This dissertation aims to enhance the understanding of stewardship in family firms by studying its antecedents related to the controlling family\'s ability and willingness to influence the firm, management control mechanisms design and procedural justice and its consequences regardingits moderating effect onthe relationship between family involvement and performance. First, we explore the heterogeneity among family businesses, by considering the influence of a family\'s ability and willingness on the design of formal and participative management control mechanisms. We define ability as the level of family involvement in ownership and in management. Willingness is based on the socioemotional wealth (SEW) literature, which refers to the controlling family\'s affect-related value invested in the firm. We focus on the following SEW sub-dimensions (1) family control and influence (2) and renewal of family bonds. Second, we investigate whether management control mechanisms such as goal setting and performance evaluation often installed to curb manager\'s opportunistic behavior, stimulate stewardship in family firms. We focus on the degree of participation and formality applied to these management control mechanisms, which elements are studied in the procedural justice literature. Therefore, we discuss how management control mechanisms\' design and procedural justice are associated with stewardship. Stewardship implies a collective-serving and pro-organizational attitudes and behaviors and constitutes a distinctive characteristic of family firms. Third, we examine whether a stewardship-oriented culture moderates the association between family involvement and family firm performance, whereby family involvement is a sub-item of the familiness construct, which focuses on the interaction between family members and its business.To test these relationships in an empirical way, we developed a survey and selected data from medium and large Brazilian family firms. We applied Structural Equation Modeling (SmartPLS) as the main data analysis method to test our hypotheses. The contributions of this study are multiple to the literature. First, more insights are provided in the adoption of participative and formal management control mechanisms in family firms and how a family\'s willingness to influence the firm creates different adoption patterns. We also demonstrate that different SEW intentions must be treated separately since each sub-dimension influences the design of management control mechanisms in the family business in a different way. Second, the results show how formal and participative goal setting and performance evaluation stimulate stewardship identification and stewardship-oriented culture in the family firm. This study provides evidence to practitioners that goal setting and performance evaluation, usually studied as agency mechanisms can foster stewardship in the family firm if they are designed based on the fairness principles. Third, the study reveals that the relationship between familiness and family firm performance is moderated by a stewardship-oriented culture, indicating patterns that lead to a higher financial performance. / Esta tese visa aprimorar a compreensão sobre stewardship nas empresas familiares, estudando seus antecedentes relacionados à capacidade e às intenções da família controladora de influenciar a empresa, o desenho dos mecanismos de controle gerencial e a justiça processual, e suas consequências ao moderar a relação entre envolvimento da família e desempenho. Primeiro, exploramos a heterogeneidade entre as empresas familiares, considerando a influência da habilidade e da intenção da família sobre o desenho de mecanismos de controle gerencial formais e participativos. Definimos habilidade como o nível de envolvimento familiar na propriedade e na gestão. As intenções são baseadas na literatura da riqueza sócio-emocional (SEW), que se refere ao valor do afeto da família controladora investido na empresa. Estudamos as seguintes sub-dimensões da SEW (1) controle e influência familiar (2) e renovação dos laços familiares. Em segundo lugar, investigamos se os mecanismos de controle gerencial, como a definição de objetivos e a avaliação de desempenho, geralmente estabelecidos para reduzir o comportamento oportunista do gestor, estimulam o stewardship nas empresas familiares. Focamos no grau de participação e formalidade aplicados a esses mecanismos de controle gerencial, cujos elementos são estudados na literatura de justiça processual. Portanto, discutimos como o desenho dos mecanismos de controle gerencial e a justiça processual estão associados ao stewardship. Stewardship implica em atitudes e comportamentos coletivos e pró-organizacionais e constitui em uma característica distintiva das empresas familiares. Em terceiro lugar, examinamos se uma cultura orientada para o stewardship modera a associação entre envolvimento da famíliae desempenho da empresa familiar,onde o envolvimento da família é um subitem doconstruto familinessque por sua vez foca na interação entre os membros da família e o negócio. Para testar essas relações de forma empírica, desenvolvemos uma pesquisa e obtivemos dados de empresas familiares brasileiras de médio e grande porte. Aplicamos a Modelagem de Equações Estruturais (SmartPLS) como o principal método de análise de dados para testar nossas hipóteses. As contribuições deste estudo são múltiplas para a literatura. Em primeiro lugar, são fornecidas mais ideias sobre o desenho de mecanismos de controle gerencial participativos e formais nas empresas familiares e como a intenção da família de influenciar a empresa cria diferentes padrões de adoção. Também demonstramos que as diferentes intenções da SEW devem ser tratadas separadamente, uma vez que cada sub-dimensão influencia o desenho dos mecanismos de governança na empresa familiar de uma maneira diferente. Em segundo lugar, os resultados mostram como a definição de objetivos e a avaliação do desempenho formais e participativos estimulam a identificação cultura orientada para o stewardship na empresa familiar. Este estudo fornece evidências aos profissionais de que a definição de objetivos e a avaliação do desempenho, geralmente estudados como mecanismos de agência podem promover o stewardship na empresa familiar, se forem delineados com base nos princípios da justiça. Em terceiro lugar, o estudo revela que a relação entre envolvimento da família e desempenho da empresa familiar é moderada pela cultura orientada para ostewardship, indicando padrões que levam a um maior desempenho financeiro.

Antimicrobial resistance is a significant global health problem. Misuse of antibiotics is associated with antimicrobial resistance which presents clinicians with treatment challenges and increases the complexity of the decision making process related to the selection of appropriate antibiotic therapy. Antibiotic resistant organisms can often lead to nosocomial infections (NIs) and undoubtedly causes patient harm and increases healthcare costs. According to the National Institute of Allergy and Infectious Diseases (NIAID), at least 70% of the nosocomial infections are caused by antibiotic-resistant organisms. In addition to the problem of inappropriate prescribing, the decreased production of antimicrobial agents over the past 25 years has restricted the arsenal of available antimicrobial agents. The combination of inappropriate antibiotic prescribing practices and reduced research and development of new antimicrobial agents have promoted concerns that society may soon return to a pre-antibiotic era. Addressing the attitudes and behaviours that contribute to inappropriate antibiotic prescribing is a potentially effective and immediate solution to the growing antimicrobial resistance problem. Modifying clinicians' prescribing behaviour with antibiotic decision guidelines and highlighting the problematic side of this issue can promote judicious antibiotic prescribing practices. Representing the existing data regarding the use and misuse of antimicrobials in a Lebanese hospital can support and encourage initiating and complying with antibiotic stewardship programs and prescription guidelines. Purpose: The objectives of this study were to determine current levels and trends in prescribing antibiotics to patients in a Lebanese hospital, (2) to identify the factors that physicians considered when deciding to start antibiotics, (3) to explore whether antimicrobial use (empiric, prophylactic, targeted) will change when physicians fill out a form to document why they prescribed antibiotics, (4) to explore whether an increase in bacterial resistance occurs when antimicrobial consumption increases, (5) to explore the clinicians' perception towards antimicrobial use and antimicrobial stewardship program pre- and post- implementation of an antibiotic assessment form, (6) to explore the effect of the implemented antimicrobial stewardship intervention combined with hand hygiene (HH) on healthcare associated infection rate (HAIs) in the hospital. One-year retrospective study in a Lebanese hospital was conducted to determine the percentage of patients who received antimicrobial treatment and to identify the inappropriateness of their use in different hospital departments. A 12-months intervention was then implemented during which all attending physicians were asked to fill an antimicrobial assessment form (AAF) to document their rationale for starting antimicrobial therapy. In addition, this AAF was used to identify factors physicians considered when deciding to prescribe antimicrobials. Data from the AAFs suggested that physicians in the hospital often considered elevated C-reactive protein, elevated white blood cell counts, and elevated temperatures when deciding to start antimicrobial therapy. Data showed that antibiotic consumption and the median duration of empiric and targeted therapies decreased significantly during the intervention period when compared to the pre-intervention period. Antibiotic appropriateness was also increased significantly after the intervention was conducted. In addition, a better understanding of antimicrobial stewardship strategies was also noted by physicians after the implementation of the intervention. On the basis of these results, AAF filling was a successful intervention to reduce antibiotic use and to urge physicians to refer to antibiotic guidelines when initiating an antimicrobial agent. However, additional measures such as automatic stop orders and computer decision support may be easier and useful for reducing the duration of therapy in hospitals.

Uppsatsen utgår ifrån Agency- och Stewardship Theory samt Project Governance som bakgrund till att beskriva hur projektorganisationer arbetar med styrning av projekt. Studien ämnar skildra hur styrning av projekt påverkar projektbeställares och projektledares arbete i projekt vad gäller tillsyn, tillit samt kommunikation. För att göra detta är studien baserad på sju kvalitativa semi-strukturerade intervjuer med respondenter som verkar inom olika branscher på arbetsmarknaden. Datan från intervjuerna bearbetades sedan med s.k. deduktiv tematisk analys för att göra den mer presenter- och hanterbar. Agency- och Stewardship Theory är nära sammankopplade med Project Governance, även om de i sig själva är helt skilda. Agency- och Stewardship theory berör den eventuella problematik som kan uppstå när en uppgift delegeras från en part till en annan, något som är högst aktuellt i en projektorganisation. Project Governance är däremot ett ramverk vari det framkommer hur moderorganisationen vill att projekt förhåller sig till rörande ett antal parametrar. Vi har valt att presentera fyra olika perspektiv på Project Governance och en sammanställning av gemensamma drag i perspektiven är att Project Governance involverar ett antal styråtgärder så som att anpassa projektets syfte och mål med moderorganisationens, olika former av kontrollmekanismer och styrgruppens sammansättning. Det framkom i intervjuerna och sedermera i resultatet att inslag av Project Governance är ständigt påverkande och återkommande i samtliga av respondenternas arbetssituation. Det rör sig om generella styrmedel så som ekonomimöten med kunder eller entreprenörer och rapporteringsskyldigheter till fasta beslutspunkter och kontinuerliga möten med styrgruppen. Det främsta och kanske mest utpräglade resultatet är hur pass mycket tilltro det finns i s.k. partneringssamarbeten och hur styrningen blir allt mer komplex när allt fler företag blandas in.

Earnings management has had consequence in financial disasters, such as Enron, WorldCom and Nortel. More recently, it is alleged in the Lehman bankruptcy, which ushered in a global financial meltdown. Yet despite increased regulation and focus on governance and auditing, researchers find that earnings management remains a common practice. Accounting academics have responded to the earnings management problem by conducting studies using secondary data for governance variables and financial models to measure earnings management indirectly. Meanwhile, governance variables measured with secondary data now show little variability because of improved best practice and regulation, and there is strong evidence that the agency causal model and the earnings management measures are seriously flawed. This study uses a mixed-mode research model based on agency and stewardship theory to explain earnings management, and uses a more direct measure of its occurrence, namely the level of board information asymmetries and board monitoring and control actions, as a proxy for earnings management. Primary data is used to provide direct measures of important governance variables, which produce mixed results relative to earnings management using secondary data. In a survey of 245 Canadian public company directors, this study finds that an independent chair, less busy directors, and a smaller board does reduce earnings management, but that this impact is strongly moderated by the CEO's attributes. A CEO with stewardship attributes reduces earnings management, and a CEO with agency attributes increases earnings management. There also is evidence in the study that agency conflict variables improve governance outcomes, in this case, reducing the level of earnings management, and that board processes around monitoring and control actions could be a problem.

Abstract Background & Problem: During recent years there have been disclosed instances of labor union representatives wrongfully using the members’ funds. Considering the nature of the labor unions this kind of behavior is surprising, and therefore there is an interest in what motivates these representatives in their actions. Agency theory and Stewardship theory suggests two opposing views of corporate governance and motivation. The authors of this study attempt to contribute to this discussion by exploring the environment within labor unions.  Purpose: The purpose of this study is to explore whether the management representatives within labor unions are acting as agents or stewards as well as whether they are perceived as such in the eyes of the members. Method: This study is based on a deductive research approach using a qualitative research strategy. The primary data was collected through semi-structured interviews from representatives of the unions as well as members of the unions. This was complemented with information from the websites and documents from the labor unions. A thematic analysis approach was used to analyze the findings. Conclusion: This study concluded that the representatives of the different labor unions are leaning more towards acting as stewards rather than agents and that they are perceived as such by the members.  The authors found that there was a lot of focus on member recruitment and the importance of recognizing what type of relationship that exists.

The widespread and increasing forest degradation in the Amazon contrasts with a range of individual or collective practices developed by local agents, which have the potential to reconcile conservation and local understanding of the quality of life and economic development. The role of women among these initiatives has been overlooked or not well understood.  Therefore, methods are needed that allow their voices and understandings to be centralized. In this thesis, I make use of decolonial and process-relational approaches to do justice to women, as an invitation to a folk science, when addressing questions about their role in landscape stewardship practices in the Amazon. How can these practices contribute in an innovative way to food diversity and biodiversity conservation in the region? What are the processes that can facilitate or restrict women's individual or collective agency?    Women play a crucial role in landscape stewardship. Still, their agency is severely restricted by the ongoing neo-colonial processes, which affects socioecological spaces. However, they have been organizing themselves to overcome obstacles through their local networks. By understanding womenature and their stewardship practices of caring for the land as an indissoluble part of the forest means to understand in depth the tipping points of the Amazon, which are interconnected to the tipping points of its populations. This is a key factor to broaden our understanding of togetherness that can lead to a more equitable and fairer path towards sustainability in and for the Amazon. / A degradação florestal generalizada e crescente na Amazônia contrasta com uma gama de práticas individuais ou coletivas desenvolvidas por agentes locais, que têm o potencial de conciliar a conservação e a compreensão local sobre qualidade de vida e desenvolvimento econômico. O papel das mulheres nessas iniciativas tem sido esquecido ou não é bem compreendido. Portanto, são necessários métodos que permitam que suas vozes e entendimentos sejam centralizados. Nesta tese utilizo abordagens descoloniais e processuais-relacionais para fazer jus às mulheres, como um convite à ciência popular, ao abordar questões sobre seu papel nas práticas de manejo da paisagem na Amazônia; ou como essas práticas podem contribuir de forma inovadora para a diversidade alimentar e conservação da biodiversidade na região?; e quais são os processos que podem facilitar ou restringir a agência individual ou coletiva das mulheres? As mulheres desempenham um papel crucial na gestão da paisagem. Ainda assim, sua agência é severamente restringida pelos processos (neo)coloniais em andamento, nos quais afetam espaços socioecológicos. Porém, eles vêm se organizando para superar obstáculos por meio de suas redes locais. Entender as mulheresnatureza e suas práticas de manejo do cuidado com a terra como parte indissolúvel da floresta significa entender em profundidade os pontos de inflexão da Amazônia, que estão interligados aos pontos de inflexão de suas populações. Este é um fator chave para ampliar nosso entendimento de união que pode levar a um caminho mais equitativo e justo em direção à sustentabilidade na e para a Amazônia.

Background The antimicrobial stewardship is developed to provide a guide on the responsible use of antimicrobial drugs. Thus, slowing down the development of antimicrobial resistance. However, the nurse's role in antimicrobial stewardship is not clarified. Failure toinclude the nurse within the antimicrobial stewardship guidelines may result in poor execution of antimicrobial stewardship.Aim To explore the role of nurses in antimicrobial stewardship and how it can be practically implemented within the medical field.Method This is a literature review where seven qualitative studies, two quantitative studies and a mix-methods study examines the nurse's role in antimicrobial stewardship.Results Two main themes and five sub-themes were created. The two main themes were clinical role and collaboration. The clinical role described the nurse's role as a patient advocate and the nurse's contribution to antimicrobial stewardship through monitoring and evaluation of the patient and treatment, as well as through safe sampling, drug administration and hygiene. The collaboration showed and identified the nurse's role as a communicator and educator. Conclusion Conclusions that can be drawn from the literature review are that the potential roles the nurse may have in antimicrobial stewardship are many and those we have identified are already included in the nurse's daily work.

From June 2017 to June 2019, 291 cases of Staphylococcus aureus bacteraemia (SAB) were evaluated retrospectively. Patient baseline characteristics, clinical presentations, empiric and targeted treatment, and clinical outcomes were assessed. Our study aimed to evaluate the adherence to a designated SAB care bundle and to assess whether proper adherence improved patient survival. Furthermore, as data for spa type distributions in MSSA-SAB are scarce for Germany, we aimed to describe circulating spa types and spa Clonal Complexes (spa CC) in our epidemiological setting.

Background: CEO compensation as a phenomenon is a well explored topic in both forprofit and non-profit organisations but limited research is made on sports organisations. Due to the important social role that sports organisations entails, one can argue for the need to investigate the purpose of CEO compensation in these organisations as well. Purpose: The main purpose of this study is to explore the purpose of CEO compensation in sports organisations. The purpose of executive compensation will further be studied from both a CEO perspective as well as from the board perspective. Method: This thesis has an abductive research approach and proceeds from previous theories within corporate governance to investigate the purpose of CEO compensation in sports organisations. The empirical part consists of a qualitative interview study to investigate if previous theories are applicable to explain the purpose of CEO compensation in these organisations or if there exists other, unexplored purposes. ii Findings: The findings of the study suggests that the view on the purpose of CEO compensation in sports organisations is different from the board perspective and the CEO perspective. From the board perspective, the purpose appears to be to control the behaviour of the CEO, to gain organisational legitimacy, to make the organisation more business-oriented and to attract individuals with shared interests. On the other hand, from the CEO perspective, the purposes appear to be to increase the motivation and to attain individual legitimacy.

As the planet rapidly urbanizes and demand for locally-produced ecosystem services grows, the effective management of urban green infrastructure is increasingly important. A number of digital tools have recently been developed and released that share information and incite citizen participation in the governance, management and planning of urban green infrastructure. In this paper, I analyse six different e-tools within the context of New York City with a focus on the types of knowledge they share and the forms of participation they incite in relation to urban green infrastructure. I explore how e-tool knowledge exchange and participation relate to civic stewardship of urban green spaces, as stewards play a significant role in the local production of urban ecosystem services. The findings indicate that most e-tools are designed to share a large amount of data describing social-ecological systems. In many cases, the tool developers hope that through gaining knowledge about the system, users will develop an ethical consideration for the environmental resource and even take action as environmental stewards. Additionally, while many of the e-tools present complex, exploratory digital learning environments, many also combine virtual experiences with in-person trainings, workshops and coaching. These hybrid approaches harness the power of digital platforms to organize diverse social networks and share large amounts of data while employing more traditional on-the-ground organizing techniques and offer a way forward in an age of increasing dominance of digital data. Further research on these types of hybrid digital approaches is warranted. Future research on e-tool usership and connections to stewardship outcomes could enrich the understanding of how e-tools operate as well as their social-ecological potential and impact.