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Wear behaviour of PVD (Ti,Si)N-(Ti,Al)N coated cemented carbide in down milling pearlitic compacted graphite iron
No full textCompacted graphite iron (CGI) is an intermediate material between conventional grey cast iron and the stronger, more wear resistant ductile iron, making it a suitable material choice for different automotive applications. The improved material properties of CGI as to conventional grey cast iron makes it more difficult to machine, and finding a suitable tool material with low wear rates is a challenge and remains largely unexplored in research. This study examines the performance of multilayer PVD (Ti,Si)N-(Ti,Al)N coated cemented carbide round inserts at varying cutting data parameters in the down face dry milling of pearlitic CGI grade EN-GJV-450. Eight different cutting conditions, with a cutting speed range vc = 154–461 m/min and feed per tooth range fz = 0.277–0.554 mm/rev were evaluated. As-worn tools are studied and later cross-sectioned to be further analysed under a scanning electron microscope (SEM). The primary wear mechanisms identified included adhesion, abrasive wear, thermal crack formation, particularly comb cracks, and diffusional dissolution of WC and Co. Cobalt diffusion from the binder into the CGI material, along with a potential tungsten oxidation within cracks, led to significant tool degradation, forming Co carbides and Fe-doped WO3, respectively. The interaction between CGI material and the PVD coating also resulted in the formation of a Mg-Si-O rich layer atop (Ti,Si)N-(Ti,Al)N coating, which could potentially act as a protective barrier. Additionally, in some conditions due to outward diffusion from WC grains together with Fe form a strong carbide Tool Protection Layer (TPL) which is developed as flank built-up edge atop the exposed cemented carbide, potentially extending tool life by reducing further wear.CC-BY 4.0This study was conducted in connection to a project granted by the Swedish Strategic Innovation program RE:Source financed by Swedish Energy Agency and the authors gratefully acknowledge the support. The authors would like to express their sincere gratitude to Ryszard Wierzbicki (LU) for milling programming and inestimable help with material handling. The authors also want to acknowledge the support from the research school Agenda 2030 at Lund University and Sustainable Production Initiative (SPI), a research cooperation between Lund University and Chalmers University (VINNOVA). The authors would also like to thank Sintercast AB, Seco Tools AB, and Volvo Group Trucks Operations, Powertrain Production Sk\u00F6vde for their support.</p
Attachment styles and sense of coherence as indicators of treatment adherence and completion among individuals with substance use disorder
No full textBackground: Substance use disorder (SUD) is a growing public health concern in Sweden. Various treatments for SUD exist, with motivational treatment, cognitive behavioral therapy, and relapse prevention being the nationally recommended approaches. Attachment theory and the salutogenic theory with its core concept, sense of coherence (SOC) provides valuable insights into individuals’ available personal resources and their potential for adherence to treatment. The aims of the present study were to examine attachment styles (secure, insecure-avoidant, and insecure-anxious) and SOC (overall and dimensional - comprehensibility, manageability, and meaningfulness- scores) in individuals with SUD; to explore potential correlations between these constructs ; and to assess their predictive value for treatment completion. Methods: Clinical data were collected between 2014 and 2023 from 164 clients at a Swedish outpatient clinic for addiction who initiated the intensive, integrated treatment program. The sample comprised 109 men and 55 women, aged 18 to 72 years (M = 40.71). Data were gathered using validated self-report instruments (the Attachment Style Questionnaire and the Sense of Coherence Questionnaire). Statistical analyses included descriptive statistics, correlation analysis, and logistic regression. Results: Individuals with SUD predominantly exhibited an insecure-avoidant attachment style. The four dimensions reflecting insecure attachment (discomfort with relationships, relationships as secondary, need for approval, and preoccupation with relationships) were negatively correlated with overall SOC and its three components. In contrast the secure attachment dimension (confidence in self and others) showed positive association with SOC. The strongest associations were found between the manageability component of SOC and all attachment dimensions. The insecure-anxious attachment style showed the strongest association with early dropout from treatment, while higher manageability was significantly associated with an increased likelihood of treatment completion. Conclusion: The predominance of an insecure-avoidant attachment style among clients undergoing intensive, integrated treatment for SUD underscores the importance of reinforcing a secure attachment and strengthening SOC to facilitate treatment completion. These findings highlight the need for comprehensive, integrated social and psychiatric care for individuals with SUD.CC-BY 4.0</p
Patients' experiences of a standardized care pathway for suspected bladder cancer due to macroscopic hematuria
No full textObjective: To explore patients´ experiences navigating the Standardized Care Pathway (SCP) for macroscopic hematuria through semi-structured interviews. Methods and materials: An interview study was conducted to explore patients´ experiences of SCP for macroscopic hematuria. The study employed content analysis with an inductive approach, as described by Lundman and Graneheim, to explore both explicit and implicit patterns in the data. Informants were recruited from an outpatient clinic for investigation of macroscopic hematuria, with interview questions derived from literature and clinical experience. Researchers immersed themselves in the data through repeated readings of transcripts, identifying meaning units that were coded and analyzed to develop subcategories reflecting similarities and differences. Results: Twelve patients, with a median age of 71 years (58% women), participated in the study. Among them, one was diagnosed with urinary bladder cancer (UBC). The findings highlight a mix of appreciation and questioning associated with the SCP process, as patients valued the efficiency of one stop policy for testing but also experienced heightened anxiety. A lack of detailed and patient-centred communication emerged as a key issue, with primary care centers providing insufficient information. Conclusions: Although SCP is effective, it prompts consideration of whether it is suitable for all patients. A more individually tailored approach might be more appropriate, prioritizing rapid evaluation for those with a high likelihood of cancer while directing others to a standard diagnostic route. Continuing the one-stop policy was seen as beneficial. CC-BY 4.0The study was supported by grants from Department of Research and Development,NU-Hospital Group, Sweden.</p
Age and Passion : Breaking the Silence on Older Adults' Sexuality
No full textBakgrund: Äldres sexuella hälsa är ett område som ofta förbises inom vården. Tabun, stigma och okunskap påverkar möjligheten till öppna samtal om ämnet, vilket kan ha negativa konsekvenser för äldres livskvalitet och välbefinnande. Syfte: Syftet med studien var att belysa vårdpersonal och äldre patienters erfarenheter av samtal om sexuell hälsa. Metod: Studien genomfördes som en systematisk integrativ litteraturöversikt, där kvalitativa, kvantitativa och mixade metoder analyserades enligt Whittemore och Knafls femstegsmodell. Resultat: Studien visade att vårdpersonal ofta har bristande kunskap och känner sig obekväma med att diskutera sexuell hälsa, medan äldre patienter ofta upplevde skam och stigma. Detta försvårade en öppen dialog. En mer positiv inställning och utbildning hos vårdpersonal kan bidra till att underlätta dessa samtal. Slutsats: Ökad utbildning och medvetenhet hos vårdpersonal behövs för att skapa en trygg miljö där sexuell hälsa kan diskuteras, vilket kan förbättra äldres hälsa och livskvalitet.Background: Elderly patients' sexual health was a subject often overlooked in healthcare, despite its significance for quality of life and well-being. The study examined healthcare professionals' and elderly patients' experiences and attitudes regarding conversations about sexual health, with a focus on breaking stigmas and improving communication.Aim: The study aimed to highlight healthcare professionals' and elderly patients' experiences with discussions about sexual health. Method: A systematic integrative literature review based on Whittemore and Knafls five-step model was conducted. The data collection included qualitative, quantitative, and mixed methods from international studies published between 2014–2024. Results: The study revealed that healthcare professionals often lacked knowledge about elderly patients' sexual health, and the subject was characterized by stigma and taboo. Elderly patients frequently felt shame and insecurity, while healthcare professionals experienced discomfort discussing the topic. An open and inclusive approach among healthcare staff facilitated dialogue. Conclusion: Breaking taboos required education and increased awareness among healthcare professionals. Effective communication improved elderly patients' health and quality of life by creating a safe and respectful environment for discussions about elderly patients' sexual health. Suggestions for Clinical Application: The study's findings suggested educational initiatives for healthcare professionals on elderly sexual health to enhance their knowledge and skills
Take Back Control over the pain : A literature review on Patients' Experiences of Treatment with Non-Pharmacological Alternatives for Chronic Pain within Healthcare
No full textBackground: Chronic pain affects 20% of the global population and is defined as a sensory and emotional experience of pain lasting more than three months. It can result from conditions such as lower back pain, fibromyalgia, arthritis, and musculoskeletal disorders, impacting both physical function and mental health. Pain-relieving medications are often the first choice of treatment, but long-term use carries the risk of side effects. Non-pharmacological treatments offer an alternative that can reduce dependence on medications, enhance functional ability, and improve quality of life. Aim: The purpose of this study was to highlight the experience of nonpharmacological treatment options within healthcare for patients with chronic pain. Method: The method used in this study was a literature review. Both qualitative and quantitative articles were included. The databases used for the search were PubMed and CINAHL, with the majority of the articles found in CINAHL. The searches resulted in 10 scientific articles, which were quality assessed and compiled. Results: The results led to three main themes and seven subthemes. The first theme, “Patient Experiences of Non-Pharmacological Treatments, ”highlighted how patients engaged with the different treatments, how they experienced the effects, and how they interpreted the results. This theme also emphasized the various types of treatments. The second theme, “Loneliness in the Invisible Suffering,” explored into how patients experienced their lives and daily routines before and during the treatments, with a strong focus on a sense of loneliness that could not be healed, although this might have changed with treatment. Finally, the third theme, “To find strength beyond chronic pain” reflected the patients' positive influence from the treatments they received, which helped them experience reduced suffering and view life from a more positive perspective. Conclusion: The experience of the different treatment options varied for different individuals. Some described that the nonpharmacological treatments provided temporary pain relief, and the effect improved as the frequency of treatments increased. Living with chronic pain causes stress, as it can increase difficulties in daily life, and it has also been shown that stress exacerbates the experience of pain. Therefore, a changed mindset and acceptance of pain contributed to better pain management. By participating in the treatment, individuals were given a chance to take control of their pain with their own hands.Långvarig smärta drabbar 20% av världens befolkning. Läkemedelsbehandlingar är vanligtvis det första alternativet och det finns en större mängd tillgänglig forskning om läkemedel jämfört icke-farmakologiska behandlingsalternativ. Denna studies syfte var att belysa upplevelsen av icke-farmakologiska behandlingsalternativ inom hälso- och sjukvården för patienter med långvarig smärta. Resultatet visade att de icke-farmakologiska behandlingsalternativ ofta hade en smärtlindrande effekt, dock botade det sällan smärtan helt, utan smärtan lindras tillfälligt. Ofta upplever denna patientgrupp missnöje över den behandling som erbjöds på grund av otillräcklig smärtlindring och bristande förståelse från omgivning och vårdpersonal för de fysiska och mentala påfrestningar smärtan medför. De kände även en ökad känsla av isolering och ensamhet på grund av oförmåga att kunna delta i vardagliga aktiviteter. Några av de icke-farmakologiska behandlingsmetoderna, såsom yoga och mindfulness kunde för vissa personer bidra till ökat välbefinnande och förbättrad livskvalitet. Ökad förståelse och acceptans för den långvariga smärtan bidrog till bättre smärthantering. Sjuksköterskan hade även en avgörande roll för att etablera en vårdande relation där patienten får vara delaktig i den egna vården. Metoden för denna studie var en litteraturöversikt med analys av vetenskapliga artiklar utav kvalitativ och kvantitativ ansats
Pedagogers förhållningssätt och kompetenser i våldspreventivt arbete : En fallstudie av två skolor i Tanums kommun
No full textVåldsförebyggande arbete, eller våldsprevention, är åtgärder som ska förhindra att våld uppstår eller upprepas. I Sverige ses idag ett utökat våldsförebyggande arbete som avgörande för den nationella strategi som antagits för att förebygga och motverka mäns våld mot kvinnor, våld mot barn, våld i hbtqi-relationer och hedersrelaterat våld och förtryck (Socialdepartementet 2016) med avseende på alla former av fysiskt, psykiskt och sexuellt våld samt hot om våld. Våldsförebyggande arbete är centralt även i bekämpandet av gäng- och nätverkskriminalitet (Justitiedepartementet 2023). Då forskning visar att en stereotyp syn på könsroller ökar risken för våld (se ex. Miller m.fl. 2020) ses arbete mot destruktiva könsnormer och för jämställdhet som en förutsättning för att våldspreventiva åtgärder ska vara effektiva (Franzén & Gottzén 2020; Jämställdhetsmyndigheten 2020). Den nationella strategin (Socialdepartementet 2016) framhåller bland annat att föreställningar om våld och hot som legitima uttryck för manlighet aktivt bör motverkas i sammanhang som är särskilt viktiga i formandet av pojkars och unga mäns identitet (Regeringskansliet 2016). Eftersom föreställningar om hur män är och bör vara kan upprätthållas av alla behöver dock insatserna för att förändra förväntningarna på pojkar och män rikta sig till alla, oavsett kön. I Sveriges kommuner finns flera verksamheter som kan och bör arbeta våldsförebyggande, däribland förskolan och skolan, där fritidshemmen också ingår. Den här rapporten behandlar ett våldpreventivt utvecklingsarbete i två skolor i Tanums kommun. Arbetet leds av Hälsokällan, en verksamhet som drivs av Fyrbodals kommunalförbund. Hälsokällan kallar projektet Tidiga våldsförebyggande insatser i förskola, skola och fritidshem – rätten till en uppväxt fri från våld. Det finansieras av statsbidrag från Jämställdhetsmyndigheten. Under 2023 inledde Hälsokällan och Högskolan Väst en samverkan med syfte att utforska detta utvecklingsarbete. Samverkan pågick under hela 2024 och innebar att forskare genom observationer och intervjuer följde pedagogernas arbete med att införa Hälsokällans modell för våldspreventivt utvecklingsarbete.Forskargrupperna på Institutionen för individ och samhälle på Högskolan Väst arbetar strategiskt med forskningssamverkan tillsammans med verksamheter som har fokus på barn, ungdomar och unga vuxna. Målet är att producera och sprida kunskap om barns och ungdomars livsvillkor och därmed stärka deras ställning i samhället. Samverkansforskningen utgår från en dialog mellan forskare och samverkanspart där parterna tillsammans utarbetar och formulerar undersökningsområde och forskningsfrågor.Samverkan med Hälsokällan/Fyrbodals kommunalförbund. Läs mer på www.fyrbodal.se/verksamhet/valfardsutveckling/halsokallan</p
Exploring atmospheric plasma spraying as a pathway to fabricate solid-state battery constituents
No full textThis study aims to demonstrate the feasibility of the atmospheric plasma spraying (APS) technique to fabricate individual constituents of solid-state batteries (SSBs) such as anode, solid electrolyte (SE) and cathode as well as further produce their half-cell (anode|SE) and full-cell (anode|SE|cathode) configurations. The materials targeted in this work were Li4Ti5O12 (LTO) as an anode, Li7La3Zr2O12 (LLZO) as a SE and LiNi1/3Mn1/3Co1/3O2 (NMC111) as a cathode, with aluminium substrates being used as current collectors. The microstructure of the LTO and LLZO layers exhibited a characteristic lamellar structure along with the presence of a secondary phase attributed to delithiation at high temperatures, whereas the NMC111 layer was found to undergo substantial structural change. X-ray diffraction (XRD) analysis suggested that both LTO and LLZO layers retain most of the characteristic peaks along with the presence of secondary phases while NMC111 layers undergone significant change in the crystal structure. The XPS analysis confirms the presence of expected elements and oxidation states for the LTO layer. In the case of the LLZO layer, a metal carbonate surface reaction layer was observed, while the NMC111 layer reveals the presence of Li, Ni, Mn, Co, and O along with feeble metal carbonate. Fabrication of half-cell and full-cell configurations shows encouraging results by revealing a well-intact interface demonstrating the feasibility of the APS technique to accomplish such layered structures. This proof-of-concept effort provides valuable insights into the efficacy of APS for fabricating SSB components for further development, benefiting both the battery and thermal spray communities.CC-BY 4.0The authors gratefully acknowledge the financial support provided by the Green-BAT project (M-ERA.NET, Project nr. 9257).</p
Evaluation of collaborative oral health care planning between older adults and personnel from public dental care and municipal care organizations : a study protocol for a cluster-randomized controlled study in Sweden
No full textBackground: Patient participation is key in person-centred care, emphasizing individual choices in treatment. Oral health, integral to overall well-being, is sometimes a neglected part of health. This intervention introduces a novel approach to strengthen person-centred care in homecare settings, employing collaborative, interprofessional teamwork and shared documentation across care organizations. This protocol outlines the design of a cluster-randomized controlled trial (RCT) in Sweden, comparing traditional oral assessments with an interorganizational, team-based oral health care planning model facilitated by a shared digital platform for documentation. The overall aim is to evaluate a person-centred interprofessional and interorganizational model for oral health care planning supported by a digital platform to enable healthy ageing. Methods/design: The intervention, co-designed with older adults, academic institutions, healthcare providers in public dental care, and municipal organizations, will undergo ethical approval. The RCT will randomize older adults, dental hygienists (DHs) and nursing assistants (NAs) into two groups. The intervention group will attend a two-day workshop on a person-centred, three-step team-based model, while the control group will continue using standard procedures. Thereafter, the three-step collaborative model will be compared to standard procedures. Primary outcomes will be measured using the Revised Oral Assessment Guide (ROAG) and the General Oral Health Assessment Index (GOHAI). Secondary outcomes include health economic evaluations, participation rates and quality of care assessments. Qualitative studies from theoretical perspectives of change and learning based on interviews with key stakeholders will be conducted in both the test and control groups. Discussion: Taking a co-produced approach where theory and practice shape the research iteratively, a person-centred health care planning model supported by a shared digital platform for home settings is evaluated. Anticipated outcomes include improved oral assessments and a deeper understanding of effective person-centred care practices. The co-produced approach of the intervention is also expected to further develop knowledge regarding co-production within domains of healthy ageing from an oral health perspective. As such, the intervention shapes and fosters co-produced person-centred care and healthy ageing.CC-BY 4.0This research was funded by the Health Promotion Research Funding (VGFOUREG-937918, VGFOUREG-966932), Region Västra Götaland, Sweden, and the Local Research and Development Board of Göteborg and Södra Bohuslän (VGFOUGSB-942302), Region Västra Götaland, SwedenClinicalTrials.gov NCT06310798. Registered on 13 March 2024.</p
Coworker Phubbing and Links to the Psychosocial Work Environment Among Electricians in Sweden
No full text“Phubbing” (phone snubbing) has been consistently associated with negative intra‐ and interpersonal outcomes across various social contexts. However, the potential impact of phubbing on horizontal workplace relationships has not been extensively explored. The present study aimed to examine associations between coworker phubbing during breaks and social support and community, horizontal trust, and organizational commitment among electricians in Sweden. An auxiliary aim was to adapt and validate a coworker phubbing scale. In Studies 1a and 1b, confirmatory factor analysis was used to assess and validate the coworker phubbing scale in two samples. In Study 2, structural equation modeling was used to examine the relationship between phubbing and included psychosocial work environment measures. Exposure to phubbing from coworkers was associated with lower perceived support and community, trust, and commitment. The associations were stronger for more severe phubbing behaviors. Engaging in phubbing others was not considerably linked to the psychosocial measures. Younger participants reported engaging in more phubbing and lower perceived exposure to more severe phubbing. Smartphone habits at work may have implications for the psychosocial work environment and, by extension, important outcomes such as well‐being, job satisfaction, performance, and turnoverCC BY NC ND</p
Labour ward midwives’ experiences of remote video calls with women during early labour
No full textBackground: The shortage of midwives makes it difficult to meet healthcare needs in early labour, a phase when professional support and personal evaluation are crucial. Digitalisation has transformed healthcare, offering new communication and support methods. Although still uncommon, the use of a virtual waiting room with video calls by midwives during early labour could provide vital support for pregnant women and their partners. This study aimed to describe labour ward midwives’ experiences of remote video calls with women during early labour. Methods: A qualitative descriptive study with seven semi-structured interviews followed by a qualitative content analysis was conducted. Results: The findings revealed that remote video calls enabled the midwives to work flexibly with chosen working hours and become involved in a challenging new e-function. They interacted with the women and their partners and experienced that they created a supportive relationship and simultaneously gained an overview of the situation. They felt secure in their professional role when providing the necessary care and had confidence in their competence. Conclusion: The potential benefits of integrating remote video calls into midwives’ tasks during early labour care include flexible working hours and fostering supportive relationships with women and their partners at home.CC BY 4.0</p