"Vad som behövs? Det är sällan glasklart!" : En studie kring en organisations tillväxt och växtvärksproblematik

I en organisation belägen på Dalarnas landsbygd framkommer det i en medarbetarundersökning att ett ökande missnöje finns hos de anställda, där flera av problemen kan kopplas till den kraftiga expansion som organisationen just nu genomgår. Även en positiv organisationsförändring som tillväxt kan alltså bidra till problem hos de anställda. Denna studie har avsett att undersöka vilka utmaningar och möjligheter som upplevs hos de anställda i organisationen kopplat till den tillväxtfas de genomgår. Detta genom åtta djupintervjuer där urvalet var såväl chefer, medarbetare som HR-ansvariga. Utifrån respondenternas upplevelse av situationen fann vi fyra stora problemområden; avsaknad av gemensamma rutiner, otydliga roller, bristfällig information och kommunikation samt brist på proaktivt arbete för att säkerställa medarbetarnas kompetens. Vårt empiriska material tyder på att organisationen har ett gap när det kommer till utvecklingen av såväl de mänskliga resurserna, arbetssystem som ledarskapet. Antalet anställda ökar i en högre takt än organisationens infrastrukturella processer, något som kan ses som en organisatorisk växtvärk. Med utgångspunkt från resultatet ger vi förslag på vilka aktiviteter HR-funktionen bör fokusera på. För att bemöta utvecklingsgapet samt förhindra att fler växtvärkssymptom uppstår anser vi att HR bör fokusera på ett proaktivt arbete. En nyckelfaktor som vi genom vår utvecklade modell visar är att ledaren är av stor vikt för hur organisationen och dess medarbetare hanterar en växtvärkssituation. HR bör därför ha en klar bild över vilket stöd verksamhetens ledare behöver för att kunna skapa värde för organisationen, ledarna och medarbetarna. Några generella förslag på HR-aktiviteter går däremot inte att ge eftersom, precis som tidigare forskning visar, verksamheters individuella situation och kontext avgör vilka aktiviteter som är aktuella.

Rapport från/Report from IEA Task-14 mötet/meeting on solar heating system, Hameln Tyskland/Germany August 1992

Participation as observer at the meeting of Task 14 of IEA's Solar Heating and Cooling Projects held in Hameln, Germany has led to greater understanding of interesting developments underway in several countries. This will be of use during the development of small scale systems suitable for Swedish conditions. A summary of the work carried out by the working groups within Task 14 is given, with emphasis on the Domestic Hot Water group. Experiences of low-flow systems from several countries are related, and the conclusion is drawn that the maximum theoretical possible increase in performance of 20% has not been achieved due to poor heat exchangers and poor stratification in the storage tanks. Positive developments in connecting tubes and pumps is noted. Further participation as observer in Task 14 meetings is desired, and is looked on favourably by the members of the group. Another conclusion is that SERC should carry on with work on Swedish storage tanks, with emphasis on better stratification and heat exchangers, and possible modelling of system components. Finally a German Do-it-Vourself kit is described and judged in comparison with prefabricated models and Swedish Do-it-Yourself kits.

Vård i livets slut av personer med demens. Personal och anhörigas upplevelse av given vård : En metasyntes

Palliativt förhållningssätt kännetecknas av helhetssyn av människan och uppnås genom stöttning av individen att leva med värdighet och största möjliga välbefinnande till livets slut oavsett diagnos eller ålder. Demens är en sjukdom som är svårt handikappande för den som drabbas och för de anhöriga är sjukdomen förödande. Den palliativa vården av personer med demens är inte optimerad. Studier visar att det dels beror på demenssjukdomen som är svår att vårda och dels för att stöd till de personer som vårdar sina anhöriga och det sociala kommunala nätverket har brister. Syfte: Att analysera upplevelsen av given vård i livets slutskede hos personer med demensdiagnos ur personalens och anhörigas perspektiv. Metod: Metasyntes utförd med Howell Major och Savin-Badins analysmodell, Qualitative Research Synthesis. Resultat: Kunskap och personcentrering var de två begrepp som blev produkten av syntesen. Begreppen fungerar som motsatser, om det finns kunskap och personcentrering så finns en bra upplevelse av given vård hos personal och anhöriga och om det brister i kunskap och personcentrering blir upplevelsen sämre. Diskussion: Kunskap om demens bland personal har i syntesen visats vara en indikator för god vård vid livets slut. Utbildning i demenssjukdom bör ske kontinuerligt och på olika nivåer beroende på vilken personalkategori som utbildas. Konklusion: Palliativ vård och demens måste få utrymme i utbildningarna av all personal, från undersköterska till specialistläkare.

Performance Evaluation of Different PV-Array Configurations under Weak Light Conditions and Partial Shadings

The paper analyses empirical performance data of five commercial PV-plants in Germany. The purpose was on one side to investigate the weak light performance of the different PV-modules used. On the other hand it was to quantify and compare the shading losses of different PV-array configurations. The importance of this study relies on the fact that even if the behavior under weak light conditions or the shading losses might seem to be a relatively small percentage of the total yearly output; in projects where a performance guarantee is given, these variation can make the difference between meeting or not the conditions.When analyzing the data, a high dispersion was found. To reduce the optical losses and spectral effects, a series of data filters were applied based on the angle of incidence and absolute Air Mass. To compensate for the temperature effects and translate the values to STC (25°C), five different methods were assessed. At the end, the Procedure 2 of IEC 60891 was selected due to its relative simplicity, usage of mostly standard parameters found in datasheets, good accuracy even with missing values, and its potential to improve the results when the complete set of inputs is available.After analyzing the data, the weak light performance of the modules did not show a clear superiority of a certain technology or technology group over the others. Moreover, the uncertainties in the measurements restrictive the conclusiveness of the results.In the partial shading analysis, the landscape mounting of mc-Si PV-modules in free-field showed a significantly better performance than the portrait one. The cross-table string using CIGS modules did not proved the benefits expected and performed actually poorer than a regular one-string-per-table layout. Parallel substrings with CdTe showed a proper functioning and relatively low losses. Among the two product generations of CdTe analyzed, none showed a significantly better performance under partial shadings.

Acupuncture for labour pain

Background: Acupuncture involves puncturing the skin with thin sterile needles at defined acupuncture points. Previous studies are inconclusive regarding the effect of acupuncture on labour pain, but some studies have found a reduction in the use of pharmacological pain relief when acupuncture is administered. The appropriate dose of acupuncture treatment required to elicit a potential effect on labour pain has not been fully explored. The dose is determined by many different factors, including the number of needles used and the intensity of the stimulation. In Sweden, manual stimulation of the needles is common practice when acupuncture is used for labour pain, but electrical stimulation of the needles, which gives a higher dose, could possibly be more effective. The overall aim of this thesis was to evaluate the effectiveness of acupuncture with manual stimulation (MA) of the needles as well as acupuncture with a combination of manual and electrical stimulation (EA) in reducing labour pain, compared with standard care without any form of acupuncture (SC). Methods: The study was designed as a three-armed randomised controlled trial in which 303 nulliparous women with normal pregnancies were randomised to MA, EA, or SC. The primary outcome was labour pain, assessed using the Visual Analogue Scale (VAS). Secondary outcomes were relaxation during labour, use of obstetric pain relief, and associations between maternal characteristics and labour pain and use of epidural analgesia respectively. Also, labour and infant outcomes, recollection of labour pain, and maternal experiences, such as birth experience and experience of the midwife, were investigated two months after the birth. The sample size calculation was based on the potential to discover a difference of 15 mm on the VAS. Data were collected during labour before the interventions, the day after birth, and two months later. Besides using the VAS, information was collected by means of study specific protocol, questionnaires and medical records. Results: The mean VAS scores were 66.4 in the MA group, 68.5 in the EA group, and 69.0 in the SC group (mean differences: MA vs. SC 2.6 95% CI -1.7 to 6.9, and EA vs. SC 0.6 95% CI -3.6 to 4.8). Other methods of pain relief were used less frequently in the EA group, including epidural analgesia, MA 61.4%, EA 46%, and SC 69.9%. (EA vs. SC OR 0.4 95% CI 0.2 to 0.7). No statistically significant differences were found in the recollection of labour pain between the three groups two months after birth (mean VAS score: MA 69.3, EA 68.7 and SC 70.1). A few maternal characteristics were associated with labour pain (age, dysmenorrhea, and cervix dilatation), but none of the investigated characteristics predicted the outcome of the acupuncture treatment in MA or EA. Women in the EA group experienced acupuncture as being effective for labour pain to a higher extent than women who received MA, MA 44.4%, EA 67.1% (EA vs. MA OR 2.4 95% CI 1.2 to 4.8). Women in the EA group also spent less time in labour (mean 500 min) than those who received MA (mean 619 min) and SC (mean 615 min) (EA vs. MA HR 1.4 95% CI 1.0 to1.9, EA vs. SC HR 1.4, 95% CI 1.1 to 2.0), and had less blood loss than women receiving SC, (EA vs. SC OR 0.1 95% CI 0.3 to 0.7). The women’s assessment of the midwife as being supportive during labour (MA 77.2%, EA 83.5%, SC 80%), overall satisfaction with midwife care (MA 100%, EA 97.5%, SC 98.7%), and having an overall positive childbirth experience (MA 64.6%, EA 61.0%, SC 54.3%) did not differ statistically. No serious side effects of the acupuncture treatment were reported. Conclusion: Acupuncture, regardless of type of stimulation, did not differ from standard care without acupuncture in terms of reducing women’s experience of pain during labour, or their memory of pain and childbirth overall two months after the birth. However, other forms of obstetric pain relief were less frequent in women receiving a combination of manual and electrical stimulation, suggesting that this method could facilitate coping with labour pain.

'They would never receive you without a husband' : Paradoxical barriers to antenatal care scale-up in Rwanda

OBJECTIVE: to explore perspectives and experiences of antenatal care and partner involvement among women who nearly died during pregnancy ('near-miss'). DESIGN: a study guided by naturalistic inquiry was conducted, and included extended in-community participant observation, semi-structured interviews, and focus group discussions. Qualitative data were collected between March 2013 and April 2014 in Kigali, Rwanda. FINDINGS: all informants were aware of the recommendations of male involvement for HIV-testing at the first antenatal care visit. However, this recommendation was seen as a clear link in the chain of delays and led to severe consequences, especially for women without engaged partners. The overall quality of antenatal services was experienced as suboptimal, potentially missing the opportunity to provide preventive measures and essential health education intended for both parents. This seemed to contribute to women's disincentive to complete all four recommended visits and men's interest in attending to ensure their partners' reception of care. However, the participants experienced a restriction of men's access during subsequent antenatal visits, which made men feel denied to their increased involvement during pregnancy. CONCLUSIONS: 'near-miss' women and their partners face paradoxical barriers to actualise the recommended antenatal care visits. The well-intended initiative of male partner involvement counterproductively causes delays or excludes women whereas supportive men are turned away from further health consultations. Currently, the suboptimal quality of antenatal care misses the opportunity to provide health education for the expectant couple or to identify and address early signs of complications IMPLICATIONS FOR PRACTICE: these findings suggest a need for increased flexibility in the antenatal care recommendations to encourage women to attend care with or without their partner, and to create open health communication about women's and men's real needs within the context of their social situations. Supportive partners should not be denied involvement at any stage of pregnancy, but should be received only upon consent of the expectant mother.

The effects of Ikea and external shopping centers on regional trade and retail growth : A comparative analysis of Ikea’s establishment in Kalmar and Karlstad

This paper examines the effects of Ikea store establishment in Kalmar and Karlstad on the trade and retail inside the two cities, and as well on the trade and retail in the close neighboring municipalities and in further peripheral municipalities in both regions. After the establishment of Ikea store, Kalmar and Karlstad have experienced significant growth in trade and retail. The question, however, is how big this growth is in both cities? And how different locations on different distances from Ikea have been affected? What impact there was on different segments of the retail? How different business branches have been affected? How large the catchment area for the emerging new large-scale retail locations is? These questions, in addition to few others, are investigated in this paper. The thesis starts with an introduction chapter containing a background of the topic, problem description, the investigated questions, the purpose, and the outline of the paper. The next chapter includes the frame of reference which consists of literature review and theoretical framework about the external shopping centers and their impact on retail and regional trade development. It includes also information gathered from previous studies technical reports and other available sources about the subject. The third chapter includes description for the methods used to collect the primary and secondary data needed for the purpose of this study. Then the empirical framework which demonstrates the results of the conducted research followed by analysis and concluded in discussion and conclusion. Mixed methods are used as research strategy in this thesis, and the method to conduct the research is based on telephone interviews for the primary (qualitative) data, and documents and desk research for the secondary (quantitative) data. The gathered data is analyzed and designed in a way that allows the usage of comparative analysis technique to present the findings and draw conclusions. The results showed that new established Ikea retail store outside the city boundaries results with many effects on the city center and on the neighboring municipalities as well. The city center seems not to be affected negatively, but on the contrary positive effects were witnessed in both regions, these positive effects are linked to the increase inflow of customers from the external retail area which is known as spillover effect. III On the other hand, the neighboring towns and municipalities are more negatively affected especially with the trade of con-convenience goods as the consumers in these towns and municipalities start to go to the area of Ikea and the large external retail center to do their purchasing, the substitution effect is then said to be occurred. Moreover, the further far municipalities do not seem to be significantly affected by the establishment of Ikea. These effects whether positive or negative could be monitored by looking to few trade parameters such as the turnover, the sales index, and the consumers’ expenditure, these parameters can be very useful to measure the developments and changes in the trade and retail in a given place.