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  • Public defence: 2018-09-28 13:15 Örebro universitet, Forumhuset, Hörsal F, Örebro
    Ekström, Cecilia
    Örebro University, Örebro University School of Business.
    Enabling and Coercive Control: Coexistence in the Case of Banking2018Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This thesis focuses on subjects of control and attitudinal outcomes of formalized control in organizations. Previous research have concluded contradicting results of whether formalized control is positive or negative for the employees and propose that not only degree of formalization, but also type of formalization, can explain attitudinal outcomes.

    With the theoretical perspective of Adler and Borys’ concepts of enabling and coercive types of control, this thesis explore the concepts and practices of enabling and coercive control, and their relationships with attitudinal outcomes. This is done with a focus on the banking industry, which serve as a case of an extensively regulated context. An assumption put forth in this thesis is that the context in which individuals are part must be considered in the study of attitudinal outcomes of control.

    The analysis show that both enabling and coercive control can be found in banking, for example in business plans and regulations. However, the picture emerging is more complex than enabling control leading to positive attitudes, and coercive control leading to negative attitudes. Also, coexistence of enabling and coercive control is responded to with decoupling and acquiescence, and by drawing on global transparency.

    Based on these findings, together with theoretical elaborations, this thesis contribute to the literature of enabling and coercive control in a number of ways. First, it make explicit central concepts and relationships within the theory, such as design vs. perception, the role of zone of indifference as an outcome of control, and enabling and coercive control as dual roles or qual-ities of control. Moreover, this thesis suggests that multiple-level explanations to attitudinal outcomes of control, where contextual and institutional structures are considered, helps us understand attitudes to control in this context. Lastly, this thesis contribute to the notion of coexistence of enabling and coercive control by showing that coexistence can be simultaneous systems, and simultaneous cognitions, where a control can be perceived as both enabling and coercive at the same time.

  • Public defence: 2018-10-04 10:00 Örebro universitet, Hörsalen, Musikhögskolan, Örebro
    Andersson, Jeanette
    Örebro University, School of Law, Psychology and Social Work.
    Omsorgsplikt och god sed i avtal om shipmanagement2018Doctoral thesis, monograph (Other academic)
    Abstract [en]

    Under Swedish law a service provider’s performance is pervaded by a duty of care (Swe: omsorgsplikt). The study deals with the meaning and significance of the duty of care in a ship management contract under which a shipmanager undertakes to carry out one or several management services in respect of the vessel as agents for and on behalf of a shipowner. The study is mainly focused on the shipmanager’s duty of care and duty to perform the management services in accordance with sound ship management practice as set out in the standard ship management agreement SHIPMAN 2009.

    The first aim of the study is to analyze and systematize the shipmanager’s duty of care in a ship management agreement. The second aim of the study is to analyze what it means to provide management services in accordance with sound ship management practice. Thirdly, the shipmanager’s duty of care is examined in relation to a service provider’s general duty of care in long term commercial relationships. To achieve these aims, a number of research questions are examined, namely:

    Regarding the meaning and extent of a shipmanager’s duty of care: What is the relevance and meaning of a service provider’s duties to act in accordance with the mandate and in the interest of the client, to follow the client’s directions, to perform the service professionally, to act with care when choosing a counterparty to the prospective contract, to take good care of the client’s property, and to give account for the services?

    Regarding the question of sound ship management practice: How does the shipmanager’s duty of care differ from the duty to perform the management services in accordance with sound ship management? Which duties to act with care and in accordancewith sound ship management practice could be required from the shipmanager as regards specific ship management processes such as the vessel operating budget, the vessel operating report, and the use of safety and quality management systems.

    In addition, the sanctions and legal consequences of a breach of the duty of care are analyzed briefly.

    The study is based on a problem- and interestoriented methodological approach with teleological considerations and weighing of different interests. Also, the study of the meaning and significance of the shipmanager’s duty of care includes certain internal as well as external comparative elements. A number of different theories of the duty of care are examined and analyzed.

    The conclusions of the study are summarised in Chapter 8. One general conclusion is that the shipmanager’s duty of care and duty to perform the management services in accordance with sound ship management practice could be viewed and serve as a management control function towards the interests of the contractual promise, the contractual relationship as well as the interest of sustainability respectively.

  • Public defence: 2018-10-05 13:00 Örebro universitet, Campus USÖ, hörsal C1, Örebro
    Ziegler, Ingrid
    Örebro University, School of Medical Sciences.
    Quantitative detection of bacterial DNA in whole blood in bloodstream infection2018Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    This thesis aims to increase the knowledge on how quantitative PCR can be used in the diagnostics of bloodstream infections, with an emphasis on quantitative elements.

    In Papers I and II, we evaluated quantitative data from two commercial PCR tests for pathogen detection directly in blood, Magicplex Sepsis (I) and SeptiFast (II), from patients with suspected sepsis. We found that high quantification cycle (Cq) values, indicating low DNA loads, were associated with findings of pathogens with doubtful clinical relevance, whereas low Cq values, indicating high DNA loads, were correlated with sepsis and septic shock, as well as with positive blood culture results.

    In Paper III, we aimed to study the bacterial DNA load during Staphylococcus aureus bacteremia, in relation to different clinical factors. For this purpose, we developed a droplet digital PCR (ddPCR) for precise DNA quantification, targeting S. aureus specifically. We found that a high initial S. aureus DNA load was associated with laboratory markers for immune dysregulation as well as with sepsis, endocarditis, and mortality.

    In Paper IV, we aimed to develop a tool for repeated DNA quantification during bloodstream infection. For this purpose, we optimized a ddPCR, targeting the universal bacterial 16S rDNA, and performed a comparison with species-specific ddPCRs on spiked blood, and on clinical samples. The performance of the16S rDNA ddPCR was adequate, and we found that a high 16S rDNA load was associated with sepsis and mortality.

    In conclusion, our results indicate that the pathogen DNA load in blood plays an important role in the clinical picture in BSI. In future research on molecular BSI diagnostics, studies on DNA loads and clearance should be included.

    List of papers
    1. Evaluation of a Commercial Multiplex PCR Assay for Detection of Pathogen DNA in Blood from Patients with Suspected Sepsis
    Open this publication in new window or tab >>Evaluation of a Commercial Multiplex PCR Assay for Detection of Pathogen DNA in Blood from Patients with Suspected Sepsis
    2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 12, article id e0167883Article in journal (Refereed) Published
    Abstract [en]

    The Magicplex Sepsis Real-time Test (MST) is a commercial multiplex PCR that can detect more than 90 different pathogens in blood, with an analysis time of six hours. The aim of the present study was to evaluate this method for the detection of bloodstream infection (BSI). An EDTA whole blood sample for MST was collected together with blood cultures (BC) from patients with suspected sepsis at the Emergency Department of a university hospital. Among 696 study patients, 322 (46%) patients were positive with at least one method; 128 (18%) were BC positive and 268 (38%) were MST positive. Considering BC to be the gold standard, MST had an overall sensitivity of 47%, specificity of 66%, positive predictive value (PPV) of 23%, and a negative predictive value of 87%. Among the MST positive samples with a negative BC, coagulase-negative staphylococci (CoNS) and species that rarely cause community-acquired BSI were frequently noted. However, the quantification cycle (Cq) values of the MST+/BC- results were often high. We thus hypothesized that the performance of the MST test could be improved if the Cq cut-off level was adjusted downwards. With a lower Cq cut-off value, i.e. 6.0 for Staphylococcus species and 9.0 for all other species, the number of MST positive cases decreased to 83 (12%) and the overall sensitivity decreased to 38%. However, the PPV increased to 59% and the specificity increased to 96%, as many MST positive results for CoNS and bacteria that rarely cause community-acquired BSI turned MST negative. In conclusion, our study shows that with a lower Cq cut-off value, the MST will detect less contaminants and findings with unclear relevance, but to the cost of a lower sensitivity. Consequently, we consider that a positive MST results with a Cq value above the adjusted cut-off should be interpreted with caution, as the result might be clinically irrelevant. In a correspondent way, quantitative results could probably be useful in the interpretation of positive results from other molecular assays for the detection of BSI.

    Place, publisher, year, edition, pages
    San Francisco, USA: Public Library of Science, 2016
    National Category
    Clinical Laboratory Medicine
    Identifiers
    urn:nbn:se:oru:diva-54404 (URN)10.1371/journal.pone.0167883 (DOI)000392842900017 ()27997618 (PubMedID)2-s2.0-85006866953 (Scopus ID)
    Note

    Funding Agency:

    Resaerch committee of Region Örebro Län

    Available from: 2017-02-07 Created: 2017-01-10 Last updated: 2018-09-12Bibliographically approved
    2. Quantitative data from the SeptiFast real-time PCR is associated with disease severity in patients with sepsis
    Open this publication in new window or tab >>Quantitative data from the SeptiFast real-time PCR is associated with disease severity in patients with sepsis
    Show others...
    2014 (English)In: BMC Infectious Diseases, ISSN 1471-2334, E-ISSN 1471-2334, Vol. 14, no 1, article id 155Article in journal (Refereed) Published
    Abstract [en]

    Background: The commercial test, SeptiFast, is designed to detect DNA from bacterial and fungal pathogens in whole blood. The method has been found to be specific with a high rule-in value for the early detection of septic patients. The software automatically provides information about the identified pathogen, without quantification of the pathogen. However, it is possible to manually derive Crossing point (Cp) values, i.e. the PCR cycle at which DNA is significantly amplified. The aim of this study was to find out whether Cp values correlate to disease severity.

    Methods: We used a study cohort of patients with positive results from SeptiFast tests for bacteria from a recent study which included patients with suspected sepsis in the Emergency department. Cp values were compared with disease severity, classified as severe sepsis/septic shock or non-severe sepsis, according to the criteria of the American College of Chest Physicians/Society of Critical Care Medicine.

    Results: Ninety-four patients were included. The prevalence of severe sepsis/septic shock in the study was 29%. SeptiFast positive tests from patients with severe sepsis/septic shock had significantly lower Cp values compared with those from patients with non-severe sepsis, median 16.9 (range: 7.3 - 24.3) versus 20.9 (range: 8.5 - 25.0), p < 0.001. Positive predictive values from the SeptiFast test for identifying severe sepsis/septic shock were 34% at Cp cut-off <25.0, 35% at Cp cut-off <22.5, 50% at Cp cut-off <20.0, and 73% at Cp cut-off <17.5. Patients with a positive Septifast test with a Cp value <17.5 had significantly more severe sepsis/septic shock (73% versus 15%, p < 0.001), were more often admitted to the Intensive Care Unit (23% versus 4%, p = 0.016), had positive blood culture (BC) more frequently (100% versus 32%, p < 0.001) and had longer hospital stays (median 19.5 [range: 4 - 78] days versus 5 [range: 0 - 75] days, p < 0.001) compared with those with a Cp value >17.5.

    Conclusions: Our results suggest that introducing quantitative data to the SeptiFast test could be of value in assessing sepsis severity. Moreover, such data might also be useful in predicting a positive BC result.

    Place, publisher, year, edition, pages
    London: BioMed Central, 2014
    Keywords
    Polymerase-chain-reaction, blood-stream infections, staphylococcus-aureus bacteremia, genomic bacterial load, rapid detection, united-states, pathogens, diagnosis, culture, epidemiology
    National Category
    Infectious Medicine
    Research subject
    Infectious Diseases
    Identifiers
    urn:nbn:se:oru:diva-34951 (URN)10.1186/1471-2334-14-155 (DOI)000333601600004 ()24656148 (PubMedID)2-s2.0-84899124239 (Scopus ID)
    Note

    Funding Agency:

    Research Committee of the Örebro County Council

    Available from: 2014-05-05 Created: 2014-05-05 Last updated: 2018-09-12Bibliographically approved
    3. nuc DNA in Whole blood in Relation to Immune dysregulation, Sepsis, and Mortality in Staphylococcus aureus Bacteremia
    Open this publication in new window or tab >>nuc DNA in Whole blood in Relation to Immune dysregulation, Sepsis, and Mortality in Staphylococcus aureus Bacteremia
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    (English)Manuscript (preprint) (Other academic)
    National Category
    General Practice
    Identifiers
    urn:nbn:se:oru:diva-68880 (URN)
    Available from: 2018-09-12 Created: 2018-09-12 Last updated: 2018-09-12Bibliographically approved
    4. 16S rDNA droplet digital PCR for monitoring bacterial DNAemia in bloodstream infections
    Open this publication in new window or tab >>16S rDNA droplet digital PCR for monitoring bacterial DNAemia in bloodstream infections
    Show others...
    (English)Manuscript (preprint) (Other academic)
    National Category
    General Practice
    Identifiers
    urn:nbn:se:oru:diva-68881 (URN)
    Available from: 2018-09-12 Created: 2018-09-12 Last updated: 2018-09-12Bibliographically approved
  • Public defence: 2018-10-05 13:15 Örebro universitet, Forumhuset, Hörsal F, Örebro
    Bajramović, Sanela
    Örebro University, School of Humanities, Education and Social Sciences.
    Hierarchical Sisterhood: Supporting Women's Peacebuilding through Swedish Aid to Bosnia and Herzegovina 1993-20132018Doctoral thesis, monograph (Other academic)
    Abstract [en]

    This dissertation examines possibilities and challenges faced by international interveners in a post-socialist and violently divided area. The study object is the Swedish foundation Kvinna till Kvinna, formed in 1993 during the Bosnian war, originating from the peace movement and supported by the Swedish government aid agency Sida. The aim is to contextualize and analyze Kvinna till Kvinna’s two decades of engagement in peacebuilding in Bosnia. The encounter with domestic women’s NGOs is of particular interest. By focusing on rhetoric, practice and silences, the ambition has been to understand the international/local relationship from the perspective of both actors.

      In terms of methodology, this study combines a hermeneutic approach with that of oral history. The empirical material utilized consists of both written and oral sources, the majority of which appear in research for the first time. To capture the complexity of the peacebuilding endeavor, critically scrutinize it and discern its benevolence, this research draws inspiration from postcolonial and semiperipherality theories, as well as influential theorizing on peacebuilding, sisterhood and solidarity.

      This study shows that even well-intentioned, locally-focused external efforts, constrained by donor agendas and circumstances on the ground, contain problematic characteristics common in the era of liberal peace. While subscribing to the idea of transnational sisterhood, Kvinna till Kvinna also presented a belief in Swedish supremacy and demonstrated a lack of interest in local knowledge. It sought to educate and change its Bosnian counterparts by using soft methods. Further, the findings challenge idealized images of the ‘local’ as a peace-loving force for change and a powerless victim of Western domination. The hierarchical sisterhood that over time evolved between the two actors, founded on basic shared values related to women’s situation, was driven by mutual benefit. Acknowledging advantages of this type of transnational encounters in peacebuilding contexts, the study raises questions about dilemmas in them and underlines the importance of rhetorical listening.

  • Public defence: 2018-10-17 09:00 Örebro universitet, Gymnastik- och idrottshuset, Hörsal G, Örebro
    Folkesson, Mattias
    Örebro University, School of Health Sciences.
    Heat shock proteins in exercised human skeletal muscle2018Doctoral thesis, comprehensive summary (Other academic)
  • Public defence: 2018-10-26 10:00 Örebro universitet, Långhuset, Hörsal L2, Örebro
    Lagin, Madelen
    Örebro University, Örebro University School of Business.
    The Price We Pay: The Autonomy of Store Managers in Making Price Decisions2018Doctoral thesis, comprehensive summary (Other academic)
  • Public defence: 2018-10-26 13:15 Örebro universitet, Prismahuset, Hörsal P1, Örebro
    Adenskog, Magnus
    Örebro University, School of Humanities, Education and Social Sciences.
    Democratic innovations in political systems: towards a systemic approach2018Doctoral thesis, comprehensive summary (Other academic)
  • Public defence: 2018-11-16 09:00 Örebro universitet, Campus USÖ, hörsal C3, Örebro
    Carling, Anna
    Örebro University, School of Medical Sciences.
    Nedsatt balans och fallrisk vid multipel skleros2018Doctoral thesis, comprehensive summary (Other academic)
  • Public defence: 2018-11-16 13:00 Örebro universitet, Campus USÖ, hörsal C2, Örebro
    Björkman Hjalmarsson, Louise
    Örebro University, School of Medical Sciences.
    Aspects on neonatal septicaemia - prevention and complications2018Doctoral thesis, comprehensive summary (Other academic)
  • Public defence: 2018-11-23 09:00 Örebro universitet, Campus USÖ, hörsal C3, Örebro
    Hildén, Karin
    Örebro University, School of Medical Sciences.
    Gestational diabetes, obesity and adverse pregnancy outcomes in Sweden2018Doctoral thesis, comprehensive summary (Other academic)