Going Digital First while Safeguarding the Physical Core: How an Automotive Incumbent Searches for Relevance in Disruptive Times

Incumbent firms typically face significant risk of losing the relevance of their physical core when facing industry disruption driven by digital technologies. Existing literature emphasizes a digital first approach, whereby firm offerings are fundamentally redeveloped from a digital point of view, from the point of conception. While this prescription can help accelerate innovation, it does not tell us how incumbents might safeguard the relevance of their traditional physical core resources when going digital first. This is important, since major discontinuities in strategic repositioning, while often celebrated in digital innovation and transformation literature, create significant risks to firm survival. To this end, we conduct a grounded analysis of a European automotive firm’s innovation journey over an eight-year period. We contribute to the digital innovation and transformation literature by developing a process model explaining how a digital first approach can be employed in a way that also safeguards the physical core

Baseline data from a planned RCT on attitudes to female genital cutting after migration: when are interventions justified?

OBJECTIVES: To present the primary outcomes from a baseline study on attitudes towards female genital cutting (FGC) after migration. DESIGN: Baseline data from a planned cluster randomised, controlled trial. Face-to-face interviews were used to collect questionnaire data in 2015. Based on our hypothesis that established Somalis could be used as facilitators of change among those newly arrived, data were stratified into years of residency in Sweden. SETTING: Sweden. PARTICIPANTS: 372 Somali men and women, 206 newly arrived (0-4 years), 166 established (>4 years). PRIMARY OUTCOME MEASURES: Whether FGC is acceptable, preferred for daughter and should continue, specified on anatomical extent. RESULTS: The support for anatomical change of girls and women's genitals ranged from 0% to 2% among established and from 4% to 8% among newly arrived. Among those supporting no anatomical change, 75%-83% among established and 53%-67% among newly arrived opposed all forms of FGC, with the remaining supporting pricking of the skin with no removal of tissue. Among newly arrived, 37% stated that pricking was acceptable, 39% said they wanted their daughter to be pricked and 26% reported they wanted pricking to continue being practised. Those who had lived in Sweden ≤ 2 years had highest odds of supporting FGC; thereafter, the opposition towards FGC increased over time after migration. CONCLUSION: A majority of Somali immigrants, including those newly arrived, opposed all forms of FGC with increased opposition over time after migration. The majority of proponents of FGC supported pricking. We argue that it would have been unethical to proceed with the intervention as it, with this baseline, would have been difficult to detect a change in attitudes given that a majority opposed all forms of FGC together with the evidence that a strong attitude change is already happening. Therefore, we decided not to implement the planned intervention. TRIAL REGISTRATION NUMBER: Trial registration number NCT02335697;Pre-results

Causes of death among undocumented migrants in Sweden, 1997–2010

Background: Undocumented migrants are one of the most vulnerable groups in Swedish society, where they generally suffer from poor health and limited health care access. Due to their irregular status, such migrants are an under-researched group and are not included in the country's Cause of Death Register (CDR). Objective: To determine the causes of death among undocumented migrants in Sweden and to ascertain whether there are patterns in causes of death that differ between residents and undocumented migrants. Design: This is a cross-sectional study of death certificates issued from 1997 to 2010 but never included in the CDR from which we established our study sample of undocumented migrants. As age adjustments could not be performed due to lack of data, comparisons between residents and undocumented migrants were made at specific age intervals, based on the study sample's mean age at death±a half standard deviation. Results: Out of 7,925 individuals surveyed, 860 were classified as likely to have been undocumented migrants. External causes (49.8%) were the most frequent cause of death, followed by circulatory system diseases, and then neoplasms. Undocumented migrants had a statistically significant increased risk of dying from external causes (odds ratio [OR] 3.57, 95% confidence interval [CI]: 2.83–4.52) and circulatory system diseases (OR 2.20, 95% CI: 1.73–2.82) compared to residents, and a lower risk of dying from neoplasms (OR 0.07, 95% CI: 0.04–0.14). Conclusions: We believe our study is the first to determine national figures on causes of death of undocumented migrants. We found inequity in health as substantial differences in causes of death between undocumented migrants and residents were seen. Legal ambiguities regarding health care provision must be addressed if equity in health is to be achieved in a country otherwise known for its universal health coverage

Metabolism during anaesthesia and recovery in colic and healthy horses: a microdialysis study

<p>Abstract</p> <p>Background</p> <p>Muscle metabolism in horses has been studied mainly by analysis of substances in blood or plasma and muscle biopsy specimens. By using microdialysis, real-time monitoring of the metabolic events in local tissue with a minimum of trauma is possible. There is limited information about muscle metabolism in the early recovery period after anaesthesia in horses and especially in the colic horse. The aims were to evaluate the microdialysis technique as a complement to plasma analysis and to study the concentration changes in lactate, pyruvate, glucose, glycerol, and urea during anaesthesia and in the recovery period in colic horses undergoing abdominal surgery and in healthy horses not subjected to surgery.</p> <p>Methods</p> <p>Ten healthy university-owned horses given anaesthesia alone and ten client-owned colic horses subjected to emergency abdominal surgery were anaesthetised for a mean (range) of 230 min (193–273) and 208 min (145–300) respectively. Venous blood samples were taken before anaesthesia. Venous blood sampling and microdialysis in the gluteal muscle were performed during anaesthesia and until 24 h after anaesthesia. Temporal changes and differences between groups were analysed with an ANOVA for repeated measures followed by Tukey Post Hoc test or Planned Comparisons.</p> <p>Results</p> <p>Lactate, glucose and urea, in both dialysate and plasma, were higher in the colic horses than in the healthy horses for several hours after recovery to standing. In the colic horses, lactate, glucose, and urea in dialysate, and lactate in plasma increased during the attempts to stand. The lactate-to-pyruvate ratio was initially high in sampled colic horses but decreased over time. In the colic horses, dialysate glycerol concentrations varied considerably whereas in the healthy horses, dialysate glycerol was elevated during anaesthesia but decreased after standing. In both groups, lactate concentration was higher in dialysate than in plasma. The correspondence between dialysate and plasma concentrations of glucose, urea and glycerol varied.</p> <p>Conclusion</p> <p>Microdialysis proved to be suitable in the clinical setting for monitoring of the metabolic events during anaesthesia and recovery. It was possible with this technique to show greater muscle metabolic alterations in the colic horses compared to the healthy horses in response to regaining the standing position.</p

Metabolism before, during and after anaesthesia in colic and healthy horses

<p>Abstract</p> <p>Background</p> <p>Many colic horses are compromised due to the disease state and from hours of starvation and sometimes long trailer rides. This could influence their muscle energy reserves and affect the horses' ability to recover. The principal aim was to follow metabolic parameter before, during, and up to 7 days after anaesthesia in healthy horses and in horses undergoing abdominal surgery due to colic.</p> <p>Methods</p> <p>20 healthy horses given anaesthesia alone and 20 colic horses subjected to emergency abdominal surgery were anaesthetised for a mean of 228 minutes and 183 minutes respectively. Blood for analysis of haematology, electrolytes, cortisol, creatine kinase (CK), free fatty acids (FFA), glycerol, glucose and lactate was sampled before, during, and up to 7 days after anaesthesia. Arterial and venous blood gases were obtained before, during and up to 8 hours after recovery. Gluteal muscle biopsy specimens for biochemical analysis of muscle metabolites were obtained at start and end of anaesthesia and 1 h and 1 day after recovery.</p> <p>Results</p> <p>Plasma cortisol, FFA, glycerol, glucose, lactate and CK were elevated and serum phosphate and potassium were lower in colic horses before anaesthesia. Muscle adenosine triphosphate (ATP) content was low in several colic horses. Anaesthesia and surgery resulted in a decrease in plasma FFA and glycerol in colic horses whereas levels increased in healthy horses. During anaesthesia muscle and plasma lactate and plasma phosphate increased in both groups. In the colic horses plasma lactate increased further after recovery. Plasma FFA and glycerol increased 8 h after standing in the colic horses. In both groups, plasma concentrations of CK increased and serum phosphate decreased post-anaesthesia. On Day 7 most parameters were not different between groups. Colic horses lost on average 8% of their initial weight. Eleven colic horses completed the study.</p> <p>Conclusion</p> <p>Colic horses entered anaesthesia with altered metabolism and in a negative oxygen balance. Muscle oxygenation was insufficient during anaesthesia in both groups, although to a lesser extent in the healthy horses. The post-anaesthetic period was associated with increased lipolysis and weight loss in the colic horses, indicating a negative energy balance during the first week post-operatively.</p

Technology as an extension of the human body : Exploring the potential role of technology in an elderly home care setting

The present thesis explores the potential role and implications of technology in elderly care from the users’ perspective. This exploration is undertaken in terms of five empirical studies of a telehealth project and a meta-analysis of their contributions. An important insight emerging from this work is the need to rethink the human subject as a body, rather than as a mere mind using technology. The thesis draws on phenomenology to reconceptualize the user of technology, and on this basis, to theorize about the potential role and implications of technology in care. It concludes that, in combination with humans that integrate technology with their other sensory and emotional capacities, technology can produce affect. The findings indicate that technology can contribute to senior citizens feeling safe, cared for and thereby less isolated. The findings further demonstrate that, because of the perceptual capacity gained from technology, the care workers become aware of new health problems that urgently call for their sensory and emotional responsiveness. On this ground, the thesis challenges the determinist view that technology threatens the essentially ‘human’ aspect; rather, it concludes that feeling and other bodily resources are fundamental in the use of technology. Indeed, technology activates such ‘human’ capabilities. Hence, technology plays a role as a complement for rather than as a replacement of care workers. It increases their work burden by informing them about new needs. This may improve care quality but at an increased cost, which is relevant from a practical perspective. At a more general level, the thesis challenges the dualist legacies in mainstream management research that have sought to divorce mind form body, nature from culture and reason from emotion. It can therefore contribute to broader theoretical developments and fuel existing debates beyond the care setting

Kvarboende och äldrevård i hemmet med modern teknik - vad hämmar utvecklingen?

Trots en förväntad framtid, med en växande äldremarknad som till en del är beredd att betala mer för bra vård, klart uttalade och allt större vårdbehov, ökande svårigheter att rekrytera vårdpersonal och en pressad ekonomi inom den svenska vården, har ingen marknadsmässig efterfrågan på tekniklösningar för äldrevård i hemmet etablerats i Sverige, och därmed inget motsvarande utbud. Den utveckling som hittills skett inom området har i stor utsträckning drivits av autonoma eldsjälar inom vården eller leverantörssidan och de försöksprojekt som initierats har ofta genomförts isolerat. Teknikens fulla effektiviseringspotential har därmed inte alltid realiserats. Vidare har utvärderingar av projekten i många fall varit ofullständiga. Generellt ligger orsakerna till den långsamma utvecklingstakten hos såväl teknikleverantörer som inom vården; sällan i brister i själva grundtekniken men ofta i dialogen mellan leverantörer och vårdgivare. Andra djupa orsaker står att finna i vårdsektorns komplexa organisation och ofta slutna disparat IT-system. Denna rapport påvisar att det finns en stor latent marknad för de teknik- och tjänsteleverantörer som baserar sin utveckling på verkliga behov, vars lösningar är anpassade till slutanvändarnas situation och - inte minst - som lyckas föra fram ett budskap som genererar en betalningsvilja hos den aktuella målgruppen.äldrevård i hemmet; tekniklösningar för äldrevård;

Svensk invandring och arbetsmarknaden

Kan invandring bidra till försörjningen av det stora antalet pensionärer som förväntas i framtiden? Forskning visar att de ekonomiska konsekvenser som invandring medför i mottagarlandet beror på hur väl invandrare integreras på arbetsmarknaden. Det finns i detta avseende stora skillnader bland arbetskraftsinvandrare och flyktingar som kommit till Sverige under efterkrigstiden. Det är vidare osäkert i vilken grad emigranter i framtiden kommer att söka sig till Sverige. Detta är sannolikt relaterat till hur väl dagens invandrare assimileras ekonomiskt.invandring; migration; arbetsmarknad