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This study investigates 30 lone actors in Sweden with a register-based design using a group of male lone actors and two reference groups: same-sex siblings and other male violent extremists. We compare lone actors to the reference groups along social background, criminal background, and co-offending relations (1995 –2016), and mental health (1980–2016). Our results show that lone actors are primarily born in Sweden to two Swedish-born parents. They have a high degree of criminality and co-offending, indicating that they are not completely loners in their criminal behaviour. They have higher enrolment in secondary education than the reference groups, but lower enrolment in higher education than other male violent extremists. Additionally, they suffer considerably more from mental disorders compared to the reference groups. An analysis of criminality and in- and outpatient hospitalisation over the life course indicates that lone actors may have had problems in their transition into middle age. [ABSTRACT FROM AUTHOR]

Trauma injury is the sixth leading cause of death worldwide, and interpersonal violence is one of the major contributors in particular regarding injuries to the head and neck. The incidence, demographics, and outcomes of penetrating trauma reaching hospitals in Sweden are not known. We report the largest, nationwide epidemiological study of penetrating injuries in Sweden, using the Swedish Trauma Registry (SweTrau). A multi-center retrospective descriptive study of 4,776 patients was conducted with penetrating injuries in Sweden, between 2012 and 2018. Due to the increase in coverage of the SweTrau registry during the same period, we chose to analyze the average number of cases for the time intervals 2013–2015 and 2016–2018 and compare those trends to the reports of the Swedish National Council for Crime Prevention (Brå) as well. A total of 663 patients had Injury Severity Score (ISS) ≥ 15 at admission and were included in the study. Three hundred and sixty-eight (55.5%) were stab wounds (SW), 245 (37.0%) gunshot wounds (GSW), and 50 (7.5%) other traumas. A majority of the cases involved injuries to the head, neck, and face. SW increased from 145 during 2013–2015 to 184 during the second period of 2016–2018. The increase was greater for GSW from 92 to 141 during the same respective periods. This trend of increase over time was also seen in head, neck, and face injuries. The 30-day mortality was unaffected (48–47%) in GSW and trended toward lower in SW (24–21%) when comparing 2013–2015 with 2016–2018. Patients with head trauma had 45% mortality compared to 18% for non-head trauma patients. Head trauma also resulted in worse outcomes, only 13% had Glasgow outcome score (GOS) 5 compared to 27% in non-head trauma. The increasing number of cases of both SW and GSW corresponded well with reports from Brå although further studies also are needed to address deaths outside of hospitals and not registered at the SweTrau. The majority of cases had injuries to the head, neck, and face and were associated with higher mortality and poor outcomes. Further studies are needed to understand the contributing factors to these worse outcomes in Sweden and whether more targeted trauma care of these patients can improve outcomes. [ABSTRACT FROM AUTHOR]

The article presents the discussion on Sweden being a robust democratic state with a well-functioning legal system, stable political institutions, vibrant associational life, and high electoral turnout. Topics include collapse of the Soviet Union and the end of the Cold War and domestic national security challenges gaining more political importance; and alarming increase in firearms and explosives violence putting Sweden among the EU countries with the highest level of gun homicides.

The Swedish National Board of Institutional Care (SNBIC) is an independent governmental agency that provides compulsory care for minors with psychosocial problems, criminal behavior, and substance abuse. During recent years, a noticeable number of the youth placed at compulsory care institutions have been asylum-seeking minors who have arrived in Sweden without parents or guardians. This steady increase in placements has raised questions and concerns among the involved actors regarding the motives and needs underlying these placements. This qualitative study investigates the main motives that lead unaccompanied asylum-seeking minors to be placed at SNBIC residential homes and the problems that are to be solved during their placement, according to social workers and SNBIC staff. The study is based on 28 in-depth interviews with social workers and SNBIC staff. Findings indicate clear disagreement between social workers and SNBIC staff with regard to the motives for placing unaccompanied minors at SNBIC homes. Although the social workers and SNBIC staff explain that most of the unaccompanied youth placed at SNBIC homes have some form of criminal behavior or substance abuse, SNBIC staff believe, in some cases, the problem is not sufficiently serious to warrant compulsory care. As these disagreements and misunderstandings between the actors have an impact on their collaboration and, consequently, the situation of the unaccompanied minors, all attempts to reach a consensus on the leading causes for placement and the problems that need to be solved with SNBIC placement would increase security for both the young people and the relevant staff. [ABSTRACT FROM AUTHOR]

Hand grenade attacks have increasingly been reported in Sweden. However, to date no research on the topic exists. The present study aims to describe the illegal use of hand grenades and to test its spatio-temporal relationship with gun violence to explore whether the two forms of violence are connected. Data were collected for the years 2011 to 2016 from the Swedish police and from open sources about hand grenade detonations, which were considered alongside shootings as two types of violence commonly attributed to criminal groups. Descriptive data and trends are presented and spatio-temporal analysis of near-repeat patterns was performed using a near-repeat calculator. All in all, there were 77 incidents of detonated hand grenades in Sweden during the six-year observation period, in which nine individuals were injured and one killed. The number of incidents increased, with about half of the them occurring during the last year. A near-repeat analysis was performed on shootings (N = 1048) and hand grenades (N = 55) in Stockholm, Gothenburg and Malmö. The shootings exhibit a strong component of near-repeat patterns, but adding hand grenades to the analysis did not strengthen the patterns, suggesting that the two types of violence only partially share spatio-temporal patterns. The study confirms an increase in the use of hand grenades in Sweden, although the reason for the increase is unknown. The increase does fit with the overall changing pattern in violence in urban areas in Sweden, which broadly tends to be attributed to criminal groups in disadvantaged neighbourhoods. [ABSTRACT FROM AUTHOR]

This population-based time-trend study examines gun violence rates among males in Sweden during the years 1996 to 2015 and compares the rate in Sweden to other Western European countries. Data were collected from six registries and are presented descriptively per 100,000 inhabitants. The risks among males in Sweden increased considerably in both lethal and non-lethal gun victimization and perpetration. Among males aged 15 to 29 there was a five-fold increase in risk for victimization in lethal and non-lethal gun violence during the 20-year observation period. In a comparative perspective the rate of gun homicide victimization among males 15 to 29 years was higher in Sweden compared to other Western European countries, while the risk for males over age 30 was at an average level. Based on the results of this study we conclude that gun violence among young males in Sweden has been on the rise and is at a high level compared to other Western European countries. The development of gun violence in Sweden can be characterized as endemic, prevalent in both population and socially vulnerable areas. [ABSTRACT FROM AUTHOR]

Background: Arterial hyperglycemia is associated with poor outcome in traumatic brain injury (TBI), but the pathophysiology is not completely understood. Previous preclinical and clinical studies have indicated that arterial glucose worsens pressure autoregulation. The aim of this study was to evaluate the relationship of arterial glucose to both pressure reactivity and cerebral energy metabolism.Method: This retrospective study was based on 120 patients with severe TBI treated at the Uppsala University hospital, Sweden, 2008-2018. Data from cerebral microdialysis (glucose, pyruvate, and lactate), arterial glucose, and pressure reactivity index (PRx55-15) were analyzed the first 3 days post-injury.Results: High arterial glucose was associated with poor outcome/Glasgow Outcome Scale-Extended at 6-month follow-up (r = - 0.201, p value = 0.004) and showed a positive correlation with both PRx55-15 (r = 0.308, p = 0.001) and cerebral lactate/pyruvate ratio (LPR) days 1-3 (r = 0. 244, p = 0.014). Cerebral lactate-to-pyruvate ratio and PRx55-15 had a positive association day 2 (r = 0.219, p = 0.048). Multivariate linear regression analysis showed that high arterial glucose predicted poor pressure autoregulation on days 1 and 2.Conclusions: High arterial glucose was associated with poor outcome, poor pressure autoregulation, and cerebral energy metabolic disturbances. The latter two suggest a pathophysiological mechanism for the negative effect of arterial hyperglycemia, although further studies are needed to elucidate if the correlations are causal or confounded by other factors. [ABSTRACT FROM AUTHOR]

Penetrating trauma to the head and neck has increased during the past decade in Sweden. The aim of this study was to characterize these injuries and evaluate the outcomes for patients treated at a tertiary trauma center. Swedish trauma registry data were extracted on patients with head and neck injuries admitted to Karolinska University Hospital (Stockholm, Sweden) between 2011 and 2019. Outcome information was extracted from hospital records, with the primary endpoints focusing on the physiological outcome measures and the secondary endpoints on the surgical and radiological outcomes. Of 1436 patients with penetrating trauma, 329 with penetrating head and neck injuries were identified. Of the 329 patients, 66 (20%) had suffered a gunshot wound (GSW), 240 (73%) a stab wound (SW), and 23 (7%) an injury from other trauma mechanisms (OTMs). The median age for the corresponding 3 groups of patients was 25, 33, and 21 years, respectively. Assault was the primary intent, with 54 patients experiencing GSWs (81.8%) and 158 SWs (65.8%). Patients with GSWs had more severe injuries, worse admission Glasgow coma scale, motor, scores, and a higher intubation rate at the injury site. Most GSW patients underwent major surgery (59.1%) as the initial procedure and were more likely to have intracranial hemorrhage (21.2%). The 30-day mortality was 45.5% (n = 30) for GSWs, 5.4% (n = 13) for SWs, and 0% (n = 0) for OTMs. There was an annual increase in the incidence and mortality for GSWs and SWs. Between 2011 and 2019, an increasing annual trend was found in the incidence and mortality from penetrating head and neck trauma in Stockholm, Sweden. GSW patients experienced more severe injuries and intracranial hemorrhage and underwent more surgical interventions compared with patients with SWs and OTMs. [ABSTRACT FROM AUTHOR]

Iran has the highest prevalence of multiple sclerosis (MS) in the Middle East and Asia. Rate of emigration has been significantly raised among Iranians and though, multiple studies have been published on prevalence of MS among Iranian emigrants. Here we systematically reviewed these publications. We performed a comprehensive literature search was performed on April 30, 2015 in data bases of MEDLINE, EMBASE, Scopus and Google Scholar for the terms 'multiple sclerosis', 'incidence', 'prevalence', 'epidemiology', 'migration', 'emigrant', 'immigrant', 'Iran', 'Parsis' and 'Persian'. Study location, prevalence day or period, and age of at disease onset were recorded for all the included publications. Nine publications from Sweden, Canada, Norway, UK, and India were included. Only three reported age-adjusted prevalence and six reported age of disease onset. MS prevalence among Iranian emigrants varied from 21 per 100,000 people in Bombay, India in 1985 to 433 per 100,000 people in British Columbia, Canada in 2012. Five studies reported the prevalence in the region of interest, ranging from 1.33 in Bombay, India to 240 in British Columbia, Canada. Five studies also reported the prevalence of MS in the population of the destination country, and in all of them, the prevalence of MS was higher in Iranian immigrants compared to native people. Prevalence studies performed in Iran and also on Iranian emigrants indicate roles for both genetic and environmental factors in MS susceptibility. Data might indicate that living in a high-risk area increases the susceptibility to MS. [ABSTRACT FROM AUTHOR]

In this criminological study we have combined ethnographic fieldwork observations with twelve in-depth interviews with Swedish street gang leaders and twelve associate gang members to understand the driving forces behind street gang leadership and gang membership by delineating the multiple themes of the subjects' narratives. A descriptive and interpretive analysis of the data suggested four ideal-types, each with specific goals, aspirations, and motives. These were in accord with a limited, though diverse literature on gang leader ship that has primarily emerged in the United States. The analysis, however, does not necessarily support the claim that U.S.-style intergenerational, institutionalized gangs exist in Sweden; simply that there are similar gang leadership styles and motivations in these different contexts. In terms of policy, the analysis contains important lessons for agencies involved in social control efforts against street gangs and similar subcultures by focusing on the heterogeneous roles and influences of gang hierarchies. Further, the analysis reiterates the need for a more nuanced understanding of street gangs and the structured agency of members within their own narrative accounts. In terms of research, these findings suggest a need for further in-depth, holistic studies to create a more empirically grounded gang leader typology. [ABSTRACT FROM AUTHOR]

In this study we investigate the application of the Maxson and Klein gang typology on a dataset of seven Swedish street gangs. Individual-level data on 239 gang members were analyzed. While some Swedish criminologists maintain that no street gangs exist in Sweden, this research project provides evidence to the contrary. Findings support the utility of the Maxson and Klein typology. Results show that the “compressed gang” was the most common type of street gang in the dataset. This finding is also in concert with other European gang studies, adding further evidence for the applicability of the gang typology. Findings also suggest a similar pattern of gang development and structure to that of American and European street gangs. [ABSTRACT FROM AUTHOR]

Current guidelines in traumatic brain injury (TBI) recommend a cerebral perfusion pressure (CPP) within the fixed interval of 60–70 mm Hg. However, the autoregulatory, optimal CPP target (CPPopt) might yield better cerebral blood flow (CBF) regulation. In this study, we investigated fixed versus autoregulatory CPP targets in relation to cerebral energy metabolism and clinical outcome after TBI. Ninety-eight non-craniectomized patients with severe TBI treated in the neurointensive care unit, Uppsala University Hospital, Sweden, 2008–2018, were included. Data from cerebral microdialysis (MD), intracranial pressure (ICP), pressure autoregulation, CPP and CPPopt55–15 (a variant of CPPopt based on filtered slow waves from 15–55 sec range) were analyzed the first 10 days. The good monitoring time (GMT %) below/within/above the fixed and autoregulatory CPP targets were calculated. CPPopt55–15 was >70 mm Hg 74% of the time the first 10 days. Higher GMT (%) ΔCPPopt55–15 ± 10 mm Hg correlated with lower lactate/pyruvate ratio (LPR) on day 1 and lower cerebral glycerol on days 6–10, and predicted favorable clinical outcome. Higher GMT (%) CPP within 60–70 mm Hg correlated with lower cerebral glucose on days 2–10 and higher LPR on days 6–10, but predicted favorable clinical outcome. Higher GMT (%) CPP >70 mm Hg had the opposite associations; that is, with higher cerebral glucose and lower LPR, but unfavorable clinical outcome. Autoregulatory CPP targets may be beneficial, because patients with CPP values close to the optimal CPP had both better cerebral energy metabolism and better clinical outcome, but this needs to be evaluated in randomized trials. [ABSTRACT FROM AUTHOR]

Hyperventilation is a controversial treatment in traumatic brain injury (TBI). Prophylactic severe hyperventilation (below 3.3 kPa/25 mm Hg) is generally avoided, due to the risk of cerebral ischemia. Mild hyperventilation (arterial pCO 2 within 4.0–4.5 kPa/30–34 mm Hg) in cases of intracranial hypertension is commonly used, but its safety and benefits are not fully elucidated. The aim of this study was to evaluate the use of mild hyperventilation and its relation to cerebral energy metabolism, pressure autoregulation, and clinical outcome in TBI. This retrospective study was based on 120 patients with severe TBI treated at the neurointensive care unit, Uppsala University Hospital, Sweden, between 2008 and 2018. Data from cerebral microdialysis (glucose, pyruvate, and lactate), arterial pCO 2 , and pressure reactivity index were analyzed for the first 3 days post-injury. Mild hyperventilation, 4.0–4.5 kPa (30–34 mm Hg), was more frequently used early and the patients were gradually normoventilated. Low pCO 2 was associated with slightly higher intracranial pressure and slightly lower cerebral perfusion pressure (P < 0.01). There was no univariate correlation between low pCO 2 and worse cerebral energy metabolism. Multiple linear regression analysis showed that mild hyperventilation was associated with lower pressure reactivity index on day 2 (P = 0.03), suggesting better pressure autoregulation. Younger age and lower intracranial pressure were also associated with lower pressure reactivity index. These findings support the notion that mild hyperventilation is safe and may improve cerebrovascular reactivity. [ABSTRACT FROM AUTHOR]

Introduction: Sweden is facing a surge of gun violence that mandates optimized prehospital transport approaches, and a survey of current practice is fundamental for such optimization. Management of severe, penetrating trauma is time sensitive, and there may be a survival benefit in limiting prehospital interventions. An important aspect is unregulated transportation by police or private vehicles to the hospital, which may decrease time but may also be associated with adverse outcomes. It is not known whether transport of patients with penetrating trauma occurs outside the emergency medical services (EMS) in Sweden and whether it affects outcome., Method: This was a retrospective, descriptive nationwide study of all patients with penetrating trauma and injury severity scores (ISSs) ≥ 15 registered in the Swedish national trauma registry (SweTrau) between June 13, 2011, and December 31, 2019. We hypothesized that transport by police and private vehicles occurred and that it affected mortality., Result: A total of 657 patients were included. EMS transported 612 patients (93.2%), police 10 patients (1.5%), and private vehicles 27 patients (4.1%). Gunshot wounds (GSWs) were more common in police transport, 80% (n = 8), compared with private vehicles, 59% (n = 16), and EMS, 32% (n = 198). The Glasgow coma scale score (GCS) in the emergency department (ED) was lower for patients transported by police, 11.5 (interquartile range [IQR] 3, 15), in relation to EMS, 15 (IQR 14, 15) and private vehicles 15 (IQR 12.5, 15). The 30-day mortality for EMS was 30% (n = 184), 50% (n = 5) for police transport, and 22% (n = 6) for private vehicles. Transport by private vehicle, odds ratio (OR) 0.65, (confidence interval [CI] 0.24, 1.55, p = 0.4) and police OR 2.28 (CI 0.63, 8.3, p = 0.2) were not associated with increased mortality in relation to EMS., Conclusion: Non-EMS transports did occur, however with a low incidence and did not affect mortality. GSWs were more common in police transport, and victims had lower GCS scorescores when arriving at the ED, which warrants further investigations of the operational management of shooting victims in Sweden., (© 2023. Norwegian Air Ambulance Foundation.)

The aim of this cross-sectional study is to increase our understanding of job satisfaction in Swedish police officers by taking into account work-related stress, and sexual and gender-based harassment. Data were collected from 152 police officers working in vulnerable areas in Stockholm using sociodemographic questions, the Police Stress Identification Questionnaire (PSIQ), Sexual and gender-based harassment questions, and Job Descriptive Index (JDI). The obtained results indicated that male and female police officers reported the highest satisfaction in "people on your present job." The lowest score of job satisfaction in both male and female police officers was related to "opportunity for promotion" and then "pay." There were no significant differences in the subscales of job satisfaction between male and female police officers. The older and more experienced officers, the less satisfaction was reported in "job in general" and more satisfaction reported in "pay." Comparing job satisfaction between patrol officers and those officers who worked in internal services showed police patrol officers had higher job satisfaction in "job in general," "work in the present job," "opportunity for promotion" and "supervision" compared to their counterparts in internal services. There were not any significant differences between the subscales of job satisfaction between male and female police officers. There was not any significant association between job satisfaction subscales and having experience of sexual or gender-based harassment. Among various subscales of police stressors, organizational stress was in negative relation with three domains of job satisfaction; "job in general," "pay" and "supervision." Also, hierarchical multiple regression analyses showed organizational stress was most often of predictive impact related to various job satisfaction domains in police officers., (Copyright © 2022 Rostami, Ghazinour, Burman and Hansson.)

In this study we investigate organized crime by studying the degree of criminal organization. We use population-level register data on criminal suspicions between 2011 and 2016 to analyze the territoriality of Swedish street gangs in terms of geographical mobility, their collaboration in crime through their co-offending network's clustering and community structure, and their crime versatility. Although Swedish street gangs exhibit varying degrees of geographical mobility and criminal collaboration, overall, they have limited reach along these dimensions, characterized by low clustering and limited crime specialization. Violence seems to become a necessary tool only when a gang reaches a certain degree of organization. By unbraiding criminal mobility and its association with other organizational elements such as criminal collaboration in different settings, we provide insights into the structure and dynamics of criminal organizations and contribute to a richer understanding and conceptualization of how crime is organized., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

The field of social network analysis has received increasing attention during the past decades and has been used to tackle a variety of research questions, from prevention of sexually transmitted diseases to humanitarian relief operations. In particular, social network analyses are becoming an important component in studies of criminal networks and in criminal intelligence analysis. At the same time, intelligence analyses and assessments have become a vital component of modern approaches in policing, with policy implications for crime prevention, especially in the fight against organized crime. In this study, we have a unique opportunity to examine one specific Swedish street gang with three different datasets. These datasets are the most common information sources in studies of criminal networks: intelligence, surveillance and co-offending data. We use the data sources to build networks, and compare them by computing distance, centrality, and clustering measures. This study shows the complexity factor by which different data sources about the same object of study have a fundamental impact on the results. The same individuals have different importance ranking depending on the dataset and measure. Consequently, the data source plays a vital role in grasping the complexity of the phenomenon under study. Researchers, policy makers, and practitioners should therefore pay greater attention to the biases affecting the sources of the analysis, and be cautious when drawing conclusions based on intelligence assessments and limited network data. This study contributes to strengthening social network analysis as a reliable tool for understanding and analyzing criminality and criminal networks.