Background - Multiple studies within different industries have shown that the majority of innovations adopted by organizations partly or completely fail, in the critical stage between the decision to use the innovation and its routinization. In the pursuit of understanding what makes innovation implementation fail or succeed, previous research has examined innovation implementation as a rather static process within single dimensions. We therefore still know little about what is beyond the implementation other than routine use, meaning that other outcomes have been overlooked. Purpose - Expanding on the dynamic view within innovation implementation literature beyond routine use by exploring how and why unintended outcomes form. Methodology - Inductive, qualitative methodology based on a single case study at Saab AB. Data were collected through a total of 13 unstructured and semistructured in-depth interviews to map the implementation process of Model Based Definition (MBD). Findings - By understanding innovation implementation as a dynamic process of mutual adaptation we found that when an organization implements an innovation, unintended outcomes may arise from Unreasonable expectations, Obstructed adaptation, Underestimated need for adaptation, One-way adaptation and Over adaptation. Our research has thereby highlighted the importance to not only consider if but also how an innovation is implemented.

Drawing from the ever-evolving processes that reproduce and re-define our everyday life in our living environment, this study explores the reverberations of flagship projects in the wider urban landscape. The power structures that formulate spatial production are discussed. Flagships are viewed as tangible representations of governmental and public authorities’ strategies. In-depth understanding of the consequences that stem from such implementations evidence the power dynamics in urban development processes. Stockholm’s vision for 2040 envisages the reinforcement of democratically sustainable development. This study delves into the socio-spatial earmarks that emerge from leading urban development projects in the wider urban landscape and more specifically in the adjoining to the project areas. To do so, this research looks into the urban development of the districts adjoining two large-scale projects, the Hammarby Sjöstad and the Royal Seaport.

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The purpose of this study is to investigate the topic of how a brand’s increased associations with unintended customer segments may impact the consumers who purchase the brand’s products for their intended use. This regards the consumer’s brand perception, brand avoidance, and purchase intentions. The focus of this study is the outdoor sports brand Haglöfs and Swedish gangster culture as the unintended customer segment. The possible associations between Haglöfs and gangster culture gave rise to this thesis. This research adopts a qualitative logic, using a focus group to collect data and gain insight into consumers’ brand perception, brand avoidance, and purchase intentions. Six (6) participants in total were included in the interview. The data was analyzed with ananalytical framework with support from the existing theoretical frameworks. The results from the focus group suggested that the increased associations between gangster culture and Haglöfs have not largely negatively affected the participants’ brand perception, brand avoidance, and purchase intention, with the exception of one participant. However, other insightful results were discovered related to ‘product avoidance’. The managerial contributions may include insights for brands in mitigating potential devaluation of brand perception as a result of being associated with unintended customer segments.

Teenage pregnancies are often not intended, and there is a high risk that unintended pregnancies will lead to abortion. The wide-spread availability of Youth Clinics, the subsidizing of contraceptives and the introduction of new and effective contraceptives have failed to lower the abortion rates. The aim of this thesis was to study possible risk groups and to highlight underlying reasons for contraceptive failure. Methods: Study I and II were quantitative studies with the aims of investigating whether teenagers who sought emergency contraception (Paper I) and teenage mothers (Paper II) were at risk for new unintended pregnancies during a 12-month follow-up period. Study III and IV were qualitative studies. The aim in study III was to see how contraceptive use was documented in medical records (MRs) concerning teenagers who had attended for induced abortion. In study IV the aim was to find out reasons for non- use or inconsistent use of contraceptives among teenagers attending for abortion. Results: In study I and II data were collected from medical and antenatal records. The results showed that both groups, despite contraceptive counselling, were at high risk for new unintended pregnancies leading to abortion. Attendance at the postpartum visit was low and 24% of the teenage mothers did not receive any recommendation about using a particular contraceptive method. Within 12 months 25% had a new pregnancy and of these one third led to legal abortion. In Study III two themes were generated from the analysis of the MRs; ‘Contraceptive methods previously used’ and ‘Plan for future contraceptive use’. All MRs did not contain information about contraceptive use. In study IV one theme was generated from the analysis of the interview text: ‘Struggling with feelings of uncertainty and patterns of behaviour’. Conclusion: Teenagers using emergency contraceptive pills and teenage mothers were at high risk for unintended pregnancies. Contraceptive failure in teenagers who have had an abortion may be due to in part to the absence of contraceptive counselling at abortion visits and in part to problems with contraceptive use due to insufficient knowledge and not knowing what do when side-effects occurs.

Background: In the United States, currently about half (49%) of the 6.7 million pregnancies are reported as mistimed or unplanned, and this rate of unintended pregnancy is significantly higher than the rate in most other developed countries. Abortion services are critical to the prevention and management of unintended pregnancies. Abortion in the United States has been legal since the 1973; however this right has little meaning without access to safe abortion care and access is declining. Medication abortion, the use of medications to induce abortion and terminate an early pregnancy, has been legal in the United States since 2000, is ideal for the outpatient setting, and allows for increased provision of and access to abortion services. The literature assessing the provision of medication abortion has largely been conducted in populations of physicians, and combined groups of advanced practice clinicians including physician assistants (PAs), certified nurse midwives (CNMs), and nurse practitioners (NPs). No studies exist assessing provision of and barriers to medication abortion by NPs and CNMs (Advance Practice Registered Nurses or APRNs) in the state of Vermont. Purpose: This study sought to fill this gap in the literature. Data was collected in order to determine whether APRNs are providing care to women at risk for unintended pregnancy and are providing medication abortion, the characteristics of these providers, and perceived barriers or supports to practice. Methods: The design was a cross-sectional survey, using purposive sampling methods. Between July 2014 and September 2014, 21 eligible participants completed an anonymous, self-administered online survey, recruited via notifications sent out through professional listserv. The survey assessed their personal characteristics, beliefs and clinical practice related to reproductive health care and unintended pregnancy prevention and management. All participants had current APRN certification with prescriptive authority in the state of Vermont. Results: Ninety percent of respondents reported care for women of reproductive age as at least one-third of their clinical work and 85% of respondents reported seeing women with unintended pregnancies as part of their practice. Eighty-five percent agreed or strongly agreed that medication abortions fall within the scope of practice of an APRN and of a primary care provider, and 85% would like to be trained to provide medication abortions to manage unintended pregnancy. Lack of training opportunities, clinical facility constraints, and legal uncertainties were the most frequently reported barriers to provision of medication abortion. Conclusions: Many APRNs in Vermont may be interested in receiving medication abortion training. APRNs are experienced and highly trained health care professionals that have the competence and skills to provide comprehensive reproductive health care, including medication abortion. The perceived barriers of training, clinical facility constraints, and legal uncertainties are amenable to change, and can be decreased through inclusion of these topics into APRN education. The political and social climate of Vermont, combined with the findings of this preliminary study, suggest that the state of Vermont is ready, willing, and able to serve as a model for the primary provision of and improved population access to, comprehensive reproductive health care including abortion services.

Rapid repeat pregnancy (RRP) is associated with adverse maternal and infant outcomes and a range of undesirable social and economic challenges for the mother, her baby, and society. Although the consequences of RRP are well known, Zimbabwe—a country with some of the poorest maternal health indicators—has not investigated or made efforts to directly address this problem. This is confirmed by the lack of targeted programs to curb RRP, the unavailability of documented evidence regarding RRP significant risk factors, and the lack of understanding of the extent of RRP in the country. Using social cognitive theory as the theoretical framework, an unmatched case-control study was conducted using data from the Zimbabwe Demographic and Health Survey of 2015 to determine the prevalence of RRP and to assess associations between sociodemographic, sexual-relational, women's health, fertility preference, previous birth outcomes, and social factors and having an RRP in Zimbabwe. Logistic regression analysis showed statistically significant associations between all factors except for women's health characteristics. The prevalence of RRP among women of reproductive age (15–49 years) in Zimbabwe was 50.2%. The high prevalence of RRP and the multiple statistically significant associations reported in this study affirm the need for Zimbabwe to make prevention of RRP a public health priority. Zimbabwe must develop targeted interventions that work in context and integrate these into an ongoing comprehensive family planning program. In-depth research is needed to establish and understand the underlying motivations for having an RRP among Zimbabwean women. Such information may help develop targeted interventions to create social change.

The organizational consequences of information technology (IT) constitutes a core focus in information systems (IS) research. The relationship between organizations and IT has received considerable attention by IS researchers in order to develop knowledge related to how and why organizations and IT are related. While organizational use of IT continues to increase in practice, previous research has shown that the effects of IT at best are difficult to predict. Consequently, the adoption and assimilation of IT in organizational settings must be recognized as complex and challenging processes, which makes the production of knowledge related to such processes important and pressing.   This dissertation identifies, characterizes and explains a paradoxical outcome of the adoption and assimilation of an enterprise content management (ECM) system in a context of organizational information management. The outcome, labeled the duplicate systems paradox, is constituted by a situation in which an organization continuously allows multiple, overlapping, partially competing and largely incompatible information systems to persist and continue to evolve over time, despite continued awareness of the adverse consequences on organizational information management capabilities. A qualitative case study approach was used as the primary means for data collection. The case study was conducted in the administrative divisions of HealthOrg, a large organization in the medical- and health care sector. To this end, the main objective of this dissertation is to investigate how this paradox was formed, and furthermore, how and why it was able to persist. In order to do this, dialectical theory is combined with contextualism and theory on organizational information processing to form a comprehensive theoretical perspective used to inform the analytical efforts.   By using a dialectical approach, the analysis presents empirical evidence of the existence and composition of three overarching contradictions found to affect the formation and persistence of the duplicate systems paradox. More specifically, the resulting explanatory model demonstrates how three pairs of opposites, control versus support at the requirements level, options versus practices at the solutions level, and top-down versus bottom-up approaches at the transformations level, along with contextual tensions, were essential components in the formation and persistence of the paradox. Thus, the duplicate systems paradox could form and continue to evolve due to contradictory forces present at, and interconnected between, different vertical and horizontal levels within the organization. Through the identification and explanation of the duplicate systems paradox, this study provides a detailed example of how, and why, unintended consequences of IT in organizations may emerge and continue over time.   In terms of implications for research and practice, the findings of this dissertation point to six important observations. First, this research suggests that understanding and characterizing the context in which IT is to be implemented is crucial and challenging. Thus, organizations should pay careful attention to the practical side of context, rather than to the somewhat theoretical boundaries of organizations. It is suggested that the concepts of ‘inner’ and ‘outer’ context may be useful in analyzing and understanding context. Second, this research suggests that organizations should attempt to identify potentially conflicting requirements, and devise clear strategies to decide how to prioritize between such requirements as the identification and explication of requirements present at different levels in the organization may reveal problems that need to be considered when choosing information system (IS). Third, organizations need to pay careful attention to what the adoption of a new IS means in terms of adaptation and/or realignment, and to what extent organizational activities, technological functionalities, or both, should be adapted. Organizations should furthermore be aware that the adoption of systems that can also be used as development platforms may cause a cascade of effects and dependencies that are difficult to manage. Fourth, the findings of this research suggest that organizations faced with the challenge of adopting complex IT solutions need to take into account their previous strategies and planned new ones in order to devise a comprehensive strategic approach since the coexistence of radically different strategies may cause uncertainty and inertia within the overall assimilation process. Fifth, this research indicates that IT management and information management (IM) are highly interrelated activities, but are not mutually exclusive. Thus, organizations adopting technologies that are specifically focused on information management may benefit from developing distinct areas of responsibility and clear communication channels between the involved organizational units. Furthermore, these findings suggest that future research should pay careful attention to, and specifically investigate, the exact nature of the relationship between information management and IT management. Finally, this research demonstrates how a dialectical approach may be used to adequately investigate organizational information management, specifically in relation to the adoption and assimilation of IT.

Hur barn förhåller sig till regler har belysts i forskning som visat att barnen lägger stor vikt vid moralrelaterade regler. Hur barnen accepterar konventionella regler beror på vilken funktion regeln upplevs fylla. Det som saknas i forskningen är ett dynamiskt perspektiv som tar hänsyn till interagerande aktörers ömsesidiga inflytande över varandra när förutsättningarna förändras och hur detta i sin tur skapar nya förutsättningar. För att belysa detta utgår studien från Giddens struktureringsteori som stipulerar att människors sociala handlingar både formar och formas av de strukturella förutsättningarna till skillnad från ett mer strukturalistiskt perspektiv där aktörerna ses som underkastade den struktur som de verkar inom. Struktureringsteorin möjliggör också för underordnade aktörer att utöva kontroll över de med mera makt. Datainsamlingen har genomförts genom deltagande observationer på en skola. Observationsobjektet har varit incidenter där eleverna agerat på ett sätt som inte är förenligt med verksamhetens konventioner. Fokus har legat på elevernas utnyttjande av resurser i form av material och lokaler. Resultatet visar att inbyggda motsättningar i de strukturella förutsättningarna öppnar en möjlighet för eleverna att ta kontroll över de resurser som personalen försöker reglera. När personalen försöker återta kontrollen resulterar det i oavsiktliga konsekvenser på grund av faktorer som inte uppmärksammats vilket i regel förskjuter problematiken och upprätthåller det olovliga resursutnyttjandet. / How children relate to rules has been highlighted in research in which children attach great importance to moral-related rules. How children accept conventional rules depends on what function the rule is perceived to fulfill. What is missing from the research is a dynamic perspective that considers how interacting actors influence each other when conditions change and how this in turn creates new conditions. To illuminate this, the study is based on Gidden's theory of structuration which stipulates that people's social actions both shape and are shaped by the structural conditions as opposed to a more structuralist perspective where the actors are seen as subjects to the structure in which they operate. The theory of structuration also enables subordinate actors to exercise control over those with more power. The data collection was carried out through participant observations at one school. The object of observation has been incidents where the students acted in a manner incompatible with the conventions of the school. The focus has been on students' utilization of resources in the form of materials and premises. The result shows that built-in contradictions in the structural conditions open opportunities for students to take control of the resources that the staff is trying to regulate. When staff try to regain control, it results in unintended consequences due to factors that have not been recognized, which usually offsets the problem and maintains the unwanted utilization of resources.

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