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Empowering Physical Activity through eHealth : Web-Based Exercise for Older Adults and People with Intellectual Disabilities
No full textBackground: Health inequalities impact older adults and individuals with intellectual disabilities (ID) significantly, increasing their barriers to a healthy lifestyle. eHealth has emerged as a promising tool for addressing these public health challenges by facilitating greater access to interventions that promote physical activity. Non-communicable diseases (NCDs) are responsible for 71 percent of all global deaths, many of which are preventable through adherence to physical activity guidelines. As WHO identifies older adults and individuals with disabilities as priority groups for health interventions, this dissertation aims to assess whether web-based exercise can promote physical activity and health markers in these populations. Therefore, the aim of this dissertation was to evaluate the effectiveness, feasibility, and sustainability of web-based exercise interventions in target groups that rarely meet the recommended levels of physical activity: older adults and people with ID. Method: This dissertation includes four studies, two with mixed method design, one with quantitative design and one with qualitative design. Study I evaluated the effectiveness and user experiences of an online resistance training program for older adults with pre- sarcopenia. Study II assessed the effects of a web-based exercise, designed for individuals with ID. Study III explored the experiences of support staff in assisting individuals with ID while participating in such a web-based exercise program. Study IV provided a long-term, 12-month, follow-up on Study II, assessing effects and experiences. Results: Both web-based exercise programs achieved high adherence rates, with 80% in Study I and 83% in Study II. The exercise improved chair stand time (95% CI: 0.8–2.3, p < 0.001) and lean muscle mass i (95% CI: 0.06–0.72, p < 0.05) for older adults (Study I) and reduced fat mass (95% CI: 0.9-2.9, P < 0.001) and waist circumference (95% CI: 0.99-5.01, P = 0.009) for individuals with ID (Study II). Additionally, older adults reported feeling more active and noticing physical improvements (Study I). Feedback from support staff (Study III) underscored the importance of communication, structure, and motivation, within support teams, to foster physical activity. Study IV observed no sustained long-term effects, though some participants reported health benefits that motivated continued exercise, while others cited low motivation or lack of post-program support. Conclusion: The conclusion from this dissertation was that a web-based program seems effective and feasible for older adults with pre-sarcopenia and adults with ID, short-term. Adaptability and accessibility were two crucial building blocks for successful implementation for these target groups. In addition, the support structure was of high importance, affecting long-term sustainability and requiring further investigation.Bakgrund: Hälsoskillnader påverkar äldre vuxna och personer med intellektuell funktionsnedsättning (IF) i hög grad, vilket ökar utmaningarna för en hälsosam livsstil. eHälsa har visat sig vara ett lovande verktyg för att möta dessa folkhälsoutmaningar genom att underlätta tillgången till interventioner som främjar fysisk aktivitet. Icke-smittsamma sjukdomar står för 71 procent av alla globala dödsfall, varav många kan förebyggas genom att följa riktlinjer för fysisk aktivitet. Eftersom världshälsoorganisationen identifierar äldre vuxna och personer med funktionsnedsättningar som prioriterade grupper för hälsointerventioner, syftar denna avhandling till att undersöka om digital träning kan främja fysisk aktivitet och hälsomarkörer hos dessa grupper. Målet var därför att utvärdera effektiviteten, genomförbarheten och hållbarheten av webbaserade träningsinterventioner i målgrupper som sällan uppnår de rekommenderade nivåerna av fysisk aktivitet: äldre vuxna och personer med IF. Metod: Avhandlingen omfattar fyra studier, två med en mixed- method-design, en med kvantitativ design och en med kvalitativ design. Studie I utvärderade effektiviteten och genomförbarheten av ett onlineprogram för styrketräning för äldre vuxna med pre- sarkopeni. Studie II utvärderade effekterna av ett webbaserat träningprogram, utformad för personer med IF. Studie III undersökte erfarenheterna hos stödpersonal som assisterar personer med IF vid deltagande i ett webbaserat träningsprogram. Studie IV utvärderade en 12-månaders långtidsuppföljning av Studie II och bedömde dess effekter och undersökte deltagarnas erfarenheter. Resultat: Båda träningsprogrammen hade hög följsamhet, med 80 % i Studie I och 83 % i Studie II. Träningen förbättrade uppresningstid (95% KI: 0.8–2.3, p < 0.001) och muskelmassa (95% KI: 0.06–0.72, p < 0.05) för äldre vuxna (Studie I) samt minskade fettmassa (95% CI: 0.9-2.9, P < 0.001) och midjeomfång (95% CI: 0.99- 5.01, P = 0.009) för personer med IF (Studie II). Dessutom rapporterade äldre vuxna att de kände sig mer aktiva och märkte fysiska förbättringar (Studie I). Stödpersonalens feedback (Studie III) betonade vikten av kommunikation, struktur och motivation inom stödteam för att främja fysisk aktivitet. Studie IV visade inga långsiktiga effekter, även om vissa deltagare rapporterade hälsofördelar som motiverade fortsatt träning, medan andra nämnde låg motivation eller brist på stöd efter programmets slut. Slutsats: Slutsatsen från denna avhandling var att ett webbaserat program verkar vara effektivt och genomförbart för äldre vuxna med pre-sarkopeni och vuxna med intellektuell funktionsnedsättning på kort sikt. Anpassningsmöjlighet och tillgänglighet var två avgörande byggstenar för en framgångsrik implementering för dessa målgrupper. Dessutom var stödstrukturen av stor betydelse, vilket påverkar långsiktig hållbarhet och kräver vidare undersökning.Vid tidpunkten för disputationen var följande delarbete opublicerat: delarbete 4 inskickat.At the time of the doctoral defence the following paper was unpublished: paper 4 submitted.</p
Deemed as 'Distant' : Categorizing Unemployment in Sweden’s Evolving Welfare Landscape
No full textOver the past 30 years, Swedish labor market politics has swayed towards stronger workfare tendencies, emphasizing activation requirements for unemployed individuals to access welfare benefits. This process aligns with broader neoliberal reforms, fostering an individualistic view of unemployment characterized by personal responsibility for employability. In 2023, the Swedish Public Employment Service (PES) published a report addressing the needs of and solutions for long-term unemployed individuals ‘distant from the labor market’ (Sw. personer långt från arbetsmarknaden), marking the first formal use of this term as the main adhesive category in a political document. This paper examines the construction of the subject position ‘distant from the labor market’, investigating how it delineates and differentiates subgroups within the unemployed population, how this subgroup is understood in relation to other actors, and how discursive frameworks imbue this category with various meanings. Lastly, the paper discusses the categorization in relation to the current developments in the Swedish welfare system, arguing that the formalization of this category should be understood in relation to parallel political processes, such as proposals for a duty of activity for the unemployed, suggesting how this points to a way forward defined by neoliberal tendencies and welfare conditionality.Lokala arbetsmarknadsprogram – Utmaningar av och för en inkluderande arbetsmarkna
Economic situation and late-life divorce : A “his” and “hers” perspective
No full textObjective: This study investigated the association between individuals' economic situation and divorce among the population aged 60+ in Sweden, with a focus on the role of gender and potential changes across cohorts. Background: Previous research on divorce has mainly considered individuals of working age or all ages combined, although late-life divorce is increasing in several Western countries. Economic considerations regarding divorce may differ for older members of the population, who often have a more restricted economic situation and fewer possibilities to respond to the consequences of a dissolution. Method: Using Swedish population registers, this study investigated late-life divorce among cohorts born 1930–1956. Discrete-time event-history analysis was employed to study the relationship between income (recent and accumulated individual income, and spouses combined income levels) and divorce across gender and cohorts. Results: For women, the results showed a shifting pattern from a positive to a slightly negative gradient of the two individual income measures for divorce. Men had an increasingly negative income gradient in divorce across cohorts. The results for combined income levels for couples corroborate these patterns. Late-life divorce has become increasingly linked to low income over cohorts. Conclusion: The novel findings for older individuals mirror previous findings on trends in the general population, although those studies used other socioeconomic measures. As the association between income and divorce becomes increasingly negative among older women and men, and as the divorce rate increases, there is a growing need to understand different aspects of couple dynamics in later life.
The Role of Migration in the Change of Northern Hemisphere Vegetation for the Past 50,000 Years
No full textAim: Our primary aim was to assess how dispersal limitation affected forest changes in the Northern Hemisphere during the last glacial cycle, and especially after the last deglaciation. Location: Northern Hemisphere (between 20°N and 80°N). Time Period: 50,000–0 years before present. Major Taxa Studied: Angiosperms and gymnosperms. Methods: We used the LPJ-GM 2.0 dynamic global vegetation model to simulate the vegetation dynamics of the Northern Hemisphere over the past 50,000 years. We compared two dispersal modes by allowing establishment as soon as suitable environmental conditions were realised (free dispersal), or by additionally constraining establishment based on potential migration speed and maturation time (dispersal limitation). For both dispersal modes, we inferred (mega-)biomes and calculated the fraction of forest cover, earliest post-glacial forest establishment, and the difference between dispersal modes (dispersal lag). To evaluate our results, we compared simulated tree cover with pollen-based reconstructions of European Holocene vegetation and of North American vegetation since the Last Glacial Maximum. Results: We simulated multi-millennial dispersal lags in post-glacial establishment of temperate forests in Europe, boreal forests in Central Siberia, and scattered forest areas close to mountain chains (Rocky Mountains and north of Himalaya). Overall, the simulation with limited dispersal had lower forest extents compared to the free-dispersal simulation, especially after the Last Glacial Maximum, with greater mismatches following intervals of rapid warming, notably the onsets of GI-1 and the Holocene. Comparisons with pollen reconstructions showed that the simulation with limited dispersal better captured both the expansion of European temperate trees and the distribution of broadleaved and needleleaved trees in North America during the early Holocene. Main Conclusions: The lag in response of forests to rapid climate change has implications for past ecosystems and projections of future ecosystem services.
Hur kan förskolan möta särbegåvade barns behov? : En kvalitativ studie med pedagoger och vårdnadshavares perspektiv.
No full textI denna uppsats undersöker vi förskollärares och vårdnadshavares perspektiv på hur särbegåvade barn kan stöttas på förskolan. Datainsamling gjordes i form av kvalitativ metod där sju semistrukturerade intervjuer genomfördes med tre pedagoger och fyra vårdnadshavare. Insamlat data analyserades med hjälp av tematisk analys som innebär att kategorisera insamlat data som hjälper med att identifiera teman som är kopplat till forskningsfrågorna (Bryman, 2018). Med hjälp av relationellt specialpedagogiskt perspektiv (Aspelin och Persson, 2011) och kompensatoriskt perspektiv (Nilholm, 2020) analyserades vilka behov som vårdnadshavare och pedagoger anser att särbegåvade barn har och hur deras behov kan mötas. Deltagarna var från olika förskolor i Sverige. Resultaten visar att både vårdnadshavare och pedagoger anser att det fattas stöd till särbegåvade barn, otydliga instruktioner från utbildningsystemet och ledningen begränsar pedagogers möjligheter att effektivt stötta särbegåvade barn. I studien upplevde deltagarna att arbetet med särbegåvade barn sker av eget engagemang. Bristen på stöd och tydliga riktlinjer från ledningen leder till att pedagoger och vårdnadshavare har begränsade möjligheter att stötta särbågade barn ur ett relationellt perspektiv (Aspelin och Persson, 2011). Ur det kompensatoriska perspektivet (Nilholm, 2020) tyder bristen på anpassning att förskolan inte uppfyller rollen att ge alla barn likvärdiga förutsättningar. Den huvudsakliga slutsatsen i studien är betydelsen av vårdnadshavarnas engagemang, vårdnadshavarna behöver ha kunskap om särbegåvning för att kunna identifiera deras barns särbegåvning. Vidare framkom det att pedagogerna behöver ökad kunskap och vägledning för att stötta särbegåvade barn. Ytterligare en slutsats handlar om att ledningen har viktig roll för att strukturera hur särbegåvade barn ska stöttas för deras utveckling.Betyg i Ladok 250324.</p
Nurses’ professional roles : Supervision and support during meals in caring for adult inpatients with anorexia nervosa – a qualitative study
No full textThis study aims to describe how nurses perceive their professional roles in providing meal support for adult inpatients with anorexia nervosa. A qualitative design and reflexive thematic analysis were used, as well as the SRQR (i.e. Standards for Reporting Qualitative Research) reporting guidelines for accuracy and completeness. Personal interviews were conducted with 11 nursing staff in a general psychiatric inpatient ward. The results revealed an overarching theme: performing meal support – fluent shifting between roles, with two themes: acting as a supervisor, monitoring food intake, and getting into the supportive and helping role. Both themes further consisted of three subthemes each. The results show nurses’ ability to shift between roles and adapt to patients’ needs at the same time as maintaining treatment structure during meal support. Moving between differences in approach is important in fostering a therapeutic relationship and facilitating patient recovery. Balancing this is especially vital in nursing and involves meeting challenging responsibilities at the same time as addressing individual patient requirements
Salivary cortisol response to post-exercise infrared sauna declines over time
No full textHeat exposure after exercise may enhance recovery of physical performance but can also impose additional physiological stress on athletes. This study investigated the effects of post-exercise infrared sauna (IRS) on adrenal and autonomic nervous system (ANS) responses and examined how these responses adapt over time during a 6-week training intervention. Forty female team-sport athletes were pair-matched into an IRS-group and a control group (CON). Participants completed jumping exercises followed by IRS (10 min, 50 °C) or passive recovery and physiological assessments during two experimental trials: in the first (EX1) and in the last (EX2) week of the training intervention. The ANS responses were assessed by nocturnal heart rate (HR) and heart rate variability recorded before and after exercise session. Saliva cortisol concentrations, muscle soreness, and perceived recovery were assessed in the morning, before and after the exercise sessions. Cortisol increased by 5.1 ± 8.6 nmol/l the morning after EX1 in the IRS-group (p = 0.017), but not in the CON-group. Furthermore, a greater pre-post change in cortisol concentration was observed following EX1 (4.6 ± 10.4 nmol/l) compared to EX2 (−1.8 ± 7.6 nmol/l). The IRS-group showed a higher post-session HR in EX1 compared to the CON-group (61 ± 8 bpm vs. 55 ± 6 bpm; p = 0.019). Increased muscle soreness was observed at EX1 post36h only in the CON-group. Post-exercise IRS initially elevated physiological stress responses in female athletes. After six weeks of regular IRS use, athletes’ ANS balance and cortisol response adapted, suggesting effective physiological adjustment to the heat intervention within six weeks
Disrupting climate adaptation lock-ins? : Swedish local civil servants’ strategies to enable adaptation
No full textLocal climate adaptation is constrained and steered along specific paths by various mechanisms, which together form a lock-in. The study focuses on Swedish local civil servants’ strategies to deal with climate adaption lock-ins and to what extent the strategies disrupt the lock-ins. Interviews were conducted with civil servants in six municipalities, complemented by interviews at regional and national public agencies. The study investigates the presence of physical infrastructural, institutional, mental/cognitive, and discursive lock-in mechanisms and finds that they together limit and steer local civil servants’ work on climate adaptation. The study shows that the lock-in mechanisms are dealt with by civil servants through two types of strategies. Influencing strategies target others to change their thinking, behavior, or decisions, while subversive strategies involve ignoring, violating, or undermining formal and informal institutions. Civil servants used influencing strategies to mitigate several types of lock-in mechanisms. The strategies had a higher impact when targeted at mental/cognitive mechanisms, as influencing others to change their mindsets and practices widened opportunity spaces. This increased the possibilities to disrupt also other types of lock-in mechanisms. Civil servants also employed subversive strategies in the form of disregarding the legislation, departmentalization, mindsets, and practices. The subversive strategies were successful in, for example, enabling decisions, but did not weaken the lock-in mechanisms. The study shows that to disrupt climate adaptation lock-ins, civil servants need to use influencing strategies to sequentially target lock-in mechanisms.
Exploring the Value of Arts-Based Interventions in Organizations from a Systems Perspective
No full textThere is a growing interest in arts-based innovation (ABI) in organizations to foster human capital as a value-added resource to achieve and sustain quality. As a co-creative process, arts-based practice stimulates out-of-the-box thinking and reflection essential to leading organizations in complex times. Transforming arts-based interventions into systemic organizational practice and understanding its value for the organization is one of the contemporary questions for leaders. This article presents an exploratory qualitative analysis of an arts-based intervention in a health care facility to explore new insights into understanding the value of arts-interventions for organizations. The current models for determining the value of ABIs lack a focus on the presence of systemic practice as a key variable to transforming individual experience into organizational value. Organizational learning theory provided a theoretical backdrop for understanding organizational growth as a socially derived process, defined by the interplay between the micro and the macro. The learning organization model served as an analytic framework to identify the presence of systemic practice through architectures for social interaction and deep learning that support the interplay between the micro and the macro
Medarbetarskap och rekommendationsvilja : Delrapport inom samverkansprojektet Mittuniversitetet – Sundsvalls kommun, attraktiva och kommunala arbetsplatser
No full textI denna delrapport redogörs för resultat och tolkningar från publicerade studier och intervjuer med medarbetare mellan februari 2024 och februari 2025 i Sundsvalls kommun. Den första delen medarbetarengagemang och rekommendationsvilja baseras på analyser av mätningen av Hållbart Medarbetar Engagemang (HME) och rekommendationsvilja (net Promotor Score, eNPS). I den andra delen, Hur pratar medarbetare om medarbetarengagemang, presenteras resultat med utgångspunkt i intervjuer med grupper av medarbetare från olika verksamheter inom kommunen. Fokus i dessa intervjuer var att försöka fånga och skapa en förståelse om hur medarbetarna upplever faktorerna motivation, styrning, ledarskap samt rekommendationsvilja. Syftet var att försöka beskriva de underliggande resonemangen bakom faktorerna som mäts i HME - undersökningarna. I den tredje delen Intervjuer med första linjens chefer presenteras analyser av enskilda intervjuer med sex chefer från olika verksamheter. I del fyra Vad kan arbetsgivaren göra för att du skall stanna kvar? presenteras resultat från intervjuer med olika medarbetargrupper med fokus på medarbetarskap och arbetsgruppens syn på kommunen som arbetsgivare. Rapporten avslutas med ett sammanfattande slutord där möjligheter och utmaningar beskrivs, avsnittet avslutas med förslag på personalpolitiska åtgärder. För teoretiska resonemang hänvisas till publicerade artiklar. I den slutrapport som planerar att presenteras i januari 2026 fördjupas resultat, teoretiska resonemang och förslag för framtida åtgärder