage was found to be very similar to the grief experienced following the death of a relative. Furthermore, the grief was found to be independent of number of children, women’s age, or earlier experience of miscarriage.Conclusions: Every fourth woman who gives birth reports that she has also experienced early miscarriage. The experience of these women is that they have suffered a substantial loss and their reaction is grief similar to that experienced following the death of a relative.
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