Sverige har haft tydliga problem med sin styrning av välfärdssektorn till följd av incitament som kan hämtas ur NPM. Detta främst i form av en mål- och resultatstyrning som centraliserat makten med återkommande rapporteringskrav. För att komma till bukt med problemen inrättades åtgärder för att främja en ny styrning. I nuläget har styrformen tillitsbaserad styrning och ledning sett dagens ljus vilket innefattar en styrning, kultur och arbetssätt med fokus på verksamhetens syfte och brukarens behov. Studien avsåg ge en grundlig bild kring upplevelser av styrning och ledning inom en kommunal vård- och omsorgsförvaltning i förhållande till ett ideal av tillitsbaserad styrning och ledning. Detta för att producera kunskap om hur styrning och ledning upplevs inom en kommunal vård- och omsorgsförvaltning och för att bidra till utvecklingen av tillitsbaserad styrning och ledning inom densamma. I studien genomfördes kvalitativa intervjuer med fyra enhetschefer vilkas upplevelser ställts i förhållande till en idealtyp av tillitsbaserad styrning och ledning. De sammanvägda upplevelserna av styrning och ledning motsvarar ett ideal av tillitsbaserad styrning och ledning i hög grad. Mot denna bakgrund indikerar studien på att det finns incitament som går att härleda från ett ideal av tillitsbaserad styrning och ledning. Vidare framkommer att det finns incitament som kan härledas från NPM. Respondenternas svar indikerar även på att förvaltningen ses som värderingsstyrd med uppfattningar om gott ledarskap, något som skapar förutsättningar att försätta utveckla den tillitsbaserade styrning och ledningen inom densamma. Slutligen har studien, baserat på respondenternas svar, resulterat i en rad upplevda utvecklingsområden för den fortsatta utvecklingen av styrformen inom förvaltningen. Resultaten skall enbart ses som indikationer på hur styrning och ledning upplevs samt hur styrformen kan utvecklas inom förvaltningen. Allt eftersom svaren i många meningar går och inte speglar en övergripande upplevd bild. / Sweden has had clear problems with its governance of the welfare sector because of incentives that can be obtained from NPM. This mainly in forms of performance management that has centralized the authority with recurring reporting requirements. To overcome these problems, measures were taken to promote a new governance. At present, the form of trust-based governance has seen the light of day. This includes a governance, culture and working method with focus on the purpose of the organisation and the needs of the user. The following study was intended to provide a thorough picture of experiences regarding governance within a municipal healthcare administration, in relation to an ideal of trust-based governance. This with an intention to produce knowledge about how governance is experienced within a municipal healthcare administration and to contribute to the development of governance within it. The study was based on qualitative interviews with four first line managers, whose experiences where compared to an ideal of trust-based governance. The results show that the combined experiences of governance largely correspond to an ideal of trust-based governance. Under those terms the study indicates that there are experiences which can be deduced from an ideal of trust-based governance. Furthermore, there are incentives which can be deduced from NPM. The interviewees responses indicate that the administration is regarded as value-driven with perceptions of good leadership, which creates conditions for developing the trust-based governance within it. Finally, the study, based on the responses, has resulted in several experienced aspects for the continued development of the trust-based governance within the administration. The results should only be indications of how governance is experienced and how the form of governance can be developed. All because the responses in many sentences differ and not reflects an overall perceived image.

Background: In Swedish elderly care, New Public Management (NPM) can be identified in several different ways, for instance it has entailed changed control principles with an increased element of various standardized instruments. Another important feature is that political governance has become increasingly decentralized. The unit managers within elderly care are the professional group that to a large extent has the responsibility to implement various changes. For unit managers, this means a complex professional role with a responsibility for the staff and their work environment, the budget and the realization of the organization's overall goals in practice. Hence the unit managers' professional role often entails conflicts of loyalty between competing interest on different levels in the organization. Purpose: The purpose of the study is to investigate how the unit manager's work processes and professional role in a medium-sized municipality can be understood in relation to NPM. Methods: The study was conducted through individual interviews with eight unit managers in elderly care. Respondents were recruited through e-mail, all respondents worked in the same medium-sized municipality. The interviews were conducted using an interview guide. We used a qualitative empirically driven thematic analysis method to categorize our data. In our analysis we implored a deductive approach, using several concepts from a critical perspective in relation to NPM. Results: Unit managers' professional role in elderly care in the chosen municipality is largely characterized by budget, administrative work and a lot of time is devoted to evaluating different key figures. Thus, the way in which the professional role of unit managers and elderly care in general is organized, managed, and evaluated in the municipality we studied can be understood as a form of NPM. The position of unit managers is an intermediate position between the organization, staff, caregivers, and relatives. Unit managers are faced with many demands from management, from caregivers and from relatives. The biggest challenge both in the present and in the future is the recruitment of educated and experienced staff.

In September 2015, all member states of the United Nations signed upon the 17 Sustainable Development Goals (SDGs), constituting the core of the 2030 Agenda. The 2030 Agenda form an integrated policy agenda, with the SDGs characterised as inherently interlinked. Policy integration and coordination across customary boundaries are assumed as fundamental when attempting to implement the indivisible and interlinked objectives. The public sector has, however, shown insufficient capabilities of such, characterised by increasing specialisation and fragmentation following from unforeseen effects of New Public Management (NPM) reforms. To facilitate necessary policy integration and coordination, significant alterations to policies and institutions are assumed to be necessary, and post-NPM approaches that seeks to join up the governmental apparatus have surfaced as counter-movements.  Building on the above, the thesis set out to examine policy integration and coordination as cornerstones when attempting to implement the 2030 Agenda, as well as organisational key capabilities and/or barriers for such. The thesis’ theoretical point of departure builds on the fields of organisation theory and public administration, and the longstanding deliberation between the two dichotomies specialisation and coordination. Such dichotomy is elaborated on through the NPM perspective contrasted against the post-NPM perspective. The thesis’ central theoretical concepts are policy integration, coordination and specialisation. The thesis was carried out as a qualitative case study, researching the experiences and opinions of 16 civil servants, from 14 Swedish municipalities, operating strategically within sustainable development on the municipal level, through semi-structured interviews.  Research findings indicate deficient policy integration in the majority of municipalities, with the 2030 Agenda being treated in separate programmes for social, environmental and economic sustainability respectively. Further, is vertical coordination, within the organisation as well as between governmental levels, appearing as insufficient. Identified organisational key factors include: the role of organisation; the role of the budget; the role of the ordinary municipal structure; the role of the leaders; the role of the center; the role of the individual civil servant; and, the role of communication. Many of the organisational key factors are described as capabilities as well as at the same time being barriers, and, hence, constituting contradictory practices for the civil servants and the organisations. The budgetary process especially stands out as one such contradiction. Similarly, are signs of the NPM perspective and the post-NPM perspective surfacing as simultaneous logics, practices and contradictions the civil servants must relate to. To strengthen policy integration and coordination, as well as the advancements of the 2030 Agenda, some practices may have to be modified.

La Nucléophosmine (NPM1) est l’une des protéines les plus fréquemment altérée dans les troubles hématopoïétiques. Sa mutation, au niveau de l’exon 12, est impliquée dans un tiers des leucémies myéloïdes aiguës et constitue l’un des premiers évènements dans la leucémogénèse. Elle est caractérisée par la séquestration aberrante de NPM1 au cytoplasme, on parle alors de NPMc+. NPM1 peut également subir plusieurs translocations menant à la synthèse de protéines de fusion dont NPM-MLF1. Cette dernière est impliquée dans les syndromes myéloprolifératifs et en plus faible proportion dans les leucémies myéloïdes aiguës. Cette translocation reste peu documentée. NPM1 est une protéine multifonctionnelle dont le rôle dans la régulation génique reste à être définie. La littérature fait état de quelques études rapportant que NPM1 influencerait l’expression génique mais aucun mécanisme n’a encore été clairement décrit. Nous proposons donc dans ce projet de doctorat, de définir comment NPM1 régule la transcription et nous déterminerons si la translocation NPM-MLF1 a un effet différent de celui de NPM1. Afin de déterminer de nouveaux partenaires d’interaction, nous avons purifié les complexes protéiques de NPM1 et NPM-MLF1 dans la lignée de cellules hématopoïétique K562. Dans une étude protéomique, nous avons mis en évidence par spectrométrie de masse puis par immunoprécipitation, que NPM1 et NPM-MLF1 interagissent avec les complexes de remodelage de la chromatine NuRD, P/BAF et ISWI. Par Ampli-Sequencing, nous avons identifié des gènes dérégulés par la baisse d’expression de NPM1 et anormalement exprimés chez les patients présentant une leucémie myéloïde aiguë avec mutation NPMc+. Nous avons déterminé par immunoprécipitation de la chromatine que NPM1 et NPM-MLF1 peuvent influencer l’expression de gènes cibles via le recrutement du complexe NuRD au niveau du site d’initiation de la transcription. Le profil des modifications d’histone est également perturbé. Nous montrons ici que NPM1 et NPM-MLF1 sont impliqués à la fois dans la répression et l’activation génique. Dans une seconde partie du projet, nous proposons de déterminer l’importance physiologique de la régulation, par NPM1-NuRD, de l’un des gènes cibles mis en évidence : SPARC. La méthode CRISPR-Cas9 a été utilisée pour générer des clones uniques K562 dont l’expression de SPARC est absente et celle de NPM1 est diminuée. Cette étude démontre que la diminution d’expression de NPM1 synergise avec la perte de SPARC afin d’induire la différenciation érythroïde et réduire l’invasion cellulaire. Nous montrons donc pour la première fois que NPM1 et la translocation NPM-MLF1 peuvent interagir avec des complexes de remodelage de la chromatine et peuvent influencer leur recrutement au niveau de gènes cibles afin de réguler la transcription. Nos résultats suggèrent que NPM1 est un facteur important dans le contrôle de la modification du transcriptome associée à la différenciation des cellules hématopoïétiques. Ce projet apporte donc de nouvel éclairage sur la compréhension des mécanismes associés à la mise en place des leucémies myéloïdes aiguës présentant une mutation NPMc+ ou la translocation NPM-MLF1. / Nucleophosmine (NPM1) is one of the most frequent altered proteins in hematopoietic disorders. NPM1 exon 12 mutation characterizes one third of all acute myeloid leukemia and can be fundamental to leukemogenesis. This mutation is characterized by the aberrant sequestration of NPM1 to the cytoplasm, the mutated protein is then called NPMc+. NPM1 can also undergo several translocations leading to the synthesis of fusion proteins including NPM-MLF1. The latter is involved in myeloproliferative disorders and in a lower proportion in acute myeloid leukemia. Little is known about this translocation. NPM1 is a multifunctional protein reported to influence gene regulation. The function(s) of NPM1 in gene regulation remains to be defined. The aim of this doctoral research project was to define how NPM1 regulates transcription and determine whether the NPM-MLF1 translocation could disrupt gene regulation imposed by NPM1. In order to determine new protein interaction partners, we purified NPM1 and NPM-MLF1 complexes in the K562 hematopoietic cell line. In a proteomic analysis performed by tandem immunoaffinity purifications followed by mass spectrometry and immunoprecipitation, we identified multiple nuclear protein partners of NPM1 and NPM-MLF1. Importantly, we found that NPM1 and NPM-MLF1 can interact with the chromatin remodeling complexes NuRD, P/BAF and ISWI. An analysis made by Ampli-Sequencing, indicated that multiple genes dysregulated by the decrease expression of NPM1 were also reported to be abnormally expressed in acute myeloid leukemia cells characterized by the NPMc + mutation. We demonstrate that not only NPM1 but also NPM-MLF1 can be recruited to NPM1 regulated genes and affect the chromatin recruitment of the NuRD complex. The variation in NuRD recruitment imposed by NPM1 knockdown or NPM-MLF1 expression, is associated to the abnormal transcriptional regulation of the target genes. We show here that NPM1 and NPM-MLF1 are involved in both gene repression and activation. In a second part of the project, we investigated the physiological importance of gene regulation imposed by NPM1-NuRD in these cells. Importance of the genetic link between NPM1 and the target gene SPARC was defined. Using the CRISPR-Cas9 methodology, we generated unique K562 clones whereby SPARC expression is abrogated and NPM1 expression is decreased. The decrease of NPM1 expression synergizes with the loss of SPARC expression to induce erythroid differentiation and reduce cell invasion. The results presented provide the first demonstration that NPM1 and NPM-MLF1 translocation can interact with chromatin remodeling complexes, influence their recruitment to target genes and thereby, influence the expression of specific genes. This project provides new information to understanding mechanisms affected in acute myeloid leukemia characterized by NPMc+ mutation or NPM-MLF1 translocation.

For a long time, the Swedish welfare sector has received criticism, something that has placed great demands on managers within these organizations. The study’s purpose was to investigate how managers shape their leadership in relation to their environment and the demands placed on them. The study used various leadership theories and emotional intelligence research as tools for analysis. Data collection was conducted using 5 semistructured interviews with managers within various human-treating organizations in Dalarna. The data was analyzed through a qualitative thematic analysis method. The results found obstacles that negatively affect managers’ leadership development, such as greater administrative responsibility and streamlining, something NPM encourages. The results also show that staff shortages have a big impact on managers’ leadership. The managers express that there has been a shift in focus from management providing the best quality for users to instead be about cost efficiency. / Under lång tid har den svenska välfärdssektorn fått hård kritik, något som har ställt stora krav på cheferna inom dessa organisationer. Syftet med denna studie var att undersöka hur chefer inom människobehandlande organisationer formar sitt ledarskap utifrån förutsättningarna som finns och kraven som ställs. Studien har använt sig av olika ledarskapsteorier samt forskning om emotionell intelligens som analysverktyg. Som datainsamlingsmetod utfördes 5 semistrukturerade intervjuer med chefer inom olika människobehandlande organisationer i Dalarna. Data analyserades genom en kvalitativ tematisk analys. Resultatet fann hinder som negativt påverkar chefers ledarskapsutveckling, såsom större administrativt ansvar och fokus på budget samt effektivisering som styrlogiken NPM uppmuntrar. Resultatet visade även att personalbrist har en stor inverkan på chefernas ledarskap. Cheferna uttrycker att det skett ett skifte från att chefskapet handlat om att ge bästa möjliga kvalitet för klienterna till att handla om kostnadseffektivitet.

Polismyndigheten har i uppdrag av regeringen att med sitt kompetensförsörjande arbete öka sin tillväxt med 10 000 fler anställda till utgången av 2024. Mot bakgrund av kompetensförsörjningens styrande roll i en organisation syftar uppsatsen till att undersöka hur de olika styrformer som präglat offentlig sektor över tid har präglat Polismyndighetens kompetensförsörjande arbete. I uppsatsen tillämpas institutionell logik som analytisk lins, vilket innebär en analytisk inramning för att kunna studera de ömsesidiga relationerna mellan institutioner, individer och organisationer i sociala system. För detta ändamål används en byråkratisk logik, en managementlogik och en tillitslogik för att närmare undersöka de bärande principerna för att styra och organisera Polismyndighetens kompetensförsörjande arbete. Det teoretiska ramverket bygger på olika kännetecken utmärkande för de styrningsreformer som präglat offentlig förvaltning över tid. Med kvalitativ textanalys som metodologisk utgångspunkt har Polismyndighetens styrande regler, rutiner och beslut med relevans för det kompetensförsörjande arbetet bearbetats och tolkats. Resultatet tyder på att Polismyndighetens kompetensförsörjande arbete bär spår av de tre logikerna, med den byråkratiska logiken och managementlogiken tydligast framträdande. Observationer av tillitslogiken kunde enbart skönjas fragmentariskt, ett faktum som innebar utmaningar i tolkningen av logikens särskilda egenskaper för att styra och organisera. Uppsatsen presenterar därutöver ett resonemang kring logikernas samtidiga existens i modellen för kompetensförsörjning och vad detta kan innebära för Polismyndighetens mål om en ökad tillväxt.

The most usual form of out-of-home care for children in Sweden is foster care. The responsibility lies with the municipalities' social services, while implementation can be handed over to independent foster care agencies, IFA. The purpose of this thesis is to examine the unit managers’ experiences with IFA, with a focus on support towards the foster parents. The thesis was conducted through semi-structured interviews with eight unit managers from various parts of the country and analyzed through qualitative thematic analysis. The results showed that the quality of the service varied between different providers, and that most municipalities wanted to become independent again with the management of foster homes, due to excessive costs and a lack of transparency. The result also showed that support such as high availability of the consultant could be a contributing factor when engaging the service, especially in more difficult cases. The unit managers often experienced a competition for the few available foster homes, while at the same time they believed that the recruitment work of private actors was deficient as they approved unsuitable foster homes. This result creates uncertainty about whether the children's needs are met in a legally secure manner.

The present thesis is an exploration of normalization processes and the problem of appropriation in labor conflict. More specifically, it analyses the way contemporary labor conflicts in nursing relate to, and thereby help to illuminate, changes in modes of gender normalization under neoliberalism, and how nurse labor conflict thereby sheds light on wider patterns of labor strife. Analysis shows how a “virtue script” bound up with long-lasting patterns of gender normalization in nursing becomes tangled with forms of abstract labor related to “new public management” reform. Although the restructuring of work threatens public professionals’ autonomy, at the same time, it provides opportunities for resistance through collective action. What is more, this restructuring process facilitates the appropriation by nurses and, by implication, other public workers, of the discourses and ideals that belonged to the ethos of the Keynesian welfare state. However, this is a contradictory process, since the discourses and ideals thus appropriated inhere in modes of labor exploitation and normalization. Analysis indicates that although appropriation risks to reinforce gendered and exploitative ideas about work, the strategy can be a lever of collective mobilization, and one of its possible outcomes is the radical transformation of the entities it takes possession of. This interview study is mainly based on four journal articles, attending to different aspects of an act of collective resignation taken by registered nurses at a Swedish hospital ward. This is an emerging form of collective action and the thesis provides one of the first analyses of this new grassroots and workplace-based phenomenon, which may be considered its particular empirical contribution. On the other hand, the chapters of the cover essay unfold a sustained argument on normalization and appropriation, thereby elaborating theoretical themes broached in the articles. The focal point of this discussion is a certain concept of form, deployed in Marxist and feminist theory, a concept pointing to the identity of thought-forms and practically enacted forms. Further, these forms migrate: they are evoked in practices wherein “the mind is not active as sentient” (Hegel), later to be projected by the mind onto different entities. The results of the discussion thus question common approaches to normalization. In particular, it is untenable to oppose a tacit and internal mode of control where individuals are induced to comply by attaching to identifications (by becoming/being made into subjects) to an overt and external mode reliant on sheer coercion. This matter–form dichotomy should be dissolved, and modes of coercion should be understood to leave subjective imprints—not at the level of identity but at the level of thought’s infrastructure, that is, form. / Föreliggande avhandling utforskar normaliseringsprocesser och problem rörande appropriering i samband med arbetskonflikter. Avhandlingen analyserar hur sam-tida arbetskonflikter i sjuksköterskeprofessionen relaterar till och sålunda belyser förändrad genusnormalisering i en nyliberal tid, samt hur dessa konflikter belyser övergripande konfliktmönster i arbetslivet. Analysen påvisar hur en ”dygdighets-norm” kopplad till långlivade modaliteter av genusnormalisering sammanvävs med en form av abstrakt arbete relaterad till sentida NPM-reformer. Men medan denna omstruktureringsprocess urholkar den autonomi som professioner i offentlig sektor länge innehaft medför den också möjligheter till kollektiva motståndshandlingar. Vidare möjliggör denna nyliberala omstrukturering sjuksköterskors—liksom andra offentliga professioners—appropriering av diskurser och ideal som var centrala i den tidigare, keynesianska, välfärdsstaten; men detta är en motsägelsefull process då dessa diskurser och ideal är sprungna ur, och präglade av, historier av utsugning och normalisering. Analysen visar att medan appropriering visserligen riskerar att reproducera former av normalisering underlättar denna strategi mobilisering och kan i förlängningen omvandla övertagna diskurser och ideal. Denna intervjustudie är huvudsakligen baserad på fyra artiklar: de analyserar olika aspekter av en kollektiv uppsägningsaktion bland sjuksköterskor vid en sjukhus-avdelning. Detta är en framväxande typ av aktion i Sverige och avhandlingen är en av de första studierna av denna gräsrots- och arbetsplatsbaserade kampform, vilket kan ses som dess empiriska forskningsbidrag. I kappan förs, å andra sidan, en kon-tinuerlig teoretisk diskussion kring normalisering och appropriering som utvecklar teman som lyfts i de enskilda artiklarna. Diskussionen kretsar kring ett visst form-begrepp, som härrör ur marxistisk och feministisk teori och som påvisar en identitet mellan tankeform och praktiskt artikulerad form. Dessa former migrerar; de uttrycks omedvetet i praktiker där individens fokus är annorstädes och projiceras sedan på andra praktiker. I diskussionen ifrågasätts sålunda vedertagna förståelser av norma-lisering: det är teoretiskt ofruktbart att ställa omedvetna, interna, former av kontroll där lydnad eller konformitet uppnås via internaliseringen av påbjudna identiteter mot medvetna, externa, eller tvingande, former av kontroll. En häri latent dikotomi om materia respektive form bör upplösas i syfte att synliggöra hur ett slags kontroll över arbete lämnar subjektiverande avtryck, inte genom att påbjuda identifikationer utan genom att forma vad som kan beskrivas som tänkandets minsta beståndsdelar. / <p>Vid tidpunkten för disputationen var följande delarbeten opublicerade: delarbete 2 och 4 inskickat.</p><p>At the time of the doctoral defence the following papers were unpublished: paper 2 and 4 submitted.</p>

This essay concerns teacher professionalism and how its prerequisites have been affected by the politcs of the employer organization Swedish Association of Local Authorities and Regions (SALAR). In Sweden, the government has during the last thirty years carried out extensive school reforms, fueled by the paradigm of New Public Management. On the whole, these reforms have contributed to the so called 'de-professionalization' of Swedish school teachers. However, the impact of labour politics has to great lenghts been neglected in political research on teacher professionalism, and that is the gap which this thesis aims to fill. By using a wide range of material, such as collective bargaining agreements, policy documents, debate articles and semistructured interviews, a reconstruction of the SALARs' labour politics has been made. Furthermore, an ideal-typical analytical framework of the two contrasting and competing governance models new managerialism and professionalism was applied on the reconstruction. The results are in short that the organization in many ways has contributed to the de-professionalization process which Swedish school teachers have undergone. By allocating power and authority to headmasters and municipalities, the discretion and legitimacy of theteacher profession itself has been circumscribed. Via these policies, a clearer hierarchy between the profession and its headmasters has come into place. Furthermore, the results indicate that the SALAR promotes organizational norms and values, rather than professional dito. In the light of the now being 'recruitment crisis' and the low attraction of the teaching profession, the results are particurlarly relevant.

I föreliggande uppsats ville vi fokusera på den styrning vi i dag ser och hur den i olika grad påverkar specialpedagogens yrkesroll. Diskussionen om lärarna som professionella har betonats i takt med att styrningen av skolan har förändradrats och decentraliserats till att bli den mål- och resultatstyrda skola vi har i dag med ett kommunalt huvudmannaskap. Syftet formulerades som så att beskriva och analysera ett antal skolpolitiska reformer och deras potentiella inverkan på specialpedagogprofessionen. Vi utgick ifrån professionsteori som ett teoretiskt ramverk som hjälpte oss att expandera förståelsen för studiens resultat. Med hjälp av styrdokument, forskning inom området samt intervjuer med specialpedagoger skulle studien besvara följande frågeställningar. Vad har specialpedagoger för tankar, erfarenheter och idéer gällande sin profession? Vad har specialpedagoger för tankar, erfarenheter och idéer om professionen i förhållande till de senaste reformerna på området? Vilka faktorer påverkar specialpedagogens profession? Specialpedagogerna i studien har alla ett specialpedagogiskt perspektiv där de ser på skolan utifrån tre olika nivåer; organisation-, grupp- och individ. Vi fann att ändringarna i lagen gällande extra anpassningar och särskilt stöd samt förstelärarreformen har inverkat på professionen och i och med delvis detta kom vi fram till fem faktorer som påverkar specialpedagogprofessionen. Forskning om och utvärdering av implementering av reformer och utfallet av dem kan vara ett sätt att förhoppningsvis stärka professionerna i vårt ovanifrån styrda utbildningsväsende.