Bakgrund: I Sverige dör cirka 90 000 personer varje år. Majoriteten av dessa är förväntade dödsfall relaterat till ålder och sjukdomar. Plötslig död innefattar mord, suicid, olycksfall eller akut sjukdom. I mötet med anhöriga efter plötslig död har sjuksköterskan till uppgift att delge stöd och information. Det finns många studier gjorda på hur anhöriga upplever bemötandet i vården men desto mindre forskning om hur sjuksköterskan upplever mötet med anhöriga vid plötslig död. Syfte: Att beskriva sjuksköterskans upplevelse av att möta anhöriga vid plötslig död på sjukhus. Metod: Kvalitativ intervjustudie där 10 sjuksköterskor, från två olika avdelningar från ett sjukhus i södra delen av Sverige, har intervjuats.  Intervjuerna bearbetades och har analyserats genom en kvalitativ innehållsanalys. Resultat: Studien resulterade i tre huvudkategorier; Kräver professionalitet, Anhörigas reaktioner påverkar och Behöver vara personlig. Slutsats: Hur sjuksköterskan möter och bemöter anhöriga är ett viktigt moment i vården och för den familjecentrerade omvårdnaden. Sjuksköterskor som påträffar plötsliga dödsfall i sitt yrke upplever att det är komplext att möta anhöriga vid dessa situationer. / Background: Approximately 90 000 people die each year in hospitals throughout Sweden. The majority of these are expected deaths related to age and disease. The causes of sudden death include homicide, suicide, accidental or acute illness. When this occurs, nurses are responsible for sharing support and information with the relatives. There have been many studies conducted on the experience of family members and the treatment they receive in hospitals. However, there is less research present on the experiences of nurses when meeting families after sudden death. Aims: To describe nurses' experience of meeting relatives, when sudden death occurs in a hospital. Method: Qualitative interview study where a total of 10 nurses participated in the interviews, from two different departments of a hospital, in southern Sweden. The interviews were analyzed using a qualitative content analysis. Results: The study resulted in three main categories; Require professionalism, Relatives` reactions effects and Need to be personal. Conclusion: How the nurse meets and treats families is an important part of the care and the family-centered care. Nurses who encounters sudden death in the professional experience that it is complex to meet relatives after sudden death.

While it implies aimless movement, the act of wandering is an act of discovery and can become a search for the unexpected. Wandering, as a metaphor for making, creates opportunities to work in ways where the final outcome is unknown. This can be accomplished by the creation of methods and instructions designed for wandering-the act of discovery. In the field of design, these ideas can be incorporated as methods for making that guide the design process in ultimately unknowable ways, resulting in products that bear little trace of preconception. The role of chance and indeterminacy as methods for relinquishing control and generating narrative are explored in three projects relying on video and interactivity.

Bakgrund: Att hantera luftvägen hos en patient i samband med anestesi är en av anestesisjuksköterskans huvuduppgifter. Då en oväntat svår luftväg uppstår så ställs det höga krav kompetensmässigt på anestesisjuksköterskan. Tidigare forskning har i liten utsträckning fokuserat på anestesisjuksköterskans erfarenheter kring denna komplexa situation. Det är därför önskvärt att utföra ytterligare studier inom detta ämne med fokus på erfarenheter. Syfte: Syftet med studien var att belysa anestesisjuksköterskans erfarenheter av den oväntat svåra luftvägen i samband med anestesi. Metod: Studien genomfördes utifrån kvalitativ ansats. Data samlades in genom semistrukturerade intervjuer med tio anestesisjuksköterskor anställda på två olika operationsavdelningar i Sverige. Intervjuerna transkriberades och analyserades med innehållsanalys. Resultat: I analysen framkom fyra kategorier som beskriver anestesisjuköterskornas erfarenheter av oväntat svår luftväg i samband med anestesi; upplevelser av att arbeta under press, att samarbeta i team, betydelsen av att känna sig trygg i sin yrkesroll samt värdet av reflektion. Slutsats: Anestesisjuksköterskornas delade erfarenheter tyder på en samstämmighet om att när en oväntat svår luftväg uppstår så efterfrågades mer träning tillsammans. Detta dels för att underlätta samarbetet och för att kunna ta del av andras erfarenheter och strategier för att lösa liknande situationer i framtiden. Nyckelord: Anestesisjuksköterska, oväntat svåra luftvägar, erfarenheter, känslor, upplevelser. / Background: Managing the airway of a patient during anesthesia is one of anesthesia nurse's main tasks. When an unexpected difficult airway occurs, the high demands in terms of competence of the nurse anesthetist. Previous research has small extent focused on the nurse anesthetist experiences of this complex situation. It is therefore desirable to perform further studies on this subject, focusing on experience. Aim: The aim was to illustrate anesthetic nurses experiences of the unexpected difficult airway associated with anesthesia. Method: The study was conducting using qualitative approach. Data were collected through semi-structured interviews with ten anesthetic nurses employed in two different surgical departments in Sweden. The interviews were transcribed and analyzed by content analysis. Result: The analysis revealed four categories that describe anesthetic nurses experiences of the unexpected difficult airway associated with anesthesia; experiences of working under pressure, to work in teams, the importance of feeling safe in their professional capacity and the value reflection Conclusion: Anesthetic nurses shared experiences suggest a consensus that when these situations occur they requested more training together. This is partly to facilitate cooperation and also to take advantage of others' experiences and strategies to solve similar situations in the future. Keywords: Nurse anesthetist, unexpected difficult airways, experiences, feelings.

Background: Parents of children with epilepsy have been shown to have higher rates of depression, anxiety and stress in comparison to parents of children without epilepsy due to the impact of caring for a child with a chronic condition. A systematic review of existing literature aimed to identify qualitative research that examined parents' experiences of caring for their children with epilepsy. Methods: The systematic review explored the experiences that parents have in caring for their child with epilepsy. A search of electronic databases for qualitative literature was completed. The quality of all eligible articles papers was assessed, and findings from studies were synthesised. Results: Twelve studies met inclusion criteria for the review; findings suggest that parents need time to process their child's diagnosis of epilepsy; they cope with this in differing ways and are motivated to learn how to adapt and cope with parenting their child with epilepsy. Conclusions: Parents of children with epilepsy may experience symptoms of stress, this may motivate them to learn how best to care for their child. Empirical Paper Abstract Background: Parents' experiences of being told about sudden unexpected death in epilepsy (SUDEP) may be particularly challenging to cope with. As little is known about how mothers understand and make sense of SUDEP, a qualitative research project aimed to explore mothers' experiences. It was hoped this would be helpful for clinicians to understand in order to assist them in providing information to parents in a way that minimises distress. Methods: The empirical article explored mother's experiences of being told about SUDEP and the subsequent impact of this for 11 mothers of children with epilepsy. Interpretative Phenomenological Analysis methodology was utilised, with themes derived from interpretation of interview transcripts, in order to describe the experiences of the participants. Results: Within the empirical study, five themes emerged. The way in which mothers found out about SUDEP seemed to have a link to their perception of risk and how they subsequently managed feelings of uncertainty and the psychological impact of knowing about SUDEP. Mothers' recommendations to clinicians included when, how and what to tell other parents, and were based on their own helpful and unhelpful experiences of being informed about SUDEP. Conclusions: In being told about SUDEP, mothers may struggle to make sense of it and this can be associated with an increase in anxiety. However, clinicians can reduce potential distress by carefully timing when and how they tell parents, and by making sure information is clear and relevant for the child in question.

abstract: Reading partners’ actions correctly is essential for successful coordination, but interpretation does not always reflect reality. Attribution biases, such as self-serving and correspondence biases, lead people to misinterpret their partners’ actions and falsely assign blame after an unexpected event. These biases thus further influence people’s trust in their partners, including machine partners. The increasing capabilities and complexity of machines allow them to work physically with humans. However, their improvements may interfere with the accuracy for people to calibrate trust in machines and their capabilities, which requires an understanding of attribution biases’ effect on human-machine coordination. Specifically, the current thesis explores how the development of trust in a partner is influenced by attribution biases and people’s assignment of blame for a negative outcome. This study can also suggest how a machine partner should be designed to react to environmental disturbances and report the appropriate level of information about external conditions. / Dissertation/Thesis / Masters Thesis Human Systems Engineering 2019

The goal of this dissertation is to improve financial statement fraud detection using a cross-functional research approach. The efficacy of financial statement fraud detection depends on the classification algorithms and the fraud predictors used and how they are combined. Essay I introduces IMF, a novel combiner method classification algorithm. The results show that IMF performs well relative to existing combiner methods over a wide range of domains. This research contributes to combiner method research and, thereby, to the broader research stream of ensemble-based classification and to classification algorithm research in general. Essay II develops three novel fraud predictors: total discretionary accruals, meeting or beating analyst forecasts and unexpected employee productivity. The results show that the three variables are significant predictors of fraud. Hence Essay II provides insights into (1) conditions under which fraud is more likely to occur (total discretionary accruals is high), (2) incentives for fraud (firms desire to meet or beat analyst forecasts), and (3) how fraud is committed and can be detected (revenue fraud detection using unexpected employee productivity). This essay contributes to confirmatory fraud predictor research, which is a sub-stream of research that focuses on developing and testing financial statement fraud predictors. Essay III compares the utility of artifacts developed in the broader research streams to which the first two essays contribute, i.e., classification algorithm and fraud predictor research in detecting financial statement fraud. The results show that logistic regression and SVM perform well, and that out of 41 variables found to be good predictors in prior fraud research, only six variables are selected by three or more classifiers: auditor turnover, Big 4 auditor, accounts receivable and the three variables introduced in Essay II. Together, the results from Essay I and Essay III show that IMF performs better than existing combiner methods in a wide range of domains and better than stacking, an ensemble-based classification algorithm, in fraud detection. The results from Essay II and Essay III show that the three predictors created in Essay II are significant predictors of fraud and, when evaluated together with 38 other predictors, provide utility to classification algorithms.

Epilepsy is a neurological disorder that is characterized by aberrant electrical activity in the brain resulting in at least two unprovoked seizures over a period longer than 24 hours. Approximately 60% of individuals with epilepsy are diagnosed with temporal lobe epilepsy (TLE) and about one third of those individuals do not respond well to anti-seizure medications. This places those individuals at high risk for sudden unexpected death in epilepsy (SUDEP). SUDEP is defined as when an individual with epilepsy, who is otherwise healthy, dies suddenly and unexpectedly for unknown reasons. SUDEP is one of the leading causes of death in individuals with acquired epilepsies (i.e. not due to genetic mutations), such as TLE. Previous studies utilizing genetic models of epilepsy have suggested that circuitry within the vagal complex of the brainstem may play a role in SUDEP risk. Gamma-aminobutyric acid (GABA) neurons of the nucleus tractus solitarius (NTS) within the vagal complex receive, filter, and modulate cardiorespiratory information from the vagus nerve. GABAergic NTS neurons then project to cardiac vagal motor neurons, eventually effecting parasympathetic output to the periphery. In this study, a mouse model of TLE was used to assess the effect of epileptogenesis on GABAergic NTS neuron function and determine if functional alterations in these neurons impact SUDEP risk. It was discovered that mice with TLE (i.e. TLE mice) have significantly increased mortality rates compared to control animals, suggesting that SUDEP occurs in this model. Using whole cell electrophysiology synaptic and intrinsic properties of GABAergic NTS neurons were investigated in TLE and control mice. Results suggest that during epileptogenesis, GABAergic NTS neurons become hyperexcitable, potentially due to a reduction in A-type potassium channel current and increased excitatory synaptic input. Increases in hyperexcitability have been shown to be associated with an increased risk of spreading depolarization and action potential inactivation leading to neuronal quiescence. This may lead to a decreased inhibition of parasympathetic tone, causing cardiorespiratory collapse and SUDEP in TLE.

Risk is everywhere and it is something which we face in everyday life. Same is the case with projects. Projects are complex and risks are inherent in projects. It is not unusual for unexpected events to occur and for uncertainty to emerge in projects. These events contribute to project riskswhich require to be dealt with so that projects could continue to run effectively. The need for good project risk management is therefore especially important as it could determine the successof the project or otherwise. However, research on the factors that make project risk response successful has been neglected. Contemporary researchers focused on risk management phases other than risk response. Our main focus in this paper is to indicate determinants of project risk response success and their relative importance in the construction industry of Sweden. The construction industry is considered as construction projects are not only important but they identify tangibly with the physical outputs of projects and exemplify the uncertainty and risks that are present in this type of projects. Sweden is chosen as the context of our study owing to the immense contributions of the construction sector towards the country’s growth and GDP. On thebasis of extensive literature review, we have come up with the determinants for project risk response success and developed a proposed conceptual model. A quantitative study is undertaken with the administration of questionnaires. The empirical data is gathered from project managers in the construction industry of Sweden for this purpose. Project managers are selected as respondents as they would be the ones controlling and managing projects, along with responding to the various risks subjected to in projects. Hypotheses have been generated for this research and the results are analyzed to determine if these hypotheses are to be accepted or rejected. For data analysis, SPSS is used. The results are drawn by the use of statistical tools like ANOVA, correlation and t-tests. These outcomes will lead to the conclusion of our study as to what the factors are that determine project risk response success and their relative importance. A revised conceptual model is finally developed to address the findings of our research. This research found a set of seven success factors which can be used as a guideline for project risk response success. These factors are (1) Team competency and skills, (2) Effective communication, (3) Active leadership, (4) Negotiation and coordination, (5)Hierarchical structure, (6) Behaviour and (7) Empowerment. These determinants of project risk response success can be generalized to the construction industry in Sweden. Keywords: project risk, project risk management, uncertainty, unexpected events, risk response, construction industry.

The thesis explores middle managers sensemaking processes of a University’s social responsibility and sustainability (SRS) strategy during a period of change. Overall the thesis establishes links between middle managers simultaneous sensemaking processes, dynamics of loosely coupled organizational contexts and organizational responses to unexpected outcomes as they impact strategy creation processes in organisations. Three main issues evolve. Firstly, middle managers in loosely coupled organisations consist of two different sets (administrators and academics). Based on their nature of work in particular, administrators and academics select different sets of dominant and subtle sensemaking frames to make sense of organizational strategies. Generally, while administrators select sensemaking frames which emanate from existing strategic processes, academics select autonomous cues which exist outside strategic processes. Administrators and academics sensemaking processes are therefore not a single level or consecutive processes as typically researched, but rather occur as simultaneous sensemaking processes. Six dominant simultaneous sensemaking frames are identified and described. Secondly, the thesis examines less explored aspects of debates on loosely coupled systems. It investigates specific patterns of coupledness in middle managers strategic work and relationships. It identified and described patterns of administrative work which are tightly coupled and patterns in academic work which are loosely coupled. Thirdly, distinct links are identified between middle managers simultaneous sensemaking processes and unexpected strategy outcomes. This further led to exploring how organizations respond to unexpected sustainability initiatives, especially in light of integrating them into already existing strategy outcomes. Three integration strategies are identified and described.

Submitted by Cristiane Oliveira (cristiane.oliveira@fgv.br) on 2011-06-10T19:53:13Z No. of bitstreams: 1 83090200064.pdf: 2278221 bytes, checksum: 037a429dbfbd4dc5cb0121269d820662 (MD5) / Approved for entry into archive by Vera Lúcia Mourão(vera.mourao@fgv.br) on 2011-06-10T19:59:03Z (GMT) No. of bitstreams: 1 83090200064.pdf: 2278221 bytes, checksum: 037a429dbfbd4dc5cb0121269d820662 (MD5) / Approved for entry into archive by Vera Lúcia Mourão(vera.mourao@fgv.br) on 2011-06-10T20:00:47Z (GMT) No. of bitstreams: 1 83090200064.pdf: 2278221 bytes, checksum: 037a429dbfbd4dc5cb0121269d820662 (MD5) / Made available in DSpace on 2011-06-10T21:35:35Z (GMT). No. of bitstreams: 1 83090200064.pdf: 2278221 bytes, checksum: 037a429dbfbd4dc5cb0121269d820662 (MD5) Previous issue date: 2011-02-02 / Reputation is considered the most important asset of companies. It enables to set up business relationship and ensure the good functioning of the organization. When an unexpected even crops up, reputation could be threatened. Managers, leaders of the organization, need to demonstrate reactivity, a capacity of responding to stakeholders‟ requirements and a capacity to detect and to rectify faults within the organization through a learning process, in order to avoid negative consequences. The latter could tarnish reputation and impact the operational development of the company. Through crisis communication, we observed that Air France adopted different postures after the crash of the flight 447. These ones were adapted to stakeholders‟ requirements and to the degree of threat that the company suffered. Just after the accident, the company decided to use the recognition strategy by assuming a symbolic responsibility and by communicating uppermost to the families of victims and to the media. The following weeks, the company privileged the strategy of silence which consists in not to communicate directly with the media. Finally, Air France used the 'scapegoat' strategy when the company was subjected to direct attacks. Companies‟ reactions summed up to the advance of the ongoing judiciary investigation revealed 'historical' organizational faults within the company, as for instance, the lack of communication between pilots and managers or the managers technical and operational insensitivity. Although internal and external issues, Air France demonstrated that a well managed crisis communication limits financial and reputational impacts. Consequently, the company suffers limited negative consequences of this crisis. / A reputação é considerada o ativo mais importante das empresas. Ela permite o estabelecimento de relações comerciais e garante um bom funcionamento da organização. Quando um evento inesperado surge, a reputação pode ser ameaçada. Os gerentes, líderes da organização, têm então que demonstrar reatividade e capacidade em responder as necessidades dos stakeholders, e capacidade de detectar e consertar as falhas dentro da organização através de um processo de aprendizagem, para evitar conseqüências negativas que poderiam danificar a reputação e impactar o desenvolvimento operacional da empresa. Através da comunicação de crise, observamos que depois da queda do avião AF 447, a companhia Air France adotou diferentes posturas adaptadas ao pedido dos stakeholders e ao grau de ameaça sofrido. Logo depois do acidente, a empresa decidiu adotar a estratégia do reconhecimento, assumindo uma responsabilidade simbólica e comunicando prioritariamente para as famílias das vitimas e para a mídia. Nas seguintes semanas ela utilizou a estratégia do silêncio que consiste em não comunicar diretamente a mídia. Finalmente, ela usou a estratégia do 'bode expiatório' quando ela foi sujeita a ataques diretos. As reações da empresa somadas ao avanço das investigações judiciais revelaram falhas organizacionais 'históricas' dentro da própria empresa, como por exemplo, a falta de comunicação entre pilotos e gerentes ou uma falha de sensibilidade técnica e operacional da parte dos gerentes. Apesar de problemas interno e externo, a Air France demonstrou que uma comunicação de crise bem gerenciada limita os impactos financeiros e de reputação. As conseqüências negativas sofridas pela companhia Air France foram limitadas.