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Gender differences have been found in the outcomes of vocational rehabilitation (VR) and in Supported Employment (SE), therefore, the purpose of this study was to explore employment specialists' (ES) social representations of gender in relation to work and VR and how these social representations influence the ES's work in the VR process according to SE. The qualitative method of focus group discussions was employed. Ten focus groups were held with 39 ESs from four categories of SE organizations in Sweden. Topic analysis was applied to the transcribed material from the focus groups. Five themes with different social representations about gender and disability in relation to VR and working life formed in the analysis: (1) differences in personal and health factors among VR-participants, (2) gender norms in society influencing VR, (3) energy-intensive environmental issues influencing VR, (4) gender-specific interactions in VR, and (5) gendered paths in the welfare system. Social representations of higher strains on women with disabilities compared to men with disabilities both in private and working life, which reflect the lived experiences of the ESs, is a possible explanation for gender differences in VR and working life for persons with disabilities. Gender differences in the outcomes of vocational rehabilitation (VR) interventions have been noticed worldwide. In this study, pervasive social representations about gender and disability in relation to VR were found, but also unconsciousness about gender among VR professionals. Therefore, awareness of gender is necessary in VR. Individualized and person-centered approaches to VR like Supported Employment, although considered best practice, might hide structures like gender, which could lead to reproducing discriminating processes and therefore not achieving gender equality in VR. Therefore, knowledge of discrimination is important in VR. Gender-sensitivity in vocational rehabilitation models with a person-centered and individualized approach is needed and there might also be a need to systematically tailor vocational rehabilitation models to reach gender equality in the outcomes of the interventions. Therefore, gender equality indicators are needed for VR models, to evaluate model effectiveness from a gender perspective. [ABSTRACT FROM AUTHOR]

Aim: To explore and describe older persons' unique experiences of care encounters with home care nurses in a real‐life context. Background: The increasing number of older persons in society contributes to increases in age‐related impairments compromising their quality of life. Future care consists of "hospitals at home" where care encounters occur in a person's private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted. Design: Multiple‐case study. Methods: The cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated. Findings: The cross‐analysis emerged in three categories: "Nursing routine rules the care encounters", "Lack of knowledge and information" and "Dependency on support from others". Conclusions: Our research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person‐centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time‐sensitive care encounters. Reporting Method: Findings were reported using COREQ guidelines. Patient or Public Contribution: Patients were interviewed and contributed with data for this study. Implications for the Profession and Patient Care: This study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality. [ABSTRACT FROM AUTHOR]

Moving into a nursing home is a significant transition for older people which can be emotional and stressful. The literature on the decision to move and subsequent residential stress focuses on the time after admission; however, there is less understanding of older people's management of the process. To fully understand and possibly reduce negative consequences and health-related risks, the aim of this article is to explore how older people manage the transition from home to nursing home. The study is based on 21 longitudinal interviews with seven older people during the process of moving. Following Dorothy Smith's theory of work, the analysis finds three types of work—practical, relational, and emotional—that older people engage in during the transition process. The results highlight the importance of considering the entire transition process, not only experiences before or after, if we are to reduce the negative, stress-related consequences of relocations of this kind. The findings have practical implications for professionals in health and social care and point to the need to develop practical, relational, and emotional support for older people throughout the transition process. [ABSTRACT FROM AUTHOR]

Dementia is recognised as one of the major global health and social care challenges of present times. When the onset of dementia occurs in midlife, there is an increased possibility that there are children and young adults involved who are dependent on the parent concerned. The aim of the study was to describe health and social care professionals' experiences of identifying and supporting children and young adults with a parent with dementia. A qualitative descriptive approach was carried out with individual interviews of health and social care professionals, using a semistructured interview guide. Thirteen participants in rural and urban areas in Sweden were interviewed. The overarching theme, advocating a forgotten group with three categories were identified. They combine and reflect health and social care professionals' experiences of identifying and supporting children and young adults with a parent with dementia. Health and social care professionals who encountered children and young adults with a parent with dementia described how they were not sufficiently trained in supporting this group and identified a general shortage of available appropriate support services. The children and young adults were also described as a forgotten and overlooked group in need of affirmation and support in a more systematic way. [ABSTRACT FROM AUTHOR]

Background: Older persons with age-related and complex health problems will increasingly depend on care provision from nurses in their own homes. However, a barrier to quality care is ageism and nursing students´ disinterest in geriatrics. In addition, nurse education often falls short in preparing students for the complexity of geriatric care. Welfare technology (WT) is progressively implemented in home care to help older persons live at home despite their health problems. However, this process is intricate and requires acceptance and digital literacy among caregivers and older persons. Despite these challenges, nurse education can address and change negative attitudes through innovative teaching methods such as age suit simulation. Therefore, the study aims to describe nursing students´ experiences of age suit simulation in a home-like environment with WT and technical aids, and will reveal their perspective on ageing and providing care to older adults. Methods: A qualitative explorative design using semi-structured group interviews (n=39) among nursing students. Data was analysed through reflexive thematic analysis. Results: The analysis generated three main themes; "It's like walking in a bubble", "An eye opener" and "Concerns about ageing and the current structure of geriatric care". The main themes included eight subthemes. Adapting to the sensory and physical limitations of the age suit was an immersive experience and caused feelings of frustration, loneliness and disconnection. A prominent result was a raised awareness of cognitive loss, especially impaired vision, and students felt the simulations had made them aware of the everyday challenges older persons faced. Students highlighted the importance of patience and giving enough time in care situations by being present and having a critical perspective of WT. The students were mostly negative towards their own ageing and could better relate to older persons´ vulnerability. Conclusions: Age suit simulation was described as an embodied and eye-opening experience, raising nursing students´ awareness of older persons´ functional limitations and the consequences for dignity and independence. Coping with cognitive loss was especially difficult. Students were motivated to apply their new knowledge to clinical practice. Age suit simulation can complement geriatric education, preparing students for the complex care needs of older persons. [ABSTRACT FROM AUTHOR]

Summary: An interview study was conducted with persons receiving home care services and personal assistance in Sweden (13 individuals, 25 interviews) with the aim to analyze their experiences of managing personal and intimate care. The analytical approach was guided by phenomenologically informed research and Erving Goffman's theoretical work on self-presentation and social life as it differs in frontstage and backstage settings. Findings: A reflected approach to the complex challenges associated with becoming and being a person in need of personal and intimate care was revealed. This involved continuous adaptations and attuning to organizational and relational conditions of formal home care. Being a recipient of personal and intimate care does not mean being passive. It entails relating to and sustaining the care relation, where even choosing to accept suboptimal conditions is an act of agency. The recipients' private homes were hybridized, transformed both into a waiting room, with the recipient on standby and into a workplace. The homes thus partly lost their character as a backstage realm where one could avoid the gaze of others. This also led to a hybridization of the personal sphere, in the form of marginal scope for true privacy, necessitating strategies for protecting one's own space. Applications: It is important both to acknowledge the intrusive nature of personal and intimate care, which results in extensive hybridization of the home and personal sphere and to recognize care recipients' agency in the relationship that care establishes. [ABSTRACT FROM AUTHOR]

Access to healthcare can facilitate parents' self-management of their children's care. Healthcare access can be described as consisting of six dimensions: approachability, acceptability, affordability, availability, appropriateness, and aperture. The aim of this study was to analyse these dimensions of healthcare access experienced by parents caring for their children at home following paediatric surgery. The method-directed content analysis, conducted with the six-dimensional framework of access to healthcare as a guide, was used to analyse twenty-two interviews with parents of children treated with paediatric surgery. All six dimensions were represented in the results. Acceptability was the most frequent dimension, followed by appropriateness and approachability. Affordability, availability, and aperture were less represented. Although access to healthcare after paediatric surgery is generally appropriate and approachable, parents may experience insecurity in performing the self-management needed. Complementary forms of information provision, e.g., telemedicine, can be valuable in this regard. [ABSTRACT FROM AUTHOR]

Aims: The aim of the study was to describe child health in relation to housing renovations in more than 800 rental units, consisting of repairs of dilapidated kitchens and bathrooms, in the disadvantaged neighbourhood of Herrgården in Rosengård, Malmö, Sweden. Methods: Data on housing conditions and self-reported health were collected during home visits to families living in Herrgården (building renovations area) and a comparison area (neighbouring Törnrosen, with generally better housing conditions). At baseline, 130 families with 359 children participated, while 51 families with 127 children participated at follow-up. All data were collected between 2010 and 2012. Additionally, regional register data on health-care usage/in- and outpatient contacts within the public health-care system between 2008 and 2013 were also collected for all 8715 children registered as living in the two areas. Results: Self-reported health seemed to somewhat improve in both areas, with 74% versus 86% and 78% versus 88% reporting good or very good health in Herrgården and in the comparison area at baseline and follow-up, respectively. In Herrgården, crowdedness increased, while it decreased in the comparison area. The number of health-care contacts remained stable over time in Herrgården, while it decreased in the comparison area. Conclusions: Partial housing renovations did not seem to result in clear health improvements as measured with the indicators used in the present study. This could possibly be due to persisting health effects due to increased crowdedness or persisting poor housing conditions, as only kitchens and bathrooms were renovated. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to describe the experiences of parents handling oral anticancer drugs in a home setting. Methods: Parents of children with cancer were recruited from a paediatric oncology ward in Sweden to participate in an interview. The interviews were transcribed verbatim and subjected to qualitative content analysis. Results: We found the following categories and subcategories: parents' views on the provided information—lack of, too little or contradictory information, and parents' preferences for information delivery; safety over time; correct drug dose; and drug administration. As time passed, most parents adapted to their child's illness, felt safer and found it easier to take in and process any given information. Parents preferred information in different formats (written, movie clips and orally) and in their mother tongue. Many parents were aware of the importance of giving an accurate dose to their child and described the process of drug administration as overwhelming. Conclusion: Parents need to be provided with accurate, timely, nonconflicting and repeated information—in different forms and in their mother tongue—on how to handle oral anticancer drugs at home. [ABSTRACT FROM AUTHOR]

Our results reveal new insights in light of the recommendations of working from home enforced during the pandemic. The knowledge from this study will inform organisations and authorities for the strategic work environment management and provide useful information in adapting to the new circumstances. Objective: In this study, we aimed to describe the effect of working from home on work conditions and private life by analyzing reported changes in different work-related factors. Methods: We used descriptive analyses on cross-sectional data of 4985 people aged 20 to 67 years from Stockholm, Sweden collected in 2021. The prevalence of reported changes for factors related to work and private life was analyzed by degree of work from home and stratified by age, sex, and educational level. Results: Participants who worked from home reported increased opportunities to structure the workday and combine work and private life, while at the same time experiencing increased isolation from the workplace. More females reported increased workload, whereas younger adults reported more changes overall. Conclusions: Working from home was related to experiencing both positive and negative changes in work conditions and private life. [ABSTRACT FROM AUTHOR]

Studies have shown a need to consider environmental factors to best support the rehabilitation and recovery process after a stroke. In addition, despite intentions to increase individuals' participation in care and rehabilitation, patients and family members report weak participation. The aim of this study was to explore how the environment was integrated into rehabilitation at home from the perspective of patients after a stroke. We conducted as a qualitative study with 17 patients rehabilitated at home. Data on the participants' experiences of the rehabilitation process and their perceptions of how the environment was considered in the process were collected via interviews and analysed using qualitative content analysis. The main category that was constructed from the data was "Partial integration of person‐ environment dynamics in the rehabilitation", which was informed by three subcategories: (a) I recover in my home: Challenges and opportunities in the environment, (b) Following a generic approach to therapy: Limited integration of the environment, and (c) Informed more than involved. Our study showed that the environment was integrated in a limited manner. The participants were more informed about than involved in their planning of the rehabilitation. The results are important for informing the ongoing development of rehabilitation at home and person‐centred care strategies. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to describe the experience‐based knowledge of parents of children aged 0–3 years for creating a positive sleep situation in the family. Design: This study has a qualitative design. Data were collected using an online survey and analysed using the critical incident technique. Methods: The study participants were recruited through an announcement posted in parenting groups on a social media platform in September 2018. A total of 93 parents answered the questionnaire; 76 of the parents matched the study's selection criteria, and their responses were included in the analysis. Results: The results are presented from the two main questions in the survey: "Strategies for creating a positive sleep situation" and "Advice to new parents regarding sleep". Having routines and reading the child's signals were important strategies, as were creating good conditions for sleep and making sure the child was well‐fed and content at bedtime. Winding down and giving the child closeness and touch was described as important, and some parents would co‐sleep to soothe the child quickly and create a sense of security and belonging. Parents' most frequent advice to other parents was to accept the situation and to let go of the idea that the child should sleep without waking up in a separate bed or room. Conclusion: Personal preferences and needs are likely to vary among individuals, and it is important that nurses tailor sleep advice in accordance with families' preferences and needs, taking individual variations and views into account. [ABSTRACT FROM AUTHOR]

Hospital discharge of older people in need of both medical and social care following their hospital stay requires extensive coordination. This study aims to examine and compare the views of nurses in three Nordic cities on the influence of sociodemographic factors and having close relatives, for the hospital discharge and post hospital care of older people with complex health and social care needs. Thirty-five semi-structured interviews (Copenhagen n = 11, Tampere n = 8, Stockholm n = 16) with nurses were conducted. The nurses were identified through the researchers' networks, invitation and snowball sampling, and recruited from hospitals, primary care practices, home care units, home nursing units, and geriatric departments. The interviews were transcribed and analysed using thematic analysis. Interpretations were discussed and agreed within the team. Four main themes and 13 sub-themes were identified. Across the cities, informants reported that the patient's health status, rather than their gender or ethnicity, steered the discharge date and further care. Care costs, commonly reported in Tampere but also in Copenhagen and Stockholm including costs for medications and home help, were considered barriers for disadvantaged older people. Home situation, local arrangements and differences in collaboration between healthcare professionals at different sites also influenced the hospital discharge. Generally, the patient's health status steered the hospital discharge and post-hospital care. Close relatives were regarded important and a potential advantage. Some informants tried to compensate for the absence of close relatives, highlighting the importance of care systems that can compensate for this to minimise avoidable inequity. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine parental experiences of homeschooling during the COVID-19 pandemic in families with or without a child with a mental health condition across Europe. The study included 6720 parents recruited through schools, patient organizations and social media platforms (2002 parents with a child with a mental health condition and 4718 without) from seven European countries: the UK (n = 508), Sweden (n = 1436), Spain (n = 1491), Belgium (n = 508), the Netherlands (n = 324), Germany (n = 1662) and Italy (n = 794). Many parents reported negative effects of homeschooling for themselves and their child, and many found homeschooling to be of poor quality, with insufficient support from schools. In most countries, contact with teachers was limited, leaving parents with primary responsibility for managing homeschooling. Parents also reported increased levels of stress, worry, social isolation, and domestic conflict. A small number of parents reported increased parental alcohol/drug use. Some differences were found between countries and some negative experiences were more common in families with a child with a mental health condition. However, differences between countries and between families with and without a mental health condition were generally small, indicating that many parents across countries reported negative experiences. Some parents also reported positive experiences of homeschooling. The adverse effects of homeschooling will likely have a long-term impact and contribute to increased inequalities. Given that school closures may be less effective than other interventions, policymakers need to carefully consider the negative consequences of homeschooling during additional waves of the COVID-19 pandemic and future pandemics. [ABSTRACT FROM AUTHOR]

Background the ageing global population is living longer with complex health conditions addressed by multiple medications. Little is known about how older people manage these medications and associated packaging at home. Objectives to explore how older people manage the use of multiple medication and associated packaging in their process of self-care. Methods fifteen older, home-dwelling participants (mean age = 76.2 years) participated in this study. All participants used three or more daily medications and resided in Southern Sweden. Data were collected using photographs and written diaries completed by each participant over seven consecutive days, complemented by researcher-led interviews. Interviews and diary data were analysed using thematic analysis. Results six major themes emerged and are discussed: systematic organisation of medication, design of medication packaging, design of tablets, ease of package opening, emotional response to the need for medication, and environmental waste. Conclusion packaging plays an important role in protecting products and enabling easy storage, product longevity and transportation. Medication packaging is no exception. However, the design of medication packaging poses challenges for older people managing medications for their chronic health conditions at home. There is a need to facilitate the systematic management of multiple medications, especially for new medication regimes or changes in treatment. Design of both packaging and medication should be consistent for older users to avoid potential errors; difficulties opening packaging can potentially hinder adherence to treatment. This study highlights the need for patient-centred solutions and involvement of older people in a co-design process for medication and packaging design. [ABSTRACT FROM AUTHOR]

BACKGROUND: The COVID-19 pandemic changed the academic world in various ways, and most universities are still closed and continue operating via teleworking. OBJECTIVE: This study is intended to investigate how university faculty/staff and students in Sweden have coped with the lockdown and working/studying from home during the pandemic. METHODS: A survey was conducted among 277 women and men working and studying at different universities in Sweden. RESULTS: The results indicate that most (61%) respondents were very or somewhat satisfied with the current work-from-home arrangement. Additionally, they indicate that, overall, almost 30% were working more than usual due to the pandemic and teleworking. The coping methods having the highest impact on overall job satisfaction were: "thinking about what I can do rather than what I can't do"; "being able to access medical resources and medical services if I need to seek help"; and "having trust in state or health authorities in my country." CONCLUSIONS: The study reveals that Sweden can serve as a good example of how university faculty/staff and students can address the occupational challenges caused by a health pandemic and possible subsequent quarantines. [ABSTRACT FROM AUTHOR]

Previous studies have stressed the role of a child's family environment for future political participation. This field of research has, however, overlooked that children within the same family have different experiences depending on their birth order. First-borns spend their first years of life without having to compete over their parents' attention and resources, while their younger siblings are born into potential rivalry. We examine differences in turnout depending on birth order, using unique population-wide individual level register data from Sweden and Norway that enables precise within-family estimates. We consistently find that higher birth order entails lower turnout, and that the turnout differential with respect to birth order is stronger when turnout is lower. The link between birth order and turnout holds when we use data from four other, non-Nordic countries. This birth order effect appears to be partly mediated by socio-economic position and attitudinal predispositions. [ABSTRACT FROM AUTHOR]

Background: The observed association between the parental socioeconomic status (SES, measured as education/income) and asthma or wheezing in offspring may be explained by confounding of unmeasured factors (shared genes and family environment). We aimed to study the association between parental SES and asthma/wheeze using cousin comparison. Method: Data were collected on individuals born in Sweden 2001–2013. Parental SES (education and income) was gathered from Statistics Sweden. Asthma/wheeze was identified using national health registers. The association between parental SES at birth and incident asthma/wheeze was estimated using Cox regression also comparing differently exposed cousins. The association between parental SES at 5 years and current asthma was estimated using logistic regression. Results: Included were 955,371 individuals. Mothers with compulsory school only (lowest education group) compared with those with further education (highest education group) was associated with incident asthma/wheeze below 1 year of age HRadj = 1.45 (1.38–1.52) and over 1 year of age HRadj = 1.17 (1.13–1.20). The corresponding estimates for the lowest income group were HRadj = 1.61 (1.54–1.69) and HRadj = 0.94 (0.92–0.97), respectively. In maternal cousin comparisons, the associations for asthma/wheeze over 1 year of age was HRadj = 1.21 (1.05–1.40) for compulsory school only and HRadj = 0.94 (0.84–1.07) for the lowest income group. The ORadj for current asthma at 5 years was 1.05 (1.00–1.11) for mother's compulsory school only and 0.98 (0.94–1.02) for mother's lowest income group. Results for estimates were similar for father's SES. Conclusion: We confirm an association between low parental SES (measured as education) and asthma/wheeze. Cousin comparison suggests that this association is not wholly due to confounding of unknown familial factors, therefore supporting a causal relationship. The relationship between parental income and asthma/wheeze is less clear. This study is important for understanding risk factors for asthma/wheeze and for future prevention strategies. Further research is warranted to investigate the possible mechanisms for association between parental education and asthma/wheeze. [ABSTRACT FROM AUTHOR]

Introduction: Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method: Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings: Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grab bars (hygiene area) generated the most accessibility problems. Conclusion: Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level. [ABSTRACT FROM AUTHOR]

Background: Persistent or recurrent neck pain is, together with other chronic conditions, suggested to be associated with disturbances of the Autonomic Nervous System. Acute effects on the Autonomic Nervous System, commonly measured using Heart Rate Variability, have been observed with manual therapy. This study aimed to investigate the effect on Heart Rate Variability in (1) a combination of home stretching exercises and spinal manipulative therapy versus (2) home stretching exercises alone over 2 weeks in participants with persistent or recurrent neck pain. Methods: A randomized controlled clinical trial was carried out in five multidisciplinary primary care clinics in Stockholm from January 2019 to April 2020. The study sample consisted of 131 participants with a history of persistent or recurrent neck. All participants performed home stretching exercises daily for 2 weeks and were scheduled for four treatments during this period, with the intervention group receiving spinal manipulative therapy in addition to the home exercises. Heart Rate Variability at rest was measured at baseline, after 1 week, and after 2 weeks, with RMSSD (Root mean square of successive RR interval differences) as the primary outcome. Both groups were blinded to the other group intervention. Thus, they were aware of the purpose of the trial but not the details of the "other" intervention. The researchers collecting data were blinded to treatment allocation, as was the statistician performing data analyses. The clinicians provided treatment for participants in both groups and could not be blinded. A linear mixed-effects model with continuous variables and person-specific random intercept was used to investigate the group-time interaction using an intention to treat analysis. Results: Sixty-six participants were randomized to the intervention group and sixty-five to the control group. For RMSSD, a B coefficient of 0.4 (p value: 0.9) was found, indicating a non-significant difference in the regression slope for each time point with the control group as reference. No statistically significant differences were found between groups for any of the Heart Rate Variability indices. Conclusion: Adding four treatments of spinal manipulation therapy to a 2-week program of daily stretching exercises gave no significant change in Heart Rate Variability. Trial Registration: The trial was registered 03/07/2018 at ClinicalTrials.gov, registration number: NCT03576846. (https://pubmed.ncbi.nlm.nih.gov/31606042/) [ABSTRACT FROM AUTHOR]

Background: Poor acoustic conditions at home can have negative health impact. The aim was to investigate home environment factors and medical symptoms associated with noise disturbance.Methods: All adults (≥18 y) registered in selected apartments in Sweden were invited to participate in a questionnaire survey including medical questions and personal factors. Totally 5775 adults participated (response rate 46%). Information on home environment was obtained through an indoor environment questionnaire. Two-level logistic regression models (individual, municipality) were performed to estimate associations.Results: Totally 11.9% reported noise disturbance in general at home. Noise disturbance from voice/radio/TV/music/similar sounds from neighbours (13.2%), scraping sound/footsteps/thumping from neighbours (16.5%) and road traffic (16.1%) were common. Younger age and smoking were related to more noise disturbance and more medical symptoms. Noise disturbance was related to tiredness, headache and difficulty concentrating (OR = 1.70-8.19). Renting the apartment (OR = 2.53) and living above ground floor (OR = 1.37) were related to more noise disturbance in general. Living in newer buildings (constructed from 1986 to 2005) was related to less noise disturbance in general (OR = 0.40-0.59). A warmer climate (OR = 1.95), higher municipality population density (OR = 1.24), a longer living time (OR = 1.34), construction year (1961-1975) (OR = 2.42), renting (OR = 1.80-2.32), living above ground floor (OR = 1.45) and having a bathroom fan (OR = 1.84) were associated with increased noise disturbance from neighbours. Factors associated with increased noise disturbance from installations or ventilation/fans/heat pumps included a warmer climate, higher municipality population density, construction year (1961-1995), renting and any mechanical ventilation. Higher municipality population density, construction year (especially 1961-1985) and renting were associated with more noise disturbance from traffic (OR = 1.77-3.92). Renting the apartment (OR = 1.73) and living above ground floor (OR = 1.60) were related to more severe traffic noise disturbances. Noise disturbance in general was partly a mediator of the effects of old buildings, renting the apartment and lack of mechanical ventilation on medical symptoms (% of total effect mediated by noise disturbance: 19-44.8%).Conclusions: Noise disturbance can be associated medical symptoms. Younger age, smoking, a warmer climate, higher municipality population density and different building factors (e.g. renting the apartment, construction period 1961-1985) can be associated with noise disturbance. [ABSTRACT FROM AUTHOR]

Background: Although alcohol use disorder (AUD) runs strongly within families, studies examining the impact of rearing environment, unconfounded by genetic effects, are rare and, to date, contradictory. We here seek to conduct such a study using an adoptive co-sib control design. Methods: Defining high-risk as having ⩾1 biological parent with an externalizing syndrome (AUD, drug abuse or crime), we identified 1316 high-risk full-sibships and 4623 high-risk half-sibships containing at least one member who was home-reared and one who was adopted-away. Adoptive families are carefully screened in Sweden to provide high-quality rearing environment for adoptees. AUD was assessed from national medical, criminal and pharmacy registries. Results: Controlling for sex, parental age at birth, and, for half-siblings, affection status of the non-shared parent, hazard ratios (±95% CI) for AUD in the matched adopted v. home-reared full- and half-siblings were, respectively, 0.76 (0.65–0.89) and 0.77 (0.70–0.84). The protective effect of adoption on AUD risk was stronger in the full- and half-sibling pairs with very high familial liability (two high-risk parents) and significantly weaker when the adoptive family was broken by death or divorce or contained a high-risk adoptive parent. Conclusions: In both full- and half-sibling pairs, we found evidence that the rearing environment substantially impacts on the risk for AUD. High-quality rearing environments can meaningfully reduce the risk for AUD, especially in those at high familial risk. [ABSTRACT FROM AUTHOR]

Introduction: People with visual impairments (those who are blind or have low vision) are exposed to risks in everyday life, especially injury risks. This study aimed to examine experiences and practical knowledge among hospital social workers in Sweden concerning meetings with patients with visual impairments who have been affected by injury events in residential environments. Methods: Swedish hospital social workers specializing in patients with visual impairments (n =30) answered a questionnaire comprising 14 questions. Both fixed and open-ended questions were included, allowing an analysis of both comparable numeric data and subjectively perceived experiences and opinions. Results: A majority of the respondents had met patients who had been injured in the residential setting; the most common injury mechanism reported was tripping or falling on the stairs, or accidentally stumbling into furniture. The hospital social workers acknowledged that they could work more preventively in their professional role by encouraging patients to use orientation and mobility devices such as long canes, increasing collaboration with other professions, and conducting home visits to enable trustful dialogues with both patients and relatives. Discussion: According to these specialized hospital social workers, the provision of education and information to patients with visual impairments could potentially prevent future injury. However, in order to achieve this, there is a need to first enable a trustful dialogue between social workers and patients. Implications for practitioners: This study provides a better understanding of the importance of trustful dialogue between hospital social workers and patients with visual impairments, from the point of view injury prevention. It also offers a summary of the knowledge of hospital social workers about risks and injury events in residential settings for patients with visual impairments. [ABSTRACT FROM AUTHOR]

Risk factors at home for ocular, nasal, throat and dermal symptoms, headache, and fatigue were studied in a nationwide questionnaire survey in Sweden, the BETSI study in 2006. Totally, 5775 adults from a stratified random sample of multi‐family buildings participated. Associations between home environment factors and weekly symptoms were analyzed by multi‐level logistic regression. In total, 8.3% had ocular symptoms; 11.9% nasal symptoms; 7.1% throat symptoms; 11.9% dermal symptoms; 8.5% headache and 23.1% fatigue. Subjects in colder climate zones had more mucosal and throat symptoms but less fatigue and ocular symptoms. Rented apartments had poorer indoor environment than self‐owned apartments. Those living in buildings constructed from 1961 to 1985 had most symptoms. Building dampness, mold and mold odor were risk factors, especially headache and ocular symptoms. Lack of mechanical ventilation system was another risk factor, especially for headache. Environmental tobacco smoke (ETS), electric radiators, and crowdedness were other risk factors. Oiled wooden floors, recent indoor painting, and new floor materials were negatively associated with symptoms. In conclusion, building dampness, mold, poor ventilation conditions, crowdedness, ETS, and emissions from electric radiators in apartments in Sweden can increase the risk of ocular, nasal, throat and dermal symptoms, headache, and fatigue. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the effects of a home-based one-year case management intervention in older people with functional dependency and repeated contact with the health care services on self-reported falls and self-reported injurious falls. Methods: The study was a randomized controlled trial with repeated follow-ups. The sample (n = 153) was consecutively and randomly assigned to the intervention group (n = 80, mean age = 81.4 [SD 5.9]) or control group (n = 73, mean age = 81.6 [SD 6.8]). The intervention group received a case management intervention which comprised monthly home visits during 12 months by nurses and physiotherapists employing a multifactorial preventive approach. Results: In the intervention group, 96 falls occurred during the intervention period compared with 85 falls in the control group (p = .900). There were 40 and 38 injurious falls (p = .669) in the intervention and control groups, respectively. Conclusions: This home-based case management intervention was not able to prevent falls or injurious falls. [ABSTRACT FROM AUTHOR]

Objective: To examine adherence to the oral glucose tolerance test (OGTT) in multiple islet autoantibody children in stage 1 of developing type 1 diabetes (T1D). Methods: Children are followed from birth in The Environmental Determinants of Diabetes in the Young (TEDDY) study. Completion of an OGTT is recommended every 6 months in children ≥3 years of age who are multiple islet autoantibody positive. Factors associated with adherence to the OGTT protocol were examined. Results: The average subject level adherence with the OGTT protocol was 62% although there were large differences across countries; Finnish participants and older children from Sweden were more adherent than participants from the United States and Germany. Factors associated with nonadherence included having a first‐degree relative with T1D, using a local laboratory rather than a TEDDY center for the OGTT, and maternal underestimation of the child's risk for T1D. Children were more adherent to the OGTT if their mothers: were more satisfied with TEDDY participation, reported monitoring the child for T1D by checking blood glucose levels at home, and viewed participating in TEDDY as the primary way they were monitoring the child for T1D. Conclusions: In a study of children in stage 1 of T1D, adherence to an OGTT protocol was suboptimal despite extensive efforts to communicate the child's high risk to parents. These findings provide important guidance for development of strategies to improve methods for detecting progression or the development of T1D in high‐risk pediatric populations. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the effect of a smartphone application on exercise adherence, range of motion and self-efficacy compared to standard rehabilitation after repair of the flexor digitorum profundus tendon. Design: Prospective multi-centre randomised controlled trial. Setting: Four hand surgery departments in Sweden. Subjects: A total of 101 patients (35 women) (mean age 37.5 ± 12.8) were randomised to control (n = 49) or intervention group (n = 52). Intervention: A smartphone application to facilitate rehabilitation. Main outcome measures: Adherence assessed with the Sport Injury Rehabilitation Adherence Scale at two and six weeks (primary outcome). Secondary outcomes were self-reported adherence in three domains assessed at two and six weeks, self-efficacy assessed with Athlete Injury Self-Efficacy Questionnaire at baseline, two and six weeks. Range of motion and perceived satisfaction with rehabilitation and information were assessed at 12 weeks. Results: Twenty-five patients were lost to follow-up. There was no significant between group difference in Sport Injury Rehabilitation Adherence Scale at two or six weeks, mean scores (confidence interval, CI 95%) 12.5 (CI 11.8–13.3), 11.8 (CI 11.0–12.8) for the intervention group, and 13.3 (CI 12.6–14.0), 12.8 (CI 12.0–13.7) for the control group. Self-reported adherence for exercise frequency at six weeks was significantly better for the intervention group, 93.2 (CI 86.9–99.5) compared to the controls 82.9 (CI 76.9–88.8) (P = 0.02). There were no differences in range of motion, self-efficacy or satisfaction. Conclusion: The smartphone application used in this study did not improve adherence, self-efficacy or range of motion compared to standard rehabilitation for flexor tendon injuries. Further research regarding smartphone applications is needed. Level of evidence: I. Randomised controlled trial [ABSTRACT FROM AUTHOR]

Technology developments and demand for flexibility in health care and in contact with the health care system are two factors leading to increased use of eHealth solutions. The use of eHealth has been shown to have positive effects in people with chronic obstructive pulmonary disease, but the full potential for this group needs to be explored. Therefore, the aim was to evaluate the feasibility of an eHealth tool used for exercise training and online contacts for people with severe chronic obstructive pulmonary disease. The 10-week intervention included an eHealth tool for exercise training in home environment and regular online contacts, as well as weekly e-rounds for health care professionals. Seven of the nine participants completed the study. The eHealth tool was found to be feasible for e-rounds, exercise training and online contacts. Participants could manage the tool and adhere to training; positive effects were shown, and no adverse events occurred. Technical functions need to be improved. [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]

The language environment is important for the development of early communication and language. In the current study, we describe the natural home language environment of 9-month-old infants in Sweden and its concurrent association with language development. Eighty-eight families took part in the study. The home language environment was measured using the Language ENvironment Analysis (LENA) system, and language development was assessed using Swedish Early Communicative Development Inventory (SECDI), a parent questionnaire. LENA measures showed dramatic variation between individuals but were comparable to and showed overlapping variance with previous studies conducted in English-speaking households. Nonetheless, there were significantly more infant vocalizations and conversational turns in the present study than in one previous study. Adult word count correlated significantly and positively with infants' Use of gestures and the subscale of that section Communicative gestures. These together with another four non-significant associations formed a consistent overall pattern that suggested a link between infants' language environment and language development. Although the direction of causality cannot be determined from the current data, future studies should examine children longitudinally to assess the directionality or the bidirectionality of the reported associations between infant's language environment and language development. [ABSTRACT FROM AUTHOR]

Purpose: An increasing number of people will live with disabilities in their homes and consequently, the need for home-based interventions will increase. Housing adaptations (HAs) are modifications to the physical home environment with the purpose to enhance independence for a heterogeneous group of people. Increasing the knowledge of the characteristics of HA clients by exploring their heterogeneity, could facilitate the planning of interventions and allocation of resources. The purpose of this article was to identify and validate HA client profiles. Materials and methods: This cross-sectional study applied a mixed methods design to identify profiles of HA clients through cluster analysis confirmed by qualitative interview data. The sample consists of 241 HA clients in Sweden with a mean age of 75.1 years. Results: A classification into five groups emerged as the one best describing the heterogeneity of characteristics among this sample of clients. Five client profiles were outlined based on their age and level of disability, and the variation between the profiles was confirmed through the qualitative interview data. Conclusions: The identified client profiles are a step towards a better understanding of how home-based interventions could be delivered more effectively to groups of HA clients, based on their different characteristics. Housing adaptations are structural modifications to the physical home environment with the purpose to enhance independence for people with disabilities. People applying for housing adaptations are a heterogeneous group with different needs. This study outlines five client profiles which can guide professionals on how to differentiate home-based interventions and follow-up processes among housing adaptation clients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to explore and describe fathers' experiences during the first postnatal week after early discharge of mother and baby from the maternity unit. Methods : A meta-synthesis. Inclusion criteria: peer-reviewed qualitative single studies of fathers' experiences during the first week after early discharge (defined as less than 72 hours postpartum) from hospital after the birth of a healthy singleton baby born between weeks 37 and 40. Databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Maternity and Infant Care, Joanna Briggs, SweMed+ and PsycInfo were searched in May 2015 and May 2018. Of the 940 titles scanned for eligibility, three articles met the inclusion criteria. The consolidated criteria for reporting qualitative research checklist was used. Findings : All included studies were conducted in Sweden during the period 2002–2012. The total sample of participants in the meta-synthesis comprised 35 fathers. Analysis of the included studies generated two themes: building confidence and coping with responsibility. Conclusions : The fathers' experiences were affected by the emotional support of midwives, which boosted their confidence. This seems to be a premise for taking and coping with responsibility during the first days at home. Good cooperation between hospitals and municipalities is vital, and midwives must be available and present in order to ensure continuity in maternity care. [ABSTRACT FROM AUTHOR]

This article applies the concepts of place and space to understand youth and their engagement in risky behavior, such as drunkenness. It is based on the prolonged engagement with 23 underage youth coming from smaller municipalities in the south of Sweden. The study was comprised of semi-structured interviews, field visits, and observations at sites relevant for youths. In the stories narrated by youth, drunkenness is no longer an ad hoc activity conducted somewhere at the margins of society. The construction of drinking spaces was accomplished through highly managed, monitored, and organized practices, such as sending out invitations in advance, planning how much alcohol to drink, designating drivers, and securing transport means. Crucial to this was that spaces were products of relations existing between various youth, with no adults present. Spaces of drinking changed as those who participated in their construction changed. In addition, certain rules and codes of conduct (e.g. taking care of friends who drunk too much) were enforced to assure that the constructed spaces provided a sense of safety and enabled having fun. We conclude this article by arguing that a focus on place and space brings forward vital aspects in understanding the role of transforming party spaces that would otherwise remain obscure to social work knowledge and practice. [ABSTRACT FROM AUTHOR]

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Aim: To explore the level of thriving and associated factors among older adults living at home with support from home care services. Design: An exploratory, cross‐sectional survey design. Method: A sample of 136 participants (mean 82 years) responded to a survey about thriving, health, psychosocial and care‐related factors in 2016. Descriptive analysis and multiple logistic regression analysis with a stepwise backwards elimination procedure were performed. Result: The results showed that the level of thriving was relatively high among adults living at home with support from home care services, with dimensions concerning engaging in activities and peer relations and keeping in touch with people and places being rated the lowest. Regression analysis showed that participating in social relations and experiencing self‐determination in activities in and around the house were associated with thriving. Conclusion: Facilitating social relations and creating opportunities for self‐determination seem necessary to support thriving among older adults living at home with support from home care services. Impact: The findings in this study add important knowledge about place‐related well‐being when living at home with home care services. [ABSTRACT FROM AUTHOR]

A large proportion of the Swedish housing stock was built when policymakers and housing industry rarely considered housing accessibility issues. More than 80% of Swedish citizens aged 65+ live in dwellings built before 1980. Using detailed research data from onsite observations, we explored housing accessibility issues for people with different complexities of functional limitations. Four typical dwellings were selected, two from the 1960s and two from the 1990s. Accessibility problems were considerable, also in newer dwellings. Design features that need particular attention are highlighted, serving as research-based input to policymakers, public agencies and actors involved in housing development and provision. [ABSTRACT FROM AUTHOR]

Background: Specialized home-based palliative care (HPC) services aim at reducing the number of visits to emergency departments (EDs) and hospitalizations at end of life. In addition, it offers patients the possibility to die at home. Objective: To investigate whether the last years' expansion of palliative care in Stockholm County, Sweden, reduced the health care resource use and/or increased the number of patients who died at home. Design: This is a population-based study of all registered 2780 patients referred to HPC in 2015 in the Stockholm region. The majority of the patients (2087) had cancer, but 693 patients had chronic medical illness, most often cardiovascular and pulmonary diseases. Results: HPC reduced visits to the ED and hospital admissions by 51% and 41%, respectively. The number of hospital admissions to the departments of oncology, medicine, and surgery was reduced, whereas admissions to palliative care units increased. For the 1773 patients alive after 90 days with HPC, the number of days spent in hospital reduced from 19,628 before HPC to 13,743 (30%) days with HPC. The most common place of death was at a specialized palliative care unit (48%), whereas 36% died at home. Conclusions: HPC reduced emergency health care resource use for the majority of patients, despite patients having progressing disease. To improve the quality of end-of-life care, we need to make early integration of palliative care available for a larger number of patients. In addition, we have to improve care pathways, especially for patients with gastrointestinal and lung cancer, who continued to be frequently admitted to hospital. [ABSTRACT FROM AUTHOR]

Purpose: To explore how older men living alone, describe their everyday activities and their abilities as well as how they could be helped in everyday life. Materials and methods: Qualitative semi-structured interviews were analysed with inductive content analysis. Eight men aged 65+ years were included. They were all living alone, albeit with home help services. They were able to walk and had sufficient cognitive ability. Results: The analysis resulted in one theme "A driving force of managing activities and overcome hindering factors requires a broad spectrum of prerequisites for participating in everyday life" with the following four categories: Importance of everyday activities; individual prerequisites enabling everyday activities; body and mind inhibit, and react to the decreased, abilities; and importance of the environment. Conclusions: The results generate a complex view of older men's everyday life. It is important for older men's independence that health care and rehabilitation staff adopt a comprehensive view and work from a biopsychosocial (BPS) perspective. To be an older man living alone might mean a decreased health and good health is a strong predictor for increased abilities in everyday activities. The living situation of older men living alone is not well studied and needs to be explored to a greater extend, especially from their own perspective. An interaction of biological, psychological, and social factors was expressed as important for older men's everyday life, in accordance with the biopsychosocial (BPS) model. The expressed importance of participation as well as performing both physical and social activities reflects the need of individualised goals in rehabilitation according to the behavioural medicine approach. It is of outmost importance that health care and rehabilitation staff in contact with this group has a comprehensive view and works from a biopsychosocial (BPS) perspective, for maintenance of the older men's independence in everyday life. [ABSTRACT FROM AUTHOR]

Background: This study examined how living alone and loneliness associate with all-cause mortality in older men and women., Methods: Baseline data from the Gothenburg H70 Birth Cohort Studies, including 70-year-olds interviewed in 2000 and 75-year-olds (new recruits) interviewed in 2005 were used for analyses (N = 778, 353 men, 425 women). Six-year mortality was based on national register data., Results: At baseline, 36.6% lived alone and 31.9% reported feelings of loneliness. A total of 72 (9.3%) participants died during the 6-year follow-up period. Cumulative mortality rates per 1000 person-years were 23.9 for men and 9.6 for women. Mortality was increased more than twofold among men who lived alone compared to men living with someone (HR 2.40, 95% CI 1.34-4.30). Elevated risk remained after multivariable adjustment including loneliness and depression (HR 2.56, 95% CI 1.27-5.16). Stratification revealed that mortality risk in the group of men who lived alone and felt lonely was twice that of their peers who lived with someone and did not experience loneliness (HR 2.52, 95% CI 1.26-5.05). In women, a more than fourfold increased risk of mortality was observed in those who experienced loneliness despite living with others (HR 4.52, 95% CI 1.43-14.23)., Conclusions: Living alone was an independent risk factor for death in men but not in women. Mortality was doubled in men who lived alone and felt lonely. In contrast, mortality was particularly elevated in women who felt lonely despite living with others. In the multivariable adjusted models these associations were attenuated and were no longer significant after adjusting for mainly depression in men and physical inactivity in women. Gender needs to be taken into account when considering the health consequences of living situation and loneliness., (© 2023. The Author(s).)

Research has shown that positive evaluations of home are important for very old people's health, well-being and independence in daily life. The rationale for the present study derives from our survey study findings, confirming such associations also in a younger cohort (N = 371). The purpose of this study was to further increase the understanding of the dynamics of meaning of home and health among community-living healthy younger older people, in the present and in a projected future. Data were collected through semi-structured interviews with 13 persons aged 67–70 years living in ordinary housing in Sweden, followed by a qualitative content analysis. Findings suggest that the home becomes progressively important after retirement. Not only the immediate home environment but also local neighbourhoods influence perceptions about home. Home brings emotional and social benefits but also worries about how to cope with complex home ambivalence when reflecting upon future housing arrangements. The findings suggest that it is important to consider the role of perceived aspects of home for health and well-being in early phases of the ageing process. The findings could be used to raise awareness among policymakers, housing authorities and professionals involved in housing-related counselling. [ABSTRACT FROM AUTHOR]

The residents' perspective of the quality of housing support for people with psychiatric disabilities living in congregate supported housing has been studied and a comparison has been made with the findings from those from a previous study in ordinary housing with outreach support. One-hundred and seventy-eight residents from 27 supported housing facilities in eight Swedish municipalities completed the Quality of Psychiatric Care–Housing (QPC-H) instrument. The highest quality ratings were found for: Secluded Environment, Encounter and Support, while Participation, Housing Specific and Secure Environment were rated at lower levels. Despite relatively high ratings, a majority of items did not attain the 80% cutoff point deemed as defining satisfactory quality of service. The residents in ordinary housing with outreach support rated higher levels for the majority of the QPC-H dimensions in comparison with those in supported housing. A conclusion is that the quality of care in supported housing facilities has a number of deficiencies that need to be addressed. Supported housing is generally rated as having a lower quality of care than in ordinary housing with outreach support. Suggestions for the content of staff training are made based on the results. [ABSTRACT FROM AUTHOR]

Over the past few decades, there has been an increase in the number of children receiving home mechanical ventilation (HMV), and in many ways, families have taken responsibility for the required advanced homecare, which has placed considerable time demands on the family unit. Little is known about the life situation of the siblings of HMV-assisted children; their own voices and an insider perspective are missing. The aim of this study was to illuminate the everyday life experiences of siblings of HMV-assisted children. Data were obtained via interviews with 10 siblings with a median age of 9 years. Data were analyzed using a phenomenological hermeneutical method inspired by the French philosopher Ricoeur. Four themes emerged, all of which suggest that a complex and profound intertwined sibling bond develops that links the past, present, and future. The findings of this study provide valuable information from an insider's perspective about the meaning of having an HMV-assisted sibling. Family-focused care with particular attention and support for siblings of HMV-assisted children can encourage the development of internal strengths, self-confidence, and resilience. [ABSTRACT FROM AUTHOR]

Both genes and the environment are important for individual differences in expertise, but little is known about gene--environment interactions underlying domain-specific achievement. Here we explored this issue in a large Swedish twin cohort (N = 6,610), using moderator modeling with musical expertise as a model domain. Specifically, we tested whether musical enrichment of the childhood environment moderates adult musical achievement, as well as the magnitude of genetic and nongenetic influences on individual differences in achievement. Musical achievement was measured using the Creative Achieve- ment Questionnaire and enrichment of the childhood environment was indexed with a principal com- ponent derived from the number of music records in the family home, number of individuals in the family environment playing an instrument, frequency of concert visits, and music education before the age of 12. As expected, we found a positive association between childhood musical enrichment and musical achievement in adulthood. Interestingly, however, the total variance in musical achievement as well as the relative importance of genetic influences increased with a higher level of musical enrichment. Estimates of genetic and environmental influences as well as the magnitude of the environmental moderation differed for men and women. These findings suggest that, in line with recent multifactorial models of expert performance, a musically enriched childhood environment amplifies individual differ- ences, an effect which is largely driven by an increase in the importance of genetic factors. [ABSTRACT FROM AUTHOR]

Aim: To estimate the effects of targeted elimination of environmental barriers (EB) in the ordinary housing stock in Sweden, and to explore the estimated effects on accessibility at a population level in relation to (a) residents with different functional profiles, (b) different housing types and (c) building periods. Method: Data on dwellings from existing Swedish research databases were utilized. EB and accessibility were assessed by means of the Housing Enabler instrument. In simulations of EB removal, five items that correspond to the most common housing adaptations were selected. The simulations were applied to four functional profiles of different complexity. Result: EB known to be commonly removed by housing adaptations exist in large proportions of the existing ordinary housing stock. Estimated targeted elimination of selected barriers would have the largest accessibility effects for the more complex functional profiles. The effects would be consistently larger for one-family houses, and for all types of dwellings built before 1960. Conclusions: The elimination of the EB most commonly addressed by housing adaptations could result in a reduction of the housing accessibility problems that community-living older people are facing. For society to solve the housing situation for the ageing population well-informed and efficient upgrading of ordinary housing is imperative. [ABSTRACT FROM AUTHOR]

As part of the Swedish state-funded healthcare system, housing adaptations are used to promote safe and independent living for disabled people in ordinary housing through the elimination of physical environmental barriers in the home. The aim of this study was to describe the cohabitants' expectations and experiences of how a housing adaptation, intended for the partner, would impact their everyday life. In-depth interviews were conducted with cohabitants of nine people applying for a housing adaptation, initially at the time of the application and then again 3 months after the housing adaptation was installed. A longitudinal analysis was performed including analysis procedures from Grounded Theory. The findings revealed the expectations and experiences in four categories: partners' activities and independence; cohabitants' everyday activities and caregiving; couples' shared recreational/leisure activities; and housing decisions. A core category putting the intervention into perspective was called 'Housing adaptations - A piece of the puzzle'. From the cohabitants' perspective, new insights on housing adaptations emerged, which are important to consider when planning and carrying out successful housing adaptations. [ABSTRACT FROM AUTHOR]

When children are seriously ill, being able to be cared for at home with the family is valuable, but community nurses are often not trained to care for children. The aim of this study was therefore to describe community nurses’ perceptions of caring for seriously ill children at home. A content analysis was conducted of 11 semi-structured interviews with nurses. One theme, obligation to care, was found, followed by three categories: making an impact, feeling confident, and emotional processing. In conclusion, we found collaboration with paediatric staff in the hospital is important for community nurses in order to gain confidence, which would optimise care at home for seriously ill children and their families. [ABSTRACT FROM AUTHOR]

Where do people feel closest to those they have lost? This article explores how continuing bonds with a deceased person can be rooted in a particular place or places. Some conceptual resources are sketched, namely continuing bonds, place attachment, ancestral places, home, reminder theory, and loss of place. The authors use these concepts to analyze interview material with seven Swedes and five Britons who often thought warmly of the deceased as residing in a particular place and often performing characteristic actions. The destruction of such a place, by contrast, could create a troubling, haunting absence, complicating the deceased’s absent-presence. [ABSTRACT FROM PUBLISHER]

We present the findings of our phenomenological interview study concerning the meaning of being an autonomous person while dependent on advanced medical technology at home. This was elucidated in the participants’ narratives as befriending everyday life when bringing technology into the private sphere. We discovered four constituents of the phenomenon: befriending the lived body, depending on good relationships, keeping the home as a private sphere, and managing time. The most important finding was the overall position of the lived body by means of the illness limiting the control over one’s life. We found that the participants wanted to be involved in and have influence over their care to be able to enjoy autonomy. We therefore stress the importance of bringing the patients into the care process as chronic illness will be a part of their everyday life for a long time to come, hence challenging patient autonomy. [ABSTRACT FROM AUTHOR]