Vindkraft i Dalarna : Från acceptans och lokalisering till planering och eftertanke

This thesis examines prerequisites for wind power diffusion in a county in Sweden that quite recently was concidered to be of interest for electricty production from renewable energy sources. Three different municipalities: Falun, Mora and Orsa in the county of Dalarna are highlighted.  Their view on permitting processes of wind power installations are investigated. Other actors, such as exploiters and local citizens are also being analysed. This study shows that the local acceptance was very high when the first wind power parks were built, much thanks to local politicians and local citizens. For the politicians the wind power symbolised a key to a better green society, for the local citizens the wind power meant some economical advantages. The first wind power parks were localised to areas because of good wind conditions and social factors, especially from local communities. However, results from this study shows that the acceptance for wind power the last few years, in generel, has decreased.  The local authorities have also been conscious of some negative consequenses from already built wind power parks.  As a response they started to add planning tools to the permitting process.

Kvinnors upplevelser av fosterrörelser i slutet av graviditeten

Bakgrund: Det finns begränsad kunskap om hur kvinnor upplever fosterrörelser i slutet av graviditeten. Ökad kunskap om fosterrörelser kan bidra till bättre möjligheter att identifiera foster som riskerar att dö intrauterint. Syfte: Att utforska hur gravida kvinnor upplever fosterrörelser i slutet av en okomplicerad graviditet samt hur mammor som mist ett barn i livmodern upplevt kontakten med barnet tiden före beskedet att barnet hade dött. Metod: Delstudie I, djupintervjuer med 26 mammor vars barn dött före födelsen, efter 28 fullgångna graviditetsveckor. Delstudie II, frågeformulär till 393 kvinnor med okomplicerad graviditet som besvarades i graviditetsvecka 37 till 42. Svaren analyserades i båda studierna med kvalitativ innehållsanalys. Resultat: 22 mammor i delstudie I beskrev att de hade haft en föraning om att något kunde ha hänt deras barn innan de fick besked att barnet dött intrauterint. Föraningen grundades på att mammorna hade upplevt minskade eller uteblivna fosterrörelser. Det är något som inte stämmer; formulerades som ett sammanfattande tema på mammornas föraning. Processen mot insikten om att deras barn dött beskrivs i olika steg; Inte känna kontakt med barnet; Känna oro; Känna att något är fel; Inte begripa det ofattbara; Vilja få besked; Vara säker på att barnet har dött. I delstudie II beskrev 383 (96 %) kvinnor i fullgången okomplicerad graviditet olika rörelser som klassificerades som kraftfulla rörelser. De flesta kvinnorna beskrev flera typer av rörelser, tio (4 %) kvinnor beskrev fosterrörelser som inte inkluderade någon rörelse i kategorin kraftfulla rörelser. Konklusion: Mammor som mist sitt barn före födelsen hade känt en föraning om att deras väntade barn kunde må dåligt, de hade upplevt att de tappat kontakten med barnet innan de fick besked att barnet hade dött i livmodern men normaliserade känslan. De flesta kvinnor med okomplicerad, fullgången graviditet, beskriver att barnet rör sig med kraft och tryck, få kvinnor beskriver rörelser som inte kan kategoriseras som kraftfulla. Implikationer: Blivande mammor bör uppmanas att lita på sin upplevelse av att det är något som inte stämmer och kontakta sjukvården direkt om de är bekymrade över sitt ofödda barns rörelser. Bedömning av fosterrörelser i fullgången graviditet kan inkludera: förekomst, frekvens och intensitet. Nyckelord: Innehållsanalys, fosterdöd, fosterrörelser, fullgången graviditet, upplevelser

Strategisk utveckling och ekonomistyrning : Ett livscykelperspektiv

This dissertation synthesizes previous research and develops a model for the study of strategic development, strategic congruence and management control. The model is used to analyze a longitudinal case study of the Swedish engineering company Atlas Copco. Employing contingency theory, the study confirms that long-term survival of a company requires adaption to contingencies. Three levels of strategy are examined: corporate, business and functional. Previous research suggests that consistency between these levels (strategic congruence) is necessary for a company to be competitive. The dissertation challenges this proposition by using a life-cycle perspective and analyzes strategic congruence in the different phases of a life cycle. It also studies management control from a life-cycle perspective. In this context, two types of management control are examined: formal and informal. From a longitudinal perspective, the study further discusses how these types interact during organizational life cycles. The dissertation shows that strategic development is more complex than previous studies have indicated. It is a long, complex and non-linear process, the results of which cannot always be predicted. Previous models for strategy and management control are based on simple relationships and rarely take into account the fact that companies often go through different phases of strategic development. The case study shows that strategic incongruence may occur at times during organizational life cycles. Furthermore, the use of management control varies over time. In the maturity phase, formal control is in focus, while the use of informal control has a bigger role in both the introduction and decline phases. Research on strategy and management control has intensified in recent years. Still there is a gap regarding the coordination of complex corporate structures. The present study contributes with further knowledge on how companies manage long-term strategic development. Few studies deal with more than two levels of strategy. Moreover, the present study addresses the need to understand strategic congruence from a life-cycle perspective. This is particularly relevant in practice, when management in large companies face difficult issues for which they expect business research to assist them in the decision-making process.

Comparison of treatment of incomplete abortion with misoprostol by physicians and midwives at district level in Uganda : a randomised controlled equivalence trial

BACKGROUND: Misoprostol is established for the treatment of incomplete abortion but has not been systematically assessed when provided by midwives at district level in a low-resource setting. We investigated the effectiveness and safety of midwives diagnosing and treating incomplete abortion with misoprostol, compared with physicians. METHODS: We did a multicentre randomised controlled equivalence trial at district level at six facilities in Uganda. Eligibility criteria were women with signs of incomplete abortion. We randomly allocated women with first-trimester incomplete abortion to clinical assessment and treatment with misoprostol either by a physician or a midwife. The randomisation (1:1) was done in blocks of 12 and was stratified for study site. Primary outcome was complete abortion not needing surgical intervention within 14-28 days after initial treatment. The study was not masked. Analysis of the primary outcome was done on the per-protocol population with a generalised linear-mixed effects model. The predefined equivalence range was -4% to 4%. The trial was registered at ClinicalTrials.gov, number NCT01844024. FINDINGS: From April 30, 2013, to July 21, 2014, 1108 women were assessed for eligibility. 1010 women were randomly assigned to each group (506 to midwife group and 504 to physician group). 955 women (472 in the midwife group and 483 in the physician group) were included in the per-protocol analysis. 452 (95·8%) of women in the midwife group had complete abortion and 467 (96·7%) in the physician group. The model-based risk difference for midwife versus physician group was -0·8% (95% CI -2·9 to 1·4), falling within the predefined equivalence range (-4% to 4%). The overall proportion of women with incomplete abortion was 3·8% (36/955), similarly distributed between the two groups (4·2% [20/472] in the midwife group, 3·3% [16/483] in the physician group). No serious adverse events were recorded. INTERPRETATION: Diagnosis and treatment of incomplete abortion with misoprostol by midwives is equally safe and effective as when provided by physicians, in a low-resource setting. Scaling up midwives' involvement in treatment of incomplete abortion with misoprostol at district level would increase access to safe post-abortion care. FUNDING: The Swedish Research Council, Karolinska Institutet, and Dalarna University.

Gymnasisters skrivande : En studie av genre, textstruktur och sammanhang

Students in upper secondary school write in a number of different genres, and do this in school contexts as well as in their spare time. The study presented here is an overview of this activity and the genres concerned. The theoretical framework of the study is that of genre theory whereby genre is understood as a socially situated concept. The study is based on 2 000 texts gathered from students on different study programmes all over Sweden in the school year of 1996-97. The texts were written in different situations. The most important distinction made here is between test texts (i.e. texts from national tests) and self-chosen texts, which may come from schoolwriting or spare-time writing. The texts are categorized according to genre. This text inventory shows a repertoire of 33 different genres in the text material. A small number of genres, such as story, book-review and expository essay dominate the school writing. The test genres differ from this pattern in that they clearly imitate texts with a genuine communicative intent. The most frequent genres are studied further and each of them is demonstrated by an interpretative reading. This reading shows that the genres differ considerably with respect to genre character and stability of text structure. A quantitative study of text length and variation in vocabulary further shows that texts written by two categories of students, those on vocationally oriented programmes and those on programmes preparing for higher education, differ significantly. Reference cohesion is studied in a smaller sample of the texts. This lexico-semantic mechanism of cohesion proves to exhibit an interrelation with variation in vocabulary as well as with text type. One particular cohesive tie, inference, shows different patterns in texts written by the two categories of students mentioned above.

Women's acceptability of misoprostol treatment for incomplete abortion by midwives and physicians : secondary outcome analysis from a randomized controlled equivalence trial at district level in Uganda

OBJECTIVE: This study aimed to assess women´s acceptability of diagnosis and treatment of incomplete abortion with misoprostol by midwives, compared with physicians. METHODS: This was an analysis of secondary outcomes from a multi-centre randomized controlled equivalence trial at district level in Uganda. Women with first trimester incomplete abortion were randomly allocated to clinical assessment and treatment with misoprostol by a physician or a midwife. The randomisation (1:1) was done in blocks of 12 and stratified for health care facility. Acceptability was measured in expectations and satisfaction at a follow up visit 14-28 days following treatment. Analysis of women's overall acceptability was done using a generalized linear mixed-effects model with an equivalence range of -4% to 4%. The study was not masked. The trial is registered at ClinicalTrials.org, NCT 01844024. RESULTS: From April 2013 to June 2014, 1108 women were assessed for eligibility of which 1010 were randomized (506 to midwife and 504 to physician). 953 women were successfully followed up and included in the acceptability analysis. 95% (904) of the participants found the treatment satisfactory and overall acceptability was found to be equivalent between the two study groups. Treatment failure, not feeling calm and safe following treatment, experiencing severe abdominal pain or heavy bleeding following treatment, were significantly associated with non-satisfaction. No serious adverse events were recorded. CONCLUSIONS: Treatment of incomplete abortion with misoprostol by midwives and physician was highly, and equally, acceptable to women. TRIAL REGISTRATION: ClinicalTrials.gov NCT01844024.