Swedish health care is currently facing problems, such as lack of financial resources, staff shortage and dissatisfaction among patients and professionals. Patients’ dissatisfaction was the point of departure for the present study, and one approach dealing with this problem was investigated. It was hypothesised that a patient-centred perspective could offer a possible solution. The aim of the study was to explore health care professionals’ and medical students’ understanding of their professional role and the patient encounter. A further goal was to determine whether these understandings could be developed by educational interventions. Students and professionals have been either interviewed or responded to a survey about their professional role and the patient encounter. Qualitative analysis was used. One group- and one individualised intervention were carried out. The participants’ understandings of their professional role were taken as the starting point for learning. The results showed that a minority of medical students and professionals in diabetes care had incorporated a patient-centred perspective. Nurses in telephone advisory services recognised the patients’ needs, but experienced conflicting demands of being both carer and gatekeeper. A non-optimal match between patients’ needs and what professionals understand as their role could cause some of the problems. Competence development could be achieved by taking the participants understanding of the professionals’ role and of the patient encounter as a starting point for reflection. The results have implications for changes in organisation and education in health care, to optimise outcomes of care. Time for reflection, mentoring and professional development is needed.

Die hier zur Verfügung gestellte Datei ist leider nicht vollständig, aus technischen Gründen sind die folgenden Anhänge leider nicht enthalten: Anhang 3: Begriffshierarchie "verarbeitungstechnische Funktion" S. 141 Anhang 4: Begriffshierarchie "Eigenschaftsänderung" S. 144 Anhang 5: Begriffshierarchie "Verarbeitungsgut" S. 149 Anhang 6: Begriffshierarchie "Verarbeitungstechnisches Prinzip" S. 151 Konsultieren Sie die Druckausgabe, die Sie im Bestand der SLUB Dresden finden: http://slubdd.de/katalog?TN_libero_mab21079933

<p>Canadas regulatory system is science-based and relies on risk assessment to inform decisions about which products of biotechnology (and other technologies) are safe enough for commercial application. Since regulation involves the loss of certain liberties, it is imperative that any regulatory regime be as objective as possible. Scientific risk assessment seems to be a good way to produce the information, which guides policy makers since it involves quantitative analysis and the production of seemingly objective data.</p><p>The view adopted by regulators and in current risk assessment practices is that objective means value-free. Therefore, because risk assessment data is scientific it is thought to be value-free but this is not the case. Risk assessment necessarily involves value assumptions. Assumptions must be made at all stages of the production of risk data. This does not mean, however, that risk assessment is hopelessly subjective. The notion of value-free objectivity can be replaced with the view that genuine objectivity arises through peer review and social discourse. Regulators can adopt this understanding of objectivity to acknowledge the value-ladenness of risk assessment data.</p><p>At present, the value assumptions made by industry, government and private scientists during risk assessment go largely unnoticed yet have an effect on the outcome of regulatory decisions. Such assumptions must be recognized in order to ensure that the decisions made about the risks society face are not biased. This is particularly true in the case of biotechnology regulation. The development of the science of biotechnology has occurred concurrently with the development of the biotech industry creating the opportunity for industry-biased risk assessments.</p><p>It is possible to make changes to the existing regulatory regime in Canada in order to avoid some of the major problems associated with unrecognized value assumptions in risk assessment. A complete restructuring of the regime is unnecessary, however. Maintaining the current regulatory structure with some minor changes could address these problems. These changes include: creating an independent review board, making explicit that value assumptions are part of risk assessment in government advisory reports, and enhancing the role of regulators. Canadas regulatory system can better address the risks associated with biotechnology if it acknowledges that risk assessment is value-laden.</p>

<p>Canadas regulatory system is science-based and relies on risk assessment to inform decisions about which products of biotechnology (and other technologies) are safe enough for commercial application. Since regulation involves the loss of certain liberties, it is imperative that any regulatory regime be as objective as possible. Scientific risk assessment seems to be a good way to produce the information, which guides policy makers since it involves quantitative analysis and the production of seemingly objective data.</p><p>The view adopted by regulators and in current risk assessment practices is that objective means value-free. Therefore, because risk assessment data is scientific it is thought to be value-free but this is not the case. Risk assessment necessarily involves value assumptions. Assumptions must be made at all stages of the production of risk data. This does not mean, however, that risk assessment is hopelessly subjective. The notion of value-free objectivity can be replaced with the view that genuine objectivity arises through peer review and social discourse. Regulators can adopt this understanding of objectivity to acknowledge the value-ladenness of risk assessment data.</p><p>At present, the value assumptions made by industry, government and private scientists during risk assessment go largely unnoticed yet have an effect on the outcome of regulatory decisions. Such assumptions must be recognized in order to ensure that the decisions made about the risks society face are not biased. This is particularly true in the case of biotechnology regulation. The development of the science of biotechnology has occurred concurrently with the development of the biotech industry creating the opportunity for industry-biased risk assessments.</p><p>It is possible to make changes to the existing regulatory regime in Canada in order to avoid some of the major problems associated with unrecognized value assumptions in risk assessment. A complete restructuring of the regime is unnecessary, however. Maintaining the current regulatory structure with some minor changes could address these problems. These changes include: creating an independent review board, making explicit that value assumptions are part of risk assessment in government advisory reports, and enhancing the role of regulators. Canadas regulatory system can better address the risks associated with biotechnology if it acknowledges that risk assessment is value-laden.</p>

I ett modernt företag som Skandiabanken, vars ambition är att tillhöra de främsta inom sin bransch och som har en vision som säger att företaget ska ”ha sparmarknadens nöjdaste kunder”, ställs stora krav på effektivitet i alla led. För att möta kraven från kunder att producera varor och tjänster som motsvarar, eller helst överträffar kundernas förväntningar, samt för att möta organisationens egenintresse i att producera varor och tjänster på ett kostnadseffektivt och inkomstbringande sätt för att på så sätt säkra lönsamheten och konkurrenskraften på lång sikt, behöver företaget ständigt se över och utveckla verksamheten. D.v.s. för att överleva på en konkurrensutsatt marknad är ett strategiskt och hållbart kvalitetsarbete, och att snabbt kunna anpassa och utveckla verksamheten, av allra största vikt. Det finns inget utrymme för uppenbara kvalitetsbrister varken i verksamheten eller i produkter och tjänster som denna åstadkommer. Den snabba utvecklingen på finansmarknaderna, i kombination med att de finansiella produkter som erbjuds idag kan vara komplexa och svårbedömda, innebär att de finansiella rådgivarna under de senaste åren har fått en allt större betydelse för både privatpersoner och juridiska personer. Till grund för detta förbättringsprojekt ligger konstaterade kvalitetsbrister i den dokumentation som enligt lag ska upprättas vid all finansiell rådgivning. Syftet med förbättringsprojektet var att besvara nedan frågeställningar: Vad är de bakomliggande orsakerna till de konstaterade kvalitetsbristerna i dokumentationen av den finansiella rådgivningen? Vilka förändringar behöver genomföras för att kvaliteten ska bli bättre? Att notera här är att en bristfälligt eller utelämnad dokumentation inte per automatik behöver innebära att dåliga råd har lämnats. Metoder som använts för att utreda de bakomliggande orsakerna till kvalitetsbristerna har varit processkartläggning, orsaks-verkan-diagram, relationsdiagram, enkät, personliga intervjuer samt dokumentgranskningar. Förbättringsarbetet har, utifrån konstaterade huvudorsaker, fokuserat på förbättring av verktyg och dokument. Detta har inneburit ett tydliggörande av dokumentationspliktens innebörd vilket genererat i ett framtagande av riktlinjer samt en förbättrad dokumentationsblankett.  En reflektion efter projektets avslut är att kvalitetsförbättrande punktinsatser självklart är bra men att det inte är tillräckligt. Den viktigaste slutsatsen är därmed att avsaknaden av synliggjorda ledningsprocesser, en helhetssyn på verksamheten och ett systematiskt processorienterat arbete i kombination med återkommande omorganisationer är den troliga orsaken till att de beskrivna problemen uppstått. Därför är författarens förbättringsförslag, att som ett led i Total Quality Management, starta ett arbete i enlighet med ISO 9001:2008. För att uppnå ett hållbart långsiktigt kvalitetsarbete krävs en helhetssyn och ett systematiskt och ständigt pågående förbättringsarbete. Ett arbete med 9001:2008, i enlighet med TQM och tillsammans med de faktaunderlag som de facto redan finns tillgängliga, såsom policys, riktlinjer, rutinbeskrivningar, kundundersökningar mm, kommer att generera i förbättrad effektivitet, minskad resursåtgång, förbättrad möjlighet till verksamhetsstyrning, högre kvalitet i affären, högre kundnöjdhet, nöjda medarbetare och ägare, samt att ett långsiktigt bra ekonomiskt resultat uppnås. Dessutom blir verksamheten snabbare och mer flexibel inför framtida förändringar. / In a modern company like Skandia who wants to be in the forefront of its business and with a vision to have “the most satisfied clients in the savings market” there is high demand on efficiency in all aspects of the business. To meet the demand from customers to produce products and services that meets or even better exceeds the customers’ expectations, and to meet the organization self interest in I producing products and services in a cost efficient way and with revenues to secure profitability, and competitive long term, the company at all times needs to evaluate the strategic and sustainable quality work, and that swiftly have the ability to develop the company is of extreme importance. There is no room for obvious quality deficiencies in either the product or services that the deficiency creates. The fast development in financial market in combination with the financial products that today is more complex and harder to understand the implication is that the financial advisors during the last years have a larger influence for both private persons and legal entities. The foundation for this improvement project has been to answer the questions; What are the underlying reasons for the lack of quality in the documentation of the financial advice meeting? What has to be done to improve the quality? Note that a poor or total lack of customer documentation dose not mean that bad advice has been given to the client. Methods which has been used to investigate the underlying reasons for the lack of quality has been process mapping, reason-effect diagram, relations diagram, survey, personal interviews , and examining of documents.  The improvement work has, with the fact based main reasons, focused on improving the tools and documents, which have made it clearer, make people understand the reasons for the documentation regulation and the production of a new guideline and an improved document for the financial advisor.  The most imported conclusion is that a lack of clear management processes, a holistic view of the business and a systematic process oriented work, in combination with a lot at reorganizations is the reason for the described problem. That is the reason for the author’s improvement suggestion, as a step in Total Quality Management, start of a work according to ISO 9001:2008. A reflection after the project was finished I that ad hoc quality improvement is of course good but not good enough. To reach a sustainable long-term quality work there is a need for a holistic view and a constant improvement focus. A work with 9001:2008 in accordance with TQM that together with fact based approach that already Is there like policy’s, guidelines, routine manuals, customer surveys among others will lead to better efficiency, less use of resources, improved opportunity lead the business, higher quality in the business, increased customer satisfaction, more pleased staff and owners, and a long term financial result will be accomplished. Further the business will be faster on more flexible for future changes.

Nyckelord: Revision, revisorers oberoende, fortsatt drift, Big 4, konsulttjänster och klientstorlek. Bakgrund: Under 2000-talet har den finansiella revisionen genomgått en rad förändringar. Detta till följd av ett antal händelser såsom Enronskandalen som kom att ifrågasätta revisorers oberoende ytterligare. Syfte: Studiens syfte är att undersöka huruvida en revisors oberoende påverkas av variabler som revisionsbyråns storlek (Big 4), konsulttjänster och klientstorlek. Metod: Utifrån en deduktiv ansats har vi använt en kvantitativ metod genom att analysera sekundärdata som vi hämtat från Affärsdatas databas. Urvalet bestod av årsredovisningar och dess tillhörande revisionsberättelser som studerats utifrån kriterierna: svenska aktiebolag som inlett konkurs under april, maj och december 2010. Studiens kvantitativa data har jämförts med tidigare forskning inom revisionsområdet, denna forskning bottnar i teorier kring agentteori och revision som försäkran. Resultat och slutsats: Studiens resultat visar att Big 4 anmärker i något större utsträckning än övriga revisionsbyråer kring fortsatt drift. Studien fann ett signifikant samband mellan Big 4 och konsulttjänster, företag som nyttjar revisionstjänster från Big 4 nyttjar konsulttjänster i högre utsträckning än företag som har annan revisionsbyrå. Klientstorlek har enbart en påverkan på företagens benägenhet att köpa konsulttjänster, det vill säga förekomsten av att även köpa konsulttjänster utöver revisionen ökar i takt med företagens storlek, om än inte signifikant. Sammanfattningsvis kan klargöras att ingen av de undersökta variablerna har någon signifikant inverkan på anmärkning kring fortsatt drift, varken enskilt eller tillsammans. Detta resultat gör att den rimligaste tolkningen blir att revisorerna förblir oberoende trots påverkan utifrån. Det mesta talar för att valet av revisionsbyrå, vilka tjänster som nyttjats eller vilket företag man representerar inte påverkar revisorns oberoende vilket visar på att revisorn tycks klara av sin uppgift som en tredje oberoende part. / Background: During the early 2000s the financial audit went through a series of changes. The cause of these changes were several, one of these reasons were the Enron scandal which arouse the question about the importance of auditor independence once again.  Purpose: The purpose of the study is to examine whether variables as Big 4, advisory services or client size has any influence on auditor independence. Method: From a deductive point of view a quantitative method has been used as we analyzed data collected from the database Affärsdata. The data were collected from annual reports and audit reports which were analyzed based on the following criteria: Swedish limited companies with a started bankruptcy process during April, May or December in the year 2010. The data of the study have been compared with previous research in the audit field which deals with the theories agency theory and audit as an affirmation. Results and conclusion: The results of the study shows that Big 4 firms tend to issue going concern opinions in a slightly higher extent than other audit firms. There is a significant association between Big 4 and advisory services. Companies who use audit services provided by a Big 4 firm also use their advisory services to a higher extent than those who use audit services from other audit firms. Client size does only show an association, even though it is not statistically significant, between those companies who use both audit and advisory services, in other words, the tendency of using both audit and advisory services increase with company size. None of the investigated variables had any significant affect on the tendency to issue a going concern opinion, neither individually nor together. The most reasonable explanation to these results comes down to the fact that the Swedish auditors are independent due to the variables we studied. Based on this we conclude that the choice of audit firm, weather companies use advisory services or not, or who you are, does not affect the auditor’s independence which indicates that auditors cope with the independence issues quite well.

Mergers and acquisitions (M&amp;A) in the corporate world are achieving increasing importance and attention especially in the advent of intense globalization. This is evident from the magnitude and growth of deal values and resultant ‘mega-mergers’ transacted in recent times. As expert advisory are sought in M&amp;A activities to facilitate the undertaking and maximise the value of the transaction, advisory firms begin to play a more significant and at the same time lucrative role in M&amp;A activities, to the extent of determining the outcome of such projects. Being an area of limited research, it is thus valuable to investigate what M&amp;A advisory firms view as critical success factors to the projects they undertake. Consequently, the research question of “What are the critical success factors for merger &amp; acquisition projects in the view of merger &amp; acquisition advisory firms” has been raised. A list of ten critical success factors for M&amp;A projects is firstly identified from an extensive literature review. These factors are (1) Complete and Clear objectives, goals and scope of the project, (2) Client consultation and acceptance, (3) Project manager’s competence and commitment, (4) Project team member’s competence and commitment, (5) Communication and information sharing and exchange, (6) Project plan development, (7) M&amp;A advisory firm’s resource planning, (8) Time management and tight secrecy, (9) Price evaluation and financing scheme, and (10) Risk management. In an attempt to explore the importance of each factor in the practical context, data have been collected through three research methods. Primarily, the authors conduct a semi-structured interview with six interviewees currently working in three organizations which provide professional services related to M&amp;A projects. Meanwhile, a self-completion questionnaire method is employed, following which a sample of 325 M&amp;A advisory firms based in the U.S. is selected to participate in an online survey. In addition, the authors follow a case study approach based on the three organizations of the six interviewees in order to establish comprehensive knowledge about issues relating to M&amp;A projects. In response to the research question, the findings strongly indicate that seven out of ten factors in the original list have a positive impact, being the factors listed above as (1), (2), (3), (4), (5), (8), and (9). On the other hand, it revealed the lesser importance of the other three. In addition, three new factors have been discovered from analyzing the data collected, being (i) Having a number of key potential buyers with suitable profile (ii) Right, correct and complete information and data in the data room, and (iii) The quality of the selling company. While as another outcome of this research, further practical insights have been provided regarding the role of M&amp;A advisory firms, the M&amp;A process, common issues faced by M&amp;A projects and the success criteria for M&amp;A projects. The findings from this research contribute valuable new knowledge to both researchers and practitioners in both project management and M&amp;A fields, while facilitating the achievement of successful M&amp;A projects.

The supply and demand situation is crucial for the oil and gas industry during the first half of the 21st century. For the future, we will see two trends going in opposite directions: a decline in discoveries of conventional oil and gas reservoirs and an increase in world energy demand. Therefore, the need to develop and produce unconventional oil and gas resources, which encompass coal-bed methane, gas-shale, tight sands and heavy oil, will be of utmost importance in the coming decades. In the past, large-scale production from tight gas reservoirs occurred only in the U.S. and was boosted by both price incentives and well stimulation technology. A conservative study from Rogner (1997) has shown that tight gas sandstone reservoirs would represent at least over 7,000 trillion cubic feet (Tcf) of natural gas in place worldwide. However, most of the studies such as the ones by the U.S. Geological Survey (U.S.G.S.) and Kuuskraa have focused on assessing the technically recoverable gas resources in the U.S. with numbers ranging between 177 Tcf and 379 Tcf. During the past few decades, gas production from tight sands field developments have taken place all around the world from South America (Argentina), Australia, Asia (China, Indonesia), the Russian Federation, Northern Europe (Germany, Norway) and the Middle East (Oman). However, the U.S. remains the region where the most extensive exploration and production for unconventional gas resources occur. In fact, unconventional gas formations accounted for 43% of natural gas production and tight gas sandstones represented 66% of the total of unconventional resources produced in the U.S. in 2006. As compared to a conventional gas well, a tight gas well will have a very low productivity index and a small drainage area. Therefore, to extract the same amount of natural gas out of the reservoir, many more wells will have to be drilled and stimulated to efficiently develop and produce these reservoirs. Thus, the risk involved is much higher than the development of conventional gas resources and the economics of developing most tight gas reservoirs borders on the margin of profitability. To develop tight gas reservoirs, engineers face complex problems because there is no typical tight gas field. In reality, a wide range of geological and reservoir differences exist for these formations. For instance, a tight gas sandstone reservoir can be shallow or deep, low or high pressure, low or high temperature, bearing continuous (blanket) or lenticular shaped bodies, being naturally fractured, single or multi-layered, and holding contaminants such as CO2 and H2S which all combined increase considerably the complexity of how to drill a well. Since the first tight gas wells were drilled in the 1940's in the U.S., a considerable amount of information has been collected and documented within the industry literature. The main objective of this research project is to develop a computer program dedicated to applying the drilling technologies and methods selection for drilling tight gas sandstone formations that have been documented as best practices in the petroleum literature.

Auditing is common in many organizations and a legal requirement for all limited liability companies in Sweden (ABL 9:1). In directives from the government it is clearly stated that small firms will be exempted from the statutory audit requirement. In light of this forthcoming change in regulations, this thesis is used to analyze which factors are associated with a demand for auditing. Analysis in this thesis is based on a national survey including 900 Small and Medium-sized Enterprises (SMEs). Around 2/3 of respondent’s (CEO or CFO) state that the firm will choose to have audited accounts even in the absence of such a legal requirement. Based on responses from 421 firms, logistic regression results indicated that firms purchasing advisory services from an audit firm will choose to have their accounts audited to a higher extent than those firms not receiving advisory services. This finding, not identified in prior studies, is linked to advisory services being of higher quality when the audit firm also performs audit work. The demand for auditing is further positively associated with firm size, use of a Big 4 audit firm and firms located in the county of Småland. From these findings it follows that the traditional view of auditing as merely a control mechanism needs to be complemented by consideration of aspects of the internal value of auditing. The approaches of SME’s when engaging an audit firm for different types of advisory services is examined in this study based upon survey data. It is shown that the majority of advisory services provided are related to core competencies of an auditor such as tax, accounting and law. Logistic regression results show a positive association between firms purchasing advisory services and the length of the relationship with the provider as well as with the respondent’s perception of the audit quality. The latter association further confirms the close connection between audit and advisory services. It should be noted that when an audit firm recommends advisory services their use is significantly higher. There is also support for the demand for advisory services being positively related to firms that are corporate subsidiaries and located in Småland and Norrland, but negatively associated with the respondent’s level of education. It follows that factors related to demand for advisory services on an aggregate level could be categorized as being dependent on firm characteristics, audit firm characteristics and the relationship between the parties. Provision of non-audit services (NAS), such as different types of advisory services, to audit clients and the potential consequences for auditor independence and audit quality have been discussed in public debates and research as well as being subject of regulation. OLS regression results show that reporting quality is higher when the audit firm provides advisory services as well as preparing accounts. These findings hold for both discretionary accruals and a respondent’s perception of reporting quality. The provision of NAS improves the reporting quality due to better knowledge of the client and its operations. From the perspective of reporting quality this finding implies that there is no necessity to further restrict the possibility for an audit firm to provide advisory services as well as preparing accounts for audit clients.

No description available.