48 research outputs found
Management of Information Systems Outsourcing: Challenges and Lessons Learned
To be successful in Information Systems (IS) outsourcing the necessity of better management practices has been pointed out.This research contributes to the knowledge base on management of IS outsourcing by addressing management of ISoutsourcing relationships. The research describes two cases of IS outsourcing relationships that differ in type of activityoutsourced, IS development versus IS maintenance and operation, and relationship composition. From the cases lessonslearnt are identified which with support from IS outsourcing literature are proposed as propositions for management of ISoutsourcing. It can be concluded that if the propositions, related to negotiation, communication and way of working, areadopted in an early stage they could contribute to successful IS outsourcing relationships. Another conclusion is that the ISoutsourcing management approach should not differ between type of IS activity outsourced, but rather reflect the nature ofthe IS activity; if it is a simple or complex activity
A Voice for the Voiceless: Young Women's Leadership Experiences in Zimbabwe
The purpose of the study has been to gain an understanding of how socio-cultural structures and gender norms affect young womenâs leadership possibilities. This has been explored through a qualitative case study focusing on how young women leaders, working with sexual and reproductive health rights issues, experience and pursue leadership in Zimbabwe. A theoretical framework based on contextual and relational understandings of womenâs leadership and theories of gender relations, intersectionality and body politics was used to analyze the empirical data. The findings revealed that young women leaders have to challenge gender norms and confront negative attitudes as they are perceived as going against womenâs expected role in society. In relation to other women leaders within the womenâs movement, conflicts between young and older generations were evident. Mentorship and cooperation was seen as main opportunities to facilitate for more young women to pursue leadership. The studyâs results showed that young women are put under a lot of pressure in terms of being leaders in an environment that is mainly dominated by men and older women, but also in terms of being role models for other âvoicelessâ young women
Alle 40-vuotiaiden suun ja suunielun levyepiteelikarsinoomatapausten esiintyvyyden muutokset ja etiologiset tekijÀt vuosien 2000 ja 2019 vÀlillÀ Turun yliopistollisessa keskussairaalassa.
TÀmÀn syventÀvien opintojen kirjallisen opinnÀytetyön tavoitteena oli selvittÀÀ nuorten suun ja suunielun levyepiteelikarsinooman ilmaantuvuutta, ilmaantuvuuden muutosta ja etiologisia tekijöitÀ.
OpinnĂ€ytetyö koostuu kirjallisuuskatsauksesta ja rekisteritutkimuksesta. Aineisto koostuu Varsinais-Suomen sairaanhoitopiirin potilaista vuosilta 2000â2001 sekĂ€ 2018â2019, joilla on diagnosoitu suuontelon tai suunielun levyepiteelikarsinooma, eli ICD-10-diagnoosit C02-06 tai C09- 10, alle 40-vuotiaana. Tutkimukseen on saatu tutkimuslupa Varsinais- Suomen sairaanhoitopiiriltĂ€ (T277/2021). Aineistossa on 4 potilasta.
Suuontelon ja suunielun levyepiteelikarsinooman ilmaantuvuus on viime vuosikymmenien aikana noussut nuorilla potilailla etenkin lÀnsimaisissa populaatioissa, kun taas samanaikaisesti ilmaantuvuus on vÀhentynyt iÀkkÀillÀ. Nuorilla altistuminen suusyövÀn tÀrkeimmille riskitekijöille, alkoholille ja tupakalle, on vÀhÀisempÀÀ verrattuna iÀkkÀÀmpiin potilaisiin. Erityisesti nuorilla mahdollisia riskitekijöitÀ ovat virusinfektiot, heikentynyt puolustusjÀrjestelmÀn toiminta, ruokavalio, suun mikrobiomin dysbioosi sekÀ geenimutaatiot. Tutkimusta aiheista tarvitaan lisÀÀ. HPV-infektio on suunielun syövÀn merkittÀvÀ riskitekijÀ ja siihen liittyvien suunielun syöpien ilmaantuvuus on noussut.
PienessÀ aineistossa jokaisen neljÀn potilaan syöpÀ sijaitsi kielessÀ, ja syöpÀ uusiutui. Potilaiden syövÀt todettiin keskimÀÀrÀistÀ hoitoresistentimmÀksi. Jatkossa selvitetÀÀn laajemmalla aineistoilla saman ikÀryhmÀn suusyöpiÀ histologisisten riskitekijöiden osalta
Samspelet mellan fredsprocessers utformning och spoilergruppers agerande: En fallstudie av fredsprocessen i Nordirland
The aim of this thesis is to analyze how different phases of peace processes are related to the behaviour of spoiler groups, and to illustrate this with a case study of the peace process in Northern Ireland. The thesis divides the peace process in three different phases: the prenegotiations, the official negotiations and the implementation phase. In each phase three variables are analyzed: the composition and function of the phase, the behaviour of spoiler groups and their influence on the negotiations. This study concludes that the varying composition of the different phases may lead to different types of spoiler behaviour. In the prenegotiation phase, the spoiler groups aim at manoeuvring the peace process in line with their own agenda. During the official negotiations some groups attempt to spoil the negotiations while others attempt to orientate the talks to achieve advantages for themselves. The behaviour of spoiler groups in these phases is subject to the inclusive character of the peace process, the mistrust between the parties and the lack of political progress in the negotiations. In the implementation phase, the spoiler behaviour is aimed at achieving a renegotiation of the peace accord or preventing the implementation of the agreement. The spoiler behaviour correlates with the composition of the peace accord, e.g. concerning how the accord states that the changes are to be implemented and concerning the potential gains that the accord may bring the parties
Konflikten i Colombia - en studie av faktorer i nya krig
Det har i Colombia sedan 1960-talet pÄgÄtt en konflikt mellan regeringen och olika vÀpnade grupper. Konflikten har visat sig vara svÄrlöst. Vi har utgÄtt frÄn Mary Kaldors teori om nya krig för att analysera vilken roll olika faktorer har spelat i konflikten, för att sedan kunna dra slutsatser om de har försvÄrat en konfliktlösning. De vÀpnade gruppernas ökade inblandning i narkotikahandeln har lett till att de har kunnat finansiera sin fortsatta krigföring. Konsekvenserna av detta har blivit att de delvis frÄngÄtt sin ideologiska mÄlsÀttning, dÄ de tjÀnar pÄ att upprÀtthÄlla konflikten. Vidare har vÄldet mot civilbefolkningen ökat, till följd av gruppernas nya krigföring dÀr erövring av territorium sker genom folkfördrivning och mord. Den colombianska regeringens strategier för bekÀmpning av de vÀpnade grupperna har förÀndrats för att svara mot det nya konfliktmönstret. Regeringens strategier har möjliggjorts till följ av den internationella bekÀmpningen av terrorism. Regeringens sÀkerhetsstrategi har försvÄrat lösningen av konflikten, dÄ den genom att stÀmpla gerillan som terrorister exkluderar dem frÄn den politiska arenan
The process of identifying, solving and preventing drug related problems in the LIMM-study
Objective To avoid negative effects of drug treatment and need for additional medical care, drug treatment must be individualised. Our research group has developed a model for clinical pharmacy which improves several aspects of the patient's drug treatment. This study describes the process behind these improvements, i.e. drug related problems identified by pharmacists within a clinical pharmacy service. Setting Three wards at a department of internal medicine. Method Pharmacists performed systematic interventions during the patient's hospital stay, aiming to identify, solve and prevent drug related problems in the elderly. Identified drug related problems were put forward to the health care team and discussed. Information on identified problems, and their outcomes was collected and analysed. A questionnaire was used to evaluate the health care personnel's attitudes towards the process. Main outcome measure The number of drug related problems identified by the clinical pharmacists, the proportion of problems discussed with the physicians, the proportion of problems adjusted by the physicians and whether pharmacists and physicians prioritised any subgroup of drug related problems when choosing which problems to address. Finally, we wanted to evaluate the health care personnel's attitudes towards the model. Results In total, 1,227 problem were identified in 190 patients. The pharmacists discussed 685 (55.8%) of the identified problems with the physicians who accepted 438 (63.9%) of the suggestions. There was no significant difference in which subgroup to put forward and which to adjust. There was a high response rate (84%) to the questionnaire, and the health care personnel estimated the benefits to be very high, both for the patients and for themselves. Conclusion The process for identifying, solving and preventing drug related problems was good and the different types of problems were considered equally important. The addition of a clinical pharmacy service was considered very useful. This suggests that the addition of our clinical pharmacy service to the hospital setting add skills of great importance
Is breast cancer prognosis inherited?
Introduction: A genetic component is well established in the etiology of breast cancer. It is not well known, however, whether genetic traits also influence prognostic features of the malignant phenotype. Methods: We carried out a population-based cohort study in Sweden based on the nationwide Multi-Generation Register. Among all women with breast cancer diagnosed from 1961 to 2001, 2,787 mother-daughter pairs and 831 sister pairs with breast cancer were identified; we achieved complete follow-up and classified 5-year breast cancer-specific prognosis among proband (mother or oldest sister) into tertiles as poor, intermediary, or good. We used Kaplan-Meier estimates of survival proportions and Cox models to calculate relative risks of dying from breast cancer within 5 years depending on the proband's outcome. Results: The 5-year survival proportion among daughters whose mothers died within 5 years was 87% compared to 91% if the mother was alive (p = 0.03). Among sisters, the corresponding proportions were 70% and 88%, respectively (p = 0.001). After adjustment for potential confounders, daughters and sisters of a proband with poor prognosis had a 60% higher 5-year breast cancer mortality compared to those of a proband with good prognosis (hazard ratio [HR], 1.6; 95% confidence interval [CI], 1.2 to 2.2; p for trend 0.002). This association was slightly stronger among sisters (HR, 1.8; 95% CI, 1.0 to 3.4) than among daughters (HR, 1.6; 95% CI, 1.1 to 2.3). Conclusion: Breast cancer prognosis of a woman predicts the survival in her first-degree relatives with breast cancer. Our novel findings suggest that breast cancer prognosis might be inherited
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and lowâmiddle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of âsingle-useâ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for lowâmiddle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both highâ and lowâmiddleâincome countries
Kommunikation mellan enheter i multinationella organisationer - En studie om hur kommunikationen mellan en kinesisk och en svensk enhet kan optimeras
Studien syftar till att undersöka hur en optimal kommunikation mellan enheter i multinationella
organisationer kan etableras, samt vilka möjligheter och barriÀrer sÄdana organisationer stÄr inför
gÀllande kommunikation. Den teoretiska referensramen bestÄr av olika delar som samtliga behandlar
Ă€mnet kommunikation. Tidigare forskning om interkulturell kommunikation blandas med studier om hur
tekniska kommunikationsmedel pĂ„verkar kommunikationen. Ăven studier om sprĂ„klig mĂ„ngfald,
samt en modell som beskriver kommunikationens komplexitet har anvÀnts.
Studien Àr genomförd pÄ en kinesisk enhet i en multinationell organisation, enheten har dagligen
kontakt med en annan enhet i Sverige. Intervjuerna har genomförts pÄ plats i Kina med sex
medarbetare med kinesisk bakgrund och tre medarbetare med svensk bakgrund.
Studiens resultat tyder pÄ att multinationella organisationer stÄr inför svÄrigheter med
kommunikationen mellan olika enheter, bland annat pÄ grund av att bÄda parter ofta kommunicerar pÄ
sitt andrasprÄk. Kulturella skillnader kan ocksÄ vara en barriÀr om det fÄr till följd att de olika
enheterna har olika sÀtt att kommunicera, men studien understryker att organisationer inte bör
fokusera pÄ olika nationskulturer nÀr de ska förklara och hantera kommunikativa svÄrigheter.
Avsaknaden av direktkommunikation ansikte mot ansikte Àr ocksÄ nÄgot som försvÄrar, eftersom
det leder till att organisationerna mÄste anvÀnda sig av mer datorbaserad kommunikation.
AnvÀndningen av den typen av kommunikation tar bort mÄnga av de mekanismer som finns vid
kommunikation ansikte mot ansikte och gör dÀrför kommunikationen mindre effektiv. Det krÀvs dÀrför
att organisationens medlemmar kan anvÀnda ett flertal olika kommunikationsmedel, samt Àr medvetna
om i vilken situation ett visst kommunikationsmedel bör anvÀndas. En möjlighet som identifierats Àr
att organisationerna mer medvetet kan utnyttja företagsgemensamma, i detta fall tekniska, termer
som individerna delar samma tolkningar av, för att underlÀtta för individer pÄ de olika enheterna
att förstÄ varandra. En god relation förenklar kommunikationen och multinationella företag bör
dÀrför sÀkerstÀlla att medarbetarna pÄ de olika enheterna besöker varandra, och pÄ sÄ sÀtt
förbÀttrar relationer. Besöken mÄste vara vÀlplanerade och uppfylla sitt syfte och dÀrför bör Àven
besöken, precis som de företagsgemensamma termerna, anvÀndas mer medvetet