Den globala pandemin har förändrat hela världssituationen och lämnar troligen ingen oberörd. Den största förändringen för både organisationer och dess involverade aktörer är den förändrade arbetssituationen till följd av kraven på social distansering. Distansarbete uppmanas i största möjliga mån vilket har resulterat i drastiska förändringar av människors livssituationer och företags styrning och arbetssätt. Nyckeln till att lyckas med det distansbaserade arbetet anses vara utökandet av digitala verktyg och teknologiska arbetssätt, som enligt flertalet forskare behöver implementeras på ett hållbart sätt och dess effekter analyseras. Det sociala samarbetet är viktigt inom revision och påverkas av fysisk distans och rätt digitala lösningar krävs för att bibehålla effektivitet och kvalitet i arbetet. Genom denna studie syftade därför författarna till att undersöka hur en plötslig kris påverkat en organisation i revisionsbranschen, med fokus på styrningen mot ett distansbaserat arbetssätt och introducering av nya digitala lösningar. Syftet var att skapa en djupare förståelse för vilka organisatoriska effekter detta kan medföra genom att med hjälp av Normalisation Process Theory identifiera och analysera organisationens specifika förutsättningar för implementering av det nya arbetssättet. Detta gjordes genom kvalitativa intervjuer och resulterade i synliggörande av de mest påtagliga komponenterna i organisationens omställningsprocess men gav också ljus till potentiella problem relevanta att undersöka vidare inom organisationen. Drabbandet av denna kris bedöms ha resulterat i mestadels positiva eller neutrala effekter medförbättring av digitala arbetssätt och effektivare rutiner. Den mest påtagliga negativa effekten gäller den psykosociala arbetsmiljön, medarbetarnas samarbete och styrningens effektivitet. Studien ger ett bidrag som kunskapsunderlag för omställningsarbete på grund av kris och en avspegling till vad som anses bli det nya normala i en organisation av denna typ. Vidare forskning krävs för att skapa en större förståelse för de långvariga effekterna av en global arbetssituation med distansarbete och digitala arbetsprocesser. / The global pandemic has changed the whole world situation and probably leaves no one unaffected. The biggest change for both organizations and the involved actors is the changed work situation as a result of the requirements for social distancing. Teleworking is encouraged to the extent possible, which has resulted in drastic changes in people's life situations and companies' governance and working methods. The key to success with distance-based work is considered to be the expansion of digital tools and technological working methods, which according to most researchers needs to be implemented sustainably and its effects analyzed. Social cooperation is important in auditing and is affected by physical distance, the right digital solutions are required to maintain efficiency and quality of the work. Through this study, the authors therefore aimed to investigate how a sudden unexpected crisis has affected an organization in the auditing industry, with focus on the management towards a distance-based approach and the introduction of new digital solutions. The purpose was to create a deeper understanding of what organizational effects this can entail by using Normalization Process Theory to identify and analyze the organization's specific conditions for implementing the new way of working. This was done through qualitative interviews and resulted in the visibility of the most obvious components in the organization's change process, but also shed light on potential problems relevant to investigate further within the organization. The impact of this crisis is judged to have resulted in mostly positive or neutral effects with the improvement of digital working methods and more efficient routines. The most obvious negative effect concerns the psychosocial work environment, the employees' cooperation and the effectiveness of management. The study contributes to the knowledge base for adjustment work due to crisis and a contribution to what is considered to be the new normal. Further research is needed to create a greater understanding of the long-term effects of a global work situation with distance-based work and digital work processes.

Oral health promotion interventions (OHPI) seek to achieve sustainable oral health improvements through actions directed at the underlying determinants of oral health. Clinical trials often promise levels of effectiveness which are not actually achieved in general use, indicating problems with implementation. This study set out to identify an OHPI for which there was strong evidence of effectiveness and then aimed to explore issues that arose in the implementation of that intervention. Research methods A sequential portfolio design was utilised. The first phase involved systematic reviews of literature to identify existing community based OHPI and interventions shown to be effective in reducing dental caries. These were also examined to determine whether the existing evidence base was informative about the process of implementing best evidence. Systematic reviews were undertaken on effectiveness of: supervised toothbrushing with fluoridated toothpastes, supervised fluoridated mouthrinsing and promotion of dietary behaviours, all, in school children. MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE and BNI electronic databases were searched for articles published between 1990 and 2013. In total, 47 studies were included in the reviews: 21 studies on supervised toothbrushing with fluoridated toothpastes, 12 on fluoridated mouthrinsing and 14 studies on healthy dietary behaviours towards caries prevention. The second phase was a qualitative research study, which was undertaken to explore the experiences, and perceptions of participants involved in decision-making, planning and delivery of one specific community based OHPI (supervised toothbrushing) in the North East of England. Nineteen participants (NHS and school staff) participated in the qualitative study. Knowledge translation in oral health promotion One-to-one interviews and focus groups interviews were conducted with the participants. Normalisation Process Theory constructs informed the development of the interview guides and was also used in data analysis. In the third phase of the study, an integration of the findings of the first and second phases of the study was conducted. Results In the systematic reviews of literature conducted, the various levels of clinical effectiveness identified were influenced by appropriate and regular fluoride use, involvement of OHP specialists, supervision by parents and the free provision and availability of materials. There was however a general lack of comprehensive information on all aspects of implementation of OHPI. In the second phase of the study, an exploration of barriers to implementation of an OHPI revealed the following: -inadequate utilisation of research evidence -gaps in leadership and management structures -non- investment in engagement and ownership of the intervention -challenges with partnership working and evaluation of implementation of OHPI. Conclusions Availability of evidence of effectiveness of an intervention does not imply that the intervention will be successful when rolled out. Published articles on evidence-based interventions do not have comprehensive information on the mechanisms and workability of the processes required for effective implementation of OHPI. Normalisation Process Theory (NPT) enabled the exploration of factors that could facilitate knowledge translation and successful implementation of OHPI. In previous studies, NPT was used to evaluate effectiveness of interventions; in this study it was used to explore the implementation process of an OHPI and has highlighted the need for Knowledge translation in oral health promotion oral health promotion strategy makers and commissioners to revisit the “sense-making” aspect of evidence implementation, to reflect on the need for investing in all members of the team, to encourage the ‘ownership’ of interventions being implemented. In addition, there is a need to review existing leadership and management structures and to re-examine and amend the processes by which OHPI are monitored and reported. These measures would enable maximised effectiveness and sustainability of clinically effective OHPI.

There is a consensus within the United Nations (UN), as well as various governmental entities, politicians, individuals, scholars, and academic communities, on the need to reform governmental performances. However, there is no unanimity among them pertaining to a specific reforming model that is valid for all contexts worldwide. Accordingly, many performance management processes and practical techniques have been put into practice, which aim at improving governmental institutions' performance. Hence, the purpose of this research is to develop, by studying the public health services that are provided by the government, an effective model, with the aim of improving governmental performance in the context of Bahrain. With regard to originality and values, the research discerns that among the many factors affecting governmental entities' performance, there are two dominant contextual factors, i.e. the sociocultural and political forces, both of which synergise with the so-called United Nations Development Programme (UNDP) Good Governance Approach. The study develops a new perspective on the Interactive Complex Intervention Model (ICIM), stemming from the Grounded Theory (GT) and Normalisation Process Theory/Model (NPT/M), as disclosed in practical terms by the outcomes of the data gathered and its analysis. In fact, although those elements influence all other factors, there are interactive correlative impacts among all factors. Despite these outcomes, the data obtained from the research cannot be generalised, as they are derived from the local context of Bahrain; certainly until now, they can allow other similar contexts in particular to implement the insights reported in this study. It is important to note that the most influencing factor enabling this research, which aims to develop the ICIM for reforming governmental entities' performance in Bahrain, is the salient points raised in Imam Ali's famous consultative letter to the Governor of Egypt, Malik Ashtar, which he wrote while he was the Caliph, as scholars regard this letter as a basic guide for the Islamic administration and the UNDP Good Governance Approach. Regarding the practical implications, the research has attempted to empirically understand the role of the aforementioned primary contributing forces, that are regarded as the critical prerequisite - the first step that allows the governments' decision makers, based on the underlying knowledge involved in the work, to forthwith provide them with several contextual practical insights towards adopting the ICIM in order to enhance and reform the government entities' performance.