Integrated and seamless?:Single Parents’ Experiences of Cross-Organizational Interaction

The lack of integration of public organizations and services is a recurring challenge for scholars, policymakers, and citizens. Within the e-government field, scholars have presented web-stage models, which predict that digitization will lead to a fully integrated public sector and seamless user journeys for citizens. Although these models have not delivered on their promises, scholars and policymakers still regard digitization as a means to integrate the public sector, achieve efficiency gains, and improve service quality. We argue that the web-stage models overlook barriers to integration, as they are mostly conceptual, and primarily focus on the potential of technology, rather than its actual implementation and use. Moreover, the models occur on the organizational level of analysis and ignore citizens and their actual experiences. Therefore, we present an empirical study of how citizens experience crossorganizational interaction during benefit application following a family break-up or divorce. Through observations, contextual interviews, focus group discussions and workshops we identify seven challenges citizens experience. These challenges make citizens aware that they are interacting with different organizations and break their experience of an integrated public sector. Further, the challenges cause citizens to turn from the digital channels towards traditional channels to complete their interaction. Thus, the lack of integration challenge both citizens’ satisfaction and efficiency gains from public sector digitalization

The effects of centralised and specialised combined pharmacological and psychological intervention compared with decentralised and non-specialised treatment in the early course of severe unipolar and bipolar affective disorders - design of two randomised clinical trials

<p>Abstract</p> <p>Background</p> <p>In unipolar, and bipolar affective disorders, there is a high risk of relapse that increases as the number of episodes increases. Naturalistic follow-up studies suggest that the progressive development of the diseases is not prevented with the present treatment modalities. It is not known whether centralised and specialised secondary care intervention initiated early after the onset of the diseases can prevent the progression and thereby improve the prognosis.</p> <p>Methods</p> <p>Two randomised clinical multi-centre trials comparing a centralised and specialised outpatient intervention program consisting of combined pharmacological and psychological intervention with standard decentralised psychiatric treatment. Patients discharged from their first, second, or third hospitalisation due to a manic episode or bipolar disorder (trial 1) or to a single depressive episode or recurrent depressive disorder (trial 2) were randomised. Central randomisations for both trials were stratified for the number of hospitalisations and treatment centre. The primary outcome measure for the two trials is time to re-hospitalisation with an affective episode.</p> <p>Discussion</p> <p>These trials are the first to evaluate the effect of a centralised and specialised intervention in patients with early severe affective disorders. The trials used a pragmatic design comparing a specialised mood disorder clinic intervention with decentralised, non-specialised standard psychiatric treatment.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00253071">NCT00253071</a></p

Metaproteomics of saliva identifies human protein markers specific for individuals with periodontitis and dental caries compared to orally healthy controls

Background The composition of the salivary microbiota has been reported to differentiate between patients with periodontitis, dental caries and orally healthy individuals. To identify characteristics of diseased and healthy saliva we thus wanted to compare saliva metaproteomes from patients with periodontitis and dental caries to healthy individuals. Methods Stimulated saliva samples were collected from 10 patients with periodontitis, 10 patients with dental caries and 10 orally healthy individuals. The proteins in the saliva samples were subjected to denaturing buffer and digested enzymatically with LysC and trypsin. The resulting peptide mixtures were cleaned up by solid-phase extraction and separated online with 2 h gradients by nano-scale C18 reversed-phase chromatography connected to a mass spectrometer through an electrospray source. The eluting peptides were analyzed on a tandem mass spectrometer operated in data-dependent acquisition mode. Results We identified a total of 35,664 unique peptides from 4,161 different proteins, of which 1,946 and 2,090 were of bacterial and human origin, respectively. The human protein profiles displayed significant overexpression of the complement system and inflammatory markers in periodontitis and dental caries compared to healthy controls. Bacterial proteome profiles and functional annotation were very similar in health and disease. Conclusions Overexpression of proteins related to the complement system and inflammation seems to correlate with oral disease status. Similar bacterial proteomes in healthy and diseased individuals suggests that the salivary microbiota predominantly thrives in a planktonic state expressing no disease-associated characteristics of metabolic activity

Forsyningskæder i forandring konsekvenser for logistik og transport

En omfattende og grundlæggende forandring af logistik- og godstransportmarkedet i Europa er i gang. Drivkræfterne i denne forandringsproces er bl.a. teknologisk udvikling, globalisering af samhandelsrelationerne og deraf følgende vækst i transportindhold. Alle disse udviklinger resulterer i strukturelle forandringer i den europæiske transportsektor bl.a. kendetegnet ved at kompleksiteten i forsyningskæderne og det samlede transportsystem forøges. I dette paper sammenfattes hovedresultaterne fra et projekt, der afklarer hvordan globaliseringen påvirker danske forsyningskæder og distributionssystemer, samt hvilke konsekvenser det har for logistik og godstransport i fremtiden. Resultaterne af undersøgelsen viser, at forsyningskæder påvirkes af globaliseringen, men konsekvenserne for logistik og transport afhænger af den specifikke kæde. Globaliseringen resulterer i et øget behov for transporter mellem kontinenterne og/eller landene, men transportindholdet i kæden behøver ikke nødvendigvis at stige i samme omfang, da tilpasningen af logistikken giver muligheder for effektiviseringer. Derfor er det nødvendigt at forholde sig til de enkelte kæders særpræg for at kunne vurdere ydre påvirkningers effekter på de konkrete kæder og konsekvenser heraf for logistik og godstransport