<p>The present thesis follows an intensive care unit during four year of hard work and demanding organisational changes (1998-2001). The changes were mainly initiated by diminishing resources and a legislative claim to pay regard to the quality aspect of health care service. The process of implementing a quality system was the main focus for the thesis. Triangulation was used aiming at explore the process from different views. Two interviews studies were conducted one with the staff and another with the leadership. Both interviews were analysed thematically combined with a phenomenographic technique (e.g. using the how, and what aspect). A longitudinal quasi experimental time-series study was also accomplished. The correlation between staff variables and workload were measured once a year. The result show a 20 % increase in workload per staff and year. The staff judged the organisational climate for innovativeness stable over the period. Sick leave increased, and more so, than the general trend in the society. In spite of this increase the prevalence of stress related symptoms was the same. Two different systems emerged, a complex adaptive system and a mechanical system. The two systems exist and functions intertwined. Because of the construction of the patient register it is possible to see that the situation around a patients being admitted ≥ 5 days functions according to the complex systems character while the situation around the acute patients functions according to a mechanical system. Sick leave correlated with number of patient admitted ≥ 5 days (P=,000). It seemed the problem found had its root in the unawareness of the existing of a complex system. The result has implications for a need of increased awareness about how to manage the situation when the ICU is functioning according to the complex adaptive system.</p>

The present thesis follows an intensive care unit during four year of hard work and demanding organisational changes (1998-2001). The changes were mainly initiated by diminishing resources and a legislative claim to pay regard to the quality aspect of health care service. The process of implementing a quality system was the main focus for the thesis. Triangulation was used aiming at explore the process from different views. Two interviews studies were conducted one with the staff and another with the leadership. Both interviews were analysed thematically combined with a phenomenographic technique (e.g. using the how, and what aspect). A longitudinal quasi experimental time-series study was also accomplished. The correlation between staff variables and workload were measured once a year. The result show a 20 % increase in workload per staff and year. The staff judged the organisational climate for innovativeness stable over the period. Sick leave increased, and more so, than the general trend in the society. In spite of this increase the prevalence of stress related symptoms was the same. Two different systems emerged, a complex adaptive system and a mechanical system. The two systems exist and functions intertwined. Because of the construction of the patient register it is possible to see that the situation around a patients being admitted ≥ 5 days functions according to the complex systems character while the situation around the acute patients functions according to a mechanical system. Sick leave correlated with number of patient admitted ≥ 5 days (P=,000). It seemed the problem found had its root in the unawareness of the existing of a complex system. The result has implications for a need of increased awareness about how to manage the situation when the ICU is functioning according to the complex adaptive system.

In this thesis I reframe theories of love-relationships in late modernity (by Anthony Giddens, Zygmunt Bauman and Ulrich Beck &amp; Elisabeth Beck-Gernsheim) in relation to a general framework of discursive theory (inspired by Michel Foucault). I suggest that current developments and contradictions in the field of love-relationships with advantage can be understood in terms of discourse and discursive conflict. Utilizing the discursive framework, I conceptualize two conflicting discursive regimes (as romantic love and individualized freedom), and their components. With these components in mind, I explore how contradicting discursive components are problematized in established risk-discourse, using cases of popular culture as illustrative reference. Risk-discourses force short-term practical solutions, and put pressure on further discursive change by inducing anxiety and cognitive dissonance. Future discourse will have to adapt to several conditions, including the (in)compatibility of discursive components, how well practical strategies work out, how social interaction is organized, and how discursive deconstruction unavoidably have consequences for the fundaments of love itself. / I uppsatsen omtolkar jag senmodernitetsteorier om kärleksrelationer (av Anthony Giddens, Zygmunt Bauman och Ulrich Beck &amp; Elisabeth Beck-Gernsheim) till ett generellt diskurs­teoretiskt ramverk (inspirerat av Michel Foucualt). Uppsatsen redogör för hur samtida utvecklingar och motsättningar inom fältet kärleksrelationer med fördel kan förstås i diskursteoretiska termer. Med hjälp av detta ramverk utvecklar jag två diskursiva regimer och deras respektive komponenter (konceptualiserade som romantisk kärlek och individualiserad frihet). Med dessa komponenter i åtanke granskar jag hur konflikterande komponenter problematiseras genom etablerade riskdiskurser, med fallstudier av populärkultur som illustrativa exempel. Jag menar att att dessa riskdiskurser driver fram kortsiktiga praktiska lösningar, och orsakar ångest och kognitiv dissonans vilka motiverar ytterligare diskursiva förändringar. Kommande diskursiva förändringar måste förhålla sig till flertalet omständig­heter inklusive diskurskomponenternas (in)kompabilitet, huruvida praktiska lösningar är hållbara, hur social interaktion organiseras i allmänhet och hur diskursiv dekonstruktion oundvikligen får konsekvenser för kärlekens fundament.

Dans cette thèse, nous présentons une nouvelle approche pour la simulation numérique des phénomènes électroconvectifs et électro-therrno-convectifs. La principale difficulté réside dans la détermination du champ électrique et de la distribution de densité volurnique de charges électriques. Dans cette approche, des schémas de type TVD (Total Variation Dirninishing) et IDC (ImprovedDeferred Correction) sont utilisées dans la discrétisation des flux convectifs et diffusifs par la méthode des volumes finis. La première partie de cette thèse présente certains aspects numériques liés à l'implémentation de ces schémas. Une approche unifiée pour les schémas convectifs TVD de type borné à haute résolution est présentée et diverses fonctions limiteur sont comparées. Dans une deuxième partie, l'électro-convection entre deux plaques parallèles est simulée. La méthodologie a étéévaluée et validée par la détermination des Critères de stabilité linéaire et non linéaire. Les différents scenarii d'évolution du développement de cette instabilité électroconvective vers l'état chaotique ont été définis. L'effet du mécanisme de diffusion la densité volumique de charge sur la boucle d'hystérésis et sur la structure de l'écoulement est étudié. L'influence du rapport d'aspect de la cavité est analysé. Enfin dans une dernière partie, nous étudions l'électro-thermo-convection lorsque le fluide est soumis simultanément à une injection unipolaire et à un gradient thermique. L'augmentation des transferts de chaleur a été caractérisée. / In this thesis, a numerical approach is presented to simulate the electro- and electro-thermo convection in dielectric liquids. The total variation diminishing (TVD) scheme and improved deferred correction (IDC) scheme are used to compute the convective and diffusive respectively. The aim of TVD scheme is to avoid non-physical oscillations and to capture high gradient of charge density. Some fundarnental aspects related to TVD and LDC schemes are investigated firstly. A unified approach for TVD schemes is explained and various limiter functions are compared. The connection among three methods for diffusive flux computation has been revealed. The original IDC scheme is improved by the application of 2nd order gradient evaluation method.The electro-convection between two parallel plates is then simulated. The methodology was assessed by the determination of the linear and nonlinear stability criterion. By continuously increasing the driving parameter, the successive instabilities and route to chaotic state has been defined. The effects of the diffusion mechanism for the charge density and vertical walls on the hysteresis 100p and the structure are also investigated. The last part is to simuiate electro-thermo-convection when injection and thermal gradient are simultaneously applied. Our solver was verified with a stationary and an overstable stability problem.The case that both heating and injection are from a bottom electrode has been analyzed in details. The neutral stabiliïy curve was reproduced. The existence of nonlinear phenornenon and the structure are highlighted.

Approved for public release; distribution in unlimited. / This thesis represents a cross Systems Command (NAVSEA/NAVAIR) developed product. The product - the Sunset Supply Base (SSB) system - provides a complete system for addressing the risks and supportability issues involved with Commercial Off the Shelf (COTS) products in Navy combat and support systems. The SSB system was implemented on three Navy combat weapon systems at various phases of the product development life cycle. The main body provides to the Program Management Offices (PMO) and other decision makers, a high level summary of performance expectations. Appendix A - The Sunset Supply Base Architecture - identifies at a high level of abstraction a collaborative architecture providing a roadmap for design and development of the SSB system. Appendix B - The Systems Engineering Development and Implementation (SEDI) plan - is a prescriptive or "How to" manual describing activities that have been used to successfully implement the SSB system. Appendix C - Business Case Analysis (BCA) - presents the data collected as a result of SEDI plan implementation then addresses the business/programmatic attributes showing the viability and value proposition possible through the SSB system. Appendix D - The Marketing Plan for the SSB system - defines methods and practices necessary to establish the SSB system as the alternative of choice. / Chemical Engineer, United States Navy / Systems Engineer, United States Navy