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Domestic violence against older women in intimate relationships : Case managers' attitudes towards older women’s exposure to violence
No full textPurpose: The purpose is to investigate perceptions of the older woman as a victim of violence and how the exposure to violence can be understood based on ageist perceptions of social workers in elderly care and how these affect the social workers' work with older women who experience domestic violence. Method: The study has a qualitative study design with semi-structured interviews where data is analyzed based on an abductive approach. Results: Results show that older people are not associated with violence. Domestic violence in older women is seen as something that has been going on for a long time and thus normalized, while neglect and psychological violence are considered common forms of violence in older women. Older women receive support in the form of special housing to escape violence.Syfte: Syftet är att undersöka föreställningar av den äldre kvinnan som våldsoffer och hur våldsutsattheten kan förstås utifrån ålderistiska föreställningar hos biståndshandläggare inom äldreomsorgen samt hur dessa påverkar biståndshandläggarnas arbete med äldre kvinnor som upplever våld i nära relation. Metod: Undersökningen har en kvalitativ studiedesign med semistrukturerade intervjuer där data analyseras utifrån en abduktiv ansats. Resultat: resultat visar att äldre personer inte associeras med våld. Våld i nära relationer hos äldre kvinnor betraktas som något som pågått under en lång tid och därmed normaliserats medan försummelse och psykiskt våld anses som vanligt förekommande våldsformer hos äldre kvinnor. Äldre kvinnor får insats i form av särskild boende för att komma ifrån våldet
To report or not? : The role of organizational culture in reporting misconduct in disability care
No full textThe study aims to investigate the importance of organizational culture for the reporting of misconduct in disability care, focusing on one team in one group home providing support to individuals with challenging behavior. Using a case study design and a qualitative approach, semi-structured interviews and vignette cases were conducted with care staff and the unit manager. The interview material was analyzed using thematic analysis. The results show that there are variations in how staff define misconduct, leading to uncertainty about what should be reported. Relationships and group dynamics play a role in reporting tendencies, with fear of "frame" colleagues and inadequate feedback emerging as barriers. The study also highlights practical difficulties with the reporting systems.Studien syftar till att undersöka organisationskulturens betydelse för rapportering av missförhållanden inom funktionshinderomsorgen, med fokus på en arbetsgrupp på en gruppbostad som ger stöd åt personer med utmanande beteende. Genom en fallstudiedesign och en kvalitativ strategi genomfördes semistrukturerade intervjuer samt vinjettfall med omsorgspersonal och enhetschef. Intervjumaterialet analyserades med tematisk analys. Resultatet visar att det finns variationer i hur personalen definierar missförhållanden, vilket leder till osäkerhet kring vad som ska rapporteras. Relationer och gruppdynamik spelar roll för rapporteringsbenägenheten, där rädsla för att "sätta dit" kollegor och bristfällig återkoppling framkommer som hinder. Studien belyser även praktiska svårigheter med rapporteringssystemen
The Way Out of Gang-Related Crime : The Struggle Between Loyalty and Independence
No full textThe increasing gang-related criminality is a serious growing social phenomenon and constitutes one of the most urgent challenges in today's society. The study increases the understanding of the exit process, which can strengthen support efforts and reduce costs through the continued development of effective methods in social work. By studying two autobiographies, the study aims to investigate the psychological and social processes in the experiences of former gang criminals leaving gang-related crime. The study uses system theory to analyze relevant data. The analysis identified two central themes: inner navigation and social structures and relationships. What primarily emerges in connection with that is doubt, group dynamics, loyalty bonds, the creation of a new identity, and life changes. The results show loyalty to criminal gangs versus the pursuit of independence in one's own life during the process of leaving the gang.Den ökande gängkriminaliteten är en allvarlig samhällsutveckling och utgör en av de mest akuta utmaningarna i dagens samhälle. Studien ökar förståelsen för avhoppsprocessen, vilket kan stärka stödinsatser och kostnadsbesparingar genom fortsatt utveckling av effektiva metoder inom socialt arbete. Studien syftar till att undersöka psykologiska och sociala processer som framträder i före detta gängkriminellas upplevelser av att lämna gängkriminalitet, genom två självbiografier. Studien använder systemteorin. Analysen identifierade två huvudteman: inre navigering samt sociala strukturer och relationer. Det som framkommer främst är tvivel, gruppdynamik, lojalitetsband, skapande av en ny identitet och livsförändringar. Resultatet visar på lojalitet till kriminella gäng kontra strävan efter självständighet i sin egen tillvaro under avhoppsprocessen
”Have I missed anyone?” : Staff stories about work in private preschool and mandatory reporting
No full textThe aim of this study was to investigate how private preschool staff perceive their work with children, particularly in relation to how organizational factors may influence their understanding of the child's best interests and their reporting obligations. The study is based on semi-structured interviews conducted with six participants working in groups of children at private preschools. The interviews were analyzed using thematic analysis. The results showed that preschool staff regarded the reporting obligation as an obvious duty. However, there was hesitations about which signs of vulnerability should be observed, as well as fear of negative consequences when making a report of concern. Furthermore, lack of knowledge regarding the reporting process emerged, which was aggravated by poor collaboration with social services, both in terms of knowledge transfer and feedback. The results were discussed in light of new institutional theory and highlighted how the reporting obligation may be influenced by organizational factors.Denna studies syfte var att undersöka hur personal på privata förskolor upplever sitt arbete med barn, där barnets bästa och anmälningsplikten kan influeras av organisatoriska faktorer. Studien bygger på semistrukturerade intervjuer genomförda med sex informanter som arbetar i barngrupp på privata förskolor. Intervjuerna analyserades med hjälp av tematisk analysmetod. Resultatet visade att förskolepersonalen såg anmälningsplikten som en självklar skyldighet. Samtidigt fanns det osäkerhet kring vilka tecken på utsatthet som bör uppmärksammas, samt en rädsla för negativa konsekvenser vid upprättandet av orosanmälningar. Vidare framkom en brist på kunskap om hur anmälningsprocessen fungerar, vilket förvärrades av bristande samverkan med Socialtjänsten, både när det gäller kunskapsöverföring och återkoppling. Resultatet diskuterades utifrån ny institutionell teori och belyste hur anmälningsplikten kan influeras av organisatoriska faktorer
En metod för kvantitativ bedömning av arbetsställningar riskexponering hos anställda på ridskolor
No full textBakgrund: Hög fysisk belastning är en av de främsta arbetsrelaterade orsakerna till problem i rörelseorganen, funktionsnedsättningar och sjukskrivningar. Riskfaktorerna för arbetsrelaterade belastningssjukdomar är väl kända och innefattar tunga lyft, repetitiva rörelser och obekväma arbetsställningar. Organisatoriska och sociala faktorer i arbetsmiljön har också en betydande inverkan på riskerna. För att kunna identifiera relevanta åtgärder för att minska risken för belastningsskador hos anställda, krävs en riskbedömning av den fysiska belastningen. Att objektivt och kvantitativt mäta belastningen har tidigare varit praktiskt svårt och tillförlitligheten hos subjektiva observationer och expertbedömningar har visat sig vara låg. Smarta arbetskläder är en relativt ny metod för att kvantifiera fysisk belastning under arbete. Tekniken består av ett trådlöst system som automatiskt samlar in, analyserar och riskbedömer belastningar i överkroppen via en t-shirt med integrerade sensorer som mäter vinklar och rörelser i överarmar och rygg. Metoden ger säkrare resultat och är mindre tidskrävande jämfört med traditionella bedömningar av fysisk belastning och den kräver inte tillgång till tränad expertis för bedömningarna. I Sverige finns ca 425 ridklubbar som bedriver ridskoleverksamhet. Ridskolornas anläggningar har ofta låg mekaniseringsgrad och stallarbetet utförs vanligtvis manuellt och kännetecknas av tungt, ensidigt arbete och besvärliga arbetsställningar. Trots att det är känt att anställda på ridskolor har en hög förekomst av belastningsbesvär, främst i axlar, ländrygg och nacke, är riskexponering, arbetsrelaterade skador/sjukskrivningar samt förebyggande åtgärder för denna yrkesgrupp ännu relativt outforskat. Syfte: Syftet med studien är dels att utvärdera användbarheten av en metod med en smart tröja för att kvantitativt mäta arbetsställningar, dels att öka kunskapen om arbetsställningar och belastning samt relaterade riskfaktorer hos yrkesverksamma på ridskolor. Metod: I studien har 8 ridskolor ingått, som representerar olika grad av mekanisering och organisering av arbetet. Datainsamlingen inkluderar kvantitativa mätningar av arbetsställningar och rörelsehastighet för bål och överarmar samt av puls med hjälp av en smart tröja (Wergonic). Systemet kan med hjälp av algoritmer och vetenskapligt framtagna rekommenderade gränsvärden ge en riskbedömning för en hel arbetsdag. Parallellt med dessa mätningar har forskarna gjort observationer av arbetsmoment och forskningspersonerna har fått skatta sin ansträngning i olika arbetsmoment enligt Borgs RPE-skala. Efter varje arbetsdag fick forskningspersonerna skatta sin stress- och energinivå. De ridskoleanställda har fått svara på frågeformuläret COPSOQ, som bidrar till en förståelse för respektive arbetsplats organisatoriska och sociala arbetsmiljö. Resultat: Analysen av data är pågående och avser att beskriva arbetsställningar och riskexponering hos ridskoleanställda under olika arbetsuppgifter och över hela dagar. Resultatet kommer relateras det till deltagarnas upplevda arbetsförmåga, arbetstempo och fysiska ansträngning. Data inkluderar 44 personer och 75 heldagsmätningar. En preliminär analys för rygg och överarmar indikerar att urvalsgruppen generellt sett låg inom acceptabla ergonomiska gränsvärden, även om vissa risker kan ses. Resultatet för enskilda personer belyser individuella avvikelser vilket, trots acceptabla genomsnittliga nivåer, understryker vikten av riktade insatser för att effektivt hantera risker för specifika individer
Exploring the Practice of HR Analytics : Insights from a Public Sector Context
No full textHuman Resource Analytics (HRA) is a technology-enabled organisational practice that utilises quantitative data and analysis to enhance HR decision-making. While HRA has gained increasing interest among HR practitioners, its adoption has been predominantly concentrated in technology-intensive private sector companies. At the same time, academic research on HRA remains limited, particularly in the public sector. Although factors such as low technological maturity and a lesser focus on profit maximisation and competitive advantage may hinder its implementation, HRA holds significant potential for public sector organisations due to their distinct characteristics. These include large workforces generating extensive HR-related data, political authority, governmental ownership, and a strong emphasis on transparency, accountability, and efficiency in areas such as competence supply, workforce recruitment, and retention.This thesis comprises four papers that collectively conceptualise and investigate the practice of HRA, exploring the reasons, preconditions, and processes involved in its implementation within public sector organisations. Empirical data were collected from three Swedish public sector organisations at the national, regional, and local levels. The study employs an engaged scholarship research design, allowing for the pragmatic application of multiple theoretical perspectives best suited to address the overarching research question: How is HRA being implemented in public sector organisations? This research aims to contribute to the existing HRA literature while also offering practical insights for organisations and HR practitioners operating in this under-researched context.By adopting a practice-based approach, informed by institutional legitimacy concept, the AMO (Ability, Motivation, Opportunity) framework, and organisational translation perspective, this thesis reveals that HRA practices undergo significant adaptation during implementation. In the public sector, HRA has primarily been limited to improving HR reporting and the visualisation of descriptive HR data. HRA practitioners, driven by contextual factors and the need to ensure the legitimacy of HR activities through economic rationality, face constraints related to analytical skills, organisational resources, and sector-specific characteristics.Given the rapid advancements in technology, including the growing influence of AI, future research should explore how these developments, alongside challenges such as employee privacy and data protection, impact the further evolution of HRA practices in the public sector
Achieving health-promotion practice in primary care using a multifaceted implementation strategy : a non-randomized parallel group study
No full textBACKGROUND: Evidence-based healthcare recommendations exist for tobacco use, harmful alcohol consumption, low physical activity, and poor diet. However, the uptake of these recommendations in Swedish primary healthcare is poor, and the potential benefits for patients are not fully realized. Our aim was to evaluate the effect (i.e. the uptake) of a 12-month multifaceted implementation strategy to achieve a more health-promoting practice. We hypothesized that primary healthcare centers receiving this strategy would increase and sustain their health-promotion practices to a significantly greater extent than control centers, from baseline to the 6-month follow-up. METHODS: In a non-randomized parallel group study, 5 intervention centers and 5 matched control centers were compared regarding health-promotion activities delivered in relation to visits to each center. The intervention centers received a multifaceted implementation strategy over at least 12 months based on established strategies, the Astrakan model of leading change, and findings from pre-implementation studies. The main strategies were: using external and internal facilitators to combine bottom-up and top-down perspectives, and emphasizing leadership responsibility for change. Medical record data on health-promotion activities, including prescribed physical activity and use of lifestyle screening forms, were collected monthly for 2 years: 6 months before and after implementation, and during the implementation phase. The implementation strategy effect was estimated using generalized linear mixed models. RESULTS: During the 12-month implementation phase, the intervention and control sites had 135 002 and 160 987 healthcare visits, respectively; conducted 8839 and 6171 health-promotion activities, respectively; and administered 2423 and 282 lifestyle screening forms, respectively. A statistically significant higher relative uptake rate of health-promotion activities was found in intervention sites compared to control sites after the implementation period compared to before. The effect increased during the active phase, with the intervention sites having on average 1.07 and 2.0 times the uptake rate of the control sites at 1 and 12 months, respectively; this effect was largely maintained during the 6-month post-intervention phase. A significant absolute effect, in terms of difference in predicted uptake per 1000 visits, was evident 7 months into the implementation phase. CONCLUSION: This multi-faceted implementation strategy was successful in achieving a more health-promoting practice. (ClinicalTrials.gov ref: NCT04 799,860, 03/04/2021, https://clinicaltrials.gov/study/NCT04799860 ). TRIAL REGISTRATION: This study is part of the Act in Time project, registered at ClinicalTrials.gov on 4 March 2021 (ref: NCT04 799,860)
Global, Regional, and National Burden of Nontraumatic Subarachnoid Hemorrhage : The Global Burden of Disease Study 2021
No full textIMPORTANCE: Nontraumatic subarachnoid hemorrhage (SAH) represents the third most common stroke type with unique etiologies, risk factors, diagnostics, and treatments. Nevertheless, epidemiological studies often cluster SAH with other stroke types leaving its distinct burden estimates obscure. OBJECTIVE: To estimate the worldwide burden of SAH. DESIGN, SETTING, AND PARTICIPANTS: Based on the repeated cross-sectional Global Burden of Disease (GBD) 2021 study, the global burden of SAH in 1990 to 2021 was estimated. Moreover, the SAH burden was compared with other diseases, and its associations with 14 individual risk factors were investigated with available data in the GBD 2021 study. The GBD study included the burden estimates of nontraumatic SAH among all ages in 204 countries and territories between 1990 and 2021. EXPOSURES: SAH and 14 modifiable risk factors. MAIN OUTCOMES AND MEASURES: Absolute numbers and age-standardized rates with 95% uncertainty intervals (UIs) of SAH incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) as well as risk factor-specific population attributable fractions (PAFs). RESULTS: In 2021, the global age-standardized SAH incidence was 8.3 (95% UI, 7.3-9.5), prevalence was 92.2 (95% UI, 84.1-100.6), mortality was 4.2 (95% UI, 3.7-4.8), and DALY rate was 125.2 (95% UI, 110.5-142.6) per 100 000 people. The highest burden estimates were found in Latin America, the Caribbean, Oceania, and high-income Asia Pacific. Although the absolute number of SAH cases increased, especially in regions with a low sociodemographic index, all age-standardized burden rates decreased between 1990 and 2021: the incidence by 28.8% (95% UI, 25.7%-31.6%), prevalence by 16.1% (95% UI, 14.8%-17.7%), mortality by 56.1% (95% UI, 40.7%-64.3%), and DALY rate by 54.6% (95% UI, 42.8%-61.9%). Of 300 diseases, SAH ranked as the 36th most common cause of death and 59th most common cause of DALY in the world. Of all worldwide SAH-related DALYs, 71.6% (95% UI, 63.8%-78.6%) were associated with the 14 modeled risk factors of which high systolic blood pressure (population attributable fraction [PAF] = 51.6%; 95% UI, 38.0%-62.6%) and smoking (PAF = 14.4%; 95% UI, 12.4%-16.5%) had the highest attribution. CONCLUSIONS AND RELEVANCE: Although the global age-standardized burden rates of SAH more than halved over the last 3 decades, SAH remained one of the most common cardiovascular and neurological causes of death and disabilities in the world, with increasing absolute case numbers. These findings suggest evidence for the potential health benefits of proactive public health planning and resource allocation toward the prevention of SAH
Advancing sustainable healthcare through multidisciplinary stroke team rehabilitation
No full textEmpirical studies evaluating stroke team rehabilitation interventions from a sustainability perspective are scarce. This paper highlights the significant role of multidisciplinary stroke team rehabilitation in promoting sustainable healthcare by applying principles of sustainable healthcare. Climate change and air pollution are significant risk factors for stroke and other cardiovascular diseases. Healthcare contributes to 5% of global CO2 emissions, exacerbating the disease burden associated with climate change. The vulnerability of individuals with disabilities to climate change has been highlighted, calling for global collaboration to address climate justice and health equity. This paper argues that multidisciplinary stroke team rehabilitation is essential for achieving sustainable stroke care, optimizing patient functioning, and contributing to all principles of sustainable healthcare: prevention, patient empowerment, lean pathways, low carbon alternatives, and efficient resource use. Timely assessments and dose-specific interventions are crucial for successful outcomes, providing significant co-benefits for healthcare resource use. Enhancing self-management and patient empowerment reduces healthcare utilization without compromising health outcomes. Telerehabilitation increases accessibility to healthcare services, particularly where transportation is challenging, and complements hospital-based procedures. Preventive healthcare activities, with their low carbon footprint, offer strong incentives for optimizing secondary prevention in stroke. Overall, multidisciplinary stroke team rehabilitation aligns with all sustainable healthcare principles, reducing overall healthcare consumption through optimized functioning and health. Increased investment in rehabilitation resources leads to better quality of care and reduced long-term resource use. By integrating sustainable practices, stroke team rehabilitation can significantly contribute to sustainable healthcare, addressing both human and planetary health. Copyright © 2025 Persson, Reinholdsson, Lange, Barna and Palstam
Emergency medical services, treatment of cardiac arrest patients and cardiac arrest registries in Europe – Update on systems
No full textIntroduction: Incidence and survival rates following cardiac arrest vary significantly across Europe. While several studies have sought to address the knowledge gap in the epidemiology of out-of-hospital cardiac arrest (OHCA), they have not successfully identified the reasons behind these disparities. This study aims to provide an updated overview of European Emergency Medical Systems (EMS). Methods: A questionnaire consisting of 35 main questions was used. The survey encompassed topics related to ambulance and dispatch characteristics, on-scene cardiac arrest management, as well as the availability and scope of datasets in cardiac arrest registries. Results: Survey responses were received from 27 European countries. While there were differences in the proportion of staff with advanced life support skills between countries, these staff were almost invariably dispatched in the event of a cardiac arrest call. First responder systems were available in only 17 countries. There were huge differences in ambulance control models, with the number of dispatch centres ranging from 0.4 to 42.2 per million population. Nine countries reported having out-of-hospital registries of prehospital cardiac arrest with national coverage while only three countries had registries of in-hospital cardiac arrest with full coverage. Conclusions: There are differences in EMS structures and the management of OHCA across Europe. Understanding these discrepancies is essential for improving OHCA outcomes and fostering greater uniformity in emergency response protocols throughout the region. Although there has been an increase in the population covered by a cardiac arrest registry, there is still a need to expand registry coverage, especially for registries of in-hospital cardiac arrest. © 2025 The Author(s