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This article traces the origin, sustenance and implications of a persistent rumour that is responsible for low measles mumps and rubella (MMR) vaccination uptake in the Somali diaspora in a number of countries across the globe. The rumour stipulates that the MMR vaccine – the silent shot – causes autism spectrum disorder (ASD). Although the association between MMR and ASD is non-causal, and various public health initiatives have promoted health information campaigns, the rumour continues to circulate in the Somali diaspora in many countries, including Sweden. This paper shows that there are valid reasons for this. The findings from this paper draw on a systematic scoping review and qualitative interview data from Sweden. The results show that the Somali community experiences higher than average rates of ASD compared to the general population. Moreover, ASD does not exist in the Somali language or their home country, is considered a Western disease that only affects Somali children in the diaspora, and is a highly stigmatised disease. Also, the Somali diaspora has had negative experiences with ASD diagnosis and care. The rumour has been sustained by the absence of an answer to their ASD fear and through active diaspora networks on social media. The network that surrounds the rumour has arguably further helped to create an epistemic community for a community whose concerns have been silenced. [ABSTRACT FROM AUTHOR]

We aimed to survey the findings of phenomenological studies built up in the field of diabetes care in Sweden. This is a meta-synthesis of phenomenological studies on experiences related to diabetes in Sweden focusing on learning to live with diabetes. We proceeded by reference to the seven phases of Noblit & Hare. We examined papers from seven phenomenological studies on learning to live with diabetes in Sweden. From the papers, which describe the experience of living with diabetes, three overarching themes were selected—perception and awareness of the body; integration and responsibility; and presence of others who provide support. From those describing the expert's experience, an overarching theme emerged—encouraging reflection in persons with diabetes. We interpreted each of these themes in phenomenological terms and compared them with theories in Japan. Persons with diabetes take responsibility for coping with a range of things brought on by the illness and learn to live with diabetes. Experts support these persons so they can see their world objectively and critically scrutinize it. By building a model of diabetes care in Japan that references Scandinavian human science, it will be possible to find new approaches that support learning at the existential level. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To evaluate the reliability, internal consistency, and construct validity of the Swedish versions of PROMIS-29 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) instruments in patients with systemic sclerosis (SSc). In a cross-sectional study, consecutive SSc patients completed a paper-based survey. Internal consistency was assessed using Cronbach's alpha. Test–retest reliability was tested employing weighted Kappa (Kw) and intra-class correlation coefficient (ICC). Construct validity was evaluated by hypotheses testing using RAND-36, MRC Dyspnea score, Scleroderma Health Assessment Questionnaire (SHAQ) and clinical measurements. Forty-nine patients (86% female; 73% limited cutaneous SSc) completed the survey. The mean disease duration was 11 years and mean SHAQ was 0.5. Internal consistency and test–retest reliability were good with the exception of PROMIS-29 anxiety. PROMIS-29, FACIT-Dyspnea, and Functional limitation showed strong correlations to corresponding RAND-36 domains (|rs|=0.67 to −0.85). Relevant PROMIS-29 domains, FACIT-Dyspnea and Functional limitation correlated strongly to SHAQ and VAS overall disease severity (|rs|=0.60 to −0.75). Ceiling effects (>15%) were found in six PROMIS-29 domains and in both FACIT-Dyspnea and Functional limitations. Four (4/5) hypotheses were confirmed. PROMIS-29 and FACIT-Dyspnea meet the requirements for reliability and have adequate construct validity in Swedish patients with SSc. PROMIS-29v2 and Functional Assessment of Chronic Illness Therapy-Dyspnea (FACIT-Dyspnea) Index are patient outcome measures that gain increasing interest for the evaluation of patient with rheumatologic diseases. PROMIS-29v2 and FACIT-Dyspnea Index meet the requirements for reliability and have adequate construct validity compared to legacy measures in Swedish patients with systemic sclerosis. Translation and validation of PROMs is important for studies of rare diseases in multi-center collaborations. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Being aware of factors that affect fertility can help people make informed decisions about their reproductive futures. To some, however, fertility information leads to worry and self-blame. In this paper, we explore how people from different generations discuss fertility and reproductive decision-making, along with their perceptions of fertility information. The study was conducted in southern Sweden with 26 focus-group discussions that included a total of 110 participants aged 17–90 years. The material was analysed thematically. Our results show that fertility knowledge and openness to talking about fertility problems have increased over generations. Participants who were assigned female at birth were more often concerned about their fertility than those who were not, and fertility concerns were transferred from mothers to daughters. While age-related fertility concerns had been uncommon in older generations, participants aged 25–40 often expressed these concerns. Young adults appreciated being knowledgeable about fertility but simultaneously expressed how fertility information could lead to distress. Our conclusion is that fertility information was best received by high-school students, and efforts to improve fertility education in schools are therefore recommended. [ABSTRACT FROM AUTHOR]

To explore Swedish clinical practice regarding assessment of suspected Speech Sound Disorders (SSD) in children. A web-based questionnaire, regarding assessment of SSD in children 4;6–6;11 (years; months), was distributed to Swedish speech-language pathologists (SLPs) through social media and online forums. The questions concerned the frequency and manner of assessment for seven assessment components, chosen based on a review of international recommendations for SSD assessment. A total of 131 SLPs responded to the questionnaire. The results show that Swedish SSD assessment practices vary with regards to the frequency and manner of assessment for many components. Speech output is frequently assessed while speech perception, phonological awareness and oral-motor function are assessed less frequently. A variety of manners of assessment, for example, standardised tests, non-standardised material, and informal assessment procedures, such as observation, are utilized by respondents. Swedish SSD assessment practices are variable. The present paper reveals areas for development within SLP practice and education programmes, and provides a new perspective on present praxis with regards to the assessment of suspected SSD in Sweden. [ABSTRACT FROM AUTHOR]

An ageing population presents a challenge for municipal eldercare in Sweden due to difficulties recruiting staff and there being a strained economy. A strategy involving welfare technology is presented as one such solution. An important group to carry out this strategy involves those who work with welfare technology in municipal eldercare. In this paper we describe their perception of welfare technology, and the challenges and opportunities they perceive in utilizing it. A self-administered online questionnaire was distributed to all Swedish municipalities and answered by 393 respondents. Analyses show that the respondents were representative of the different professions who work with welfare technology within municipal eldercare. Welfare technology was perceived as being more reliable and safer than humans with regards to supervisions and reminders. The respondents acknowledged factors that slowed down the implementation of welfare technology in municipal eldercare organizations, such as resistance to change, lack of finances, lack of supporting evidence, lack of infrastructure, high staff turnover, difficulties with procurement and uncertainties about responsibility and laws. We found that the people who work with and make decisions about welfare technology in municipal eldercare organizations were generally very positive about the deployment and use of such technology, but there appear to be problems within municipal eldercare organizations to realize this vision. The lack of structured implementation processes and coherent evaluation models indicates inequality of the access to welfare technology and, as a result, even though Swedish eldercare is publicly funded, the availability of welfare technologies and their usage differ between municipalities. The research findings show that implementing welfare technologies in municipal eldercare must include transformed working processes and long-term strategies or they may lead to conflicts of priorities or unstructured implementation processes. Structured implementation processes and coherent evaluation models are needed for equality of access and availability of welfare technologies in municipal eldercare. High staff turnover negatively affects the deployment of welfare technology and the root cause of high staff turnover needs to be addressed. [ABSTRACT FROM AUTHOR]

Contemporary welfare organizations engage in various evaluation practices to assess the quality of their services. In this paper we report a qualitative exploration of how technology-enabled evaluations are understood by organizational members who participate in quality assurance activities in Swedish social services. The study contributes to critical information systems literature, focusing on the tensions professionals experience in relation to the digital systems they use for evaluations. For example, "quantities" take precedence over the qualities of such work, as information systems constrain ambitions to realize knowledge-based social services. The results reveal three tensions in professionals' evaluation-related activities arising from conflicting uses or desires. One is between desires for flexible systems that enable reflection and standardized digital support systems. Another is between uses or desires for indicators that are meaningful at the operational level and for general, comparable measures at the management level. The third is between desires to use evaluation procedures for learning and control. The study contributes to both theory and practice related to technology-enabled evaluation of welfare services, and critical perspectives on information systems. [ABSTRACT FROM AUTHOR]

This paper addresses the phonology of a Swedish girl, aged 3 years 10 months, with extensive phonological difficulties that include an unusual phonological pattern. She had relatively well-developed phonological building blocks in terms of features, stress pattern and word length (number of syllables), but had extensive difficulties regarding syllable and word shapes, with frequent deletions of both segments and whole syllables. Word-initial position was dominated by non-continuant consonants, both voiced and voiceless, with extensive deletion. Word-medial position was dominated by voiceless obstruents, with extensive use of [j] in place of voiced consonants. Word-final position was similar to word-medial, but with more deletion than [j]. Non-initial stressed syllables resemble word-initial syllables. Consonant clusters mirrored singletons, i.e. with similar substitution patterns or deletions. We present a non-linear analysis of her speech production, and a plan for intervention targeting her special difficulties. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this paper, we explore the performance of past-tense inflection of non-verbs (NVI) in children with developmental language disorder (DLD) and in typically developing controls, to investigate its accuracy as a clinical marker for Swedish-speaking children with DLD. Further, we investigate the relationship between NVI, nonword-repetition, and family history. The sample consists of 36 children with DLD (mean age 9;5 years) and 60 controls (mean age 9;2 years). The DLD group performed significantly lower than the controls on the NVI task, with a large effect size of the difference (d = 1.52). Analysis of the clinical accuracy of NVI resulted in 80.6% sensitivity and 76.6% specificity. NVI was significantly and moderately associated with nonword-repetition in the controls, but not in the DLD group. A positive family history, 80.6% in the DLD group and 6.9% in the controls, was associated with lower performance on NVI. When controlling for group (DLD and controls), a non-significant association between family history and performance on the NVI task was found. NVI is a potential clinical marker of DLD in Swedish school-aged children, but the current NVI task does not reach the level of being acceptable. Further development of the NVI task is warranted to improve its accuracy. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper draws together empirical work that has been produced by the authors in two different autistic spaces: the Swedish magazineEmpowermentproduced by and aimed at adults with autism, and English-speaking autistic communities online. While the two points of data collection are quite different, there are important points of commonality that enable us to explore central issues concerning autistic and neurotypical space and the meanings assigned to these in different contexts. The paper aims to introduce the notion of social geographies of autism, based on talks among adults with autism and a social movement to promote autistic identities, giving examples from our previous work that has spanned both online and off-line spaces. Key issues discussed in the paper include a focus on autistic political platforms and the carving out of both social and political spaces for people with autism. In doing so, neuro-separate and neuro-shared spaces must be negotiated. [ABSTRACT FROM PUBLISHER]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introducing continental European approaches to UK child welfare practice raises a problem of comparison: to what extent are the problems and issues similar to or different from one country compared to another. Social pedagogues trained in continental Europe and working in English residential care services often encountered the phrase ‘our young people are worse’ from their English colleagues, with the implication that the social pedagogic approach was not suitable for the client group. This paper examines two propositions: (1) that in the context of introducing the continental European approach of social pedagogy into children's residential care services in England, young people are ‘different’ in England compared to other European countries and (2) that the placement options and practices for young people living away from their birth parents in continental European countries differ from those in England. Using data from a five nation study of young people from public care backgrounds, the paper argues that while family backgrounds are remarkably similar there are marked differences in the child welfare systems that might account for the perception that young people in care are ‘worse’ in England. [ABSTRACT FROM AUTHOR]

Background and aims: Stage II cancer of the tongue is mostly managed surgically both locally and regionally. However, indications for postoperative radiotherapy and reconstructive options vary between centers. This paper aims to describe differences in treatment in a geographically homogenous cohort. Methods: A retrospective comparison was made between two cohorts of clinical T2N0 tongue cancer from Finland and Sweden. The Finnish cohort included 75 patients and the Swedish 54. All patients had curative intent of treatment and no previous head and neck cancer. Data analyzed consisted of pathological stage, size and thickness of tumor, frequency of reconstruction, radiotherapy delivered, and survival. Results: The Finnish cohort included a higher proportion of patients managed with reconstructive surgery (67%) than the Swedish cohort (0%), p < .00001. More patients were treated with postoperative radiotherapy (84%) in the Swedish cohort than in the Finnish (54%), p < .0002. The Finnish cohort had a higher level of survival and included more frequent downstaging (cTNM to pTNM). Conclusions and significance: Our data indicate a major difference in the management of T2N0 oral tongue cancer. The optimal cut-off size and growth pattern of the tumor warranting reconstruction should be further evaluated in a prospective manner considering both survival and quality of life. [ABSTRACT FROM AUTHOR]

To investigate the experiences of healthcare staff in nursing homes during the COVID-19 pandemic. Individual interviews. Latent qualitative content analysis. Ten nursing homes in Sweden. Physicians, nurses and nurse assistants working in Swedish nursing homes. Participants' experiences of working in nursing homes during the COVID-19 pandemic. Four manifest categories were found, namely: Balancing restrictions and allocation of scarce resources with care needs; Prioritizing and acting against moral values in advance care planning; Distrust in cooperation and Leadership and staff turnover – a factor for moral distress. The latent theme Experiences of handling ethical challenges caused by the COVID-19 pandemic gave a deeper meaning to the categories. During the pandemic, nursing home staff encountered ethical challenges that caused moral distress. Moral distress stemmed from not being given adequate conditions to perform their work properly, and thus not being able to give the residents adequate care. Another aspect of moral distress originated from feeling forced to act against their moral values when a course of action was considered to cause discomfort or harm to a resident. Alerting employers and policymakers to the harm and inequality experienced by staff and the difficulty in delivering appropriate care is essential. Making proposals for improvements and developing guidelines together with staff to recognize their role and to develop better guidance for good care is vital in order to support and sustain the nursing home workforce. The COVID-19 pandemic has affected both patients and staff in nursing homes, in Sweden and worldwide. Our study highlights that during the COVID-19 pandemic, nursing home staff encountered several ethical challenges which caused moral distress. Moral distress stemmed from not being given adequate conditions to perform their work, thus not giving the residents appropriate care. Moral distress could also originate from nursing home staff's feeling of being forced to act against their moral values. [ABSTRACT FROM AUTHOR]

In Sweden, physicians training to be psychiatrists must complete a basic course in psychotherapy. This study investigated the perceptions of this course by 18 physicians who completed a basic course in psychotherapy. All participants answered a paper-and-pencil questionnaire and four were also interviewed. The results show that most physicians were satisfied with the course, especially with its focus on different psychotherapeutic perspective that gave them the opportunity to train in both cognitive behavioural therapy and psychodynamic therapy. Continuing to offer physicians high-quality psychotherapy training, especially one that encourages knowledge of several theories and methods that will later be useful in clinical practice as a psychiatrist, will benefit future psychiatrists and their patients. [ABSTRACT FROM AUTHOR]

To explore the Nordic municipal health and care services' ability to promote principal goals within care for older people during the COVID-19 pandemic. Two surveys were conducted among managers of municipal health care services for older people in Denmark, Finland, Norway and Sweden; the first around 6 months into the pandemic (survey 1), and the second around 12 months later (survey 2). Data were analysed through descriptive statistics, and multiple regression (OLS). 1470 (survey 1, 2020) and 745 (survey 2, 2021) managers. 32% in home care, 51% in nursing homes, 17% combined. In all countries the pandemic seems to have had more negative impact on eldercare services' ability to promote an active and social life, than on the ability to promote or enhance older people's mental and physical health. The regression analysis indicates that different factors influence the ability to promote these goals. Managers within nursing homes reported reduced ability to promote mental and physical health and an active social life to a significantly lower degree than managers of home care. The effect of three prevention strategies (lock down, testing, and/or organisational change), were explored. Organisational change (reorganize staff and practice, restrict use of substitutes) tended to impact the units' ability to promote a social life in a positive direction, while lock down (areas, buffets etc) tended to impact both the ability to promote mental/physical health and a social life in a negative direction. Measures that can improve opportunities for an active and social life during a pandemic should have high priority, particularily within home care. It is important to learn from how the COVID-19 outbreak in 2020 affected the municipal health and care services' ability to achieve principal goals within care for older people. The pandemic had a more negative impact on the services' ability to promote an active and social life, than on their ability to promote or enhance mental and physical health. Measures that can improve opportunities for an active and social life during a pandemic situation should have high priority, particularily within home-based care. [ABSTRACT FROM AUTHOR]

Occupational therapists and occupational scientists are increasingly aware of the relationship between occupation and global climate change, with some working to raise awareness of the issues and others proposing that an occupational perspective can make a valuable contribution to understanding and addressing the issues. In this discussion paper the United Nations Global Survey on Sustainable Lifestyles (1), which reports young adults' beliefs about everyday occupations that have a substantial impact on the environment (food, housekeeping, and transportation) is introduced. The authors argue that the survey findings are a valuable resource for occupational therapists who are concerned about global climate change and work with young adults (age 18-35), providing valuable insights into their concerns and preferences in relation to sustainability. To illustrate the insights contained in the reports, findings from four countries are presented: New Zealand and Sweden, the authors' countries of origin, and the Philippines and Lebanon which have people living in New Zealand and Sweden. Application to individual and community-based interventions to promote more sustainable lifestyles is suggested, along with studies to examine the perspectives of young adults with a disability, as their concerns and sustainability preferences might differ due to the barriers that limit their participation in educational and vocational occupations. [ABSTRACT FROM AUTHOR]

Introduction:Transgender people´s general health and sexual function has previously been studied. However, holistic sexual health—physical, emotional,andrelational well-being in relation to sexuality—as both a determinant for and a part of general health is an understudied field in research concerning health among transgender people. There is no research addressing holistic sexual health and sexual health determinants combining quantitative and qualitative data. Aim:To explore and describe holistic sexual health and sexual health determinants among transgender people in Sweden. Methods:For the purpose of this paper, descriptive statistics from a previous web-based survey with 796 respondents and quotes from a previous qualitative interview study with 20 transgender people were combined. Results:Physical, emotional, and relational well-being are all vital aspects for experiencing holistic sexual health; that is, they are all important sexual health determinants, although of different importance to different individuals at different times. Satisfaction with sex life, having an ongoing sexual relationship and having been exposed to disrespectful or discriminatory care are examples of physical, emotional, and relational sexual health determinants that are connected to factors such as condom use, access to respectful STI/HIV-testing and having received reimbursement for sex. Experiences of disrespect and discrimination were reported in both the qualitative and the quantitative data, and in the qualitative data a wish for equity in access to sexual health care is evident. Conclusion:The results provide a broad and extensive insight into transgender people´s sexual health in Sweden. Furthermore it underlines that access to nondiscriminatory health care services is vital, including access to gender-confirming care and different sexual-health-promoting and preventive services such as testing facilities. [ABSTRACT FROM PUBLISHER]

Purpose: Postpartum Depression (PPD) --a common health problem for mothers' postpartum increases the risk of negative interaction between mothers and infants as it reduces the former's ability to respond to the latter's needs appropriately. Migrant mothers exhibit a higher prevalence of risk factors for PPD. Hence, this study aimed to investigate migrant mothers' life experiences pertaining to motherhood and PPD. Methods: Qualitative interviews were conducted with 10 immigrant mothers in the south of Sweden during 2021. Results: The qualitative content analysis revealed the following main themes: 1) PPD (two sub themes--psychosomatic symptoms and burden of responsibility due to feelings of loneliness); 2) mistrust of social services (one sub-theme--afraid of losing their children and Swedish social services' lack of understanding); 3) inadequate healthcare (two subthemes-- limited healthcare literacy for migrant mothers and language barrier; 4) women's coping strategy for well-being (two sub-themes--better awareness and understanding of the Swedish system and society, and freedom and independence in the new country). Conclusions: PPD, mistrust of social services, and inadequate healthcare lacking personal continuity were common among immigrant women, thus precipitating discrimination-- including lack of access to services because of limited health literacy, cultural differences, language barriers, and insufficient support. [ABSTRACT FROM AUTHOR]

This paper examines the importance of various social factors for the prevalence of “sick building syndrome” (SBS) in residential buildings. A survey has been conducted in Malmö, Sweden, resulting in 1131 randomly selected residents participating in the study (response rate 57 %). Two clusters of social factors were examined: the socio-structural position of the individual and psychosocial aspects of the housing situation. The results show that country of birth, in particular, and also education and employment status are important predictors of “domestic SBS”. “Housing satisfaction” turns out to be an important psychosocial predictor of SBS, explaining, for example, why immigrants report more symptoms than natives. [ABSTRACT FROM PUBLISHER]

Since the development of the welfare state, the Swedish school subject Health and Physical Education (HPE) has been regarded as an important site for public health work, and still assumes a central role in promoting the health of the coming generation. A specific type of health intervention, promoted by researchers in recent years, is the use of so-called exergames. In some countries, these fitness games are used as teaching aids in physical education classes and can be seen as examples of how public health issues and popular culture are shaping HPE in schools. The aim of the study reported in this paper is to examine which messages about health and body are offered, and how these are expressed in some of the fitness games used as teaching aids in school. The results of the study highlight the dangers of using exergames in the teaching of HPE in schools. The messages communicated by the games have a number of potentially harmful consequences, particularly with regard to the creation of specific health and bodily norms based on a measurable ideal. The use of this tool in education is thus far from value free, and the problems that might be solved when using the games are not necessarily the ones that education should privilege. [ABSTRACT FROM AUTHOR]

This paper aims to describe the nature of pediatric cardiology teams (PCTs) based in Sweden through the use of a mixed methods approach. Questionnaires examining issues about the organization/ways of working, functions/tasks and attitudes were answered by 30 PCTs. Focus group interviews were conducted with six PCTs, selected purposefully by size and location, and information on experiences and attitudes on interprofessional teamwork was explored in depth. Results from the quantitative indicated that in 17 of the teams, where the nurse acted as the central coordinator, there was a positive attitude to the value of teamwork. In the interviews, different problems and needs of improvements were mentioned regarding structure, leadership, presence of physicians in the team as well as the team's mandate. All of the participants, however, agreed that interprofessional teams were required to manage the complexity of the children's care. In conclusion, this study suggests that PCTs need further support to develop structure, leadership and coordination of resources to function in a more effective manner. National plans or recommendations that mandate the organization and working methods of PCTs would be helpful for the ongoing development of PCTs in Sweden. [ABSTRACT FROM AUTHOR]

Health care workers employed in nursing homes need sufficient diabetes knowledge to make adequate decisions in order to optimise diabetes management and minimise complications which may arise from poor diabetes control. The aim of this study was to determine levels of diabetes knowledge among health care workers when presented with a case description regarding an older person. Ten health care workers were asked to read a paper copy of the case description, reflect upon it and express their understanding of the case in question. The main results were summarised in two categories: namely, diabetes knowledge in relation to the presented case description and general diabetes knowledge. Some of the respondents considered the symptoms to be related to hyperglycaemia, while others were uncertain. Health care workers' general diabetes knowledge varied. In order to optimise diabetes management and minimise complications, health care workers' knowledge gaps in diabetes need to be reduced through regular diabetes education. Copyright © 2013 FEND. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

In this paper, we examine concurrent and prospective links between attachment and the Five-Factor Model (FFM) of personality from middle childhood to young adulthood (n = 66). At age 8.5 years, attachment was measured with the Separation Anxiety Test and at 21 years with the Adult Attachment Interview, whereas the personality dimensions were assessed with questionnaires at both time points. The results showed that attachment and personality dimensions are meaningfully related, concurrently and longitudinally. Attachment security in middle childhood was positively related to extraversion and openness, both concurrently and prospectively. Unresolved/disorganized (U/d) attachment was negatively related to conscientiousness and positively related to openness in young adulthood. U/d attachment showed a unique contribution to openness above the observed temporal stability of openness. As attachment security was also associated with openness, the duality of this factor is discussed together with other theoretical considerations regarding attachment theory in relation to the FFM. [ABSTRACT FROM PUBLISHER]

Conclusion: The most common mutation in the Swedish population was Connexin 26 (C×26) 35delG, which indicates that the percentage of Swedish persons with C×26 mutations and polymorphisms in the GJB2 gene among non-syndromic hearing-impaired (HI) persons is comparable to the rest of Europe. The results strongly support a Swedish policy to offer all children with diagnosed hearing impairment genetic tests for the C×26 35delG mutation. Objectives: The aim of the present study was to search for mutations in the GBJ2 gene among Swedish persons with non-syndromic hearing impairment to further clarify how common these mutations are in Sweden, one of the northernmost countries in Europe. Methods: Seventy-nine patients with non-syndromic hearing impairment participated in the study. For 87% of the participants, a pure tone audiogram showed a severe or profound hearing impairment. Dried blood spots on filter paper, taken at 3-5 days of age in the Swedish nationwide neonatal screening programme for congenital disorders and saved in a biobank, were used for the molecular genetic analyses. Results: The total number of subjects with one or two pathologic mutations or a mutation of unknown consequence found in the GJB2 gene was 28 of 79 (35%). Nineteen (19) persons (24%) were homozygotes for the 35delG mutation. [ABSTRACT FROM AUTHOR]

Few studies have assessed if Sweden's injury prevention work has been equally effective for children of different socio-economic backgrounds. The goal of this paper is to review the country's injury rates for children over time, stratified by socio-economic status (SES), to see if the effects are similar across SES levels. This study employs a retrospective case-control study design, using data from the hospitalisation records of 51,225 children, which were linked to family socio-economic data. Children and adolescents in families receiving social welfare benefits, and those living with single parents and mothers with less education had higher risks of injuries leading to hospitalisation. The population-based safety work over the past decades seems to have had only minor effects on reducing the impact of socio-economic based difference in injury risks to younger Swedes. [ABSTRACT FROM AUTHOR]

Animal-related injuries are among the most common occupational injuries in agriculture. Despite the large number of documented animal-related injuries in dairy farming, the issue has received relatively limited attention in the scientific literature. The farmers' own perspectives and views on risks and safety during livestock handling and what they think are effective ways of preventing injuries are valuable for the future design of effective interventions. This paper presents results from a qualitative study with the aim to investigate Swedish dairy farmers' own experience of animal-related occupational injuries, as well as their perceptions of and attitudes towards them, including risk and safety issues, and prevention measures. A total of 12 dairy farmers with loose housing systems participated in the study. Data collection was conducted by means of semistructured in-depth interviews. Three main themes with an impact on risks and safety when handling cattle were identified: the handler, the cattle, and the facilities. They all interact with each other, influencing the potential risks of any work task. Most of the farmers believed that a majority of the injuries can be prevented, but there are always some incidents that are impossible to foresee. In conclusion, this study indicates that Swedish dairy farmers are aware of the dangers from working with cattle. However, even though safety is acknowledged by the farmers as an important and relevant issue, in the end safety is often forgotten or not prioritized. One concern is that farmers are willing to take calculated risks to save money or time. In situations where they work alone with high stress levels and under economic distress, safety issues are easily given low priority. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between time allocation on formal and informal forms of contact within interprofessional teams and an interdependent collaboration. Data were collected by a questionnaire including items on work organization, team climate and time allocation that was responded to by 226 professionals from 44 interprofessional teams. An additional sample of 139 professionals from 18 teams responded to the same questionnaire except for the item on time allocation. The teams worked within occupational health care, psychiatry, rehabilitation and school health care. On average, team members spent about 22% of their available work time on internal meetings/consultations and they perceived their collaboration as fairly interdependent. No correlation was found between, on the one hand, time invested in meetings and informal consultations within the team and, on the other hand, degree of team interdependence. Instead, interdependence was predicted by team climate, followed by manager coordination and self-regulation. However, there may be a lower limit: all 44 teams allocated at least about 10% of their work time to internal meetings and consultations. The results suggest three ways to strengthen interprofessional team collaboration - development of team climate and communication and more opportunity for both manager coordination and self-regulation. [ABSTRACT FROM AUTHOR]

People with psychotic disorders have a significantly increased risk of physical diseases and excessive mortality rates. The aim of the study was to investigate relationships between changes in physical activity, levels of salutogenic health, and glycated hemoglobin among people with psychotic disorders after participation in an individualized lifestyle intervention. The results from analyses showed that self-reported increased physical activity was positively associated with the level of salutogenic health and negatively associated with the level of HbA1c on an individual level. The results indicate that coordinated, individualized, holistic and health-promoting nursing care is crucial to enabling enhanced lifestyle within this vulnerable target group. [ABSTRACT FROM AUTHOR]

The research-oriented objective of this study was to document the effectiveness of online support for hearing aid (HA) users compared with traditional support. This study is a randomised controlled trial with parallel group design. The research-oriented objectives were evaluated using the Hearing Handicap Inventory for the Elderly (HHIE) and the Communication Strategies Scale (CSS) at baseline and immediately postintervention. Selected clients at five different clinics were randomised to an intervention group (n = 78) that took part in online hearing support and a control group (n = 58) that received standard care. The analyses (intention-to-treat) showed statistically significant improvements in the HHIE-total and Emotional subscale scores for the intervention group compared with the control group. The intervention group also showed significantly greater improvement in the CSS-total and Verbal and Nonverbal subscale scores. A subgroup analysis was performed including two groups: HA use <1 year and HA use >1 year. A statistically significant improvement was found for the HA users >1 year compared with HA use <1 year. It is effective to clinically include online hearing support for HA users when addressing self-perceived hearing difficulties and to sharpen communication strategy skills. [ABSTRACT FROM AUTHOR]

This study investigates assistant nurses' views on and needs for orientation to care robot use in three European countries. The use of care robots is gradually being incorporated into welfare services. Orientation to care robot use (in short, introduction to the use of the care robot technology) has thus become a key issue for care services. A survey was sent to assistant nurses in Finland, Germany, and Sweden, to which 302 participants responded (Finland n = 117; Germany n = 73; Sweden n = 112). Only 11.3% of assistant nurses had experience of giving orientation to care robot use to older adults or colleagues, but over 50% were willing to do so. Those with experience of using care robots should take part in orientation. Orientation to care robot use should be seen as part of care management and an issue that may affect the whole organisation. Management should, firstly, allow assistant nurses to get to know care robots by offering information, and secondly, consider with the assistant nurses the ways care robots can change their work and the implications of this change. Emphasising the social factors and practical orientation to care robot use extends the previous theories and perspectives of technology acceptance, adoption and diffusion. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate and clarify the association between authoritative teaching at the classroom level and bullying perpetration and victimization among Swedish upper elementary school students. For this purpose, authoritative teaching was analyzed both as combined construct, and as the effects of the two dimensions that characterize authoritative teaching (i.e. structure and support). In all, 1,522 students (Mage = 10.54 SD = 0.35) from 110 classrooms completed a questionnaire in their classrooms. The findings from the multilevel regression analyses showed that students in classrooms with less authoritative teachers engaged more in bullying behaviors and were more often victimized. When authoritative teaching was divided into structure and support, only teacher support showed a significant negative association with bullying perpetration and victimization. [ABSTRACT FROM AUTHOR]

Evidence-based information and communication technology (ICT) interventions to enhance school participation among students with special educational needs (SEN) are required. To evaluate the impact of an ICT intervention on school participation among upper secondary school students with special educational needs. Data on 300 students' assessments with the School Setting Interview (SSI), grades and school attendance were used in this quasi-experimental study, with a one-group pretest-posttest design. Descriptive and inferential statistics and effect size were used, as well as Rasch analysis to generate interval data on the students' ordinal SSI ratings. In the ICT intervention (median time eight hours), 54% of the students received a tablet, and software concerned with planning and structure was received by 85%. After the ICT intervention, a significant decrease in perceived need for adjustments in school activities was found on a group level and 30% of the students improved their school attendance. Students who benefitted the most from the ICT intervention had few adjustment needs in school activities and no special educational support at baseline. An ICT intervention is promising for improving school participation among upper secondary school students with SEN. [ABSTRACT FROM AUTHOR]

The aim of this pilot study was to evaluate two new retelling tasks intended for clinical use in terms of language sample size, effects of picture support, and order of presentation. Forty Swedish-speaking children in grades 4–6 participated in the study, 31 children with typical language development (TLD, mean age 11;1), and nine children with developmental language disorder (DLD, mean age 11;5). Two oral retells, one with and one without picture support, were analyzed with regards to productivity, syntactic complexity, basic Story Grammar (SG) units, and Internal Responses (IR). Results showed no systematic order effects in the TLD group, although this needs to be investigated further, and good inter-rater reliability. Both tasks elicited sufficiently large language samples, except from one participant with DLD whose samples were excluded from subsequent comparisons. When appropriate, data were analyzed with ANOVA (productivity, mean length of C-unit/MLCU), otherwise t-tests (TLD-group) or non-parametric tests (DLD-group) were used. As expected, retells from participants with DLD were shorter, with shorter MLCU and fewer SG units compared to the TLD group. There were also task effects: in the task with picture support, all participants had longer MLCU, and participants with TLD also showed a higher proportion of subordinate clauses, indicating that pictures may function as a support for syntactic complexity. The task without picture support, on the other hand, elicited more C-units indicated by a significant main effect, and more SG units, which was a significant effect in the TLD group. >We conclude that both tasks might be useful for Swedish speech-language pathologists. [ABSTRACT FROM AUTHOR]

Background: Attention deficit hyperactivity disorder (ADHD) has in several studies been linked to substance use, including cannabis use. However, crucial gaps remain regarding how to understand this association. Analyzing the association between ADHD and substance use is complicated because of a pronounced overlap between ADHD, conduct problems, and traits such as sensation-seeking. Objectives: Using data from a large and nationally representative study among Swedish adolescents, this study explored the role of conduct problems, but also of sensation-seeking, in accounting for the association between ADHD and cannabis use. Results: There was a notable association between ADHD and cannabis use that was attenuated when conduct problems were controlled for. The association between cannabis use and conduct problems, in turn, was attenuated when sensation-seeking was controlled for. Individuals with both ADHD and conduct problems were more likely to have used cannabis than individuals with ADHD only, but not compared with individuals with conduct problems only. Conclusions: Whereas conduct problems largely explain the link between ADHD and cannabis use, sensation-seeking seems to account for the association between conduct problems and cannabis use. [ABSTRACT FROM AUTHOR]

This article explores how professionals within Swedish addiction treatment (n = 18) describe and make sense of relapse prevention (RP). RP is known as a self-control programme for maintaining behavioural change, helping people deal with high-risk situations. However, since self-control techniques have been incorporated widely in the addiction treatment field, the specificities of RP have become vague. To grasp what RP 'is', we draw on John Law's and Annemarie Mol's thoughts on how logics enact objects and realities. We thus follow critical scholarship in Science and Technology Studies and view treatment as a local knowledge-making practice that may depart from how it was originally designed. A key question is how RP is potentially transformed and made-to-matter when moved from the controlled settings of theorising and experimental studies to practice. The professionals used a logic of fixity to make RP stable, structured and evidence-based, easily distinguishable from other interventions. They also used a logic of fluidity to explain how and why they tinkered with it and adapted it to the preferences of both staff and attendees. The two logics enacted two different realities of addiction treatment: one in which RP is standardised, temporally demarcated and can solve most addiction problems, and another where interventions must be individualised, continuous and adapted to local settings and needs. It did not appear contradictory to 'make up' RP as both fixed and fluid; the two realities exist side by side, but with different material effects. [ABSTRACT FROM AUTHOR]

Social day centres can support active and healthy ageing amongst older people. However, little is known regarding the importance of social day centres. The aim of this study was to explore how older people visiting social day centres perceive the day centres' social influence on their health and well-being. Twenty older persons attending social day centres on a regular basis were interviewed regarding activities at the day centre and their importance for active and healthy ageing. The data were analysed using qualitative content analysis. The social day centres were described as arenas to provide a structure (and something to do) in the visitor's everyday life. By attending a day centre, the participants created a social context with other visitors. Staff acted as facilitators for visitors, helping them to interact with other visitors and to experience the feeling of being needed by others. The findings suggest that social day centres are important arenas for creating a sense of context and belongingness amongst older people. This study provides knowledge on how doing and being contribute to healthy and active ageing. [ABSTRACT FROM AUTHOR]

To investigate to what degree adolescent males (1) value confidentiality, (2) experience confidentiality and are comfortable asking sensitive questions when visiting a general practitioner (GP), and (3) whether self-reported symptoms of poor mental health and health-compromising behaviours (HCB) affect these states of matters. Cross-sectional. School-based census on life, health and primary care in Region Sörmland, Sweden. 2,358 males aged 15–17 years (response rate 84%). The impact of poor mental health and HCBs on adolescent males' valuing and experiencing private time with the GP, having professional secrecy explained, and being comfortable asking about the body, love and sex, analysed with structural equation modelling. Almost all respondents valued confidentiality regardless of their mental health or whether they engaged in HCBs: 86% valued spending private time with the GP, and 83% valued receiving a secrecy explanation. Among those who had visited a GP in the past year (n = 1,200), 74% had experienced private time and 42% a secrecy explanation. Three-quarters were at least partly comfortable asking sensitive questions. Adolescent males with HCBs were more likely to experience a secrecy explanation (approximative odds ratio [appOR] 1.26; p = 0.005) and to be comfortable asking about sex than their peers (appOR 1.22; p = 0.007). Respondents reporting experienced confidentiality were more comfortable asking sensitive questions (appOR 1.25–1.54; p ≤ 0.010). Confidentiality matters regardless of poor mental health or HCBs and makes adolescent males more comfortable asking sensitive questions. We suggest that GPs consistently offer private time and explain professional secrecy. Confidentiality for adolescent males has been scantily studied in relation to mental health and health-compromising behaviours. In this study, most adolescent males valued confidentiality, regardless of their mental health and health-compromising behaviours. Health-compromising behaviours impacted only slightly, and mental health not at all, on experiences of confidentiality in primary care. When provided private time and an explanation of professional secrecy, adolescent males were more comfortable asking the GP sensitive questions. [ABSTRACT FROM AUTHOR]

Research into work-related factors that positively influence Oral Health Providers (OHPs) health is scarce. This study aimed to analyse which OHPs in dental services remain healthy over time in relation to work- and health-related factors. OHPs took part in this prospective cohort study (n = 168). In 2012 and 2014 they answered a questionnaire featuring questions about demographics, health indicators, work and organisational factors. OHPs were classified into three subgroups; healthy group (n = 66), semi-healthy group (n = 45) and unhealthy group (n = 57). The healthy group reported no sick leave or sickness presence in 2012 or 2014. Factors that explained a greater likelihood of belonging to the healthy group were: good work ability, not having neck pain, perceived low exertion at the end of the working day, not having sleeping problems. They scored higher on health indicators than OHPs in the unhealthy group. OHPs with no sick leave or sickness presence report much better salutogenic health, better physical work ability and lower perceived exertion at the end of their workday compared with unhealthy group of OHPs. Understanding the relationship between working conditions and well-being is crucial to target interventions for OHPs which improve work conditions and health. [ABSTRACT FROM AUTHOR]

The aim was to compare movement patterns of lips and jaw in lateral, vertical and anteroposterior directions during vowel production in children with typical speech development (TSD) and in children with speech sound disorders (SSD) persisting after the age of six. A total of 93 children were included, 42 children with TSD (6:0–12:2 years, mean age 8:9 ± 1:5, 19 girls and 23 boys) and 51 children with SSD (6:0–16:7 years, mean age 8:5 ± 3:0, 14 girls and 37 boys). Range of motion (ROM) in lips and jaw in the vowels [a, ʊ, ɪ] produced in a syllable repetition task and median values in resting position were measured with a system for 3D motion analysis. The analysis was based on the coordinates for the mouth corners and the chin centre. There were significant differences between the groups on movements in lateral direction in both lips and jaw. Children with TSD had generally smaller and more, symmetrical movements in the lips and jaw, in all three dimensions compared to children with SSD. There were no significant differences between the groups in resting position. Children with SSD persisting after the age of six years show more asymmetrical and more variable movement patterns in lips and jaw during vowel production compared with children with TSD in a simple syllable repetition task. Differences were more pronounced in lateral direction in both lips and jaw. [ABSTRACT FROM AUTHOR]

Purpose: Vocabulary relates to overall language proficiency and is important for academic success. Word definition (WD) tasks can be used to assess vocabulary depth and definition skills. We investigate monolingual and bilingual children's performances on a WD task, and how bilingualism, level of parental education, school characteristics (proportion of students with Swedish as second language and proportion of parents with tertiary education), CELF-4 Core Language Score, and non-verbal IQ contribute to their performance. We also evaluate the level of difficulty of the test items and the test's internal consistency. Method: Two hundred and eight children (mean age 7:8, range 6:8–9:0) were assessed with a 10-item WD task. Amount of information included in the definitions gave the WD score and number of words with at least partially correct information gave a Word knowledge score. Result: The bilingual group had lower scores on both measures. In isolation bilingualism explained 15% of the variance of the WD score. With all background factors included, the only significant predictor was CELF-4 Core Language Score, uniquely explaining 24.3% of the variance. Response patterns on the WD score were similar between groups. Internal consistency was > α = 0.7 for both measurements. Conclusion: Bilingual children performed lower than monolingual children on a WD task, but bilingualism alone cannot explain poor results. [ABSTRACT FROM AUTHOR]

Loneliness is an important risk factor for mental and physical health over the life span. Little is known about psychosocial predictors and consequences of loneliness apart from social network characteristics. One important factor that may both prevent from, but also be affected by loneliness, is perceived autonomy. In the present study, we investigated the longitudinal association of loneliness and autonomy over four years among participants of the Swedish Health, Aging and Retirement Transitions in Sweden (HEARTS) study (n = 5718, age 60–66 at baseline). We used a latent curve model with structured residuals, which distinguishes within- and between-person associations and includes cross-lagged parameters. Higher levels of autonomy at baseline were associated with lower levels of loneliness, and increases in autonomy were associated with decreases in loneliness. When individuals felt more autonomous than usual, they also reported less loneliness. However, the cross-lagged paths were not significant, which means that autonomy did not predict loneliness over time on the within-person level, and loneliness did not predict autonomy over time. Our findings show that higher autonomy was related to lower loneliness on different analytical levels, but the direction of effects is unclear. More research is needed to understand the development of this association over the life span. [ABSTRACT FROM AUTHOR]

The purpose of this study was to describe experiences of being a manager in the municipal sector in rural northern Sweden. Semi-structured interviews were performed with 15 managers working in the municipal sector. The interviews were subjected to inductive qualitative content analysis. The managers' experiences were interpreted in the main theme, Striving for stability on shaky ground. They struggled within slimmed-down organizations with substitute shortages and reduced means. They expressed being burdened by conflicting demands, a work overload, work conflicts and a requirement to be present. They had to endure the negative consequences of working in small municipalities, and handling health and family life impairments. The managers expressed the importance of being strengthened by inner and outer resources, such as being motivated, having social support and finding strategies to cope. They also expressed benefits of working in small municipalities, such as great opportunities to influence and efficiency in decision-making. This study illuminates managers' adverse psychosocial working conditions, insights into working in a small municipality in the rural context and also the importance of organizational support. Future studies could focus on applying adapted workplace support interventions among managers in the municipal sector in rural northern Sweden. [ABSTRACT FROM AUTHOR]

Resilience contributes to positive adaptation after many health conditions, but little is known about its contribution to long-term recovery after stroke. This study investigated the lived experience of resilience and participation and their relationship to quality of life after stroke in Sweden. Semi-structured telephone interviews were conducted with 19 informants (10 male, 9 female), aged from 44–89 years and between 1 and 19 years post-stroke. Stroke severity ranged from mild (n = 8), moderate (n = 9) to severe (n = 2). Interviews were analysed using content analysis. The analysis resulted in an overarching theme; Life with stroke has been adapted to but not accepted, built on five subthemes: 1) Adapting and adjusting life, 2) Meaningful values in life, 3) Inner resources, 4) Support and treatment from social relations, and 5) Support and treatment from external resources. Participants described a tension between adapting and accepting life after stroke. Resilience was a useful framework, highlighting the contribution of inner, social and societal resources to recovery and quality of life, both directly and as enhanced through increased participation. Important factors for adaptation are meaningful values in life, individual strategies for adaptation and support from both social relationship and the society. [ABSTRACT FROM AUTHOR]

COVID-19 has highlighted the importance of health information for prevention of communicable disease. Knowledge about groups that have high risk is important to prevent disease transmission. In Sweden, immigrants have been identified as one such group. Yet, little is known about where they have sourced information about COVID-19 and their opinions toward it. The aim of this study was to describe the COVID-19 information sources used by immigrants with limited proficiency in Swedish as well as their opinions on how comprehensive the information has been, the importance of the recommendations and their possibility to follow them. A cross-sectional survey was conducted via introductory Swedish language classes in Region Uppsala (n = 855). The results showed the immigrants were using different information sources, with the majority using school, media and social media. The immigrants' opinions about COVID-19 information differed. Most reported they knew where to find information; however, over two-fifths reported the recommendations from the authorities should be more extensive. The majority reported it is important to follow the recommendations, whereas the possibility to follow the recommendations was more mixed. Age differences in opinions toward COVID-19 information were detected. Although the results were largely positive, there still appears to be a need for improvement in how immigrant groups with limited ability in the host country´s language are reached. Effective health communication that engages the whole nation is an important factor authorities should commit to as we face the current pandemic. This research suggests that an approach tailored by age could be helpful. [ABSTRACT FROM AUTHOR]