Introduction: The Antimicrobial Self-assessment Toolkit for Acute NHS Trusts (ASAT) was developed by a pharmacist reference group of an Advisory Non-Departmental Public Body on Antimicrobial Resistance and Healthcare Associated Infections (ARHAI). It was developed in conjunction with the Department of Health. The primary purpose of the ASAT is to identify and to measure the methods of implementation of antimicrobial stewardship programmes in acute NHS trusts. The face validity was previously tested by ARHAI. The overall aims of this programme of work were to investigate the validity of the ASAT and to make iterative changes to improve its validity. Ethical approval was not required for this PhD project because it was categorised as service evaluation by the LREC. Also, ethical approval from the University of Manchester Research Ethics Committee was deemed unnecessary at the time of the PhD project due to the nature of the data collected. Methods: A mixed methodology approach utilising a sequential exploratory strategy was used to investigate the validity of the ASAT. This PhD project was composed of four sequential studies which resulted in iterative changes to the ASAT, that is, from ASAT v15a to ASAT v18. In Study 1, cognitive interviews were conducted with eight antimicrobial pharmacists in order to investigate the content validity of ASAT v15a. In Study 2, both cognitive interviews and semi-structured interviews were conducted with 10 clinical microbiologists in order to investigate the content validity of ASAT v16. In Study 3, Rasch modelling and analyses using the Partial Credit Model (PCM) were conducted on the responses to ASAT v17 from 33 NHS trusts across England. In Study 4, simple OLS regression analyses were conducted using the NHS trust ‘ability’ estimates or calibrations and Clostridium difficile (CDI) rates of participating NHS trusts in order to investigate model fit and the predictive validity of the ASAT. Results: The cognitive interviews conducted in study 1 indicated that AMPs encountered cognitive difficulties along the cognitive processing pathway in response to ASAT v15a. These difficulties included comprehension in 27 (32.5%) questions and response generation/formatting in 13 (15.7%) questions. Also respondents indicated that the role of clinical microbiologists in ASPs was underrepresented in ASAT v15a. The interviews conducted in Study 2 were confirmatory in nature as they reflected the findings of Study 1. For example terms such as ‘formulary’ and ‘policy’ were misinterpreted by respondents. Rasch modelling and analysis showed that there were items within ASAT v17 which were underfitting and overfitting the Partial Credit Model. Item fit was investigated after removal of these items which resulted in improved fit for domains 2 and 5. ASAT v18 was developed after these analyses and was included items that were productive for measurement. On examination of the OLS regression analyses conducted in Study 4, it was seen that there was poor model fit and very limited predictive validity of the model. Conclusion: The iterative methodology utilised to investigate the validity and subsequently improve the ASAT was effective in establishing content and construct validity. However, the predictive validity of the ASAT was limited. This may be due to the outcome variable chosen for the OLS regression modelling. A more sensitive outcome measure such as compliance to treatment or prophylaxis guidelines may have been more effective at establishing predictive validity. The findings of this programme of work highlighted that there is further work required to validate the ASAT such as the determination of the appropriate weights and scores for ASAT domains and also the determination of the appropriate outcomes measures to determine the efficacy of ASPs. It is recommended that further validity testing should be conducted before a further iteration of the ASAT is used as a set of quality standards or as a hospital benchmarking tool

En anledning till att DevOps har blivit populärt hos många organisationer med fokus på mjukvaruutveckling beror på att det för utveckling och drift närmare varandra vilket ökar effektiviteten. Vidare framgår det att det finns en kunskapslucka i implementationen av DevOps. Syftet med detta arbete var därför att undersöka hur svenska organisationer hanterar implementationen av DevOps. Studien utredde även vilka hinder som uppkommit och hur dessa hinder hanterats av organisationerna. I denna undersökning genomfördes semistrukturerade intervjuer för att samla in nödvändig kvalitativa data för att svara på studiens frågeställningar. Dessa intervjuer genomfördes hos fem svenska organisationer för att samla ett brett dataunderlag. För att öka förståelsen hos den insamlade datan utfördes en tematisk analys som sedan jämfördes med tidigare litteratur inom området. Studien fann att endast två av de tre implementationsmetoder som identifierats i en tidigare studie fanns implementerade i svenska organisationer. Studien presenterar vilka implementationsmetoder som kan passa olika organisationer, vilka hinder som kan förekomma med vald implementationsmetod, samt en uppdaterad översikt hur organisationer har gått tillväga i Sverige med implementationen av DevOps. / A reason why DevOps has become popular in many organizations with a focus on software development is because it brings development and IT-operations closer to each other, which increases efficiency. Furthermore, it appears that there is a knowledge gap in the implementation of DevOps. The purpose of this work was therefore to investigate how Swedish organizations handle the implementation of DevOps. The study also investigated which obstacles arose and how these obstacles were handled by the organizations. In this survey, semi-structured interviews were conducted to collect the necessary qualitative data to answer the question posed. These interviews were conducted at five Swedish organizations to gather a broad base. To create an understanding of the data, a thematic analysis was performed which was then compared with previous literature in the field. The study found that only two of the three implementation methods identified in a previous study were implemented in Swedish organizations. The study presents which implementation methods can suit different organizations, what obstacles may occur with the chosen implementation method, and an updated view on how organizations have proceeded in Sweden with the implementation of DevOps.

Denna studie behandlar dilemmat med ett konsumtionssamhälle som präglas av en linjär ekonomi och de negativa konsekvenserna det medför. Välstånd är i många fall starkt förknippat med en ekonomisk tillväxt vilket främjas av ett konsumtionssamhälle. Samtidigt kan inte ekonomin fortsätta växa i all framtid utan att miljön tar skada. För att lösa paradoxen behövs att företag är drivande i att ställa om till en cirkulär ekonomi. I en cirkulär ekonomi behålls resurserna i samhället i kretslopp istället för att förbrukas och bli till avfall. Genom att återanvända och återvinna produkter, material och resurser kan det ekonomiska värdet behållas. Ett tydligt problem är låg kunskap inom området, bristande affärsmodeller och att företag inte ser de ekonomiska fördelarna med en omställning till en cirkulär ekonomi. Syftet med studien är att undersöka hur företag inom produktion och distributionssektorn kan utveckla och förbättra omställningen till en cirkulär ekonomi. Forskningen är baserad på en kvalitativ metod. Den litteraturöversikt som har använts i studien är baserat på litteratur inom cirkulär ekonomi och Green Supply Chain Management. Insamling av data till den empiriska undersökningen har utförts genom djupgående intervjuer tillsammans med försäljningschefer och vice direktörer på tre företag. Vidare ha insamlad data transkriberats och analyserats med hjälp av en tematisk analys. Studiens relevans har bekräftats av resultatet. Den empiriska studien styrker behovet av tydliga direktiv och riktlinjer för att utveckla och underlätta omställningen mot en cirkulär ekonomi och GSCM. Något som respondenter från de utvalda företagen anser vara nödvändigt för att utveckla och upprätthålla höga hållbarhetsstandarder som genomsyrar hela värdekedjan. Företag inom produktion- och distributionssektorn kan förbättra omställningsprocessen genom att bryta ned processen i mindre faser. Genom att analysera implementeringsprocessen utifrån fyra identifierade faser; drivkrafter, hinder, implementeringsmetoder och resultat, underlättas omställningen. Vilket även skapar förutsättningar för kontinuerlig utveckling och förbättring av cirkulärekonmiska modeller och gröna leveranskedjor. Denna studie kan ligga till grund för vidare forskning och utveckling av tydliga direktiv och riktlinjer för implementering och vidareutveckling av cirkulär ekonomi och GSCM. Identifierade implementeringsfaser såsom drivkrafter, hinder, implementeringsmetoder samt resultat kan nyttjas för att undersöka vidareutveckling av omställningsprocessen mot cirkulär ekonomi och GSCM som en del i affärsmodellen. Denna forskning har fokuserats till ett internt perspektiv på cirkulär ekonomi och GSCM, således skulle ett annat förslag till vidare forskning kunna vara inriktad på ämnesområdet sett ur ett externt perspektiv. / This thesis addresses the issue with a consumer society characterized by a linear economy and the negative consequences it entails. In many cases, prosperity is strongly associated to economic growth based on a consumer society. Simultaneously, the economy cannot continue to grow in eternity without harming the environment. In order to solve the paradox, corporations need to be driven in changing to a circular economy. In a circular economy all resources are kept in circulation instead of being consumed and turned into waste. By reusing products, materials and resources the economic value can be maintained. A problem is lack of knowledge in the area, inadequate business models and the fact that corporations do not see the economic benefits of switching to a circular economy. Thus, the purpose with this study is to investigate how corporations within the producing and distributing sector can develop and identify possibilities to improve the transition to a circular economy. This thesis is based on a qualitative method. The literature overview is based on literature in in circular economy and Green Supply Chain Management. Collection of data for the empirical investigation has been collected through in depth interviews together with sales directors and CEOs at three corporations. Further, the collected data has been transcribed and analyzed through a thematic analysis. The relevance of the study has been confirmed by the results. The empirical study clarifies the need demand of distinct directives and guidelines for development and to facilitate the transition towards a circular economy and GSCM. Which is an opinion shared by all respondents who each and every one considers necessary in order to develop and maintain high sustainability standards that permeate the entire value chain. Corporations within the production and distribution sector can improve the conversion process through a break-down-procedure. Through analysis of the implementation process by four smaller phases; drivers, barriers, implementation methods and performances, the transition will be facilitated. Which also enables continuous development and improvements of circular economy models and green supply chains. This study can form the base for future research and development of distinct directives and guidelines for the implementation process and further evolutions of circular economy and GSCM. Identified implementation phases such as drivers, barriers, implementation methods and performance can be used to study further development of the conversion process towards circular economy and GSCM as a part of the business model. An internal perspective on circular economics and GSCM has been the focus for this study, thus proposal for future research could be focused to the subject from an external perspective.

The research focused on the assessment of the effectiveness of the methods used in the implementation of environmental legislation in the Mutasa district of Zimbabwe. Successful implementation of environmental legislation and any other legislation is determined by various factors. Some of the factors include environmental education, environmental awareness programmes, consistency in implementing environmental legislation, coordination of all stakeholders, willingness of communities to co-operate and the political will by political office bearers. This research revealed that the methods used to implement environmental legislation in the Mutasa district of Zimbabwe are ineffective. Poverty is the main reason for activities leading to environmental degradation. Communities in the Mutasa district of Zimbabwe are ignorant of environmental legislation which govern their activities. Environmental education and environmental awareness programmes are rarely carried out. The political office bearers in the Mutasa district lack the political will to ensure that environmental legislation are enforced. / Public Administration / MPA (Public Administration)

The research focused on the assessment of the effectiveness of the methods used in the implementation of environmental legislation in the Mutasa district of Zimbabwe. Successful implementation of environmental legislation and any other legislation is determined by various factors. Some of the factors include environmental education, environmental awareness programmes, consistency in implementing environmental legislation, coordination of all stakeholders, willingness of communities to co-operate and the political will by political office bearers. This research revealed that the methods used to implement environmental legislation in the Mutasa district of Zimbabwe are ineffective. Poverty is the main reason for activities leading to environmental degradation. Communities in the Mutasa district of Zimbabwe are ignorant of environmental legislation which govern their activities. Environmental education and environmental awareness programmes are rarely carried out. The political office bearers in the Mutasa district lack the political will to ensure that environmental legislation are enforced. / Public Administration and Management / MPA (Public Administration)

The comprehensive cancer control approach is used by state, tribes, tribal organizations, territorial and Pacific Island Jurisdiction cancer coalitions to spur local implementation of cancer plans to reduce the burden of cancer in jurisdictions across the country. There is a rich diversity of models and approaches to the development of relationships and scope of planning for cancer control activities between coalitions and advocates in local communities. The national comprehensive cancer control philosophy provides an operational framework while support from the Centers for Disease Control and Prevention enables coalitions to act as catalysts to bring local partners together to combat cancer in communities. This manuscript describes multiple characteristics of cancer coalitions and how they are organized. Two models of how coalitions and local partners collaborate are described. A case study method was used to identify how five different state and tribal coalitions use the two models to organize their collaborations with local communities that result in local implementation of cancer plan priorities. Conclusions support the use of multiple organizing models to ensure involvement of diverse interests and sensitivity to local cancer issues that encourages implementation of cancer control activities.

В выпускной квалификационной работе раскрыта сущность теоретико-методических подходов формирования и развития концепции бережливого производства, рассмотрена терминология, принципы маркетинга и бережливого производства, методики внедрения бережливого производства. По результатам исследования предложена авторская методика внедрения бережливого производства, методика выбора инструментов бережливого производства. Проведен анализ текущей ситуации на рынке, определено положение системообразующих предприятий, проведен анализ деятельности компании, даны рекомендации. В рамках исследования предлагается концепция проекта по внедрению бережливого производства в производственную и управленческую систему ООО «Бергауф Строительные Технологии». / In the final qualifying work, the essence of theoretical and methodological approaches to the formation and development of the concept of lean production is revealed, terminology, principles of marketing and lean production, methods of implementing lean production are considered. According to the results of the study, the author's methodology for the introduction of lean production, the methodology for choosing lean production tools is proposed. The analysis of the current market situation is carried out, the position of the backbone enterprises is determined, the analysis of the company's activities is carried out, recommendations are given. Within the framework of the study, a project concept is proposed for the introduction of lean manufacturing into the production and management system of «Bergauf Construction Technologies».