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"Walter, Lars"
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Assembling health care organizations : practice, materiality and institutions
\"Assembling Health Care Organizations combines an institutional theory perspective with a materialist view of the technologies, devices, biological specimens, and other material resources mobilized and put to work in health care work\"-- Provided by publisher.
Book
Production of Oncolytic Measles Virus in Vero Cells: Impact of Culture Medium and Multiplicity of Infection
Oncolytic measles virus (MeV) is a promising anti-cancer treatment. However, the production of high titers of infectious MeV (typically 107–109 TCID50 per dose) is challenging because the virus is unstable under typical production conditions. The objective of this study was to investigate how the multiplicity of infection (MOI) and different media—a serum-containing medium (SCM), a serum-free medium (SFM) and two chemically defined media (CDM)—affect MeV production. We infected Vero cells at MOIs of 0.02, 0.2 or 2 TCID50 cell−1 and the lowest MOI resulted in the largest number of infected cells towards the end of the production period. However, this did not equate to higher maximum MeV titers, which were similar for all the MOIs. The medium had a moderate effect, generating maximum titers of 0.89–2.17 × 106, 1.08–1.25 × 106 and 4.58–9.90 × 105 TCID50 mL−1 for the SCM, SFM and CDM, respectively. Infection at a low MOI often required longer process times to reach maximum yields. On the other hand, a high MOI requires a large amount of MeV stock. We would therefore recommend a mid-range MOI of 0.2 TCID50 cell−1 for MeV production. Our findings show that SCM, SFM and CDM are equally suitable for MeV production in terms of yield and process time. This will allow MeV production in serum-free conditions, addressing the safety risks and ethical concerns associated with the use of serum.
Journal Article
Is there a demand for physical activity interventions provided by the health care sector? Findings from a population survey
Background
Health care providers in many countries have delivered interventions to improve physical activity levels among their patients. Thus far, less is known about the population's interest to increase their physical activity levels and their opinion about the health care provider's role in physical activity promotion. The aims of this paper were to investigate the self-reported physical activity levels of the population and intention to increase physical activity levels, self-perceived need for support, and opinions about the responsibilities of both individuals and health care providers to promote physical activity.
Methods
A regional public health survey was mailed to 13 440 adults (aged 18-84 years) living in Östergötland County (Sweden) in 2006. The survey was part of the regular effort by the regional Health Authorities.
Results
About 25% of the population was categorised as physically active, 38% as moderately active, 27% as somewhat active, and 11% as low active. More than one-third (37%) had no intentions to increase their physical activity levels, 36% had thought about change, while 27% were determined to change. Lower intention to change was mainly associated with increased age and lower education levels. 28% answered that physical activity was the most important health-related behaviour to change \"right now\" and 15% of those answered that they wanted or needed support to make this change. Of respondents who might be assumed to be in greatest need of increased activity (i.e. respondents reporting poor general health, BMI>30, and inactivity) more than one-quarter wanted support to make improvements to their health. About half of the respondents who wanted support to increase their physical activity levels listed health care providers as a primary source for support.
Conclusions
These findings suggest that there is considerable need for physical activity interventions in this population. Adults feel great responsibility for their own physical activity levels, but also attribute responsibility for promoting increased physical activity to health care practitioners.
Journal Article
Are Incidental Gallbladder Cancers Missed with a Selective Approach of Gallbladder Histology at Cholecystectomy?
Background
Incidental gallbladder cancer (IGBC) is an unexpected finding when a cholecystectomy is performed upon a benign indication, and the use of routine or selective histological analysis of gallbladder specimen is still debated. The aim of this study was to investigate whether the proportion of submitted gallbladder specimens for pathological investigation influences the proportion of IGBC found, and what possible factors preoperatively or perioperatively could influence the selection process.
Methods
All cholecystectomies between January 2007 and September 2014 registered in the Swedish Registry of Gallstone Surgery and ERCP (GallRiks) were included. Proportion of histological analysis was divided into four subgroups (0–25%, >25–50%, >50–75%, >75–100%).
Results
A total of 81,349 cholecystectomies were registered, and 36,010 (44.3%) gallbladder specimens were sent for histological analysis. A total of 213 cases of IGBC were discovered, which constituted 0.26% of all cholecystectomies performed and 0.59% of the number of gallbladder specimens sent for histological analysis. Hospitals submitting >75–100% of the gallbladder specimens had significantly more IGBC/1000 cholecystectomies performed (
p
= 0.003). Hospitals with the most selective approach had a significantly higher proportion of IGBC/1000 gallbladders that were sent for histological analysis (
p
< 0.001). Factors such as higher age (
p
< 0.001), female gender (
p
= 0.048) and macroscopic cholecystitis (
p
< 0.001) were more common in gallbladder specimens from hospitals that had a selective approach to histological analysis.
Conclusion
A routine approach to histological analysis in cholecystectomies with a benign indication for surgery can uncover a higher proportion of IGBC cases. When a selective approach is used, risk factors should be taken into account.
Journal Article
Multilateral Assessment of Anchorage Bond Characteristics in Steel Fibre Reinforced Concrete
Anchorage to concrete is a recurring application in construction. For such applications, bonded anchors, formed by means of a polymer adhesive injection into a borehole, are a widely used product due to their flexibility in regards to the construction logistics and positioning of the attached element as well as high load capacities. At the same time, fibre-reinforced concrete is the material of choice for many engineering applications where anchors have to be installed. Moreover, the use of steel fibre-reinforced concrete is likely to increase, since it now falls in the scope of the second-generation Eurocode 2 (exp. 2023). Therefore, the condition of the anchor installation borehole—mainly the roughness and grip of its internal surface—is known to play a critical role in the stress transfer from the attached component, through the fastening and into the concrete, and, hence, to the load-bearing performance. At the same time, drilling through the steel fibre reinforcement, along with the accelerated wear of the drilling tools, can in turn influence the borehole’s roughness and the overall installation quality. Furthermore, steel fibre may lead to an additional local stiffening of the concrete where the anchor is installed. These complex elements are discussed herein on the basis of multiple tests on anchors in plain and steel fibre concrete, as well as numerical analyses. The results indicate particular aspects of bonded anchor design and product certification for different polymer-based construction adhesives.
Journal Article
Is there a demand for physical activity interventions from health care providers?
Background: Health care providers in many countries have delivered interventions to improve physical activity levels among their patients. Thus far, less is known about the population's interest to increase their physical activity levels and their opinion about the health care provider's role in physical activity promotion. The aims of this paper were to investigate the self-reported physical activity levels of the population and intention to increase physical activity levels, self-perceived need for support, and opinions about the responsibilities of both individuals and health care providers to promote physical activity.
Methods: A regional public health survey was mailed to 13 440 adults (aged 18-84 years) living in Östergötland County (Sweden) in 2006. The survey was part of the regular effort by the regional Health Authorities.
Results: About 25% of the population was categorised as physically active, 38% as moderately active, 27% as somewhat active, and 11% as low active. More than one-third (37%) had no intentions to increase their physical activity levels, 36% had thought about change, while 27% were determined to change. Lower intention to change was mainly associated with increased age and lower education levels. 28% answered that physical activity was the most important health-related behaviour to change \"right now\" and 15% of those answered that they wanted or needed support to make this change. Of respondents who might be assumed to be in greatest need of increased activity (i.e. respondents reporting poor general health, BMI>30, and inactivity) more than one-quarter wanted support to make improvements to their health. About half of the respondents who wanted support to increase their physical activity levels listed health care providers as a primary source for support.
Conclusion: These findings suggest that there is considerable need for physical activity interventions in this population. Adults feel great responsibility for their own physical activity levels, but also attribute responsibility for promoting increased physical activity to health care practitioners.
Journal Article
Boundary stories
The role of stories in organizing has traditionally been examined within the context of specific organizations, communities of practice, or social worlds. The study reported here describes the establishment in West Sweden of a centre for developing methods that allow for the recognition of prior learning in people seeking employment. In the report, we highlight the role of stories and storytelling in coordination and organizing between and among organizations, but also between and among social worlds. We refer to such stories as boundary stories, and argue that they are not only the means for creating a shared understanding and facilitating joint actions among a number of public and private organizations, but that they also help to hide potential conflicts, paradoxes, and contradictions among actors.
Journal Article
Boundary stories: Constructing the Validation Centre in West Sweden
The role of stories in organizing has traditionally been examined within the context of specific organizations, communities of practice, or social worlds. The study reported here describes the establishment in West Sweden of a centre for developing methods that allow for the recognition of prior learning in people seeking employment. In the report, we highlight the role of stories and storytelling in coordination and organizing between and among organizations, but also between and among and social worlds. We refer to such stories as boundary stories, and argue that they are not only the means for creating a shared understanding and facilitating joint actions among a number of public and private organizations, but that they also help to hide potential conflicts, paradoxes, and contradictions among actors.
Paper
Flexibel handel. En studie av bemanningsstrategier i svensk detaljhandel
Sedan i mitten av 1990-talet har antalet personer med en tillfällig anställning ökat i Sverige. Utvecklingen inom detaljhandeln är likartad, om än på en något högre nivå än genomsnittet. Det är dessutom en sektor med förhållandeviss hög andel deltidsanställningar, en anställningsform som i sig erbjuder möjligheter till flexibel bemanning, bland annat genom att erbjuda mertid och behovsanpassad schemaläggning. Utvecklingen inom detaljhandeln har tillskrivits bredare, mer strukturella förändringar på samhällsnivå. Det handlar om förändrade köpmönster och ökade krav från konsumenter på flexibilitet och tillgänglighet när de göra sina inköp, något som sannolikt leder till utökade öppettider och behov av förändrade bemanningsstrategier. En annan förändring är beskrivningen av detaljhandelsbranschen som präglad av en allt hårdare konkurrens, med ökade krav på effektivt utnyttjande av lokaler, personal och andra resurser som följd.
Paper
Personalförsörjning och validering inom Försvarsmakten
Inom ramen för forskningsprojektet Personalförsörjning och validering inom Försvarsmakten vid GRI (Gothenburg Research Institute, Handelshögskolan vid Göteborgs universitet) har intervjuer gjorts med i huvudsak officerare och soldater inom Försvarsmakten under en period då värnplikten upphört och har ersatts med grundläggande militärutbildning. Intervjuerna har haft till syfte att fånga de intervjuades berättelser och tankar om både arbete och framtid inom Försvarsmakten. Studien belyser Försvarsmakten som en organisation som påverkas av globala trender och en omvärld där pågående konflikter även påverkar den professionella praktiken genom bland annat ett fokus på utlandsinsatser. Organisationen söker nya arbetssätt där fler aktörer utanför organisationen blir väsentliga att uppmärksamma och samarbeta med då de anställdas både kortsiktiga och långsiktiga yrkesliv och kompetenser behöver hanteras. Här beskrivs skapandet av Försvarsmaktsråden som en del i detta arbete. Studien visar också att organisationen är på väg in i en ny matchningspraktik där (frivilligt) anställda kan väga sin anställning inom Försvarsmakten mot andra möjliga aktiviteter och yrkesalternativ. Det leder till att organisationen likväl som den enskilda anställda löpande bedömer varandra.
Paper