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Aim: To describe the co‐designing process of an online support programme with and for informal carers of people with heart failure. Design: A co‐design process built on core concepts and ideas embedded in co‐design methodology. Data sources: Our co‐design process included three phases involving 32 informal caregivers and 25 content creators; (1) Identification of topics and content through literature searches, focus group interviews and user group sessions; (2) Development of the online support programme and; (3) Refinement and finalization which included testing a paper prototype followed by testing the online version and testing and approval of the final version of the support programme. Outcomes: The co‐design process resulted in a support programme consisting of 15 different modules relevant to informal carers, delivered on a National Health Portal. Conclusion: Co‐design is an explorative process where researchers need to balance a range of potentially conflicting factors and to ensure that the end users are genuinely included in the process. Relevance to clinical practice: Emphasizing equal involvement of end users (e.g. carers or patients) in the design and development of healthcare interventions aligns with contemporary ideas of person‐centred care and provides a valuable learning opportunity for those involved. Furthermore, a co‐designed online support programme has the capacity to be both accessible and meet end users' information and support needs, thereby optimizing their self‐care abilities. Additionally, an online support programme provides the opportunity to address current challenges regarding scarce resources and the lack of healthcare personnel. Reporting methods: Consolidated criteria for reporting qualitative research (COREQ). Patient or public contribution: Both informal carers and content creators were involved in developing the support programme. [ABSTRACT FROM AUTHOR]

Workarounds are commonplace in healthcare settings. An increase in the use of electronic health records has led to an escalation of workarounds as healthcare professionals cope with systems which are inadequate for their needs. Closely related to this, the documentation of vital signs in electronic health records has been problematic. The accuracy and completeness of vital sign documentation has a direct impact on the recognition of deterioration in a patient’s condition. We examined workflow processes to identify workarounds related to vital signs in a 372-bed hospital in Sweden. In three clinical areas, a qualitative study was performed with data collected during observations and interviews and analysed through thematic content analysis. We identified paper workarounds in the form of handwritten notes and a total of eight pre-printed paper observation charts. Our results suggested that nurses created workarounds to allow a smooth workflow and ensure patients safety. [ABSTRACT FROM AUTHOR]

Introduction: Two ethical challenges of nursing home nurses during the COVID-19 pandemic in Sweden are discussed in this paper. Background: Historically, the nurse's primary concern is for the person who is ill, which is the core of nurses' moral responsibility and identity. In Sweden, person-centered care is generally deemed important in nursing older nursing home residents. Objective: To chart moral responsibilities of nursing home nurses in two cases involving older residents during the COVID-19 pandemic in Sweden. Methods: We used Margaret Urban Walker's framework for moral responsibilities and the International Council of Nurses (ICN) code of ethics for nurses (2021) for our normative analysis. Ethical considerations: Written and verbal consent was obtained before the interviews, and information was given that participation was entirely voluntary and possible to cancel at any time before the work was published. The Swedish Ethical Review Agency gave an advisory opinion stating that there were no ethical objections to this research project (Dnr. 2020-05649). Findings: Case #1: a palliative older nursing home resident who was coercively tested for COVID-19, and case #2: a COVID-19–infected resident with dementia who was isolated using sedation. The decision that was finally made in the respective case was analyzed in the light of either consequentialist/utilitarian or non-consequentialist/deontological reasons. Discussion: Empowerment of nurses as moral agents is required for the application of practical wisdom in the balancing of different care relationships (responsibilities), moral identities (professional virtues), and competing moral values. This requires resources and opens possibilities for profound ethical reflection in nursing education and at work. Conclusion: During the COVID-19 pandemic, the moral and professional responsibility of nursing home nurses to deliver person-centered care was sometimes problematically abandoned in favor of a more utilitarian manner of ethical decision-making. [ABSTRACT FROM AUTHOR]

Hospital to home transfers for older people require effective communication, coordination and collaboration across multiple service settings. Rural Nursing Theory and the Beyond Periphery model explain why this is particularly difficult in rural areas, but there are few examples of how rural services respond. This paper presents a case study of the district of Tärnaby in the inland north of Sweden. Data are drawn from interviews with health and care staff in Tärnaby, observations, and experiences of the researchers. Data were analyzed thematically, with four main themes emerging – role clarity, communication, geography, and understanding of the rural context. Responses to challenges included increasing opportunities for communication between service providers and improving documentation. The paper concludes that informal "workarounds" run the risk of further disconnecting rural service settings from "the city". Rather, the aim needs to be to improve contextual understanding through formally incorporating "the rural" in service design. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this paper is to empirically describe and analyze factors deemed to be relevant for the successful provision of coordinated paediatric oncology care by physicians and nurses involved. Design/methodology/approach: A qualitative case study primarily consisting of interviews. Findings: The paper's findings indicate that certain factors (i.e. distinct mission, clear treatment protocols and support from external stakeholders) relevant for the provision of coordinated paediatric oncology care have not received sufficient attention in previous research. In addition, emphasis is placed on the necessity of facilitating constructive working relationships and a bottom-up perspective when pursuing improved care coordination. Originality/value: The factors described and analyzed may act as insights for how paediatric oncology might be improved in terms of care coordination and thus facilitate care integration. In addition, the paper's findings identify factors relevant for further empirical studies in order to delineate their generalizability. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this paper is to identify the role of the principal in establishing a whole school approach for health and wellbeing. Two questions are asked: (1) What do successful Swedish principals do when they take on a whole school approach? (2) How do these results relate to previous research on successful school leadership? Design/methodology/approach: This paper focuses on the complexity of organisational processes and considers the role of successful leadership in managing a whole school approach to health promotion. It presents findings from two different but interlinked projects, and draws on document studies and interviews with principals, student health team members and teachers in Sweden. Findings: This paper argues that successful school leaders are crucial in establishing a whole school approach, because of the work they do to synchronise the health-promoting activities in schools. The study identifies four aspects of coordination that need to be enacted simultaneously when leading health-promoting processes. The fifth aspect identified is that a whole school approach is not limited to the school, but the whole local school context, i.e. a synchronisation between different system levels. Originality/value: Although limited in scale, this paper reports key findings that could have practical implications for school leaders. The study suggests that successful school leadership research needs to use a health-promoting lens in order to make leadership practices health-promoting practices. It also proposes extended comparative research from different fields and contexts. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to describe how first-line managers (FLMs) in home care (HC) reason about the opportunities and obstacles to lead the work according to the individual's needs and goals. Design/methodology/approach: In this participatory appreciative action reflection project, eight managers within one Swedish municipality were interviewed. The data were analysed using a thematic analysis. Findings: The results showed a polarization between two different systems that FLMs struggle to balance when attempting to lead HC that adapts to the needs and goals of individuals. One system was represented by the possibilities of a humane system, with human capital in the form of the individual, older persons and the co-workers in HC. The second system was represented by obstacles in the form of the economic needs of the organization in which the individual receiving HC often felt forgotten. In this system, the organization's needs and goals governed, with FLMs needing to adapt to the cost-effectiveness principle and keep a balanced budget. The managers had to balance an ethical conflict of values between the human value and needs-solidarity principles, with that of the cost-effectiveness principle. Originality/value: The FLMs lack the opportunity to lead HC according to the needs and goals of the individuals receiving HC. There is a need for consensus and a value-based leadership model based on ethical principles such as the principles of human value and needs-solidarity to lead the HC according to the individual's needs and goals. [ABSTRACT FROM AUTHOR]

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]

Purpose The purpose of this paper is to examine how external change agents (ECAs) engaged to disseminate a national quality register (NQR) called Senior alert nationwide in the Swedish health care and elderly care sectors interpret their work. To study this, sensemaking theories are used.Design/methodology/approach This is a qualitative inductive interview study including eight ECAs. To analyze the data, a thematic analysis is carried out.Findings Well-disseminated NQRs support health care organizations’ possibility to work with quality improvement and to improve care for patient groups. NQRs function as artifacts that can influence how health care professionals make sense of their work. In this paper, a typology depicting how the ECAs make sense of their dissemination work has been developed. The ECAs are engaged in prospective sensemaking. They describe their work as being about creating future good results, both for patients and affiliated organizations, and they can balance different quality aspects.Originality/value The number of NQRs increased markedly in Sweden and elsewhere, but there are few reports on how health care professionals working with the registers interpret their work. The use of ECAs to disseminate NQRs is a novel approach. This paper describes how the ECAs are engaged in prospective sensemaking – an under-researched perspective of the sensemaking theory. [ABSTRACT FROM AUTHOR]

The aim of this paper is to analyse approaches to issues of risk, responsibility and representations of violence in women social workers' conversations with alleged or confirmed violent fathers. The study adds to a growing body of research on agencies' handling of intimate partner violence (IPV) in the context of separation. Empirically, the study draws from 12 structured, audio recorded and transcribed interviews with support‐seeking and divorced fathers, from five municipalities in Sweden, conducted as part of a cooperation project in which a risk‐detection method (Family Law Detection Of Overall Risk Screen [FL‐DOORS]) was also tested. The results suggest a tension between different professional tasks. To validate information on IPV, detect risk and enhance a child perspective competes with other professional projects, most obviously with promoting cooperation between parents. The study confirms previous research, which demonstrates unique challenges facing women social workers and counsellors when working with men as perpetrators. In conclusion, the paper concurs with the call for a focus on responsibility and on safe parenting in professional conversations with allegedly or confirmed abusive fathers. [ABSTRACT FROM AUTHOR]

Background: The risks of developmental language disorder (DLD) for both educational progress and socio‐emotional development are well documented, but little is known about how children and young people with DLD experience and describe their language and communication. The need to complement experimental and quantitative studies with qualitative perspectives of the lived experience of individuals with DLD for speech and language therapists (SLT) practice has recently been foregrounded. Aims: To understand further the experiences of young people with DLD focusing on language and communication in a school context, and thereby contribute to the improvement of the communicative situation in school for this group. The study is guided by the following research question: How do young people diagnosed with DLD describe their experiences of language and communication in school? Methods & Procedures: The study is based on data generated from qualitative semi‐structured interviews with 23 participants diagnosed with DLD (age 13–19 years old) living in Sweden. All participants attended mainstream schools. To enable data to be collected during COVID‐19 restrictions, all interviews were conducted using Zoom. Reflexive thematic analysis was used to analyse the data. Outcomes & Results: Four main themes related to experiences of language and communication in school were constructed from the interviews: (1) feelings of inadequacy and comparisons with others; (2) feelings of being misjudged and misunderstood; (3) the importance of feeling safe and comfortable; and (4) the significance of the social and communicative context. The results bear witness of difficult and challenging aspects related to language and communication in school, including educational, social and emotional dimensions. An important outcome of this study is how young people diagnosed with DLD describe their language and communication functioning to be dependent on both individual characteristics and abilities, as well as situational, contextual and social factors. Conclusions & Implications: The results from this study show that young people with DLD can have persisting problems related to language and communication in school, including educational, social and emotional dimensions. SLT services may therefore be needed throughout the school years to ensure that students with DLD receive adequate support. In addition, support that goes beyond language abilities and targets social, contextual and emotional aspects should be considered. WHAT THIS PAPER ADDS: What is already known on this subject: Children and young people have unique knowledge about their language and communication which is instrumental for designing interventions and support strategies. Qualitative analyses of interview data have been able to identify both risk factors and protective strategies in relation to the well‐being of individuals with DLD. Despite this, children and young people with DLD are rarely heard in research or clinical discussions. What this paper adds to existing knowledge: In this study we listen to the voices of young people with DLD as they describe their experiences of language and communication in school. The participants describe a condition that makes them struggle to keep up with peers and puts them at risk of being misjudged by teachers, but also give examples of situations where negative consequences are hardly felt. What are the potential or actual clinical implications of this work?: DLD is a complex and dynamic disorder where contextual and social factors interact with individual abilities in creating the end result. The results of the study indicate that DLD can cause persisting problems related to language and communication in school, with impact on educational, social and emotional dimensions. To counteract these effects, SLT services may be needed throughout the school years, and support that goes beyond language abilities must be considered. [ABSTRACT FROM AUTHOR]

Background Working as a nurse in a war zone entails providing a unique form of care, and it is important to be well prepared before and during an international assignment. To improve organized preparations it is necessary to understand how nurses previously engaged in a military mission experienced their preparations. Objective The aim of this study is to describe military nurses' experiences of preparations for a mission, including factors that contribute to their being meaningful. Methodology The data comprises eight interviews with Swedish military nurses who served in Afghanistan. The results are analyzed using a qualitative content analysis. Meaning units are condensed into codes which, via subcategories, form categories. The categories are abstracted into an overall theme. Results The results highlight the importance of recognizing challenges and making informed choices. The overall theme shows that adequate preparation promotes an accepting attitude. Conclusions It is concluded that organized preparation for care in a combat environment should stimulate realistic reflection without entrapping one in negative thinking. [ABSTRACT FROM AUTHOR]

Objective: To determine impact of undertaking an international educational program during a nurse's or midwife's pre-registration program on subsequent practice, focusing on how nurses and midwives were transformed personally through participation in such programs. Background: Participation in international educational programs has been reported to enhance nursing and midwifery students' personal and professional development, however long-term impacts remain unclear. This paper presents findings drawn from a larger grounded theory study. Study design and Methods: Charmaz's grounded theory methodology was used to elicit experiences from 13 general nurses, two mental health nurses, three midwives and four dual qualified nurse/midwives across eight different countries. Data analysis led to the creation of three categories, with this paper reporting on the category of Developing as a Person. Findings: Participation in international educational programs can be transformative for nurses and midwives with long-lasting impacts, contributing positively to their personal growth and development. Discussion: The study findings underscore significant long-term impacts of international educational programs for nurses and midwives. These outcomes highlight the importance of incorporating international experiences into healthcare education. Conclusion: By providing opportunities for healthcare professionals to engage with diverse settings and populations, organisations and educational institutions can foster the development of well-rounded and globally competent practitioners. Implications for research, policy, and practice: The study's findings hold significant implications for research, policy, and practice in healthcare education. To deepen our understandings, additional longitudinal research across diverse countries is warranted. Policymakers have an opportunity to acknowledge the positive impact of these programs on the personal growth and development of nurses and midwives, potentially leading to the integration of global competency requirements into licensure programs. In order to provide comprehensive education, educational institutions should consider the inclusion of study abroad opportunities, cultural exchanges, and global clinical placements within nursing and midwifery curricula. What is already known about the topic? • International educational programs are widely used as a way of developing nursing and midwifery students' cultural understandings. • Previous studies have reported on short-term impacts of international educational programs. What this paper adds: • Long-term impacts of participation in an international educational program on nurses and midwives are described. • Personal development and subsequent transformations occur for nurses and midwives as a result of participation in international educational programs. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate reasons for inadequate documentation of vital signs in an electronic health record. Background: Monitoring vital signs is crucial to detecting and responding to patient deterioration. The ways in which vital signs are documented in electronic health records have received limited attention in the research literature. A previous study revealed that vital signs in an electronic health record were incomplete and inconsistent. Design: Qualitative study. Methods: Qualitative study. Data were collected by observing (68 hr) and interviewing nurses (n = 11) and doctors (n = 3), and analysed by thematic analysis to examine processes for measuring, documenting and retrieving vital signs in four clinical settings in a 353‐bed hospital. Results: We identified two central reasons for inadequate vital sign documentation. First, there was an absence of firm guidelines for observing patients’ vital signs, resulting in inconsistencies in the ways vital signs were recorded. Second, there was a lack of adequate facilities in the electronic health record for recording vital signs. This led to poor presentation of vital signs in the electronic health record and to staff creating paper “workarounds.” Conclusions: This study demonstrated inadequate routines and poor facilities for vital sign documentation in an electronic health record, and makes an important contribution to knowledge by identifying problems and barriers that may occur. Further, it has demonstrated the need for improved facilities for electronic documentation of vital signs. Relevance to clinical practice: Patient safety may have been compromised because of poor presentation of vital signs. Thus, our results emphasised the need for standardised routines for monitoring patients. In addition, designers should consult the clinical end‐users to optimise facilities for electronic documentation of vital signs. This could have a positive impact on clinical practice and thus improve patient safety. [ABSTRACT FROM AUTHOR]

This paper illuminates how teachers are influenced by age, gender and sexuality in teaching about sex and relationships. In this analysis grounded in feminist theory, age, gender and sexuality are considered to be enacted as doings. Six interviews with teachers working with sexuality education in K-12 schools in Sweden were chosen from of a larger body of material consisting of 21 interviews with professionals engaged in school-based sexuality education. The six interviewees were selected because they explicitly addressed how teachers' age, gender and/or sexuality come to matter in the classroom. Findings show how male and female teachers organise their teaching in relation to normative expectations of age, gender and sexuality. In sexuality education, the diverse life-courses of (hetero)sexual women offer a wide range of pedagogic possibilities for female teachers to address issues of sexuality, consent and relationships whereas male teachers are constrained to doing safe(r) forms of masculinity by directing attention away from their bodies and experiences. In understanding these results, I argue that the figure of the tant has been key in forming the pedagogic backdrop to Swedish sexuality education, hence embedding a normative 'who' in the 'how' to teach sexuality education. [ABSTRACT FROM AUTHOR]

The aim of this study is to explore how professionals with personal experiences of family‐related childhood adversity describe and make sense of the relationship between their experience and their supportive practice. It builds on interviews with 10 professionals working within two Swedish non‐governmental organizations offering support to children experiencing family‐related adversity. The findings show that the participants draw upon their own experiences when identifying children's need for individual support, recognition, belonging, knowledge and hope. Together, these five aspects can be said to form an experience‐informed narrative about children's support needs. The paper concludes by suggesting that the concept of a 'professional peer' may be a useful term for encompassing the dual role of professionals who have personal experiences of family‐related childhood adversity and who provide support to children in similar situations. [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.)

Parents of children in out-of-home care receive little support from social services. Drawing on qualitative data collected in the project 'Parent at a distance', in which social services in seven municipalities in Sweden aimed to improve support to parents whose children are placed in foster care, this paper explores social workers' discourses about parents to children in care. The analysis is based on focus group data in which a total of 52 social workers reflected on parents to children in care and how they can be supported by social services. The concept of interpretive repertoires was used to analyse how social workers in interaction construct parents and their support needs. The identified repertoires of change, acceptance, permanency, biology and non-biology may contribute to the understanding of why so few parents receive support, even though legislation stipulates that placements should be temporary. The paper concluded that discourses may shape support practices and thus it is crucial that social workers reflect on and develop their awareness about their constructions of parents and their role for children in out-of-home care. [ABSTRACT FROM AUTHOR]

Background: Partnership research practices involving various stakeholder groups are gaining ground. Yet, the research community is still exploring how to effectively coproduce research together. This study describes (a) key programme developments in the creation of a 6‐year partnership research programme in Sweden, and (b) explores the hopes, expectations, and experiences of patient innovators (i.e., individuals with lived experience as patients or caregivers who drive health innovations) and researchers involved in the programme during the first years. Methods: We conducted a prospective longitudinal qualitative study spanning the first 2 years of the programme. Data consisted of meeting protocols and interviews with 14 researchers and 6 patient innovators; 39 interviews were carried out in three evenly‐spaced rounds. We identified significant events and discussion themes in the meeting protocols and analyzed the interviews using thematic analysis, applying a cross‐sectional recurrent approach to track changes over time. Findings: Meeting protocols revealed how several partnership practices (e.g., programme management team, task forces, role description document) were cocreated, supporting the sharing of power and responsibilities among programme members. Based on the analysis of interviews, we created three themes: (1) paving the path to a better tomorrow, reflecting programme members' high expectations; (2) going on a road trip together, reflecting experiences of finding new roles and learning how to cocreate; (3) finding the tempo: from talking to doing, reflecting experiences of managing challenges and becoming productive as a team. Conclusions: Our findings suggest that sharing, respecting, and acknowledging each other's experiences and concerns helps build mutual trust and shape partnership practices. High expectations beyond research productivity suggest that we need to consider outcomes at different levels, from the individual to society, when evaluating the impact of partnership research. Patient or Public Contribution: The research team included members with formal experiences as researchers and members with lived experiences of being a patient or informal caregiver. One patient innovator coauthored this paper and contributed to all aspects of the research, including the design of the study; production of data (as interviewee); interpretation of findings; and drafting the manuscript. [ABSTRACT FROM AUTHOR]

Purpose: At the outbreak of the COVID-19 pandemic, health care was at the centre of the crisis. New demands made existing organizational practices and services obsolete. Primary health care had a great deal of responsibility for COVID-19-related care. The pandemic demanded effective leadership to manage the new difficulties. This paper aims to explore experiences and perceptions of managers in primary health care in relation to their efforts to manage the COVID-19 crisis in their everyday work. Design/methodology/approach: The authors used a qualitative approach based on 14 semi-structured interviews with managers in primary health care from four regions in Sweden. The interviews were conducted during September to December 2020. Data were analysed using conventional qualitative content analysis. Findings: Data analysis yielded three categories: lonely in decision-making; stretched to the limit; and proud to have coped. The participants felt lonely in their decision-making, and they were stretched to the limit of their own and the organization's capacity. The psychosocial working conditions in primary care worsened considerably during the pandemic because demands on leaders increased while their ability to control the work situation decreased. However, they also expressed pride that they and their employees had managed the situation by being flexible and having a common focus. Originality/value: Looking ahead and using lessons learnt, and apart from making wise decisions under pressure, an important implication for primary health-care leaders is to not underestimate the power of acknowledging the virtues of humanity and justice during a crisis. Continuing professional education for leaders focusing on crisis leadership could help prepare leaders for future crises. [ABSTRACT FROM AUTHOR]

Although violence among youth remains an important, global issue, little research has been conducted regarding how young people themselves define violence and what practices in relation to violence that are evident in their everyday lives. Using an intersectional gender perspective, specifically exploring the intersection of gender, age, and class, this paper therefore aims to explore how young people define violence, as well as to explore what practices in relation to violence that are evident in young people's everyday lives. By using a photovoice methodology, 11 focus groups of young boys and girls (17–19 years old) living in two municipalities in northern Sweden were interviewed and asked to take photographs representing themes that were discussed. Overall, three main themes in the young peoples' stories were identified: Violence as ubiquitous, Easy prey and dangerous predators, and The way forward. The findings demonstrated that violence is pervasive, all-encompassing and normalized in young people's everyday lives, and that this violence is moderated by intersecting power orders of gender, age, and class. Any future theoretical frameworks or prevention strategies should therefore aim to include an intersectional perspective as well as including the voices of the youths themselves. [ABSTRACT FROM AUTHOR]

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]

This paper draws on two experiences of undertaking comparative research in England, Sweden and Italy, and offers a discussion of the kinds of dilemmas raised in relation to language and meaning surfaced by these. Its primary focus is to examine the reflexive construction of meaning, both in relation generally to the workings of an international research team and, more specifically, how such construction of meaning impacts on the process of qualitative interviewing across linguistic and cultural boundaries. The article argues that a culture of reflexive research practice is helpful for approaching national differences, to facilitate understanding in internationally mixed research teams and to support and empower participants in research, in second languages and differing cultures. Overall, the paper attempts to advance some tentative ideas that other international researchers may be able to consider and deploy in relation to their own research ambitions. [ABSTRACT FROM AUTHOR]

Background: In dementia with Lewy bodies (DLB), limitations in linguistic and cognitive abilities may lead to difficulties in participating in conversations. The conversational outcome is also dependent on how the conversation partner adjusts to potential communicative challenges. Aims: This study explored resources and barriers in communication in DLB. Methods & Procedures: Linguistic and cognitive function was explored through standard clinical testing. The dyad's perception of function in daily life was explored through semi‐structured interviews analysed with content analysis. Interactional patterns and participation in casual conversation was analysed with conversation analysis. Outcome & Results: The results show how the husband diagnosed with DLB performed with high scores across most cognitive and linguistic test tasks. The interview data, however, revealed how both he and his wife experienced significant challenges regarding, for example, conversational tempo, as well as negative feelings relating to adjusting to these conversational changes. The interactional data from the casual conversation revealed, among other patterns, how the wife engaged in most of the storytelling in the conversation. The husband contributed details when his wife asked for help, or he acknowledged a faulty or missing detail in his wife's storyline. Thus, they both oriented to the husband's competence in monitoring and keeping track of the conversational content, despite challenges in taking the floor. Conclusions & Implications: A holistic picture of communication in DLB necessitates the use of different evaluation approaches. Both monological (e.g., test tasks revealing cognitive and linguistic resources) and dialogical information sources (e.g., observations of conversations revealing adjustments in conversations), as well as the perceptions of those engaging in everyday conversations (i.e., people with DLB and their conversation partner(s)), need to be evaluated when assessing resources and barriers in communication. What this paper adds: What is already known on the subject: It is well‐known that dementia with Lewy bodies (DLB) affects language and cognition. In conversations, persons with DLB experience difficulties in turn‐taking, topic initiation, entering conversations and keeping up with the conversational tempo. What this study adds: This study sheds light on conversations in one dyad where the husband has been diagnosed with DLB. The results from three different information sources (testing of language and cognition, interviews and a video‐recorded conversation) reveal patterns of resources and barriers that at first appear to contradict each other. However, the contradictions can be resolved when these discrepancies are examined in light of the differences in task structure, in terms of, for example, predetermined topics and how turn‐taking is managed. What are the potential or actual clinical implications of this work?: In order to gather a holistic picture of a person's conversational abilities, clinicians need to include information from both monological tasks (e.g., linguistic testing) as well as dialogical tasks (e.g., video recordings from conversation). The results also need to be evaluated in light of all conversation partners' perspectives on function in daily life. Furthermore, it is important to consider the nature of assessment tasks (particularly their interactional structure) when interpreting assessment results. [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.)

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]

Venous leg ulcer is a recognized condition, affecting people globally. Ulcers mainly affect the elderly and recurrences are not uncommon. There is knowledge about life with venous leg ulcers, but the situation after healing is unexplored. This paper explores and describes meanings of experiences of daily life after healing of a hard-to-heal venous leg ulcer. Lived experiences of 15 individuals with healed hard-to-heal venous leg ulcers generated data for this study. Interviews were recorded for analysis using a reflective lifeworld research approach. An essence emerged, further described by its constituents. Memories of a difficult time with leg ulcer were ever present, in a way becoming part of the self. A striving for control in daily life entailed a struggle to do what was best for the own body. After healing, a new normal emerged in daily life, a reality that encompassed the risk for a new ulcer. The body had changed physically, with marks alongside those from ageing, in a life that still went on. For those who had healed from a venous leg ulcer, life had changed. Even if they referred to life as normal, it was not the same normal as before. [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.)

Accessible Summary: What is known on the subject?: Previous studies on leadership in psychiatric care have focussed on a diversity of staff and on different healthcare settings.Nurses in both Sweden and internationally, working with patients newly diagnosed with psychosis and addiction, describe an overwhelming workload.Existing research points out that experience and leadership training are the most important factors to exert a good nursing leadership. In Sweden, requirements for leadership exists already from the first day of a nurse's career.The relationship and communication between nurses in psychiatric care and members of the staff is decisive for whether the leadership will work. What the paper adds to existing knowledge: The study adds knowledge regarding the challenges leading the nursing care for patients diagnosed with psychosis and addiction.Ambivalence in the leadership role is prominent among nurses in psychiatric care and feelings of responsibility and meaningfulness are mixed with feelings of powerlessness and uncertainty.Swedish psychiatric nurses lack mandate to lead psychiatric nursing care. This may increase the feelings of uncertainty in their leadership role. What are the implications for practice?: A mandate to lead as well as a leadership guidance in communication and teambuilding will enhance the leadership, especially among newly graduated nurses.Heightened awareness within the healthcare organization about nurse's experience of difficulties in leading the psychiatric nursing care of the most severe psychiatric illnesses could increase the right prerequisites for leadership. Introduction: Research shows that psychiatric nursing care puts additional demands on the nurse as a leader due to the psychological complexity of care. Experience and leadership training are most important to exert leadership. In Sweden, demands for leadership exist already at the beginning of a nursing career, and in psychiatry, it may lead to an overwhelming workload. Aim/Question: The aim of the present study is to highlight nurses' experiences of leading the psychiatric nursing care in an adult psychiatric context. Method: A qualitative interview study of eleven registered nurses within psychiatric inpatient care. Content analysis was used for analysis. Results: Leading with combined feelings of both meaningfulness and uncertainty were the theme arising from the result. Discussion: Findings from Swedish and international studies stress special demands on leadership in psychiatric care. The result shows that nurses perceived an ambivalence of their leadership in terms of both meaningfulness and uncertainty. Implications for Practice: An official mandate to lead as well as leadership guidance in communication and teambuilding will enhance leadership, especially among newly graduated nurses. Heightened awareness within healthcare organizations about difficulties in leading psychiatric nursing care could increase the possibility to create right prerequisites for leadership. [ABSTRACT FROM AUTHOR]

Background: Preoperative skin preparation is performed differently by different operating room nurses. Aim: To deepen the understanding of skin preparation within an orthopaedic surgical setting from the operating room nurse perspective and to explore their experiences. Methods: A qualitative exploratory design was used. Four focus group interviews were conducted during 2016–2017, at four hospitals in Sweden, using procedures developed by Krueger and Casey. A total of 19 operating room nurses were recruited through purposive sampling. Results: Statements were categorized into four categories of experiences: (1) Knowing, which related to learning and sources of knowledge; (2) Doing, which related to skin preparation and activities based on tradition and evidence; (3) The Team, which related to the assignment of responsibility and collaboration with patients and other professions; and (4) The Setting, which related to factors around the patient and included feelings of time pressure and access to supplies. Conclusions: Theory and practice differ, and some skin preparation used are based on tradition rather than on evidence or recommendations. Elements both within the team in the operating room and within the organization influence the result. Operating room nurses' duty to perform safe skin preparation must be respected in the team. SUMMARY STATEMENT: What is already known about this topic? Skin preparation before surgery is performed differently at different clinics and by different operating room nurses.The procedures used deviate from manufacturers' recommendations and available guidelines.Several skin preparation methods are based on traditional routines that lack scientific support. What this paper adds? Skin preparation is mostly taught and learned in a traditional manner, and a knowledge/practice gap exists.The organization, the team, the patient and the availability of supplies influence the performance and results of skin preparation.A rising demand for keeping up with productivity made operating room nurses concerned for patient safety. The implications of this paper: To provide safe care, skin preparation needs to be based on evidence.To ensure patient safety, management and head nurses must address the insufficiency of resources, the most prominent of which is insufficient time for the assessment and performance of careful skin preparation to prevent surgical site infections. [ABSTRACT FROM AUTHOR]

This paper investigates the place of animals in the contemporary Swedish human cemetery. It does this by looking at how animals are admitted to cemeteries – alive and dead, above and below ground, physically as well as symbolically. The aim is to shed light on the various ways that animals are experienced and treated in the cemetery, and to explore how this both reflects our changing attitudes to animals and our changing attitudes to death. The paper draws on the findings from a qualitative interview study carried out at the Eastern Cemetery in Malmö, Sweden, and a follow-up study of a turtle pond, in Malmö-Limhamn Cemetery. Two different perspectives relating to animals in the cemetery were common to these studies: (1) the liminal role of the companion animal; and (2) aesthetics and care in relation to wild and domesticated animals. The two perspectives, considered as findings in their own right, are used in this paper as a foundation for discussing questions relating to how urban cemetery animals can enrich the cemetery environment and increase the importance of urban cemeteries today and in the future. [ABSTRACT FROM PUBLISHER]

The purpose of this paper is to provide an understanding of why people are still retiring earlier than would have been expected, despite policies that increase the retirement age. This is a qualitative study in a large public-service organisation in Sweden focusing particularly on how human resource routines aimed at middle management tend to inhibit the promotion of a prolonged working life, despite government efforts aimed at changing these actions. The results highlight three key routines (development talks, salary talks and internal recruitment) that inhibit prolonged working life. These routines seem rational and appropriate to the organisation's managers, because the demands of the job must have priority over employees' capabilities in recruitment routines. Furthermore, it could be considered economically rational to prioritise salary demands of younger employees over those of older employees, and it may appear economically rational to stop further training efforts for older employees. In general, then, it seems reasonable to managers to make decisions based on objective criteria like age. Nevertheless, our results suggest that these routines may need to be redesigned in order to support a prolonged working life and to avoid a discrepancy between accepted prolonged working-life policies and the actions of organisational actors. The study further reveals how intra-organisational institutions (e.g. taken-for-granted mind-sets and norms) embedded in human resource routines may promote or inhibit prolonged working life, suggesting a need for change in those institutions. [ABSTRACT FROM AUTHOR]

Purpose: This aim of this study was to explore how hospital-based physicians in Sweden experienced the challenges in working conditions related to the provision of care during the initial response to the COVID-19 pandemic in 2020 when hospitals transitioned to pandemic care. Design/methodology/approach: The study has a qualitative design. Twenty-five hospital-based physicians were interviewed about their experiences from working in a hospital while healthcare organisations initially responded to COVID-19 pandemic in 2020. A thematic analysis was used to analyse the empirical material. Findings: The analysis resulted in four themes: involuntary self-management, a self-restrictive bureaucracy, passive occupational safety and health (OSH) management, and information overload. These themes reflect how the physicians perceived their work situation during the pandemic and how they tried to maintain quality care for their patients. Practical implications: The study gives valuable insights for formulating preparedness in regard to crisis management plans that can secure the provision of care for future emergencies in the healthcare services. Originality/value: This paper shows that a crisis management plans in the healthcare services should include decision structures and management, measures of risk assessment and OSH management, and the maintenance of personnel wellbeing. A prepared healthcare management can preserve quality care delivery while under crisis. [ABSTRACT FROM AUTHOR]

Young children's engagements with digital technologies form part of their emergent everyday literacy practices. The study reported here derives from the pan-European study 'A Day in the Digital Lives of Children aged 0-3'. The methodology was centred on the videoing of an entire day's experiences of a child aged under 3, together with a reflective interview with the parents and inventories related to digital access, skills and activities of the child. In this paper, we look at three children in Spain, Sweden and England, respectively. We examine our data through three prisms. (1) Spatio-temporal: We consider the children's engagements in terms of their appropriation of space, in relationships with others in the home and the intimate geographies of young children's digital literacies. (2) Parental discourse: We use the tensions and contradictions for families framework to examine the selection and monitoring of digital literacies. (3) Practice: Drawing on the first two prisms, we zoom into how children engage with tablet devices and television. Our research demonstrates richness, diversity and agency in these young children's practices with technologies. We propose the concept of living-room assemblage as an analytical metaphor to understand the macrohabitats of young children's digital literacies and practices, which emerge as multi-layered, creative and co-occurring with other family activities.Our analysis also explores the challenges presented to parents and the ways in which they navigate tensions and contradictions in their media and digital environments, which are condensed in family practices and discourses around tablets and television. [ABSTRACT FROM AUTHOR]

Nurses working in psychiatric care daily encounter youths who are struggling with living. Despite this, nurses' suicide-prevention work is seldom addressed in research or in recommendations for care. The overall aim of this paper is to discuss how nurses, with their caring science perspective, may contribute to suicide prevention. The paper presents how nurses in psychiatric outpatient care may identify and support suicidal youths, according to experts in suicide prevention. The interviews with six experts in suicide prevention resulted in three themes: Engagement necessary but demanding, Acknowledgement of warnings signs and Supportive relationship. The respondents elaborated on how suicide-risk can be assessed. A good rapport with the youths was stressed and the recommended act of care included: to listen openheartedly without interrupting as well as to listen after risk- and protective factors to emphasize or to penetrate. To ask about suicidality as well as to let the person elaborate on what's important for him or her. To endure in the patients' suffering as well as steering the conversations toward hope. The paper also presents warning signs that need to be noticed according to the experts and the literature consensus. Our findings suggest that communication in suicide-prevention is an "art and act" that cannot be reduced to a method or simple guidelines. We argue that the recommended acts of care demand sensitivity and skills and that nurses as well as the domain of caring science may contribute to this competence. [ABSTRACT FROM AUTHOR]

Purpose: In general, newly resettled refugees have poorer physical and mental health than native-born Swedes. This indicates that the society must make special efforts to enable refugees to attain health that is on a par with the rest of the population. The challenges rest primarily with employees in the public sector. But what resources do professionals need to meet the refugees' health needs? This paper is about the need to develop strategies for professionals working with diversity and health, with a focus on the establishment of newly resettled refugees in Sweden. Thus, the purpose of this paper is to identify the needs and obstacles in working with diversity and health for the newly resettled. Design/methodology/approach: The paper is based on focus group interviews with 40 professionals working in three large municipalities and one County Administrative Board, all of whom work with challenges related to migration and health on a daily basis. Findings: The needs expressed by the interviewees are primarily about developing and improving communications. Three important areas of communication were expressed: how information can be transferred from sender to receiver, institutionalization and interactions at different levels. Originality/value: This paper identifies important needs and obstacles when working with diversity and health in Sweden, with a focus on the establishment of newly resettled refugees. It is an important contribution because refugees in general have poorer physical and mental health than native-born Swedes and strategies to improve their health, therefore, need to be further developed. [ABSTRACT FROM AUTHOR]

Purpose: Many unaccompanied children have sought asylum in Sweden during recent years. They needed different kinds of support not only from the authorities but also from the local community. The purpose of this paper is to explore how families from local communities can support the children and be the neutral companion they long for. Design/methodology/approach: A qualitative research design using semi-structured interviews was adopted for this descriptive study. Thematic analysis was used to analyse the data. Findings: The families wanted to know more about unaccompanied children than the information presented in the mass media. They showed deep engagement in getting to know the boys and strong affection for them because they got a sense of how difficult their lives were. Families with experience as parents can play an important role to guide the children into the Swedish society and be trustful adults who can complement the professionals in the authorities and accommodations. The families in this project needed more support through information and strategies about how to handle difficult situations during the children's asylum process. Research limitations/implications: This study describes a pilot project in a small municipality in Sweden. The participating families described the support given to a group of boys. More studies should focus on support for girls in similar situation. Originality/value: There are limited studies on how families in local communities can support unaccompanied asylum-seeking children. [ABSTRACT FROM AUTHOR]

This article examines the different and often overlooked roles that packages can perform in specialised organic shops. The paper reports on case studies of three organic shops of different types: a pioneering alternative organic shop, a small shop run by a big cooperative company and a recently started organic shop with a modern style, all located in Sweden. In addition to interviews, the paper draws on material produced through visual analysis and participant observation. Packages were found to take four main roles: the repetitive package, the unobtrusive package, the unfamiliar package and the returnable package. These different roles are approached in terms of agency and as viewing the package as playing a key part in the actor-networks of organic food. [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.)

Background: Patients intoxicated after abusing illicit drugs constitute a significant proportion of patients cared for in intensive care units. Intensive critical care nurses who nurse accidentally intoxicated patients face complex and demanding situations, and there is a lack of studies regarding this topic. Aims and objectives: To illuminate Swedish intensive critical care nurses' experiences of nursing accidentally intoxicated patients after abuse of illicit drugs. Design: A qualitative design with an inductive approach was used. Methods: Semi‐structured interviews were conducted with eight intensive critical care nurses at an intensive care unit in Sweden. Data were analysed using qualitative content analysis. Findings: The themes found illuminate intensive critical care nurses' experiences of nursing accidentally intoxicated patients after their abuse of illicit drugs: feeling empathy and a wish to provide dignified care; dreading nursing the patient and feeling a lack of empathy; feeling frustration and questioning the care; lacking knowledge about a complex and challenging situation. Conclusions: It is essential to respond to intoxicated patients with empathy and dignity. Intensive critical care nurses should learn how to identify factors that lead to provocation and agitation in order to reduce the occurrence of dangerous situations in intensive care units. Relevance to clinical practice: To create a caring environment where the interaction becomes more positive and harmonious, an intensive care nurse needs a deep understanding of what a drug abuse disorder means. Moreover, the ability to see the person behind the abuse and to provide non‐judgemental support is required. What is known about this topicPatients intoxicated after abuse of illicit drugs constitute a significant proportion of patients cared for in ICUs worldwide.Intensive critical nurses who nurse accidentally intoxicated patients face complex and demanding situations, and few studies have addressed this topic.What this paper contributesIt is essential to respond to intoxicated patients who are admitted to the ICU with empathy and dignity, as well as to learn how to identify factors that lead to provocation and agitation in order to reduce the occurrence of dangerous situations.Education is warranted and must be enhanced, including knowledge about drug abuse and training in communication and empathyNursing should include an understanding of what the disease of drug abuse means and the development of the ability to see the person behind the abuse and to provide non‐judgemental support. [ABSTRACT FROM AUTHOR]

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]

In organizational research, disability is most often treated as a hindrance for performance. One of the barriers to the employment of disabled people is the perceived extra costs related to adaptation of the physical work environment and reduced efficiency. This paper argues for a view on disability as a productive resource within organizations. More specifically, the paper explores how disability informs and affects management practices. In order to accomplish this aim, three in-depth interviews with disabled managers in three different Swedish companies have been conducted. The findings show that the lived experiences of disability impregnate management practices in many various ways, leading to: Creativity, innovation and problem-solving skills; Diversity promotion; Positive energy, humbleness and a holistic view on employees; Focus on well-being in the workplace, and Increased delegation skills and establishment of an empowering culture. [ABSTRACT FROM PUBLISHER]

BACKGROUND: Technology is widely used in school to assist students with visual impairments. Drawing with traditional methods is still difficult for those users. In this paper, we present and discuss an evaluation of a haptic and sound interactive drawing program (HIPP). OBJECTIVE: The aim of the study was to identify what aspects of the technological aid support the drawing skill development in children with visual impairment. METHODS: Interviews, observations and video recordings of use situations were used for data gathering. Our analysis is based on cultural-historical activity theory, and examines the mediation between the child and the object of their activity, their drawings, as well as the roles of teachers, classmates, assistants, and family. RESULTS: The haptic and audio drawing program supports the steps (doodling, interpretation, planning, and more intentional drawing) observed in visually-acquired drawing, although possible improvements have also been identified. Observations of the drawing program in use showed that its mix of dynamic multimodal interaction and a stable drawing feedback, enable visually impaired students and sighted teachers to jointly access a shared representation. CONCLUSIONS: Successful long-term use, together with the presented results of our analysis show how multimodal dynamic and stable interaction can successfully support drawing activities. [ABSTRACT FROM AUTHOR]

Activity-based Flexible Offices (A-FOs) are offices with unassigned desks that provide a variety of workspaces. This paper presents desk-sharing and speech rules identified in A-FOs in four Swedish organisations, the emergence of and compliance with these rules, and their consequences for work conditions. Data collection involved 105 semi-structured interviews, document analyses, and observations. The identified rules were: (1) to remove belongings, (2) temporal restrictions on using the same workstations, (3) temporal restrictions on using scarce zones, (4) restrictions on verbal interactions, and (5) restrictions on phone conversations. The cases with extensive user involvement in their planning process had explicit unambiguous rules. A better compliance with rules occurred when (i) the employees were well-prepared and had a unified understanding regarding how and why to follow the rules, (ii) the rules were explicitly communicated and were regarded as easy to follow, and (iii) following the rules facilitated work and improved work conditions. Practitioner summary: Five rules were identified for applying desk-sharing and speech policies in A-FOs. Extensive user involvement resulted in having well-defined and explicitly communicated rules, and prepared employees for how to use the A-FO. Implicit and ambiguous rules led to conflicting interpretations, disregarding rules, and were associated with more negative work conditions. [ABSTRACT FROM AUTHOR]

Purpose Managerial quality improvement (QI) in terms of accountability management has become central to healthcare institutions. Yet, managerial QI is largely considered irrelevant by healthcare professionals. In consequence, the implementation of managerial QI implementation is hampered. Knowledge brokering is discussed as a means to foster the implementation of (QI) knowledge in healthcare. Yet, the benefit of knowledge brokering for managerial QI has so far been neglected. Therefore, this research asks how knowledge brokering can support the implementation of managerial QI.Design/methodology/approach This article builds on a single case study approach as a unit of analysis. Qualitative data collection comprises 21 semi-structured interviews at the managerial and clinical levels, 220 h of participant observation and document analysis.Findings This paper identifies three strategies of how brokers implement managerial QI into a hospital by means of knowledge brokering: prioritizing, obscuring and redefining. The strategies help to transform multiple external QI demands into one managerial QI strategy. Yet the strategies also reduce non-managerial perspectives on QI, which generates frustration among healthcare professionals.Practical implications The paper works out the benefits and costs of managerial knowledge brokering. This allows to spell out practical implications for managers, nurses and clinicians who have to deal with managerial QI in healthcare organizations.Originality/value This paper fulfils an identified need to study managerial knowledge brokering practices as a means to implement managerial QI into healthcare organizations. By doing that, the article adds to the body of research on knowledge translation in healthcare. [ABSTRACT FROM AUTHOR]

Purpose - The aim of this paper is to report how Swedish upper secondary schools involved in a European Union-financed collaborative project intertwined aspects of subject integration and international collaboration with the use of ICT. Design/methodology/approach - The methodology used is a case study in which aspects of subject integration and international collaborative ambitions are intertwined with the use of ICT. Data consist of interviews with participants, texts concerning the project, the participating school, and the Swedish upper secondary schools system. Findings - Teachers and students have worked towards the objectives in the project and in the national curricula, and the case shows how difficult and how many barriers there are to overcome. Even though the curricula seem difficult to coordinate, students appear to have learnt more about the European perspective, as well as about themselves, through the approach. The teacher describes student motivation as high - authenticity and real people to collaborate with support the students' experience of a holistic education, which applies to real life. The teacher tried to change the role towards providing students with structure and advice, monitoring their progress, and assessing their accomplishments, but reported to be struggling with the teacher role. Originality/value - The paper demonstrates originality and value by providing important insight into the use of ICT in upper secondary schools for the purpose of collaboration and at the same time working towards joint curricular themes. [ABSTRACT FROM AUTHOR]

It is an oft-repeated trope that the recent medical advances in the field of assisted reproduction have radically transformed the ways in which we can achieve, practice and imagine parenthood. This development has enabled new forms of non-heterosexual family constellations, including same-sex nuclear families and solo-parents by choice, and as a result an increasing number of groups are mobilising politically for access to fertility treatments. Swedish transgender patients are one of these groups; after many years of political mobilisation, they are no longer required by law to go through sterilisation as a compulsory part of gender corrective surgery, and instead today, all transgender patients are offered fertility preservation through gamete freezing. This, in turn, has meant not only that Swedish fertility clinics have faced an entirely new patient group - the transgender fertility patient - but also that the cultural imagination of who can become a parent and what a family might look like is becoming further destabilised. Building on interviews with medical staff, LGBTQ-advocates and complementing qualitative data, this paper seeks to shed light on the very process by which these new rights are translated in the practical context of the fertility clinic, and also what it means, more generally, for cultural imaginations of parenting when a group whose reproductive futures were previously considered either impossible or undesirable are now 'anticipating infertility' and engaging in 'family planning' as central parts of their lifecourse and medical engagements. [ABSTRACT FROM AUTHOR]

The aim of this paper is to identify structural problems and challenges for the delivery of digital technologies for ageing in place to elderly with dementia. To that end, I conducted a case study in a Swedish municipality. The results showed that elderly with dementia are not exploiting their full potential of receiving help in the form of technology, since the four conditions of the Consumer Direction (Control and Direct services – Variety of digital technologies for ageing in place options – Information and Support – Participation in systems design) were met to a very low degree. I propose that the municipality in question creates a proper knowledge-sharing platform so that occupational therapists are well informed about digital technologies for ageing in place, to allow them to provide accurate information and support to elderly with dementia, resulting in a possible increase in use of technology and subsequently support the empowerment goal of Consumer Direction. I also believe, according to the findings of this study, that the module of Information and Support should be treated as the most important condition for achieving increased Consumer Direction. Elderly with dementia and their relatives do not receive sufficient information about digital technologies for ageing in place (DTAP). There is not enough information regarding the available options and their use. This often denies elderly with dementia and their relatives the services they are entitled. Occupational therapists knowledge about DTAP affects the variety of options presented to elderly with dementia and their subsequent use. Once a person is diagnosed with dementia, physicians tend to suggest medicinal solutions, overlooking the dissemination of DTAP information. Thus hindering their early access to DTAP. [ABSTRACT FROM AUTHOR]

This paper explores design students’ proposals for a redesign of the interior of a room of silence at the SUS hospital in Malmö. Reflection and existential meaning-making are discussed in relation to the material culture of design, and more specifically in relation to four different themes found among the students’ proposals: nature as common symbolic framework and salutary force; lighting creating a visual and spatial ambience for retreat; interactive objects allowing ritualised activities; and the presence and absence of religious symbols. In this paper, we argue that architecture and design more profoundly could support people with varying existential viewpoints when it comes to providing religiously and culturally shared public spaces for dealing with existentially crucial moments. We also argue for an interdisciplinary research approach to healing environments, where existential meaning-making is included in the overall discussion of the design of health care architecture. [ABSTRACT FROM PUBLISHER]