Submitted by admin tede (tede@pucgoias.edu.br) on 2018-08-23T16:31:07Z No. of bitstreams: 1 Ricardo de Castro e Silva.pdf: 977565 bytes, checksum: 82bbe6d38ae5db73ee3f4cac4386fd76 (MD5) / Made available in DSpace on 2018-08-23T16:31:07Z (GMT). No. of bitstreams: 1 Ricardo de Castro e Silva.pdf: 977565 bytes, checksum: 82bbe6d38ae5db73ee3f4cac4386fd76 (MD5) Previous issue date: 2018-03-27 / The emergence of the Brazilian Imperial State during the first half of the nineteenth century was a phenomenon marked by the effort to ensure the consolidation of Brazil's political and territorial unity. In this sense, the House of Bragança, the deputies and senators who represented the Provinces took their seats in the Constituent Assembly and Legislative in Rio de Janeiro and the royal officials who composed the military and bureaucratic body scattered throughout the territory corresponding to the Empire and military mobilization in the provinces is an essential part of this process of building the Brazilian Imperial State in the first decades of the nineteenth century. We therefore seek to accompany the construction of the Imperial State in the provincial perspective, that is, from the work of the Governor of Arms Raimundo José da Cunha Mattos in the Province of Goiás between 1823 and 1826 with emphasis on the project of political and administrative centralization promoted by the military . More than a forger of the representation of the decay of the Province of Goiás, we assume that Raimundo José da Cunha Mattos was an enlightened intellectual who witnessed what he considered to be the difficulties faced in the provincial area of Goiás in the sense of promoting civilization and Empire of Brazil. His writings constitute a denunciation to the Emperor of the "evils" suffered by the Goians and at the same time he expects from D. Pedro I the application of "remedies to evils". In this sense, the military, political and intellectual activities of Raimundo José da Cunha Mattos in the Province of Goiás implicitly implicit a project of political-administrative centralization in the sense of promoting territorial integration not only the political adherence of the Province of Goiás to the Empire of Brazil, but also its integration through economic bias. / A emergência do Estado Imperial brasileiro durante a primeira metade do século XIX foi um fenômeno marcado pelo esforço em garantir a consolidação da unidade política e territorial do Brasil. Atuavam neste sentido, a Casa de Bragança, os deputados e senadores que representavam as Províncias que tomaram assento na Assembleia Geral Constituinte e Legislativa sediada no Rio de Janeiro e os funcionários régios que compunham o corpo militar e burocrático dispersos em todo o território correspondente ao Império e a mobilização militar nas províncias é parte essencial deste processo de construção do Estado Imperial brasileiro nas primeiras décadas do século XIX. Buscamos, portanto, acompanhar a construção do Estado Imperial na perspectiva provincial, ou seja, a partir da atuação do Governador das Armas Raimundo José da Cunha Mattos na Província de Goiás entre 1823 a 1826 com ênfase no projeto de centralização política e administrativa promovido pelo militar. Mais do que forjador da representação da decadência da Província de Goiás, partimos do pressuposto de que Raimundo José da Cunha Mattos foi um intelectual ilustrado que testemunhou o que considerava ser as dificuldades enfrentadas na esfera provincial goiana no sentido de promover a civilização e a integração ao Império do Brasil. Os seus escritos constituem uma denúncia ao Imperador dos “males” que sofrem os goianos e ao mesmo tempo espera de D. Pedro I a aplicação dos “remédios aos males”. Neste sentido, a atuação militar, política e intelectual de Raimundo José da Cunha Mattos na Província de Goiás comporta implicitamente um projeto de centralização política-administrativa no sentido de promover a integração territorial não apenas a adesão política da Província de Goiás ao Império do Brasil, mas também sua integração pelo viés econômico agropastoril.

Comment l’Etat haïtien est-il passé du statut d’Etat centralisé à celui d’Etat unitaire et décentralisé ? Ce travail de recherche a pour objet de comprendre du point de vue du droit et de l’histoire, le comportement du pouvoir central par rapport au pouvoir local en mettant en relief leurs relations institutionnelles. Pour ce faire, un échantillon de 5 collectivités municipales est étudié. Le socle juridique des collectivités locales haïtiennes a été défini par la Constitution de 1816 avec la création des communes comme circonscriptions administratives de l’Etat pour se substituer aux anciennes paroisses héritées des structures coloniales françaises du XIXe siècle. De 1816 à nos jours, l’histoire montre des périodes d’avancées, de silence voire de recul dans la construction des collectivités locales, selon que les priorités des régimes politiques étaient centralisatrices ou décentralisatrices. Si la Constitution de 1843 a tenté d’instituer des instances locales, celles qui lui ont succédé, dans leur grande majorité, ont fait marche arrière. On doit attendre la Constitution de 1987 pour voir la naissance de trois niveaux de collectivités décentralisées ayant des prérogatives et obligations pour qualifier le système haïtien de système décentralisé. L’Etat est donc devenu unitaire et progressivement décentralisé. Toutefois, il fallait aussi s'interroger sur la réalité du fonctionnement desdites collectivités en raison de leurs faiblesses, notamment financières. L’étude de ces administrations décentralisées permet d’appréhender leurs compétences techniques, administratives et financières par rapport aux compensations de l’Etat, lesquelles restent très maigres et n’aboutissent qu’à un système peu ou faiblement décentralisé. / How did the Haitian State go from the status of Centralized state to that of unitary and decentralized one ? The purpose of this paper is to understand, from the point of view of laws and history, the behavior of the central government in relation to the local one by highlighting their institutional relations. To do this, we studied a sample of 5 municipal communities. The legal base of the local authorities of Haiti was defined by the Constitution of 1816 with the creation of the communes as administrative districts of the State to replace the old parishes inherited from the French colonial structures of the nineteenth century. From 1816 to the present days, history of Haiti shows periods of progress, of silence and even of decline in the construction of local communities, according to whether the priorities of the political regimes were centralizing or decentralizing. Although the 1843 Constitution attempted to establish local bodies, the vast majority of them followed suit. We had to wait until the 1987 Constitution to see the birth of three levels of decentralized communities with prerogatives and obligations to recognize he system of Haiti as a decentralized one. The state has become unitary and progressively decentralized. However, it was also necessary to put in question the reality of the functioning of the said communities because of their weaknesses, more specifically financial ones. The study of these decentralized administrations makes it possible to understand heir technical, administrative and financial competences in relation to the compensations of the State, which remain very inadequate and result in a weekly decentralized system.

"Hidden Hills" is a secure, isolated enclave of 550 homes, with a long history of political and economic power wielded, in some cases, by families who have lived there for generations. This neighborhood serves as the bedroom for many of Portland's wealthy and well-known and has housed many of Oregon's-leading figures. It is faced with SB 917, a 1991 mandate to merge its only formal social institution, its 104-year-old school district, with one of two contiguous districts. Merger will not mean the immediate closure of the school, but will mean the loss of local administrative and political control and changes in the delivery of education and the arrangement of staff and students. The school will be run by another district in another community. This eighteen-month field study was undertaken in order to answer the questions: (a) How do neighborhood residents define this situation, and (b) What strategies will they devise to cope with the situation. I entered the community as a marginal participant and full observer. "Marginal" because, although I was the official recorder for both the school board's Consolidation Task Force (CTF) and High School Option Committee, I attended numerous other school and community meetings as a full spectator. I also conducted both formal and informal interviews and conversed casually with residents at every opportunity. Sources of secondary data were the 1990 Decennial Census: Multnomah County Elections Office: Oregon Department of Education; Oregon Historical Society Library; City of Portland Urban Services; Hidden Hills School District; and Multnomah County's Tax Supervising and Conservation Commission. The mandate to merge posed a threat to the neighborhood. The school is valued both for its educative and non-educative functions. It is a symbol of the neighborhood's integrity, part of which is its long history and body of tradition. It stands as testimony to the neighborhood's distinctiveness, which partially inheres in the institutionalization and the privatization of its school. It is the school that residents feel distinguishes this affluent neighborhood from other such neighborhoods. Its social cohesiveness and small-town atmosphere is perceived by residents as unique. There is a symbiosis between the school and the neighborhood that makes any threat to the school a threat to the neighborhood's identity. The rational response was mounted by the CTF, whose progress was halted at the point where neighborhood input was necessary but not forthcoming, due to what members perceived as denial. But residents were articulating a form of anticipatory grieving in the recurring reference to loss loss of identity, loss of local control, loss of the neighborhood school, and loss of academic excellence and small class-size. There was organized apathy among residents while they assimilated the fact that things this time were different. Initial impulses to make the old, formerly effective, forays "down to Salem" weren't working to gain exemption from the grip of the new law. It was time to form new lines of action based on a new definition of the situation. The CTF redefined the situation and did its work by identifying five options to consolidation. Residents were then brought together at neighborhood coffees where their subjective realities were negotiated within the constraints of the objective reality of the consolidation mandate. During these negotiations an intersubjective reality was realized where all residents, while having their own subjective meanings of the threat to the school and the neighborhood, were still able to articulate the objective fact that this was a threat to a core structure of meaning. Core values, beliefs, identity, and assumptions were brought into relief as residents re-defined the situation and discussed strategies to cope as a neighborhood, rather than as individuals. The CTF was given much-needed direction from neighbors.

Inköp har en direkt påverkan på ett företags lönsamhet, vilket gör att fokus på att reducera inköpskostnader kan leda till stora positiva effekter. Inköp i ett företag är i regel organiserad i en hierarkisk struktur som bör anpassas utifrån de utmaningar ett företag ställs inför. En av faktorerna som påverkar inköpsorganisationens struktur är vilken centraliseringsgrad som används. Tenhults Pressgjuteri AB hade år 2011 en omsättning på 90 miljoner SEK och 75st anställda. Företaget har nyligen expanderat kraftigt vilket har lett till strukturella problem i inköpsorganisationen. Dessa problem syns bland annat i ansvarsfördelningen av inköp är otydlig. Företagets ledning har upplevt att inköpsorganisationen har blivit svårare att överblicka och styra vilket har lett till att de överväger att centralisera inköpsorganisationen. Examensarbetets syfte är att utreda inköpsorganisationen på Tenhults Pressgjuteri bland annat genom att applicera teorier framtagna för stora företag. För att uppfylla syftet har följande tre frågeställningar formulerats: Vilka styrkor och svagheter finns i inköpsorganisationen? Vilka förbättringsmöjligheter finns i inköpsorganisationen? Vilken grad av centralisering i inköpsorganisationen är lämplig? Inköpsorganisationen på företaget är fördelat bland olika avdelningar. Totalt har 13 anställda intervjuats under examensarbetet. Att ansvarsfördelningen är otydlig har sin grund i företagets förändring sedan det grundades. Att centralisera inköpsorganisationen är ett beslut från ledningen och är inte en nödvändighet enligt de anställda. Företaget brister i många steg i inköpsprocessen. De största bristerna återfinns vid utvärdering av leverantörsprestationer och genomförda inköp. Val av leverantör baseras ofta på pris. Företaget har hög teknisk kompetens bland de anställda. Företaget behöver skapa en struktur över inköpsorganisationen. De behöver utveckla strategi och taktik vid inköp och börja utvärdera genomförda inköp och leverantörernas prestationer. De bör använda de inköpsverktyg som finns tillgängliga och använda rätt kompetens vid rätt köp. Slutligen så rekommenderas företaget att fortsätta utveckla de områden som har bedömts som bra för att undvika att dessa blir förbisedda. Med hänsyn till Tenhults Pressgjuteris mål att växa 15 % varje år och de förutsättningar som företaget har bedöms den blandade centraliseringsgraden vara mest lämplig. Vissa av företagets inköp flyttas till en central inköpsavdelning medan tekniskt svåra artiklar köps in av lämpliga anställda. Detta alternativ ger god möjlighet för företaget att arbeta strategiskt med inköp och anses vara genomförbart. / Purchasing has a direct impact on a company’s profitability, which means that focusing on reducing purchasing costs can lead to large positive effects. The purchasing function in a company is usually organized in a hierarchical structure which depends on the challenges the company faces. One factor that affects the organization structure is what degree of centralization that is being used. Tenhults Pressgjuteri AB had the year 2011 sales of 90 million SEK and currently employs 75 people. The company has recently expanded significantly which has led to structural problems in the purchasing organization. Company directors have experienced that the purchasing organization is becoming more difficult to monitor and control and are considering a centralized purchasing organization. The purpose of this thesis is to investigate the purchasing organization at Tenhults Pressgjuteri which also includes applying theories developed for large companies. To fulfill this purpose, the following three questions have been formulated: What strengths and weaknesses are there in the purchasing organization? What opportunities for improvement are there in the purchasing organization? What degree of centralization for the purchasing organization is appropriate? The purchasing organization is spread among several departments. A total of 13 employees have been interviewed during this thesis. Responsibilities within the purchasing process are unclear due to changes in the company since it was founded. The decision to centralize the purchasing organization is made by management and not a necessity from the view of the employees. Many steps in the purchasing process are not performed properly. The main inadequacies are found where evaluation of both supplier performance and the purchase is made. Supplier selection is often based on price. The company has a high technical expertise among the employees. The company needs to create a structure in the purchasing organization. They need to develop strategies and tactics for purchasing and start evaluating purchases and supplier’s performance. The company should make use of the purchasing tools that are available and use the right competence for the right purchase. Finally, we recommend the company to continue to develop the areas of the purchasing that have been estimated to be acceptable to avoid that they are overlooked. Considering Tenhults Pressgjuteris goal to grow 15 % each year and the conditions that the company has, the mixed degree of centralization is estimated to be most appropriate. Some of the company’s purchases are moved to a central purchasing department while technically difficult items still remains at appropriate staff. This option provides a good opportunity for the company to work strategically with purchase and is considered viable.

Human being, as an individual, is a basic element of social organization and plays different roles within different organizations such as family, school, and working setting. During the process of role-taking, individuals are influenced by three factors: personality traits, organization, and interpersonal relationship within working environment. Given that, the purpose of this study is to understand the association of personal, organizational and environmental factors and ¡§perceptions of organizational politics¡¨(POPs). 29 organizations participated in this study and , from which, 1524 valid respondents were collected and analyzed through methods of ¡§factor analysis¡¨, ¡§validity & reliability test¡¨, ¡§correlation analysis¡¨ and ¡§hierarchical regression¡¨. After applying ¡§factor analysis¡¨ of the POPs, it was categorized by three dimensions analysis: ¡§(1) behaviors of superior and subordinate; (2) go along and get ahead; (3) difference between the policies of compensation and promotion and actual practices. The results of this study in summary are: 1.Personal factor has effects on POPs with respect to all its three dimensions. 2.Organizational factor has effects on POPs with respect to all its three dimensions. 3.Environmental factor has effects on POPs with respect to all its three dimensions.

World financial and economic crisis encouraged government institutions to find ways for more efficient organization of public procurement. Therefore there is growing interest in public procurement centralization process. In the dissertation there are analyzed economic, management and law aspects of public procurement centralization. The aim of the dissertation is to create a model for evaluating state’s financial benefits from centralization of public procurement and to evaluate these benefits in the case of Lithuania. By generalizing scientific literature there are abstracted elements influencing formation of financial benefits from centralization of public procurement, also there are advantages and disadvantages of public procurement centralization being analyzed. By synthesizing scientific knowledge of purchasing management and auction theory, few hypotheses are raised to explain differences in prices between centralized and decentralized public procurement. Empirical research of public procurement centralization was conducted and based on research results evaluation of Lithuanian state financial benefits from public procurement centralization was carried out. Also causes of price differences between centralized and decentralized public procurement were defined. Generalization of research results enabled to do prediction of development for public procurement centralization. / Pasaulyje 2008 metais kilusi finansinė ir ekonominė krizė paskatino valdžios institucijas ieškoti būdų, kaip efektyviau naudoti valstybės biudžeto lėšas, skirtas viešiesiems pirkimams. Todėl susidomėjimas viešųjų pirkimų centralizavimu pastaruoju metu labai padidėjo. Disertacijoje nagrinėjami ekonominiai, vadybiniai ir teisiniai viešųjų pirkimų centralizavimo aspektai. Pagrindinis darbo tikslas – sukurti viešųjų pirkimų centralizavimo finansinės naudos vertinimo modelį ir remiantis šiuo modeliu atlikti šios naudos vertinimo tyrimą viešųjų pirkimų centralizavimo Lietuvoje atveju. Disertacijoje, apibendrinus mokslinę literatūrą, išskiriami veiksniai, lemiantys viešųjų pirkimų centralizavimo finansinę naudą, taip pat analizuojami pirkimų centralizavimo pranašumai ir trūkumai. Sintetinant pirkimų valdymo dalyko ir aukcionų teorijos žinias, iškeliamos hipotezės paaiškinančios skirtumus tarp kainų centralizuotuose ir decentralizuotuose viešuosiuose pirkimuose. Darbe atlikti keli empiriniai viešųjų pirkimų centralizavimo tyrimai, kurių pagrindu įvertinta viešųjų pirkimų centralizavimo Lietuvoje finansinė nauda. Taip pat nustatytos kainų skirtumo centralizuotuose ir decentralizuotuose viešuosiuose pirkimuose susidarymo priežastys. Apibendrinti tyrimų rezultatai leido pateikti viešųjų pirkimų centralizavimo plėtros prognozę.

Pasaulyje 2008 metais kilusi finansinė ir ekonominė krizė paskatino valdžios institucijas ieškoti būdų, kaip efektyviau naudoti valstybės biudžeto lėšas, skirtas viešiesiems pirkimams. Todėl susidomėjimas viešųjų pirkimų centralizavimu pastaruoju metu labai padidėjo. Disertacijoje nagrinėjami ekonominiai, vadybiniai ir teisiniai viešųjų pirkimų centralizavimo aspektai. Pagrindinis darbo tikslas – sukurti viešųjų pirkimų centralizavimo finansinės naudos vertinimo modelį ir remiantis šiuo modeliu atlikti šios naudos vertinimo tyrimą viešųjų pirkimų centralizavimo Lietuvoje atveju. Disertacijoje, apibendrinus mokslinę literatūrą, išskiriami veiksniai, lemiantys viešųjų pirkimų centralizavimo finansinę naudą, taip pat analizuojami pirkimų centralizavimo pranašumai ir trūkumai. Sintetinant pirkimų valdymo dalyko ir aukcionų teorijos žinias, iškeliamos hipotezės paaiškinančios skirtumus tarp kainų centralizuotuose ir decentralizuotuose viešuosiuose pirkimuose. Darbe atlikti keli empiriniai viešųjų pirkimų centralizavimo tyrimai, kurių pagrindu įvertinta viešųjų pirkimų centralizavimo Lietuvoje finansinė nauda. Taip pat nustatytos kainų skirtumo centralizuotuose ir decentralizuotuose viešuosiuose pirkimuose susidarymo priežastys. Apibendrinti tyrimų rezultatai leido pateikti viešųjų pirkimų centralizavimo plėtros prognozę. / World financial and economic crisis encouraged government institutions to find ways for more efficient organization of public procurement. Therefore there is growing interest in public procurement centralization process. In the dissertation there are analyzed economic, management and law aspects of public procurement centralization. The aim of the dissertation is to create a model for evaluating state’s financial benefits from centralization of public procurement and to evaluate these benefits in the case of Lithuania. By generalizing scientific literature there are abstracted elements influencing formation of financial benefits from centralization of public procurement, also there are advantages and disadvantages of public procurement centralization being analyzed. By synthesizing scientific knowledge of purchasing management and auction theory, few hypotheses are raised to explain differences in prices between centralized and decentralized public procurement. Empirical research of public procurement centralization was conducted and based on research results evaluation of Lithuanian state financial benefits from public procurement centralization was carried out. Also causes of price differences between centralized and decentralized public procurement were defined. Generalization of research results enabled to do prediction of development for public procurement centralization.

Kriget är ingenting annat än en utvidgad tvekamp, en våldsakt för att påtvinga motståndaren vår vilja. Målet är att göra motståndaren värnlös. Om motståndaren skall uppfylla vår vilja, måste vi försätta honom i ett läge, som är ogynnsammare än det offer vi kräver av honom. Varje förändring i läget, som kan åstadkommas genom fortsatta krigshandlingar måste alltså leda till något än ogynnsammare. Med denna sanning tar många teorier och doktriner sina avstamp. För att lyckas med att försätta vår motståndare i ett ogynnsamt läge gäller det att föra striden och att göra det snabbare än motståndaren. Detta kunde Överste Boyd se i sina studier om luftstriderna under Koreakriget. OODA loopen eller "Boyds cykel" ligger numera till grund för manöverkrigföringen. William S. Lind skriver i handbok manöverkrigföring att själva syftet med manöverkrigföringen är att ta sig genom beslutscykeln, OODA loopen, snabbare än fienden. Som punkt 1 i handledningen för att lyckas med detta anger Lind att enbart en decentraliserad ledd styrka kan gå genom beslutscykeln snabbt. Denna slutsats går idag att finna i alla doktriner och metodhandböcker i Försvarsmakten. Uppdragstaktik med decentraliserad ledning förordas och beskrivs i samtliga nivåer och skall utgöra grunden för all ledning i Försvarsmakten. I samtliga doktriner och reglementen benämns dock undantag då uppdragstaktik med kommandostyrning är att föredra eller tvingas användas. Vid närmare efterforskningar så märks att uppdragstaktik används lite slarvigt både som filosofi och ledningsmetod. Efter ett antal års tjänstgöring vid luftvärnet har jag upplevt att metoden med uppdragsledning får stå tillbaka för en centraliserad ledningsmetod. Detta medför mycket lite utrymme för underställda att ta initiativ när det kommer till strid i luftarenan. Är detta önskvärt, ofrånkomligt och överhuvudtaget förenligt med uppdragstaktik. Är det möjligt att luftvärnet med sin särställning i både flygstridskrafterna och markstridskrafterna kan gå genom OODA loopen snabbare än motståndaren utan att vara decentraliserad ledd såsom Lind anger som grundregel nummer ett? Genom att klarlägga uppdragstaktiken som både filosofi och metod, jämföra med hur manöverteori och luftmaktsteori behandlar uppdragsstyrning samt se till luftvärnets förutsättningar för strid i luftarenan kan svaret på hur uppdragstaktiken kan tillämpas inom luftvärnet besvaras. Uppdragsstyrningen blir i luftvärnet en förutsättning för att kunna detaljstyra och leda genom kommando. Detaljstyrningen är just nu med de förutsättningar som finns ofrånkomlig och nödvändig. Samtidigt är uppdragsstyrningen grunden för att luftvärnet som markförband skall utveckla effekt från marken mot luften. / War is nothing but a duel on an extensive scale, an act of violence to compel our opponent to fulfil our will. The aim of the action in war is to disarm the enemy. If our opponent is to be made to comply with our will, we must place him in a situation which is more oppressive to him than the sacrifice which we demand. Every change in this position which is produced by a continuation of the war, should therefore be a change for the worse. Many theories and doctrines are based on this truth. To succeed to place our opponent in an adverse situation one must lead the battle and do it faster than the opponent. This is also what Colonel Boyd saw in his studies of the air fights during the war in Korea. The OODA loop or Boyd’s cycle is now a basic theory of maneuver warfare. William S. Lind writes in his handbook in maneuver warfare that the purpose itself of maneuver warfare is to go through the OODA loop faster than your enemy. As remark number 1 in the guidance for succeeding with that task, Lind state that only a decentralized force can go through the cycle of decision fast. This conclusion can be found in all doctrines and handbooks in the Swedish Armed Forces (SAF). Mission type tactics with decentralized control is ordered, or recommended and described in all service doctrines. It is the base for command and control within the whole organization. In all doctrines and regulations in the SAF there are exceptions when mission type tactics with direct control is preferred or an imperative necessity. After closer inquiries one can see that sometimes mission type tactics are carelessly used to describe both a philosophy and a method. After several years of service within the Ground Based Air Defense troops, my experience is that mission type control is not used as much as centralized control. This entails very little space for subordinated to take any initiative in the air war. Is that desirable, inevitable or on the whole consistent with mission type tactics? Is it possible that the GBAD with its unique position in both the ground- and air troops can go through the OODA loop faster than its opponents without decentralized control, as Lind alleged as rule number 1? Through a elucidation of mission type tactics as both philosophy and as a method, a comparison between how airpower and maneuver theory treat mission type tactics and together with the conditions for GBAD the answer to how the GBAD can apply mission type tactics will be found. Mission type tactics is a sine qua non for the GBAD in order to be able to use centralized control and to lead through command. Detailed guidance is right now inevitable and necessary with the conditions now at hand. At the same time the ability for the GBAD to be effective in the air is founded through the mission type tactics.

The management of rectal cancer has changed in many countries over the last two decades and resulted in improved survival for the majority of rectal cancer patients. In this thesis some surgical strategies and histopathological aspects to improve and clarify the management of rectal cancer patients are investigated. Even in the era of TME surgery and radiotherapy, a higher local recurrence rate and shorter survival for rectal cancer patients operated with abdominoperineal resection is reported. In the first paper we describe a new strategy with partial anterior en bloc resection of either the prostate or the vagina, resulting in very low local recurrence rates and excellent long-term survival. Histopathological examination of the specimen lays the foundation for decision making on oncological therapy. A positive circumferential resection margin (CRM) has, in previous papers, been related to a high risk of local recurrence. In the second paper we show that a CRM ≤ 1 mm was not correlated with an increased risk of local recurrence when patients were managed in a multidisciplinary setting with preoperative radiotherapy and optimal TME surgery. As the complexity of rectal cancer management is increasing, demands on organizational structure are growing. In paper three we could show that long-term survival was increased for all rectal cancer patients after the centralization to a single unit. Whether or not to resect the primary rectal tumour in patients with metastatic disease is an ongoing debate in the literature. In paper four, we studied the national management of rectal cancer patients with primary metastatic disease. Nineteen per cent of rectal cancer patients present with Stage IV disease and, at a national level, there is a clear shift to a more selective and restrictive approach. The 30-day mortality was low for patients that underwent a resectional surgery, for patients having an exploratory laparotomy, however, it was high. Overall survival was improved over time even though up to one fourth of patients received no surgical treatment.

Material supply systems have for a long time been regarded as an important function with strong potential to increase the performance of companies in different industries. Consequently, substantial research has been conducted in the field. However, in the pharmaceutical industry within research and development plants, material supply systems have historically not been a prioritized function. Therefore, there is a research gap regarding material supply systems in that peculiar context. This study aims to fill that gap by investigating how a material supply system could be designed and which factors are critical to achieve a cost-efficient service level within a research and development plant in the pharmaceutical industry. To do so, a single case study has been conducted at a Swedish pharmaceutical company’s research and development plant. An abductive approach has been applied to both test if the general design principles developed in other industries and business functions can be applied to this context. Further, context specific factors affecting the material supply system design needed to be identified and investigated to adapt the general design principles to the specific context by generalizing data. The empirical data was collected by utilizing focus groups, interviews, observations and documents. The findings yielded that there is a substantial potential for improvement of material supply systems within the context of this study. The existing decentralized inventory structure at the case company was a particularly vital aspect that hindered the system from operating cost-efficiently in relation to the service level and a centralization is crucial to improve. Further, calibration and a general decrease of safety stocks, order points and order quantities is essential to uphold a consistent service level at a justifiable cost at the case company. The general design principles and formulas retrieved from the theoretical framework was partly applicable in the context of this study but needed some adjustments. Especially the low volume articles with high variety in consumption rate was not suitable to be managed by the existing methods and needed another approach. Further, the context establishes high requirements on system dynamics, it comes with boundaries due to laws regulating the industry, and companies in the context generally need to be better at aligning their design factors to the purpose. The result of this study adds valuable content to the research field and fills the gap for material supply systems in the context of research and development plants in the pharmaceutical industry. Further studies are needed in this field to investigate how articles with low and varying demands can be managed within material supply systems cost-efficiently and with high service levels.