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Swedish Elite Rotation : Seen from Hjalmar Brantings May first speeches
No full textDenna fallstudie undersöker demokratiseringen av Sverige ur en ny vinkel för att försöka bedöma det historiska kulturella klimatet kring legitimitet. För att göra detta används en diskursanalys av Hjalmar Brantings Första maj-tal med hjälp av ett teoretiskt ramverk baserat på Elitrotationsteorin av Vilfredo Pareto. På ett experimentellt sätt föregås diskursanalysen av en innehållsanalys eftersom materialet består av tal som spänner över 30 år, i syfte att ge en stödjande struktur till diskursanalysen. Resultaten visar slående likheter med Brantings retoriska katalog och de förväntade kulturella teman som dikteras av elitrotationsteorin.This case study looks into the democratization of Sweden through a new angle, trying to assess the historical cultural climate in respect to legitimacy. To do this a discourse analysis is used on the May first speeches of Hjalmar Branting using a theoretical framework based on the Elite Rotation theory by Vilfredo Pareto. In an experimenta fashion the discourse analysis is preceded by a content analysis since the material entails speeches spanning 30 years, in order to give supporting structure to the discourse analysis. The findings show striking similarities with Branting's rhetorical catalogue and the predicted cultural themes dictated by Elite Rotation theory.
District nurses´and nurses´experience of 1177 Direct
No full textBakgrund: 1177 Direkt har lanserats för att öka tillgängligheten till primärvården, främja egenvård och avlasta akut- och jourmottagningar. Den digitala vårdutvecklingen, som accelererat efter Covid-19 pandemin, medför nya krav på arbetsprocesser och yrkesroller. Syfte: Syftet med studien var att beskriva distriktssköterskors och sjuksköterskors erfarenheter av att arbeta med 1177 Direkt som en del av den digitala vårdkontakten. Metod: En kvalitativ intervjustudie med induktiv ansats genomfördes. Data samlades in via semistrukturerade intervjuer och analyserades med hjälp av kvalitativ innehållsanalys för att fånga deltagarnas egna upplevelser och erfarenheter. Resultat: Resultatet omfattar fyra huvudkategorier och tolv underkategorier som belyser både möjligheter och utmaningar med användandet av 1177 Direkt. Bland annat framkom att bilddokumentation kan bidra till ökad säkerhet i bedömningen, medan hanteringen av flera parallella kontaktvägar upplevs som resurs- och tidskrävande. Deltagarna uttryckte även behov av vidareutbildning för att möta de krav som digitaliseringen medför i deras arbetsroll. Slutsats: Den digitala tjänsten 1177 Direkt erbjuder flera fördelar för vårdens tillgänglighet och effektivitet, men medför också utmaningar som påverkar arbetsvillkor och patientsäkerhet. Resultaten pekar på vikten av fortsatt utveckling av tjänsten och utbildningsinsatser för att stärka distriktssköterskors och sjuksköterskors kompetens inom digital vård.Background: The launch of the digital healthcare application 1177 Direkt aims to improve access to primary care, promote self-care, and reduce pressure on emergency services. The rapid digital transformation in healthcare, especially post-COVID-19, introduces new demands on work processes and professional roles. Aim: The purpose was to describe the district and registered nurses’ experiences of using 1177 Direct in digital healthcare contact. Method: A qualitative interview study with an inductive approach was conducted. Semi-structured interviews were analyzed using qualitative content analysis to understand participants’ experiences. Results: The findings include four main categories and twelve subcategories, revealing both opportunities and challenges. Image documentation was seen to enhance assessment safety, while managing parallel contact channels was resource- and time-consuming. Participants highlighted the need for further training to meet digital demands. Conclusion: 1177 Direct contributes to healthcare accessibility and efficiency but poses challenges for working conditions and patient safety. Continued development and targeted education are essential to strengthen nurses’ digital healthcare competencies
Midwives’ experiences of supporting women exposed to violence : A Qualitative Meta-Synthesis
No full textBackground: Violence against women is a major social problem globally that negatively affects women's quality of life and health. In their profession, midwives meet women of all ages. The midwife's profession includes having the knowledge to identify signs of psychological and physical violence, as well as having knowledge of the resources available to ensure that women exposed to violence receives the right support and protection. Aim: To describe midwives' experiences of supporting women exposed to violence. Methods: Qualitative meta-synthesis with meta-ethnographic and thematic analysis. Results: The results were structured around two main themes: Between obstacles and hope - the supportive role of the midwife in a limited system, and the midwife as the woman's main support person - the power of the relationship. Under these two main themes, six sub-themes emerged: Time, resources and education, the midwife as a bridge - about language, culture and multidisciplinary collaboration, navigating issues of violence, interpreting signs - intuition and uncertainty in identifying violence, the supportive encounter - the midwife's experiences and challenges, and when support becomes burden. Conclusion: The results of the meta-synthesis showed that midwives requested organisational support, training and resources to be able to support women exposed to violence. The midwife had a central role in identifying and counselling even though she lacked the training required to deal with such situations. Clinical implication: The results of the meta-synthesis can primarily be applied in the work of midwives, where educational initiatives enable the dissemination of knowledge about violence against women exposed to violence.Bakgrund: Våld mot kvinnor är ett stort samhällsproblem över hela världen som påverkar kvinnors livskvalité och hälsa negativt. Barnmorskor möter i sitt yrke kvinnor i alla åldrar. I barnmorskans profession ingår att ha kunskap om att identifiera tecken på psykiskt och fysiskt våld samt ha kunskap om vilka resurser som finns för att våldsutsatta kvinnor ska få rätt stöd och skydd. Syftet: Att beskriva barnmorskors erfarenheter av att stödja våldsutsatta kvinnor. Metod: Kvalitativ metasyntes med meta-etnografisk och tematisk analys. Resultat: Resultatet består av två huvudteman: Mellan hinder och hopp - Barnmorskans stödjande roll i ett begränsat system samt Barnmorskan som kvinnans främsta stödperson - relationens kraft. Under dessa två huvudteman framkom sex underteman: Tid, resurser och utbildning, barnmorskan som brobryggare - om språk, kultur samt multidisciplinärt samarbete, att navigera våldsfrågor, att tolka tecken - intuition och osäkerhet i att identifiering våldsutsatthet, det stödjande mötet - barnmorskans upplevelser och utmaningar samt när stöd blir beslastning. Slutsats: Resultatet från metasyntes visade att barnmorskor efterfrågade organisatoriskt stöd, utbildning och resurser för att kunna stödja våldsutsatta kvinnor. Barnmorskor har en central roll i att identifiera och samtala trots att barnmorskor generellt sett saknar vidareutbildning och den träning som krävs för att ge stöd åt våldsutsatta kvinnor. Klinisk tillämpbarhet: Metasyntesens resultat kan främst tillämpas i barnmorskans arbete, där utbildningsinsatser möjliggör spridning av kunskap om våld mot kvinnor
Combinations of BMI and metabolic syndrome and the risk of myocardial infarction, stroke, and heart failure
No full textBACKGROUND AND AIMS: The relationship between uncommon phenotypes, such as metabolically healthy obesity and normal weight with metabolic syndrome (MetS), and cardiovascular disease (CVD) risk, remains unclear. We investigated how different combinations of body mass index (BMI) and MetS are associated with overall and specific CVDs and how the number of MetS components influences CVD risk in individuals with obesity. METHODS AND RESULTS: We performed separate analyses and a meta-analysis of 36,233 individuals from four Swedish cohorts to assess the risk of incident CVDs across BMI/MetS combinations (normal-weight, overweight or obese/MetS yes or no). Participants were followed for CVDs and death through linkage to the Swedish National Registers. Compared to normal weight without MetS, overweight and obesity without MetS had most pronounced association with the risk of heart failure [multivariable hazard ratios, HR (95 % CI) = 1.37 (1.16-1.63) and 1.85 (1.37-2.48), respectively, p < 0.001]. In obese individuals, the risk of incident CVD (composite endpoint) increased with an increasing number of MetS components, but this relationship was not statistically significant in obese participants without additional MetS components, likely due to the small at-risk group. Normal-weight individuals with MetS had an increased risk of myocardial infarction [HR (95 % CI) 2.0 (1.51-2.64)], p < 0.001, and stroke [HR (95 % CI) 1.63 (1.17-2.28), p = 0.004]. CONCLUSIONS: Overweight and obesity without MetS showed a greater impact on the risk of heart failure, whereas normal-weight individuals with MetS had a higher risk of myocardial infarction and stroke. In obese individuals, CVD risk increased as the number of MetS components increased
Acupuncture for the treatment of infantile colic
No full textThis is a protocol for a Cochrane Review (intervention). The objectives are as follows: To assess the benefits and harms of acupuncture for the treatment of infantile colic
Parents’ long-term retention of the Family Talk Intervention in pediatric oncology
No full textBackground: Despite the significant psychosocial challenges faced by families in pediatric oncology, there is a notable lack of long-term scientific evaluations of family-based psychosocial interventions that address the needs of the entire family. This study examines parental retention 4-5 years after participating in a psychosocial family-based intervention family talk intervention (FTI). FTI consists of 6-11 manual-based meetings. The main goals of FTI are to facilitate family communication about illness-related topics, support parenting, and make the children's needs visible. Method: This qualitative study included interviews from 30 parents from 18 families who had participated in FTI 4-5 years earlier. Data were analyzed using content analysis. Results: Parents reported that they still used several of the strategies they had learned during FTI that helped them to continue to share their thoughts and emotions and maintain an open communication within the family, which reduced the family's stress. Parents also used strategies that helped them to put the spotlight on the children and to increase the democracy in the family. Their participation provided a springboard to participate in new contexts outside the hospital where they share their difficulties with other parents. Discussion: Long-term evaluation is crucial for understanding an intervention's sustainability over time. The psychosocial intervention, FTI, remained beneficial for families even 4-5 years after their participation, with the strategies learned during FTI demonstrating long-term persistence and enhancing parents' resilience in coping with adverse life events
Teachers' descriptions of education for sustainability at eco-certified and non-eco-certified preschools : A comparative study
No full textThis study presents a comparative content analysis of how teachers at eco-certified and teachers at non-eco-certified preschools in Sweden describe their education for sustainability (EfS). Sixteen teachers, eight from eco-certified preschools and eight from non-eco-certified preschools, were selected through a randomised sampling process. Semi-structured interviews were conducted, and the transcripts were analysed thematically, then comparatively. The thematic analysis generated four EfS practices: children's opportunity for agency, actively present teachers, children's experiences as a basis for learning, and communication between children and teachers and three teaching strategies: planned, semi-spontaneous, and spontaneous. These practices and strategies form the basis for a comparative quantitative and qualitative content analysis together with the three sustainability dimensions: economic, environmental, and social. In overall terms, the comparative quantitative content analysis shows only minor differences between the two teacher groups related to three aspects of their EfS. First, teachers at eco-certified preschools consider children's experiences in planned and semi-spontaneous teaching more often than teachers at non-eco-certified preschools. Second, teachers at eco-certified preschools create more adapted learning environments and materials to enable semi-spontaneous teaching, which lead to a more structured EfS with pluralistic elements is apparent among teachers at eco-certified preschools. These differences could be due to the profile of the preschools or the fact that they more often have relevant continuing professional education for teachers. Complementary studies are needed to demonstrate whether these differences are generalisable and to investigate the underlying causes. © 2025 Elsevier B.V., All rights reserved
Beyond Global Trends : Two Decades of Climate Data in the World’s Highest Equatorial City
No full textWhile humanity stands at a critical point—one future leading toward sustainability, equity, and resilience, the other toward escalating conflicts, ecological collapse, and irreversible loss—climate change emerges as one of the most urgent challenges of the 21st century. The Global South, specifically the northwestern South American region, lacks model confidence and reports on current climatic conditions due to gaps in historical data. This study, therefore, presents temperature and precipitation trends in the highest city on the equator, Quito, Ecuador, from 2004–2024. Six different districts were analyzed for maximum, average, and minimum temperatures, as well as cumulative precipitation, in terms of monthly and annual statistics, using Seasonal-Trend Decomposition. Over the past two decades, this Andean city has warmed by an average of +0.95 °C, with minimum temperatures rising at rates twice the global urban average of extreme urban heat islands (+2.47 °C), while precipitation has nearly doubled in rapidly developing parts of the city. These profound changes, shaped by urban expansion, El Niño–Southern Oscillation variability, and climate change, demand urgent adaptation in water management, urban planning, and climate resilience strategies, as well as comparative studies with rural Ecuador to differentiate local vs. regional climate signatures
Hazardous alcohol use among patients with psychiatric disorders : Findings from phosphatidylethanol (PEth) screening in healthcare
No full textIdentifying hazardous alcohol use among patients with psychiatric disorders is important for improving treatment outcomes. This study aimed to describe the prevalence of hazardous alcohol use across 20 psychiatric diagnoses using phosphatidylethanol (PEth) blood sampling. We conducted a cross-sectional analysis of PEth samples collected between 2017 and 2023 from a regional Swedish healthcare database, linked to clinician-assessed psychiatric diagnoses. Participants were adults (≥18 years) with a psychiatric disorder (N = 18,240). Hazardous alcohol use was defined as a PEth concentration > 0.30 µmol/L (∼210 µg/L). Marginal risk ratios (RR) were estimated using logistic regression adjusted for sex, age, comorbidity, season, and healthcare setting. In the sample (mean age: 40 years; 58.7 % female), 7.4 % screened positive for hazardous use. The highest prevalence was observed in patients with substance use disorder (12 %, RR: 1.87, 95 % CI: 1.57-2.23) and panic disorder (8.8 %, RR: 1.43, 95 % CI: 1.19-1.70). Lower prevalence was seen in patients with exhaustion syndrome (5.4 %), ADHD (5.0 %), and obsessive-compulsive disorder (4.2 %). Panic disorder remained significantly associated with hazardous use after adjustment. Male sex (RR: 1.79, 95 % CI: 1.58-2.02) and age, with the highest risk observed around 60 years, were both strongly associated with increased risk. Hazardous alcohol use is prevalent among patients with psychiatric disorders when assessed with PEth. Targeted screening, especially among older men and patients with panic disorder, may improve identification and intervention.Erratum in Corrigendum to "Hazardous alcohol use among patients with psychiatric disorders: Findings from phosphatidylethanol (PEth) screening in healthcare". [Addict. Behav. 172 (2026) 108496]. Månsson V, Hammarberg A, Hårdstedt M, LoMartire R. Addict Behav. 2026 Jan;172:108512. doi: 10.1016/j.addbeh.2025.108512. Epub 2025 Oct 7. PMID: 41058384 </p
Nurses’ experiences of coercive measures in adult psychiatric inpatient care : A literature review
No full textBakgrund Psykisk ohälsa är ett växande problem. Personer med allvarlig psykisk störning vårdas inom den vuxenpsykiatriska slutenvården mot sin vilja med stöd om lag av psykiatrisk tvångsvård och behandlas ibland med tvångsåtgärder. Det finns en maktobalans mellan sjuksköterska och patient. Sjuksköterskan ska värna om patientens behov och rättigheter samt att omvårdnaden utförs på ett värdigt och integritetsbevarande sätt. Dock är sjuksköterskan ofta den som initierar och verkställer tvångsåtgärden vilket berövarpatienten sitt självbestämmande. Syfte Syftet var att beskriva sjuksköterskors erfarenheter av tvångsåtgärder inom vuxenpsykiatrisk slutenvård. Metod Studien har genomförts som en litteraturöversikt, sammanställd av 12 vetenskapliga artiklar med kvantitativ och kvantitativ metod. Sökningen utfördes i databaserna CINAHL, PubMed och PsycINFO. Artiklarna kvalitetsgranskades och innehålletanalyserades med stöd av Fribergs analysmodell i fyra steg. Resultat Resultatet presenteras i tre huvudkategorier och sex underkategorier. Sjuksköterskor ställsi nför en rad olika etiska dilemman och oförenliga krav. Det upplevs som en stor utmaning att vårda personer under tvång och det berör dem känslomässigt vilket kan leda till moralisk stress. Slutsats Användning av tvångsåtgärder skapar lidande hos sjuksköterskorna vilket även riskerar att påverka omvårdnaden. Hög personalomsättning, bristande kunskap, otillräcklig bemanning och oerfaren personal är faktorer som ökar risken för användningen av tvång. Utbildning, arbetsmiljö samt stöd från ledning och kollegor är viktiga faktorer för att hantera den komplexa arbetsuppgift som hantering av tvångsåtgärder innebär. Background Mental illness is a growing problem. Individuals with severe mental disorders are cared for within adult psychiatric inpatient care against their will under the provisions of the Mental Health Act and are sometimes subjected to coercive measures. There is a power imbalance between the nurse and the patient. The nurse is responsible for safeguarding the patient's needs and rights and ensuring that care is carried out in a dignified and integrity preserving manner. However, the nurse is often the one who initiates and implements coercive measures, which deprives the patient of their autonomy. Aim The purpose was to describe nurses' experiences of coercive measures in adult psychiatric inpatient care. Method The study was conducted as a literature review, compiled from 12 scientific articles using quantitative and qualitative methods. The search was carried out in the databases CINAHL, PubMed, and PsycINFO. The articles were quality-assessed, and the content was analyzed using Friberg's four-step analysis model. Results The results are presented in three main categories and six subcategories. Nurses face arange of ethical dilemmas and conflicting demands. Caring for people under coercion is perceived as a major challenge, and it affects them emotionally, which can lead to moral distress. Conclusions The use of coercive measures causes suffering among nurses, which also risks impacting the quality of care. High staff turnover, lack of knowledge, insufficient staffing, and inexperienced personnel are factors that increase the risk of using coercion. Education, work environment, and support from management and colleagues are important factors for managing the complex task that handling coercive measures entails