Publikationer från Linköpings universitet
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Bridging the policy-practice gap: a dual challenge of organizational learning
No full textPurpose – This paper aims to further our understanding of policy–practice gaps in organizations from an organizational learning perspective. The authors conceptualize and analyze policy–practice gaps in terms of what they label the dual challenge of organizational learning, i.e. the organizational tasks of both adapting ongoing practices to prescribed policy demands and adapting the policy itself to the needs of practice. Specifically, the authors address how this dual challenge can be understood in terms of organizational learning and how an organization can be managed to successfully resolve the dual learning challenge and, thereby, bridge policy–practice gaps in organizations. Design/methodology/approach – This paper draws on existing literature to explore the gap between policy and practice. Through a synthesis of theories and an illustrative practical example, this paper highlights key conceptual underpinnings. Findings – In the analysis of the dual challenge of organizational learning, this study provides a conceptual framework that emphasizes the important role of tensions and contradictions between policy and practice and their role as drivers of organizational learning. To bridge policy–practice gaps in organizations, this paper proposes five key principles that aim to resolve the dual challenge and accommodate both deployment and discovery in organizations. Research limitations/implications – Because this is a conceptual study, empirical research is called for to explore further and test the findings and conclusions of the study. Several avenues of possible future research are proposed. Originality/value – This paper primarily contributes by introducing and elaborating on a conceptual framework that offers novel perspectives on the dual challenges of facilitating both discovery and deployment processes within organizations.
Clinical Outcomes and Molecular Insights in Mucinous and Non-Mucinous Rectal Adenocarcinoma : From Treatment Response to Spatial Proteomics
No full textRectal cancer is a major global health problem. Advances in surgical technique and preoperative radiotherapy over the past decades have markedly reduced the local recurrence rate, yet overall survival has only been modestly improved. Considerable variation in treatment response persists, reflecting histological and biological heterogeneity. One histological subtype, mucinous adenocarcinoma (MAC), is defined by abundant extracellular mucin and represents roughly 10% of colorectal cancers in Western populations. Compared with non-mucinous adenocarcinoma (NMAC), MAC is more often diagnosed at advanced stage, exhibits greater local invasion, and responds less favorably to radiotherapy and chemotherapy. The mechanisms underlying these differences remain unclear. The overall aim of this thesis was to determine whether rectal MAC and NMAC should be considered separately in treatment decisions regarding radiotherapy and chemotherapy, to assess potential differences in tumor and stromal protein expression between these subtypes, and to explore whether such protein expression patterns influence prognosis and treatment response. In paper I, survival outcomes were compared following short-course versus long-course radiotherapy in 289 rectal cancer patients. Patients with NMAC had better survival after short-course than long-course radiotherapy. No difference was seen among patients with MAC. In paper II, the impact of adjuvant chemotherapy on survival was evaluated in 365 patients. Patients with rectal MAC had significant survival benefit from adjuvant chemotherapy, whereas no such benefit was observed in patients with NMAC. In paper III, weighted gene co-expression network analysis (WGCNA) identified mucin-enriched modules associated with the MAC subtype across two independent cohorts, and overlapping genes included MUC1, MUC2, and TCN1. Subsequent Artificial Intelligence (AI)-assisted spatial proteomic analysis of 155 rectal cancers revealed that spatial heterogeneity of these markers, together with tumor nuclear density, was prognostic and predictive of adjuvant chemotherapy benefit, with distinct patterns in MAC and NMAC tumors, suggesting that integrating spatial protein profiling with histological classification may improve prognostic precision and guide individualized treatment strategies in rectal cancer. Taken together, these studies demonstrate clinically and biologically relevant differences between rectal MAC and NMAC. Integrating histopathology with spatial and molecular biomarker profiling may improve prognostic assessment and enable more personalized treatment strategies
Fanfiction: A tool for Community Building, Intersectional Writing and Slow Media Consumption
No full text“Fanfiction: A tool for Community Building, Intersectional Writing and Slow Media Consumption” studies the way community building, intersectional writing and media consumption are present and affected by fanfiction. The thesis used a structured online survey conducted in a feminist manner, that gathers the reports and lived experiences of three participants who are involved with fanfiction in multiple intriguing ways. The results are then analyzed and conclusions are drawn from them, while I as the author remain clearly positioned in the process. The findings suggest that fanfiction can be an extremely useful, beneficial and unique tool for community building, intersectional writing and slow media consumption. The thesis contributes to the academic field by introducing the term of Intersectional writing and brings the spotlight to the benefits of fanfiction as a tool for community building, intersectional writing and slow media consumption, consequently unraveling it as a tool for resistance under late-stage capitalism.
Asymmetric Innovation Partnerships in the Defence Industry : A framework for large corporations’ engagements with startups
No full textGlobal uncertainties and political turmoil coupled with the increasing complexity of modern warfare, is putting pressure on the defence industry which is currently facing unprecedentedly high demands. Traditionally characterised by self-sufficiency and closed innovation, the defence industry is now becoming increasingly reliant on external partnerships and the integration of cutting-edge technologies from the civil sector. Asymmetric innovation partnerships, which bring together large corporations and startups, are emerging as a crucial way for driving innovation and enhancing defence capabilities. While the importance of these partnerships is increasingly recognised, there is a clear gap in the literature on how asymmetric innovation partnerships function within the unique context of the defence industry. For these partnerships to be incentivised, they must create value for all parties involved. However, acting within the defence industry presents distinct challenges to the successful implementation of asymmetric innovation partnerships. Therefore, this study aims to address this gap by identifying the specific challenges and success factors associated with value creation in asymmetric innovation partnerships within the defence industry. The purpose was fulfilled through a literature study combined with an interview-based case study of Saab’s asymmetric innovation partnerships. In total, 34 interviews were held with representatives from both Saab and startups to create a well-founded overall understanding of both parties’ perspectives. The findings resulted in a framework providing a suggested process and recommendations for asymmetric innovation partnerships within the defence industry, helping drive value creation and capture. Findings suggest that the partnership process can be divided into two stages: "volume to value", focusing on partner selection and setting up a project, and "commitment to capability," involvingthe actual joint projects. Key challenges arise in both stages and include internal inertia withinlarge corporations, security and confidentiality concerns, and misaligned goals between partners. The study further finds that successful asymmetric innovation partnerships in the defence industry rely on specific mechanisms to overcome challenges and unlock value creation. These mechanisms include fostering a culture of open innovation, providing dedicated resources and processes. Furthermore, strong leadership support, trust and open communication emerged as critical success factors. While the volume to value stage focuses on setting the premises for and facilitate future value creation and also allows for value capture from knowledge transfer and understanding market needs, the majority of value is realised during and after the commitment to capability stage. This value stems from shared resources, collaborative development, joint learning, and ultimately, the potential for new business opportunities for the startup, which is often their primary goal
Cardiorespiratory fitness in adolescence and risk of type 2 diabetes in late adulthood in one million Swedish men: nationwide sibling controlled cohort study
No full textObjective To examine the association between adolescent cardiorespiratory fitness and risk of type 2 diabetes in late adulthood, including the potential influence of unobserved familial confounding on the association.Design Nationwide sibling controlled cohort study.Setting Swedish Military Service Conscription Register, Sweden, 1972-95, with Multi-Generation Register for identifying full siblings. National Patient Register and Prescribed Drug Register for data on diagnoses of type 2 diabetes, deaths from National Cause of Death Register, and Statistics Sweden for emigration and socioeconomic data.Participants 1 124 049 Swedish men who participated in mandatory military conscription examinations with completed standardised cardiorespiratory fitness testing. Participants were followed up until 31 December 2023.Main outcome measures Type 2 diabetes, defined as a composite endpoint of diagnosis in inpatient or specialist outpatient care and dispensation of antidiabetic drug treatment, until 31 December 2023.Results 1 124 049 men, including 477 453 full siblings, with a mean age of 18.3 (standard deviation 0.7) years at baseline were included. During follow-up, 115 958 men (10.3%) and 48 089 full siblings (10.1%) had a first type 2 diabetes event at a median age of 53.4 (interquartile range 47.6-59.3) years. Cardiorespiratory fitness was categorised into deciles (referred to as groups, with group 1 being the lowest fitness level and group 10 the highest). In a cohort analysis, the adjusted hazard ratio in fitness group 2 versus fitness group 1 was 0.83 (95% confidence interval (CI) 0.81 to 0.85), with a difference in the standardised cumulative incidence at age 65 years of 4.3 (95% CI 3.8 to 4.8) percentage points, decreasing to a hazard ratio of 0.38 (0.36 to 0.39; incidence difference 17.8 (17.3 to 18.3) percentage points) in fitness group 10. When comparing full siblings, and thus controlling for all unobserved shared behavioural, environmental, and genetic confounders, the association was replicated, but with a reduction in magnitude. The hazard ratio in fitness group 2 was 0.89 (95% CI 0.85 to 0.94; incidence difference 2.3 (1.3 to 3.3) percentage points) and 0.53 (0.50 to 0.57; incidence difference 10.9 (9.7 to 12.1) percentage points) in fitness group 10. Hypothetically moving all participants in fitness group 1 to fitness group 2 was estimated to prevent 7.2% (95% CI 6.4% to 8.0%) of events at age 65 years in the cohort analysis versus 4.6% (2.6% to 6.5%) in the full sibling analysis, whereas hypothetically moving all participants to fitness group 10 was estimated to prevent 35.6% (34.1% to 37.0%) versus 24.3% (20.5 to 28.0) of events. Indications of effect modification by overweight status were found, where the association was smaller in those with overweight than in those without overweight, particularly in the full sibling analysis.Conclusions The findings indicate that adolescent cardiorespiratory fitness could be important in the development of type 2 diabetes in late adulthood, but conventional observational analysis might give biased estimates of the magnitude of the effect.Funding Agencies|Swedish Research Council [2019- 00738]; National Institute for Aging; National Institute of Neurological Disorders and Stroke [1R01NS131433- 01]</p
Healthcare utilization and resource distribution before and after interdisciplinary pain rehabilitation in primary care
No full textObjectives Most patients with chronic pain are identified and managed in primary care (PC). Chronic pain management is challenging, which is manifested by increased healthcare utilization (HCU) in this patient group. The interdisciplinary pain rehabilitation program (IPRP) is the gold standard treatment for patients with chronic pain but is scarcely used in PC. The aim of this study was to evaluate the HCU of patients with chronic pain in PC 1 year before and 1 year after an IPRP by examining the distribution of costs and resources. Methods This retrospective cohort study combined data from a national pain registry and HCU data from regional administrative registries, including 146 patients who participated in an IPRP in PC. The outcome measure was the number of outpatient healthcare contacts. Costs and the distribution of resources were compared across the two measurement intervals using paired t-tests. HCU costs were described from a healthcare provider perspective. Results HCU decreased by 16% in the year following IPRP compared to the year before. Costs for outpatient visits dropped by 12% or &lt;euro&gt;434 per participant. Visits to physiotherapists and general practitioners decreased the most, by 31% (p = 0.048) and 23% (p &lt; 0.001) respectively. Visits to nurses, occupational therapists, and psychologists/social workers in turn increased marginally (6%, 5% vs 10%). Conclusions IPRP in PC may lead to reduced HCU, freed resources, and streamlined chronic pain management. The study offers valuable insights into expected changes in HCU for chronic pain patients after an IPRP and how these changes may impact daily activities at the PC center
Den blivande förskolläraren : Ett studentperspektiv
No full textDagens förskollärarstudent beskrivs som annorlunda jämfört med tidigare avseende exempelvis deltagande i förskollärarutbildningens moment. För att förstå de bakomliggande faktorerna och bättre kunna möta studenten tar vi i denna studie ett studentperspektiv på vem förskollärarstudenten är. Genom att använda positioneringsteori för att analysera intervjuer med både högmotiverade och lågmotiverade studenter från olika lärosäten utforskas de generella berättelser som studenterna använder för att beskriva sina erfarenheter och handlingar. Studien identifierar sju centrala berättelser som belyser studenternas bakgrund, motiv till att utbilda sig till förskollärare samt deras roll och engagemang som studenter. Resultaten visar att förskollärarstudenterna ofta positionerar sig som engagerade och aktiva medskapare av sin utbildning, samtidigt som de ibland ser sina medstudenter som mindre engagerade. Artikeln diskuterar även hur ålder och livserfarenhet påverkar studenternas positionering och engagemang, samt hur relationer mellan studenter och lärare kan öka känslan av tillhörighet och meningsfullhet i studierna. Slutligen presenteras pedagogiska implikationer för att förbättra förskollärarutbildningen.Today’s preschool teacher students are described as different compared to previous generations, especially regarding their participation in various components of the preschool teacher education program. To better understand the underlying factors and to support these students more effectively, this study adopts a student perspective on who the preschool teacher student is. Using positioning theory to analyze interviews with both highly motivated and less motivated students from different universities, the study explores the common narratives students use to describe their experiences and actions. The study identifies seven key narratives that highlight the students’ backgrounds, their motivations for becoming preschool teachers, and their roles and engagement as students. The results indicate that preschool teacher students often position themselves as dedicated and active co-creators of their education, while occasionally perceiving their peers as less engaged. The article also discusses how age and life experience influence students’ positioning and participation, and how relationships between students and teachers can foster a greater sense of belonging and purpose in their studies. Lastly, pedagogical implications are outlined to enhance preschool teacher education
Effects of vestibular rehabilitation on subjective motion sickness symptoms and postural sway in motion sickness : A systematic critical literature study
No full textBakgrund: Rörelsesjuka är ett tillstånd som kan orsaka betydande besvär hos drabbade individer, men vestibulär rehabilitering kan bidra till symtomlindring. De bakomliggande mekanismerna för förbättring är väl dokumenterade, men det saknas en systematisk kritisk litteraturgranskning och evidensgradering av effekterna. Syfte: Att systematiskt sammanställa, analysera och värdera evidens för effekter av vestibulär rehabilitering på subjektiva rörelsesjukesymtom och posturalt svaj hos individer med rörelsesjuka. Metod: En systematisk kritisk litteraturgranskning genomfördes där databaserna PubMed och CINAHL användes. Studierna granskades med stöd av Fowkes & Fultons granskningsmall och bedömdes enligt GRADE för evidensgradering. Resultat: Urvalet resulterade i inkludering av fyra randomiserade kontrollerade studier, två studier med frisk kontrollgrupp och två studier utan kontrollgrupp. Studierna uppvisade en heterogenitet avseende studiedesign, typ av vestibulär rehabilitering och utvärderingsinstrument. Flertalet studier visade signifikanta resultat både vad gällde subjektiva utfallsmått för upplevda rörelsesjukesymtom och objektiva utfallsmått för posturalt svaj. Den metodologiska kvaliteten varierade, med såväl mindre som mer omfattande brister inom olika aspekter. Sammantaget bedömdes det vetenskapliga underlaget ha låg tillförlitlighet för båda typerna av utfallsmått enligt GRADE. Konklusion: Det vetenskapliga underlaget för effekterna av vestibulär rehabilitering som behandling vid rörelsesjuka bedömdes som lågt, vilket främst kan tillskrivas det begränsade antalet tillgängliga studier av god metodologisk kvalitet.
Voxel-Wise Brain Graphs From Diffusion MRI: Intrinsic Eigenspace Dimensionality and Application to Functional MRI
No full textGoal: Structural brain graphs are conventionally limited to defining nodes as gray matter regions from an atlas,with edges reflecting the density of axonal projections between pairs of nodes. Here we explicitly model the entire set of voxels within a brain mask as nodes of high-resolution, subject-specific graphs. Methods: We define the strength of local voxel-to-voxel connections using diffusion tensors and orientation distribution functions derived from diffusion MRI data. We study the graphs’ Laplacian spectral properties on data from the Human Connectome Project. We then assess the extent of inter-subject variability of the Laplacian eigenmodes via a procrustes validation scheme. Finally, we demonstrate the extent to which functional MRI data are shaped by the underlying anatomical structure via graph signal processing. Results: The graph Laplacian eigenmodes manifest highly resolved spatial profiles, reflecting distributed patterns that correspond to major white matter pathways. We show that the intrinsic dimensionality of the eigenspace of such high-resolution graphs is only a mere fraction of the graph dimensions. By projecting task and resting-state data on low frequency graph Laplacian eigenmodes, we show that brain activity can be well approximated by a small subset of low frequency components. Conclusions: The proposed graphs open new avenues in studying the brain, be it, by exploring their organisational properties via graph or spectral graph theory, or by treating them as the scaffold on which brain function is observed at the individual level.Funding Agencies|Swiss National Science Foundation [205321-163376]; Swedish Research Council [2018-06689]</p
Cardiovascular disease as part of Long COVID: a systematic review
No full textAims Long COVID syndrome has had a major impact on million patients' lives worldwide. The cardiovascular system is an important aspect of this multifaceted disease that may manifest in many ways. We have hereby performed a narrative review in order to identify the extent of the cardiovascular manifestations of the Long COVID syndrome.Methods and results An in-depth systematic search of the literature has been conducted for this narrative review. The systematic search of PubMed and Cochrane databases yielded 3993 articles, of which 629 underwent full-text screening. A total of 78 studies were included in the final qualitative synthesis and data evaluation. The pathophysiology of the cardiovascular sequelae of Long COVID syndrome and the cardiac manifestations and complications of Long COVID syndrome are critically evaluated. In addition, potential cardiovascular risk factors are assessed, and preventive methods and treatment options are examined in this review.Conclusion This systematic review poignantly summarizes the evidence from the available literature regarding the cardiovascular manifestations of Long COVID syndrome and reviews potential mechanistic pathways, diagnostic approaches, preventive measures, and treatment options. Graphical Abstrac