Service Oriented Virtual Organizations (SOVOs) business processes and services are subject to change to meet the internal and external requirements of the competitive, complex and rapidly changing environment they operate in. More practical and efficient ways of change management are needed to allow different partners to initiate changes to their business process and services in a faster and user-transparent manner. This thesis proposes a Change Management Framework for service oriented virtual organizations including a structural and a procedural framework. The structural framework categorizes changes in the SOVO into three layers of change; which include the value network layer, the collaborative process layer and the service providers’ layer, and identifies the impact of change on each layer. Furthermore, the structural framework identifies various triggers of changes which eventually lead to actions taken at the three layers. The change management procedural framework is derived from the ITIL V3, ECM and ECOLEAD best practices and recommendations, customized to fit the SOVO change requirements. It provides different components including the six layers for change processes, change control, change actors and related management processes. The change management procedural framework provides a sequence of steps and methods that the SOVO and its participated organizations can follow in initiating changes to their business processes or services. We design an implementation architecture and a prototype for building the change management console which enables the SOVO change management participants to initiate, assess, collaborate, monitor and authorize changes. The prototype is developed to realize and validate the change management process of change in the SOVO environment. We employ the various capabilities of the IBM Business Process Management (BPM) (including its recent Web 2.0 capabilities) to increase the collaboration between partners in the process of change. We demonstrate that the proposed solutions facilitate and enhance the process of change by effectively engaging the SOVO partners in the process of change.

The spleen has been shown to contract in apneic situations in humans as well as in other diving mammals, expelling its stored red blood cell content into circulation. This natural blood boosting may increase the circulating hemoglobin concentration (Hb) by up to 10%, which would enhance the oxygen carrying capacity and likely increase performance. However, the triggers of this response in humans have not been fully clarified. Study I was therefore focused on the effect of hypoxia as a trigger of spleen contraction. It was found that 20 min of normobaric hypoxic breathing evoked a substantial reduction in spleen volume showing that hypoxia is an important trigger for spleen contraction. Knowing the role of hypoxia, Study II compared two different hypoxic situations – a 2 min apnea and 20 min normobaric hypoxic breathing – which resulted in the same level of arterial hemoglobin desaturation. Apnea evoked a twice as great spleen volume reduction, implying that variables other than hypoxia were likely involved in triggering spleen contraction. This may be hypercapnia which is present during apnea but not during normobaric hypoxic breathing. Study III therefore investigated the effects of breathing gas mixtures containing different proportions of CO2 prior to maximal apneas. Pre-breathing mixtures with higher percentages of CO2 resulted in greater spleen contraction, thus demonstrating hypercapnia's likely role as a trigger in addition to hypoxia. Study IV explored whether an all-or-nothing threshold stimulus for triggering spleen contraction existed, or if contraction was graded in relation to the magnitude of triggering stimuli. Exercise was therefore performed in an already hypoxic state during normobaria. Rest in hypoxia produced a moderate spleen volume reduction, with an enhanced spleen contraction resulting after hypoxic exercise, with a concomitant increase in Hb. This implies that spleen contraction is a graded response related to the magnitude of the stimuli. This could be beneficial in environments with varying oxygen content or work loads. Study V examined the possibility that spleen contraction is part of the acclimatization to altitude, during an expedition to summit Mt Everest. The long-term high altitude exposure, combined with physical work on the mountain, had no effects on resting spleen volume but resulted in a stronger spleen contraction, when provoked by apnea or exercise. This indicates that acclimatization to altitude may enhance the contractile capacity of the spleen, which may be beneficial for the climber. From these studies I concluded that hypoxia is an important trigger for spleen contraction but that hypercapnia also contributes in apneic situations. The spleen contraction likely provides a graded expulsion of erythrocytes in response to these stimuli, causing a temporary increase in gas storage capacity that may facilitate activities such as freediving and climbing. The storage of erythrocytes during rest serves to reduce blood viscosity, which would also be beneficial for the climber or diver. The human spleen contraction appears to become stronger with acclimatization, with beneficial effects at altitude. Such an upgraded response could be beneficial both in sports and diseases involving hypoxia.

Nomadic computing aims to be a leading short term revolution in the Internet, however to succeed in this the infrastructure, the protocols, the handoff mechanisms have to be designed and implemented to provide mobile computing with both reliability and transparency. A good deal of the work is addressed by mobile IP itself, but addressing wireless diversity is perhaps the most important next step. Many different wireless technologies are available; while one technology might provide wide coverage, another provides higher bandwidth, but can only be deployed locally, even uni-directional ad-hoc links can be used to carry IP traffic. To take full advantage of the potential infrastructure, a mobile device, with multiple network interfaces, should be able to dynamically switch from one link technology to another; hopefully totally transparently to the user. Moreover, having multiple interfaces allows the device to choose, each time a new connection is established, which interface to select to route the datagrams through, based on the type of service desired. In this thesis a possible solution is presented, involving both vertical handoff optimization and policy management. Our testing device is the the SmartBadge v4, provided with a GPRS link and a 802.11b WLAN interface. / Nomadic Computing har för avsikt att revolutionera dagens Internet tillämpningar. För att lyckas måste dock infrastrukturen, IT protokollen och handoff procedurer utformas och implementeras med intentionen att förse mobilt dataöverföring med både driftsäkerhet och autonoma processer. En stor del av de nödvändiga förutsättningarna är tillgängliga tack vare Mobile IP, men mångfalden inom de befintliga Wireless teknologierna utgör fortfarande ett problem. Det stora antalet disponibla Wireless tekniker varierar från teknologierer som förser användaren med en stor täckningsgrad, till sådana som förser användaren med högre bandbredd, begränsad till lokala anv ändningområden. Även Uni-directional ad-hoc links kan läggas i denna lista av mångfald. För att förverkliga fördelarna med den tänkta infrastrukturen fullt ut måste den mobila enheten kunna utföra omkopplingar från den ena wireless teknologin till den andra, med syftet att vara osynlig för användaren. Utöver detta är det meningen att en apparat med många anslutningar ska kunna välja den anslutning som passar bäst, var gång en ny koppling ska göras, beroende på den tjänst som efterfrågas. Det här examensarbetet presenterar en möjlig lösning, som utnyttjar både Vertical Handoff optimering och Policy Management. Prototyp-enheten vi anv änder oss av för att genomföra undersökningen är Smart Badge v4, utrustad med GPRS och 802.11b Wireless LAN anslutningar.

Bakgrund: Stress är vanligt förekommande hos yrkesverksamma sjuksköterskor och nämns som en grundläggande orsak till psykisk ohälsa och ökat antal sjukskrivningar. Arbetsmiljöverket rapporterar in yrkesrelaterad stress som den vanligaste sjukskrivningsorsaken bland vårdpersonal. Moralisk stress definieras som situationer då vi vet vad som är rätt att göra, men institutionella begränsningar gör det i princip omöjligt att göra det rätta. Syfte: Att beskriva sjuksköterskors upplevelser av moralisk stress. Metod: En deskriptiv litteraturstudie med tematisk dataanalysmetod som utgår från 13 vetenskapliga artiklar som svarar på studiens syfte.  Huvudresultat: Resultatet visade att när det finns brister i behandlingen som patienterna erhåller och kvaliteten på vården sviktar upplever många sjuksköterskor moralisk stress. Det visade även att samarbetssituationer, kommunikationsbrister och kontakter med anhöriga kan vara källor till moralisk stress. Den moraliska stressen utlöstes i de situationer där sjuksköterskor upplever att patienterna blir lidande och då sjuksköterskan upplever att hon inte kan agera på det sätt som är bäst för patienten. Som en konsekvens av den moraliska stressen upplever sjuksköterskorna flera varierande negativa känslor, där frustration är den mest frekventa känslan. Slutsats: Upplevelser av moralisk stress är vanligt förekommande bland kliniskt arbetande sjuksköterskor. Den moraliska stressen uppkommer i situationer där sjuksköterskor inte kan agera på det sätt som sjuksköterskorna anser är rätt. Som en konsekvens av den moraliska stressen upplever sjuksköterskorna flera olika negativa känslor. Genom att få en förståelse för vad moralisk stress är, hur den uppkommer och hur den yttrar sig känslomässigt kan sjuksköterskor lättare hantera sina egna reaktioner då de upplever moralisk stress. / Background: Stress is common among nurses and is mentioned as a fundamental cause of an increased number of sick leaves and mental illness. The Swedish Work Environment Authority reports occupational stress as the most common cause of sick leave among healthcare professionals. Moral distress is defined as situations when we know what is right to do, but when institutional limitations make it impossible to do the right thing. Aim: The aim of this study was to describe nurses' experience of moral distress.  Methods: A descriptive literature study with a thematic data analysis method based on 13 scientific articles that answer the aim. Main results: The result revealed that deficiencies in the treatment that patients receive and the quality of care declines, many nurses experience moral distress. It also revealed that cooperation situations, deficiencies in communication and contacts with relatives can be sources of moral distress. The moral distress is triggered in the situations where nurses feel that the patients are suffering and when the nurse feels that she cannot act in the best way for the patient. As a consequence of the moral distress, the nurses experience several varying negative emotions, where frustration is the most frequent emotions. Conclusion: Experiences of moral distress are common among clinically working nurses. The moral distress arises in situations where nurses can’t act in a way that the nurses think is right. As a consequence of the moral distress, the nurses experience several different negative emotions. By gaining an understanding of what moral distress is, how it arises and how it manifests emotionally, nurses can more easily manage their own reactions when they experience moral distress.

Yes / The increasing prevalence and associated cost of treating chronic obstructive pulmonary disease (COPD) is unsustainable. Health care organizations are focusing on ways to support self-management and prevent hospital admissions, including telehealth-monitoring services capturing physiological and health status data. This paper reports on data captured during a pilot randomized controlled trial of telehealth-supported care within a community-based service for patients discharged from hospital following an exacerbation of their COPD. The aim was to undertake the first analysis of system data to determine whether telehealth monitoring can identify an exacerbation of COPD, providing clinicians with an opportunity to intervene with timely treatment and prevent hospital readmission. Methods: A total of 23 participants received a telehealth-supported intervention. This paper reports on the analysis of data from a telehealth monitoring system that captured data from two sources: (1) data uploaded both manually and using Bluetooth peripheral devices by the 23 participants and (2) clinical records entered as nursing notes by the clinicians. Rules embedded in the telehealth monitoring system triggered system alerts to be reviewed by remote clinicians who determined whether clinical intervention was required. We also analyzed data on the frequency and length (bed days) of hospital admissions, frequency of hospital Accident and Emergency visits that did not lead to hospital admission, and frequency and type of community health care service contacts—other than the COPD discharge service—for all participants for the duration of the intervention and 6 months postintervention. Results: Patients generated 512 alerts, 451 of which occurred during the first 42 days that all participants used the equipment. Patients generated fewer alerts over time with typically seven alerts per day within the first 10 days and four alerts per day thereafter. They also had three times more days without alerts than with alerts. Alerts were most commonly triggered by reports of being more tired, having difficulty with self-care, and blood pressure being out of range. During the 8-week intervention, and for 6-month follow-up, eight of the 23 patients were hospitalized. Hospital readmission rates (2/23, 9%) in the first 28 days of service were lower than the 20% UK norm. Conclusions: It seems that the clinical team can identify exacerbations based on both an increase in alerts and the types of system-generated alerts as evidenced by their efforts to provided treatment interventions. There was some indication that telehealth monitoring potentially delayed hospitalizations until after patients had been discharged from the service. We suggest that telehealth-supported care can fulfill an important role in enabling patients with COPD to better manage their condition and remain out of hospital, but adequate resourcing and timely response to alerts is a critical factor in supporting patients to remain at home. / This project was funded by the National Institute for Health Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (CLAHRC YH).

The prevalence of distressing content on social media raises concerns about users' mental well-being, prompting the use of trigger warnings (TW) and content warnings (CW). However, varying practices across platforms indicate a lack of clarity among users regarding these warnings. To gain insight into how users experience and use these warnings, we conducted interviews with 15 regular social media users. Our findings show that users generally have a positive view of warnings, but there are differences in how they understand and use them. Challenges related to using TW/CW on social media emerged, making it a complex decision when dealing with such content. These challenges include determining which topics require warnings, navigating logistical complexities related to usage norms, and considering the impact of warnings on social media engagement. We also found that external factors, such as how the warning and content are presented, and internal factors, such as the viewer's mindset, tolerance, and level of interest, play a significant role in the user's decision-making process when interacting with content that has TW/CW. Participants emphasized the need for better education on warnings and triggers in social media and offered suggestions for improving warning systems. They also recommended post-trigger support measures. The implications and future directions include promoting author accountability, introducing nudges and interventions, and improving post-trigger support to create a more trauma-informed social media environment. / Master of Science / In today's world of social media, you often come across distressing content that can affect your mental well-being. To address this concern, platforms and content authors use something called trigger warnings (TW) and content warnings (CW) to alert users about potentially upsetting content. However, different platforms have different ways of using these warnings, which can be confusing for users. To better understand how people like you experience and use these warnings, we conducted interviews with 15 regular social media users. What we found is that, in general, users have a positive view of these warnings, but there are variations in how they understand and use them. Using TW/CW on social media can be challenging because it involves deciding which topics should have warnings, dealing with the different rules on each platform, and thinking about how warnings affect people's engagement with content. We also discovered that various factors influence how people decide whether to engage with warned content. These factors include how the warning and content are presented and the person's own mindset, tolerance for certain topics, and level of interest. Our study participants highlighted the need for better education about warnings and triggers on social media. They also had suggestions for improving how these warnings are used and recommended providing support to users after they encounter distressing content. Looking ahead, our findings suggest the importance of holding content creators accountable, introducing helpful tools and strategies, and providing better support to make social media a more empathetic and supportive place for all users.

This thesis will present results on the measurement of Z boson production in the electron channel associated with b-jets in proton-proton collision at 13 TeV, a measurement of fundamental interest in precision measurements and physics searches. This measurement represents important precision tests of perturbative QCD and provides information related to the b-quark inside of the proton. This measurement also represents one of the main sources of background in top quark production studies, Higgs precision measurements and the search for supersymmetric particles. The results on cross section measurements and kinematic distributions presented in this work have been unfolded to particle level and are compared to the four and five flavor schemes in Monte Carlo generators, showing that the predictions are consistent within the experimental uncertainties. In this thesis it will be also shown results of the development of the new event selection system proposed for high luminosity measurements. This system will be implemented during the second LHC long shutdown (2019-2020), which involves studies on the reconstruction of electrons using the concept of supercells, where the fine granularity of the cells of the ATLAS Liquid Argon detector is exploited to mitigate the problems to be found in high luminosity conditions. One of the problems is the increase of pile-up, caused by secondary collisions of protons in the same event, generating a large number of low pT jets that can be erroneously identified as electrons. The studies in this work introduce new discriminants based on the electromagnetic shower shape, showing that is possible to further reduce the rate of low pT jets maintaining a good performance on electron reconstruction. / Esta tese apresentará resultados da medida da produção de bósons Z no canal de elétrons associado com jatos b em colisões próton-próton a 13 TeV, uma medida de fundamental interesse em medidas de precisão e buscas por nova física. Essa medida representa importantes testes de precisão da QCD perturbativa e prove informações relacionadas ao quark b dentro do próton. Essa medida também representa uma das principais fontes de background na produção do quark top, medidas de precisão do Higgs e na busca de partículas supersimétricas. Os resultados na medida da seção de choque e distribuições cinemáticas apresentadas neste trabalho são comparados com os esquemas de quatro e cinco sabores nos geradores Monte Carlo, mostrando que as predições são consistentes dentro das incertezas experimentais. Nesta tese também serão apresentados estudos do desenvolvimento de um sistema de seleção de eventos proposto para medidas em alta luminosidade. Esse sistema será implementado durante o segundo LHC long shutdown (2019-2020), envolvendo estudos na reconstrução de elétrons usando o conceito de supercélulas, onde a fina granularidade das células do detector de Argônio Líquido do ATLAS será aproveitada para mitigar as dificuldades que se terão em condições de alta luminosidade. Um dos problemas é o aumento do empilhamento (pile-up), causado por colisões secundárias de prótons no mesmo evento, gerando uma grande quantidade de jatos de baixo pT que podem ser erroneamente identificados como elétrons. Os estudos neste trabalho apresentam novos discriminantes com base na forma da cascata eletromagnética, mostrando que é possível reduzir ainda mais a taxa de jatos de baixo pT mantendo uma boa reconstrução de elétrons.

This thesis will present results on the measurement of Z boson production in the electron channel associated with b-jets in proton-proton collision at 13 TeV, a measurement of fundamental interest in precision measurements and physics searches. This measurement represents important precision tests of perturbative QCD and provides information related to the b-quark inside of the proton. This measurement also represents one of the main sources of background in top quark production studies, Higgs precision measurements and the search for supersymmetric particles. The results on cross section measurements and kinematic distributions presented in this work have been unfolded to particle level and are compared to the four and five flavor schemes in Monte Carlo generators, showing that the predictions are consistent within the experimental uncertainties. In this thesis it will be also shown results of the development of the new event selection system proposed for high luminosity measurements. This system will be implemented during the second LHC long shutdown (2019-2020), which involves studies on the reconstruction of electrons using the concept of supercells, where the fine granularity of the cells of the ATLAS Liquid Argon detector is exploited to mitigate the problems to be found in high luminosity conditions. One of the problems is the increase of pile-up, caused by secondary collisions of protons in the same event, generating a large number of low pT jets that can be erroneously identified as electrons. The studies in this work introduce new discriminants based on the electromagnetic shower shape, showing that is possible to further reduce the rate of low pT jets maintaining a good performance on electron reconstruction. / Esta tese apresentará resultados da medida da produção de bósons Z no canal de elétrons associado com jatos b em colisões próton-próton a 13 TeV, uma medida de fundamental interesse em medidas de precisão e buscas por nova física. Essa medida representa importantes testes de precisão da QCD perturbativa e prove informações relacionadas ao quark b dentro do próton. Essa medida também representa uma das principais fontes de background na produção do quark top, medidas de precisão do Higgs e na busca de partículas supersimétricas. Os resultados na medida da seção de choque e distribuições cinemáticas apresentadas neste trabalho são comparados com os esquemas de quatro e cinco sabores nos geradores Monte Carlo, mostrando que as predições são consistentes dentro das incertezas experimentais. Nesta tese também serão apresentados estudos do desenvolvimento de um sistema de seleção de eventos proposto para medidas em alta luminosidade. Esse sistema será implementado durante o segundo LHC long shutdown (2019-2020), envolvendo estudos na reconstrução de elétrons usando o conceito de supercélulas, onde a fina granularidade das células do detector de Argônio Líquido do ATLAS será aproveitada para mitigar as dificuldades que se terão em condições de alta luminosidade. Um dos problemas é o aumento do empilhamento (pile-up), causado por colisões secundárias de prótons no mesmo evento, gerando uma grande quantidade de jatos de baixo pT que podem ser erroneamente identificados como elétrons. Os estudos neste trabalho apresentam novos discriminantes com base na forma da cascata eletromagnética, mostrando que é possível reduzir ainda mais a taxa de jatos de baixo pT mantendo uma boa reconstrução de elétrons.

Within corporate governance research, boards of directors constitute an essential part and are described as "the apex of the internal control system" (Jensen, 1993, p.862). Several stands of research have investigated whether, and to which degree, boards’ composition, structure and processes have impact on board task performance, but board processes and specifically the use of knowledge and skills have not been thoroughly researched, yet. Simultaneously, there is a gap within organisational behaviour research on how knowledge is explored, transformed and exploited, which is conceptualised as absorptive capacity. Further, the concept of absorptive capacity has so to date not been researched in a board context. In this thesis board processes are studied by exploring the impact of absorptive capacity on board task performance. Three dimensions of absorptive capacity, exploratory learning, transformative learning and exploitative learning, are used in the analyses. The research is conducted using mixed methods (based on a survey and a case study). A quantitative analysis is based on the Norwegian Value Creating Board Survey, and a case study is conducted based on records, observations from board meetings and interviews in the Norwegian health company Healthy. The findings show that the three dimensions of absorptive capacity, positively and significantly, mediate the relation between presence of knowledge and skills and board task performance. Complementarities between the three learning processes exist with the result that the three learning processes together are a stronger mediator than a single process. The qualitative findings show that 1) information flows have an impact on absorptive capacity, 2) that the role and power of the CEO and the division of labour between the CEO and the chair, might have an impact on board task performance and 3) that a comprehensive utilisation of consensus has an impact on transformative and exploitative learning, 4) that effort norms are positively correlated to use of knowledge and skills and 5) that activation triggers have impacts on the learning processes. The research contributes to theory with an extended application of the concept of absorptive capacity to boards, responding to calls from researchers to conduct new and more extensive research to analyse and integrate the concept. The thesis further contributes by shedding new light on learning processes in boards, underpinning former conceptual models. In the case study several findings are reported which are presented in an extended and modified model of determinants of board tasks. Finally, this thesis contributes to mixed methods research in boards. The findings have implications for board practice with regard to board selections, board evaluations and learning processes in boards. Corporate governance codes should be aligned with these findings.

O presente trabalho descreve um modelo para, a partir de Bancos de Dados Operacionais, projetar e implementar Bancos de Dados Analítico-Temporais, cujo principal objetivo é o de armazenar históricos de dados, os quais, por sua vez, visam servir de alicerce para, principalmente, auxiliar no processo de tomada de decisões de médio e longo prazo. O modelo é dividido em três atividades principais. Na primeira atividade o objetivo é mapear os Modelos de Dados Operacionais em um Modelo de Dados Unificado, sendo que este último modelo serve de base para a segunda atividade que é a geração do Modelo de Dados Analítico-Temporal. Para realizar essas duas primeiras atividades, foram elaborados alguns passos que englobam as principais características a serem verificadas e desenvolvidas. Na terceira atividade objetivou-se disponibilizar mecanismos que possibilitem a geração, o transporte e o armazenamento dos dados Analítico-Temporais. Para a realização dessa terceira atividade foram especificados gatilhos e procedimentos armazenados genéricos. / This work describes a model whose main objective is to store historic data, resulting in the Analytic-Temporal Databases. The origins of the data are the Operational Databases. This model can aid in the design and implementation of the Analytic-Temporal Databases that constitutes a very adequate foundation to help in the medium and long time decision taking process. The model is divided into three main activities. In the first activity the objective is to map the Operational Data Models into a Unified Data Model. This last model is the base for the second activity, which is the generation of the Analytical-Temporal Data Model. Considering these two activities, there were elaborated some steps, which encompass the main characteristics to be evaluated and developed. In the third activity the objective is to make available mechanisms, allowing the generation, the transport and the storage of the Analytical-Temporal data. For this third activity, there were specified generic triggers and stored procedures.