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An organisation working mainly reactively instead of proactively: a qualitative study of how frail users of home care services and their next of kin experience crises
Get PDFBackground Frail people receiving home care services face an increased risk of developing crisis, which can result in adverse events, coercive measures, and acute institutionalisation. The prevalence of frailty is expected to increase due to the ageing population in most countries. However, our knowledge of the process leading to crises among frail community-dwelling patients remains limited. The aim of our study was to explore how users of home care services and their next of kin experienced crises and how these crises were approached by home care services. Methods A qualitative explorative design with 21 interviews was conducted. We explored crises within the last year that had led to an acute institutionalisation (hospital or nursing home) or to an unstable situation with high risk of institutionalisation. Systematic text condensation (STC) was used to analyse the data. Results Our findings are summarised into one overarching theme; an organisation working mainly reactively instead of proactively, which is supported by four subthemes: (1) insufficient communication—a determinant of crises, (2) the lack of a holistic approach, (3) a sense of being a burden, and (4) the complexity of crises. The reactive approach is demonstrated in the participant’s experience of insufficient communication and the lack of a holistic approach from the service, but also in the user’s sense of being a burden, which seems to be reinforced by the experienced busyness from the staff in the home care services. This reactive approach to crises seems to have contributed to difficulties in detecting the various stressors involved in the complex process leading to crisis. Conclusions Our findings suggest that home care services tend to be characterised by a reactive approach to rising instability and the development of crises for users. This can be interpreted as an emergent property of the organisation and the adaptation towards exceeding demands due to insufficient capacity in health care services. We recommend the use of multicomponent care programmes comprising interdisciplinary case conferences in home care services to implement a cultural change that can shift the service from a reactive, fragmented, and task-oriented approach to a more proactive approach.publishedVersio
Convergent evolution revealed by paraphyly and polyphyly of many taxa of oribatid mites: A molecular approach
Get PDFA reliable phylogeny is crucial for understanding the evolution and radiation of animal taxa. Phylogenies based on morphological data may be misleading due to frequent convergent evolution of traits—a problem from which molecular phylogenies suffer less. This may be particularly relevant in oribatid mites, an ancient soil animal taxon with more than 11,000 species, where the classification of species into high-ranking taxa such as superfamilies is equivocal. Here, we present a molecular phylogeny of 317 oribatid, 4 astigmatid and 17 endeostigmatid mite species/taxa based on 18S rDNA sequences. We aimed at testing the validity of the 41 superfamilies of oribatid mites recognized by Norton and Behan-Pelletier (in Krantz and Walter, A manual of Acarology, 3rd ed., Texas Technical University Press, Lubbock, 2009). The results indicate that 17 of the 41 oribatid mite superfamilies are monophyletic but that 18 superfamilies are paraphyletic or polyphyletic (5 superfamilies were only included with one species and Microzetoidea were not included). Our findings point to the importance of convergent evolution in polyphyletic oribatid mite taxa. Convergent evolution and the old age of mites likely resulted in a mosaic-like distribution of morphological characters impeding phylogenetic reconstructions based on morphology, calling for molecular approaches to improve oribatid mite systematics.publishedVersio
Barriers and facilitators for social inclusion among people with concurrent mental health and substance use problems. A qualitative scoping review
Get PDFBackground
People with concurrent mental health and substance use problems are among the most socially excluded groups in our society, yet little attention has been paid to what socially excluded people see as central to promoting their social inclusion. The aim of this qualitative scoping review is to provide an overview of barriers and facilitators for social inclusion among people with concurrent mental health and substance use problems, based on first-person perspectives, to help guide future research, policies, and practice.
Methods
We explored first-person perspectives on social inclusion among people with concurrent mental health and substance use problems, employing Arksey and O’Malleys framework. We searched Medline, PsycINFO, Embase, Scopus, Cinahl, and other sources for studies published between January 2000 and September 2023. We employed content analysis and followed the PRISMA checklist.
Results
We included 55 articles included in our review and identified sub themes of: Intrapersonal baseline (identity, belonging), Components of social inclusion (relationships, meaningful activities, employment, economy), and Systemic failure or success (housing, public health and welfare services, the criminal justice system).
Conclusion
Social inclusion is rarely studied outside the context of direct services. Our results point to knowledge gaps in addressing social inclusion in a broad, societal context; implementing gaps in services; and developing policies to assure the fundamental needs and human rights of socially excluded persons.publishedVersio
The professionalization of the counsellor role–a comparative study of Finland and Norway
Get PDFCareer guidance counsellors’ competence requirements in Norwegian schools have been the subject of decades-long discussion. Practitioners, experts, and stakeholders have called for precise requirements and professionalized status for counsellors, but with little results. In the Finnish context, however, career guidance is more professionalized, and the counsellor competence requirements are defined by law. Why have the two systems developed differently? In this research, we used ‘historical institutionalism’ as our lens and compared the two developmental histories of the counsellor role and the reasoning behind these differentiating systems. By utilizing Toulmin’s model of argumentation, we analysed rationales in policy documents from ministries to expert groups to reveal how the policy rationales have formed the different statuses of the career counsellor profession in the 1950s, 1960s and 1990s. Norway and Finland saw the counsellor role similarly, but eventually, decisions on qualifications and competency were made from different perspectives.publishedVersio
‘All for the well-being of the infant’: nurses’ perceptions of preterm infants’ eye examinations: a phenomenographic study
Get PDFBackground: Preterm infants are at risk of complications due to their prematurity and Retinopathy of Prematurity (ROP) is one of them. To discover and treat ROP the preterm infants regularly undergo eye examinations. Nurses are responsible for the infants' care during this painful and stressful procedure. Aim: The aim of this study was to explore nurses' perceptions of preterm infants' eye examinations. Methods: Data were collected through semi-structured interviews with 10 nurses experienced in participating in preterm infants' eye examinations. Data were analysed using a phenomenographic approach. Results: The results showed several perceptions of the eye examinations, and the analysis resulted in four descriptive categories: Infants are affected by the eye examination; Nurses have comprehensive overall responsibility for the infants; Parents are important to their infants, but they need support to fulfil their parental role, and Collaboration is important for the examination's favourable outcome. The category Nurses have comprehensive overall responsibility for the infants was regarded as the most comprehensive, covering all the other categories. Conclusions: Nurses felt a great responsibility during a painful and stressful procedure for preterm infants. Infants' well-being could be better protected by interprofessional collaboration, improved nursing care and involved parents.‘All for the well-being of the infant’: nurses’ perceptions of preterm infants’ eye examinations: a phenomenographic studypublishedVersio
Psychological distances to climate change and public preferences for biodiversity-augmenting attributes in family-owned production forests
Get PDFUnderstanding public perceptions on how management can help adapt forests to climate change is fundamental to the design of socially-acceptable policies. A binary discrete choice experiment in Norway and Sweden was conducted to elicit public preferences for biodiversity-augmenting changes in three forest management attributes (set-aside, proportion of uneven-aged tree stands, and number and type of tree species) compared to typical status quo conditions in family-owned production forests. Importantly, how self-constructed psychological (spatial, social, temporal and hypothetical) distances to climate change were associated with management preferences was investigated. Following integrated choice and latent variable modeling approaches to account for their latency, our econometric results show that closer psychological distances to climate change were associated with increased support for biodiversity-augmenting changes in management attributes from status quo conditions of family-owned production forests. On average, the Norwegian public preferred larger set-asides and introducing one more broadleaved species, while the Swedish public favored changes in all attributes. The highest utility was derived from increasing set-aside areas from the status quo (5%) to 10% and 20% in both countries with respective average WTP of about 10 to 11 EUR/month in Norway, and approximately 10 to 14 EUR/month in Sweden. Findings point to universal acceptability of increasing set-aside areas in both nations, and public approval for uneven-aged and mixed forest management in Sweden.publishedVersio
Genetic variation of English yew (Taxus baccata L.) in the Bavarian Forest National Park, Germany
Get PDFTaxus baccata L. is a highly valuable species with wide distribution but scattered and locally rare occurrence. Human intervention, including forest management practices and fragmentation, can significantly impact the species’ genetic diversity, structure, and dynamics. In this study, we investigated these factors within T. baccata populations in the Bavarian Forest National Park (NP) in Germany and their implications for conservation. We used 13 EST-SSRs to assess the genetic diversity and structure of the population. Our analysis revealed a scarcity of small-diameter trees, indicating limited natural regeneration over time. However, conservation efforts, like selectively removing competitor species and using protective fencing, have improved growth conditions and promoted seedling emergence. The NP’s natural zone has no active management, which is confined to the development and management zones. Genetic diversity assessments revealed high genetic diversity (He: 0.612 and 0.614 for seedlings and adults, respectively) compared to other studies in Taxus baccata, dispelling concerns of significant inbreeding and showcasing a stable genetic structure. However, significant spatial clustering of related individuals (family structures) in both cohorts and low effective population size in the progeny hints at restricted gene flow, necessitating conservation efforts prioritizing safeguarding and promoting natural regeneration in development and management zones. Limited natural regeneration and the recent decrease in effective population size in the NP populations indicate habitat fragmentation and human interventions. Effective population size estimates emphasize the need for diverse conservation strategies. Conservation efforts should prioritize protecting natural regeneration and enhancing gene flow by actively promoting European yew, e.g., by shelterwood cutting, to ensure the long-term viability of T. baccata in the region outside the NP.publishedVersio
Characteristics of non-drinking adolescents: a longitudinal Swedish study
Get PDFThis study investigated whether non-drinking adolescents (n = 195), withno previous experience with alcohol, differed over time from drinkingadolescents (n = 406). Potential differences in psychological health (men-tal well-being, psychosomatic symptoms, conduct problems), social inter-action frequencies (new friends, time spent with friends and socialinteraction through a screen device), psychoactive substance use, andpositive attitudes towards alcohol was investigated. Additionally, thestudy examined whether these attributes in 9th grade could predicttotal abstinence two years later. Non-drinkers were consistently charac-terized by fewer social interactions, less positive attitudes towards alcohol,a lower probability of using other drugs, and fewer conduct problemsfrom 14 to 17 years, which may imply a more introverted personalityfunction. This study contributes insights into predicting factors linked toalcohol abstinence in adolescence, particularly the characteristics of non-drinking adolescents in a society where a declining trend of alcoholconsumption is emerging.publishedVersio
Practitioners' perspectives on green guidance: An international survey
Get PDFThis paper sets out the findings of a survey of 674 career guidance practitioners conducted in late 2023 and early 2024 about green guidance. The survey reports that the clients of career guidance need help with a range of sustainability issues and that a minority raise issues of environmental sustainability during career guidance interventions. Practitioners have a strong belief that the world is currently experiencing a climate crisis and that career guidance can be a small part of addressing this. However, most currently lack the theories, models and resources to deliver green guidance. Implications for the Exploring Green Guidance project and the development of models of green guidance are discussed.publishedVersio
Connecting the dots: relationship between heart rate and overall dynamic body acceleration in free-ranging cattle
Get PDFMonitoring physiological indicators including heart rate (HR) is crucial for managing animal welfare across diverse settings, from precision livestock farming to wildlife conservation. HR is a reliable indicator of energy expenditure and stress, yet the invasive nature of HR loggers limits their application in wild and free-ranging species. This study explores whether overall dynamic body acceleration (ODBA), measured with an external accelerometer, can serve as a less invasive proxy for HR. Using free-ranging cattle as a model species in Norway, we examined the relationship between ODBA and HR to assess how external accelerometry might indirectly reflect physiological states in settings that resemble wild conditions. Cattle provide an ideal model because they share some characteristics with wild herbivores, including exposure to diverse terrain and potential predation, whilst offering advantages for handling and sensor retrieval. Our findings showed that low ODBA values corresponded to static behaviours (e.g. standing, ruminating), where small movements caused HR spikes, whilst higher ODBA reflected dynamic activities (e.g. walking, foraging), with HR plateauing. This relationship suggests that ODBA can be used to approximate HR in environments where direct HR measurement is challenging. By using accelerometry to infer HR changes in free-ranging cattle, this study offers insights that could extend to wild species, offering a tool for conservationists to monitor and manage animal health and well-being less invasively.publishedVersio