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Bakgrund: Interorganisatoriska relationer har blivit allt viktigare de senaste åren, företag köper exempelvis in IT-tjänster för att kunna förbättra sin kärnverksamhet. Det är dock vanligt att interorganisatoriska relationer misslyckas, en lösning till problem med dessa relationer är att använda ekonomisk styrning. En typ av relation som är speciellt utsatt för problematiken är relationen mellan små och medelstora företag, vilket är en grupp det saknas forskning och empiriska undersökningar om, trots dess stora inverkan på den svenska ekonomin. Ännu mer problematiskt blir det när dessa företag köper eller säljer tjänster, då hantering av tjänster kräver en större administrativ kunskap som mindre företag generellt inte besitter. Därmed är det av intresse att studera hur relationen mellan små och medelstora företag som hanterar tjänster ska styras på bästa sätt. Syfte: Syftet med studien är att skapa en modell över hur styrningen av interorganisatoriska relationer utformas och används av små och medelstora företag. Genomförande: Studien är en kvalitativ fallstudie med ett abduktivt angreppsätt. Empirisk data har samlats in genom semistrukturerade intervjuer på fem olika små och medelstora företag som köper och säljer tjänster, med syfte att framhäva perspektivet från båda partner i relationen. Resultat: Studiens resultat visar att det krävs en kombination av formella och informella styrmedel för att ha en fungerande interorganisatorisk relation. Avvägningen av olika styrverktyg beror på olika bakomliggande faktorer som präglar relationen mellan små och medelstora företag men resultatet tydliggör även att tillit och kommunikation har en stor inverkan på behovet av olika slags styrning. Samtidigt har kontraktet en väsentlig del av de studerade interorganisatoriska relationerna. Det är i kontraktet som bland annat finansiella och ickefinansiella målsättningar kan specificeras och kontraktet används som ett underlag för utförandet av tjänsten, uppföljning och avstämning, vilket inte alltid utförs i praktiken. Tilliten som finns mellan parterna i en relation påverkar hur kontraktet sedan används. Studien visar att formella styrmedel och tillit i vissa delar av relationen kan användas som substitut till varandra. Background: The importance of interorganizational relationships has increased in recent years. Companies outsource peripheral components of their operations, such as IT, in order to focus on the main purpose of the company. It is common, however, for these relationships to fail and one solution to the problems arising from interorganizational relationships is the use of management control systems. Relationships between small and medium sized enterprises, in particular, present significant issues. Although they have a great impact on the Swedish economy, there are few scientific studies on them. These companies have an even harder time coping with interorganizational relationships when they are dealing with services, as they require more administrative knowledge than they don’t possess. It is therefore of elevated interest to study the relationship between small and medium sized enterprises that handles services and what type of management control system is best suited for the relationship. Purpose: The purpose of this study is to create a model of the management control systems of interorganizational relationships between small and medium sized enterprises. Design: The study is a qualitative case study with an abductive approach. Empirical data has been collected through semi-structured interviews at five different small and medium sized enterprises that sell and buy services in order to elucidate both parties’ perspectives. Conclusion: The results from the study demonstrate that it is necessary to have a combination of formal and informal management control systems in order to maintain a functioning interorganizational relationship. The balance between different control systems depends on underlying factors arising from the relationship between small and medium sized enterprises. The study also shows that trust and communication has a great impact on the need for different types of control, however, the contract has simultaneously proven to be an essential part of the interorganizational relationships that have been studied. The contract can specify the financial and non-financial aims of the parties and can also be used as a model for how the service should be provided. The contract can also be used for future reviews of the working relationship, although this is not always the case, as the level of trust between the two parties will influence how the contract is actually used. The study shows that formal control systems and trust can be used as substitutes to one another throughout the relationship.

Background Inflammatory bowel disease (IBD) is characterized by gut dysbiosis. To date, the large bowel microbiota has been in focus. However, the microbiota of the small intestine may also be of importance, as the small bowel is a site for the induction and control of mucosal immune responses, which can be modulated by constituents of the local microbiota. Methods Duodenal fluids were collected during diagnostic work-up of treatment-naïve children who were suspected of having IBD. The duodenal fluids were analyzed by pyrosequencing (average of 32,000 reads/sample, read length of 500 nucleotides). After diagnosis, the duodenal microbiota of subjects with ulcerative colitis (N = 8) or Crohn’s disease (N = 5), and non-IBD controls (N = 8) were compared. Results Pyrosequencing revealed that the duodenal microbiota of children with ulcerative colitis contained fewer Operational Taxonomic Units (OTUs) per individual than the duodenal microbiota of the controls (P = 0.005). This reduction in richness of the duodenal microbiota was seen for three major phyla: Firmicutes, Actinobacteria, and Bacteroidetes. Several bacterial genera were detected less frequently in the children with ulcerative colitis than in the non-IBD controls, including Collinsella (P = 0.001), Lactobacillus (P = 0.007), and Bacillus (P = 0.007), as well as a non-identified member of the order Sphingobacteriales (P = 0.007). Conclusions In this pilot study, we show that the duodenal microbiota of children with ulcerative colitis exhibits reduced overall richness, despite the fact that the inflammation is primarily localized to the colon. These results should be corroborated in a larger study.

The hygiene hypothesis state that microbial stimulation is necessary to fully activate and mature the immune system and to sustain tolerance mechanisms. Oral tolerance maintains immune homeostasis in the gut and prevents adverse reactions towards the comensal flora and Ags from the food and thus protects from development of allergies and inflammatory bowel diseases (IBD). The mechanisms underlying oral tolerance remain elusive but it has become clear that regulatory T cells are important mediators of oral tolerance although, little is known on how and where these regulatory T cells are induced. In order to induce oral tolerance the Ag (Ag) must be processed in the intestine. Ags present in the lumen are sampled by intestinal epithelial cells (IECs) and enter an endosomal/ lysosomal pathway that leads to loading of Ag peptides on major histocompability class class II molecules (MHCII), present on vesicular structures that are released from the IECs. Our research group was the first to identify that these vesicular structures named tolerosomes are present in serum after oral Ag administration. Tolerosomes isolated from serum shortly after a feed of Ag induce Ag specific tolerance when transferred into naive recipients. Mature intestines with MHCII expression in the IECs are necessary for development of oral tolerance and this maturation requires the presence of a comensal flora. The aim of this thesis was to study mechanisms of oral tolerance with focus on the generation of tolerosomes and what role the microbiota play in this process, and to investigate the influence of a comensal flora on the maturation of the immune system including generation of regulatory T cells.We found that oral administration of ovalbumin (OVA) result in activation of Ag specific T cells in the gut associated lymphoid tissue (GALT) as well as at peripheral lymphoid sites, including the lymph nodes draining the liver i.e. celiac lymph nodes (CLN). The proportion of Ag-specific cells with regulatory T cells were highest in CLN and that suggests that CLN could be an important site during development of oral tolerance. In addition, co-administration of Cholera toxin and OVA, preserved oral tolerance in the fed mice and lead to an increase of T cells with regulatory T cell phenotype, especially in the CLN. We confirmed, that tolerosomes can be generated in a mouse system and show that the ability to generate tolerosomes is dependent on expression of MHCII in the IECs and furthermore that the function of tolerosomes is restricted by their MHC haplotype. Tolerosomes induce Ag specific T cells activation, both in vivo and in vitro and show phenotypical similarities with in vitro generated exosomes, derived from cultured IECs. Germ free (GF) mice are unable to generate tolerosomes and neither colonization with Escherichia coli or Lactobacilli, could restore this dysfunction or induce expression of MHCII in the IECs of the former GF mice. We also demonstrate that GF mice in general have a less developed immune system with malfunctioning regulatory T cells and reduced levels of the suppressive cytokine IL-10. In conclusion, these results agree with the hygiene hypothesis that suggests that the microbiota play a crucial role for maturation of the immune system and that microbes are essential for the proper function of the tolerance mechanisms that protects us from adverse reactions to harmless environmental Ags.