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Factors that may affect sleep in patients being cared for in an intensive care unit : A qualitative literature review
No full textBakgrund: Ett av människans mest naturliga och basala behov som behöver tillfredsställas varje dygn är behovet av att få sova. Sömnen har visat sig vara viktig för människans fysiska och mentala hälsa, nekas en människa sömn har det även visat sig ha flera olika negativa effekter på dessa, både kort och långsiktigt. Intensivvårdsavdelningar karaktäriseras ofta av flertalet olika högteknologiska inslag samt ett högt arbetstempo och personaltäthet vilket alla är faktorer som kan påverka patienternas sömn och sömnkvalitet. Syfte: Syftet med denna studie var att sammanställa faktorer som kan påverka sömnen hos patienter som vårdas på en intensivvårdsavdelning. Metod: En litteraturstudie bestående av 11 kvalitativa artiklar publicerade mellan 2010–2025 genomfördes. Sökningen efter artiklar genomfördes i databaserna Cinahl och PubMed. De utvalda artiklarna analyserades sedan med Bettany-Saltikov och McSherrys analysmetod. Resultat: Tre huvudteman som påverkade sömnen inom intensivvård identifierades. Dessa var “Patienternas känsloliv”, “Inslag i vårdmiljön” och “Personalens arbets- och förhållningssätt”. Sju subteman som påverkade patienters sömn kunde identifieras och dessa var: ”Oro och Ångest”, ”Ensamhet”, ”Rädsla och tankar om döden”, “Ljud”, “Ljus”, “Kommunikation” och ”Arbetsrutiner”. Slutsats: Vårdmiljön, patienternas känslor och personal påverkar intensivvårdspatienternas sömn på flera olika sätt. För att förbättra patienters upplevelse av sömn på IVA behöver alla dessa faktorer beaktas och åtgärder implementeras relaterade till dessa för att skapa en god förutsättning för sömn. Förslag på åtgärder är att minska ljud- och ljusnivåer, att personal reflekterar mer kring sitt eget potentiellt störande beteende och att patienter erbjuds mer stöd med sitt känsloliv under vårdtiden.Background: One of the most natural and basic human needs that must be met daily is the need for sleep. Sleep has been shown to be crucial for physical and mental health and depriving someone of sleep has both short- and long-term negative effects. Intensive care units (ICUs) are often characterized by high-tech equipment, a fast-paced working environment and high staff density, which all are factors that can impact a patient’s sleep and their sleep quality. Aim: The aim of this study was to compile factors that may affect sleep in ICU patients. Method: A literature review consisting of 11 qualitative articles published between 2010 and 2025 was conducted. The article search was conducted in the CINAHL and PubMed databases. The selected articles were then analyzed using Bettany-Saltikov and McSherry’s analysis method. Results: Three main themes that affect sleep in the ICU were identified. These were “Patients emotional life”, “Elements in the care environment” and “The staffs work- and approach ways”. Seven subthemes affecting patients' sleep could be identified, and these were: 'Worry and Anxiety', 'Loneliness', 'Fear and Thoughts of Death', 'Sound', 'Light', 'Communication', and 'Work Routines' Conclusion: The care environment, patient’s emotions, and staff affect intensive care patients' sleep in various ways. To improve patients' sleep experience in the ICU, all these factors must be considered, and measures related to them must be implemented to create optimal conditions for sleep. Suggested measures would be to decrease sound- and light levels, that staff reflects more upon their own potential disturbing behaviors and that patients is offered more support with their emotional life during their period of care
Dynamic testing and simultaneous model updating of two identical timber buildings with different substructures
No full textTimber buildings, including hybrids, are increasingly popular due to their beneficial environmental aspects. During 2023-2024, the authors had a unique opportunity to perform ambient vibration testing of two six-story buildings with identical timber structures placed on top of different types of concrete substructures and with varying soil conditions. Ambient vibration tests were performed twice during the construction of each building. Finite element models were created for each vibration test, and their parameters were updated simultaneously to accurately simulate the buildings' natural frequencies and the corresponding mode shapes. The model updating process was facilitated by training four surrogate models to represent the four finite element models corresponding to the two buildings and the two construction stages, which were then verified against the finite element models. The updated models were used to investigate the effects of the in-plane shear stiffness of cross-laminated timber walls, soil-structure interaction, moisture content, and non-structural walls on the dynamic properties of hybrid timber-concrete buildings. The results showed nearly identical dynamic performance of the two buildings, suggesting that the differences in substructure and soil conditions do not affect the natural frequencies and mode shapes. A sensitivity analysis revealed that the in-plane shear stiffness of the CLT walls is the most significant factor affecting the modal properties of the two buildings.Preprint available at SSRN: https://ssrn.com/abstract=5114970 orhttp://dx.doi.org/10.2139/ssrn.5114970 </p
A practically applicable inventory management system for consumables in healthcare : A case study at Centrallasarettet Växjö
No full textDenna studie syftar till att förbättra lagerstyrningen av förbrukningsmaterial på Centrallasarettet Växjö genom att utveckla ett praktiskt användbart lagerstyrningssystem. För att uppnå syftet utgår studien från en litteraturgenomgång där förutsättningar inom sjukvården som bör tas i beaktande vid lagerstyrning identifieras. Därefter skapas ett lagerstyrningssystem utifrån litteraturen kring lagerstyrning i kombination med sjukvårdens förutsättningar. Till sist valideras lagerstyrningssystemet genom simuleringar med empirisk data från Centrallasarettet Växjö. Studiens första bidrag är att identifiera vilka förutsättningar inom sjukvården som bör beaktas vid lagerstyrning. Prioriterade förutsättningar är hög servicenivå för att undvika materialbrist, hög robusthet för att hantera stora och långvariga störningar samt tidsbesparingar för sjukvårdspersonalen, vars arbete primärt bör ägnas åt patientvård. Utöver dessa finns önskvärda förutsättningar i form av kostnadsbesparingar och minimering av överbeställningar som inte bör äventyra de prioriterade förutsättningarna. Slutligen identifieras begränsande/möjliggörande förutsättningar som platsbrist, decentralisering, okända lagernivåer, korta ledtider, efterfrågevariationer samt att beställningar görs innan påfyllning. Det andra bidraget är ett lagerstyrningssystem med fokus på praktisk användbarhet, utifrån lagerstyrningsteorier och sjukvårdens förutsättningar. Systemet bygger på installationslagerprincipen, en pullbaserad metod i form av tvåbingesystem kombinerat med kanbankort, periodisk inspektion och en (R, Q) policy. För att fastställa beställningspunkter och beställningskvantiteter skapas en lagerstyrningsmodell i Excel som bygger på constraint programming. Utöver detta inkluderar systemet en artikelklassificering där förbrukningsmaterial klassificeras utifrån hur kritiska de är samt huruvida laterala omförflyttningar är möjliga. Studies tredje bidrag är en analys av hur lagerstyrningssystemet presterar när det testas genom simulering med empirisk data från Centrallasarettet Växjö. Resultatet visar att systemet fungerar som förväntat under normala förhållanden och reagerar som förväntat vid mer utmanande förhållanden, vilket validerar lagerstyrningssystemets funktionalitet. Vidare utformar författarna en beskrivning av hur lagerstyrningssystemet bör användas i praktiken som de själva följer vid simuleringen, varpå systemets praktiska användbarhet illustreras.This study aims to improve the inventory control of medical consumables at Centrallasarettet Växjö by creating an inventory control system which is practically applicable. To achieve this, the study begins with a literature review to identify aspects within healthcare that should be considered in inventory control. Based on findings from the literature on inventory control, combined with the identified healthcare aspects, an inventory control system is created. Finally, the system is validated through simulations using empirical data from Centrallasarettet Växjö. The first contribution of the study is the identification of healthcare aspects relevant to inventory management. Aspects which are prioritised include maintaining a high service level to avoid material shortages, ensuring high robustness to handle major and prolonged disruptions and achieving time savings for the healthcare personnel, whose work should primarily focus on patient care. Additionally, desirable aspects such as cost savings and minimizing overordering are identified, though these should not compromise the prioritised aspects. Lastly, the study identifies enabling and limiting aspects such as space constraints, decentralization, unknown inventory levels, short lead times, demand variability, and the fact that orders are often placed before restocking. The second contribution is the development of an inventory control system focused on practicality, grounded in inventory control literature and adapted to the previously identified healthcare aspects. The system is based on an installation stock policy, a pull method implemented through a two-bin system combined with kanban cards, periodic review, and a (R, Q) policy. To determine reorder points and order quantities, an inventory control model is created in Excel using constraint programming. The system also includes an item classification that categorizes medical consumables based on their criticality and whether lateral transshipments are possible. The third contribution is an analysis of the system’s performance when tested through simulations using empirical data from Centrallasarettet Växjö. The results show that the system meets expectations under normal conditions and responds as expected under more challenging conditions, thereby validating the functionality of the system. Furthermore, the authors develop a description of how the system should be applied in practice, which they follow during the simulations, thereby illustrating the system’s practical applicability
Postoperativ överrapportering med kommunikationshjälpmedlet SBAR : En integrativ litteraturöversikt
No full textBakgrund: Överrapportering av patienter är ett vanligt förekommande fenomen i sjukvården. Detta är ett extra kritiskt moment när den sker mellan operationsavdelningen och den postoperativa avdelningen. Patienten överrapporteringen då handlar om har genomgått en operation och är i ett utsatt läge. Patientsäkerheten är här hotad om relevant information ej kommuniceras på rätt sätt. Bristande postoperativ överrapportering kan leda till vårdskador med stora kostnader för samhället och vårdlidande för patienten. Relevant information kan potentiellt kommuniceras på ett bättre sätt genom användning av det strukturerade kommunikationshjälpmedlet SBAR. Syfte: Studiens syfte var att undersöka effekterna av användningen av SBAR vid postoperativ överrapportering från operationsavdelningen till den postoperativa avdelningen. Metod: En integrativ litteraturstudie genomfördes med tematisk analys. Databaserna Cinahl och Pubmed har använts vid datainsamling. Resultat: Nio artiklar utformar resultatet. De inkluderade artiklarna har använt kvantitativ och mixad metod. I resultatet framkom tre beskrivande teman: Effektivitet och tidsåtgång, Ökad patientsäkerhet samt Professionstillfredställelse och bättre teamarbete. Slutsats: Resultatet visade att effekterna av postoperativ överrapportering med SBAR innebar ökad kvalitet och effektivitet. Det interproffesionella samarbetet och professionstillfredställelsen förbättrades. Mer relevant information kommunicerades och tid lades i mindre utsträckning på irrelevant information. Patientsäkerheten ökade i stor utsträckning.Background: The handover of patients is a commonly occurring phenomenon in healthcare. The handover between the operating theatre and the post-operative care unit is one of the most critical of these situations. The patient has undergone surgery and is in a vulnerable position. The safety of the patient is threatened if relevant information about the patient is not communicated or not communicated correctly. If the postoperative handover is lacking this can cause the patient care related injuries which are of great cost to society and care suffering for the patient. There is a potential for relevant information to be communicated in a better way using the communication tool SBAR. Aim: The aim of the study is to investigate the effects of the usage of SBAR in the postoperative handover between the operating theatre to the postoperative care unit. Method: An integrative literature review was performed using thematic analysis. The databases used for data collection were Cinahl and Pubmed. Findings: Nine articles form the findings. The included articles have used quantitative and mixed or integrated methods. Three descriptive themes emerged, these are: Efficiency and time usage, Increased patient safety and Profession related satisfaction and better teamwork. Conclusion: The findings showed that the effects of the postoperative handover using SBAR increased quality of care and efficiency. The interprofessional cooperation and professional satisfaction were improved. More relevant information was communicated, and less time was spent on irrelevant information. Patient safety was greatly improved
Ojämlikhetsregimer i aktivering : Görande av klass, etnicitet och kön genomsubventionerade anställningar
No full textInequality, in terms of how resources are distributed between different categories of people is a pervasive phenomenon in society. The Swedish labour market is no exception, exhibiting a significant degree of classed, ethnified and gendered inequality in terms of access to control and power over production conditions. This thesis aims to contribute knowledge about how and why inequality regimes are reproduced and counteracted by analysing the doing of class, ethnicity and gender in processes, activities and meaning making within six municipal labour market programmes using subsidised employment as its main intervention. The empirical material consists of focus groups-and individual interviews with 45 participants, 41 social workers and 4 managers in six different labour market programmes focused on subsidised employment as an activation intervention. The result is presented in four articles that highlight the doing of class, ethnicity and gender. Article I focuses on the doing of gender and ethnicity in relation to goals of gender equality and activation. Article II highlights how ethnic categorisations affect activation within a municipal labour market programme, which in turn reproduces inequality, especially for people categorised as refugees within the programme. Article III deals with participants' collective identity and community constructions in relation to how they are categorised and activated by social workers. Article IV analyses how class is done in six municipal labour market programmes and how ethnicity and gender intersect in the doing of class. In the final discussion, it is discussed how doing class, ethnicity and gender is intertwined with how inequality regimes were reproduced. It is also discussed why inequality regimes were reproduced based on the respondents' meaning-making related to the norm of paid work and the unequal conditions in the labour market. The classed, ethnicised and gendered categorisations of participants by social workers and managers are organised, influenced and reproduced in relation to each other in order to enable participants to enter the labour market quickly after the intervention was completed. Participants attributed the intervention as meaningful. Yet, the categorisations can also be interpreted as to service the municipalities' needs for labour in the lower segments of the labour market. Subsidised employment can therefore be understood to reproduce a municipal reserve army, rather than enabling a stable labour market establishment for people who have a marginal position in the labour market.Flyktinginvandring och omvandling på den svenska arbetsmarknaden – vilken roll spelar kommunerna? (Forte 2016-07123
Techno-economic and Environmental Analysis of Battery Technologies for Aircraft Towing and Pushback Operations
No full textThe imperative to decarbonize airport operations has intensified as aviation’s share of global greenhouse gas continues to rise. Ground support equipment (GSE), particularly towbar-less electric tractors (TBLTs), presents a tangible opportunity to reduce fossil fuel reliance at airports. This study conducts a techno-economic and environmental assessment of five battery systems, lithium iron phosphate (LFP), nickel cobalt aluminum (NCA), sodium-ion batteries (SIB), solid-state batteries (SSB), and nickel metal hydride (NiMH), for powering TBL-180, an electric TBLT used at Frankfurt Airport. The functional unit, defined as one kilowatt-hour delivered over a battery’s lifetime (kWhD), enabled comparison of battery performance, lifecycle environmental and economic impacts. Performance metrics such as gravimetric energy density, depth of discharge (DoD), cycle life, and technology readiness level (TRL) were evaluated to ensure suitability for towing and pushback operations in Frankfurt’s sub-zero winter temperatures. A cradle-to-gate and usephase life cycle assessment (LCA) following ISO 14040/44 and PEFCR (Product Environmental Footprint Category Rules) guidelines determined the environmental impact of the selected batteries. Parallel life cycle costing (LCC) calculations, incorporating capital, operational, and salvage costs under current-market and projected-2030 scenarios, were carried out to determine the economic feasibility of the technologies. Results indicate that NiMH exhibits the highest cradle-to-gate emissions and lowest cycle efficiency, making it the least attractive option. Currently, LFP batteries offer the optimal balance of low environmental footprint (0.58 kg CO₂ eq/kWhD) and lowest LCC (0.027 /kWhD, and its impact levels are comparable to those of LFP when scaled to kWhD. Conversely, SSBs, despite superior theoretical energy density and safety, incur the highest cradleto-gate impacts due to energy-intensive solid-electrolyte production and remain at TRL 6, limiting near-term feasibility. Overall, LFP remains the recommended choice for TBL-180 under present conditions; however, SIBs are poised to surpass LFP in the coming years, contingent on continued advancements and economies of scale.
Barriers and Drivers to a Just Wind Energy Transition in India : A Multi Dimensional Analysis
No full textThis thesis examines the factors influencing India's transition to wind energy, emphasizingprinciples of justice and equity. Utilizing a multi-dimensional analytical framework comprisingPESTEL, SWOT, and Multi-Level Perspective (MLP), the study systematically identifies criticalbarriers and drivers across policy, economic, social, technological, environmental, and legaldomains. Stakeholder perceptions collected through structured surveys with 40 key actorsincluding researchers, policymakers, developers, and financiers complement the qualitativeanalysis, providing grounded insights into practical transition dynamics. The findings reveal that policy inconsistencies, economic and financial barriers such as highupfront costs and limited access to affordable financing, and inadequate infrastructure posesignificant challenges. Social equity issues, including limited community engagement and landrights conflicts, further complicate the transition. Conversely, key enabling factors identifiedinclude stable regulatory frameworks, innovative financial mechanisms, integrated hybrid energysystems, and inclusive community benefit-sharing practices. Technological readiness,particularly advancements in grid integration and storage solutions, emerges as a criticalfacilitator for effective implementation. The thesis concludes that addressing these barriers and leveraging identified drivers throughcoherent policy-making, participatory governance, and equitable financial frameworks isessential for realizing a sustainable and just wind energy transition in India.
When Safety Becomes Power: The price of risk management and the path toward a new penal culture in Swedish criminal policy. : <em data-start="190" data-end="252">A critical examination of the Tidö agreement and SOU 2024:48
No full textMeasuring a family sense of coherence : a rasch-based study extending dyadic data analyses
No full textBackgroundFamily sense of coherence (FSOC) seems to reduce distress in the family and promote the well-being of the family. Therefore, getting accurate measurements for families with long-term illnesses is of particular interest. This study explores dyadic data analysis from the dyadic- and single-informant perspectives, and the measurement properties of the FSOC-S12 according to the Rasch model.MethodsRacked and stacked data from 151 dyads were analyzed according to the polytomous Rasch model.ResultsNotably, both the dyadic- and single-informant perspectives (i.e., racked and stacked data set-ups) showed measurement properties with minor deviations from the Rasch model according to fit statistics. However, most items had disordered thresholds and some problems with local dependency. Item hierarchies were similar in both set-ups and there was no differential item functioning (DIF) by role from the dyadic informant perspective. Four items showed DIF by informant role in the single-informant perspective.ConclusionsOur approach to handling dyadic data has shown both strengths and limitations in the evaluation of FSOC-S12, and the understanding of FSOC as a construct from the family's view of the family's ability as a whole (dyadic-informant perspective) and patient's and family member's separate views of the family's ability as a whole (single-informant perspective)
'Everything In Its Right Place' : Selective Depositions in Bronze Age Southwest Sweden
No full textHoards have played a significant role in our narratives of the European Bronze Age, but their purpose and meaning have been the source of much debate. These debates have been positively impacted by studies that investigate the ways in which hoards are connected to specific landscape contexts. In this paper, we discuss the outcome of one such in-depth field study of 62 Bronze Age metalwork deposition locations from the Swedish province of Halland. By systematically analysing digital sources such as museum archives, church records and historical maps, we were able to establish the locations of a number of previously unlocated finds, which were then visited in the field. Through this combined archival work and fieldwork, we distinguished several patterns that allude to a connection between metalwork deposits, object types and specific places in the landscape. These patterns shed light on the landscape context of hoards in this region and illuminate how deposition patterns changed over time; we consider some factors that may help to explain these changes. The results emphasize the importance of landscape studies for understanding the role of selective deposition in European Bronze Age societies, and more broadly, the social implications of hoards in their context