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Introduction: The BetterBack model of care (MoC), a best practice physiotherapy MoC for low back pain (LBP), was implemented in Swedish primary care to improve management of patients with LBP and provide patients with support tools to better self-manage episodes of LBP. Purpose: The objective was to describe how physiotherapists in primary care experienced the implementation of the BetterBack MoC for LBP. Methods: Focus group interviews were conducted with physiotherapists in 2018–2019, 14–18 months after the introduction of the BetterBack MoC. Data were analyzed using qualitative content analysis. Results: Five focus group interviews with 23 (15 female and 8 male) physiotherapists, age range 24–61 years were analyzed. A supportive organization and adaptation to the local culture, combined with health care professionals' attitudes and collaboration between physiotherapists emerged as important factors for a successful implementation and for long-term sustainability of the MoC. Physiotherapists had differing opinions if the implementation led to change in clinical practice. Improved confidence in how to manage patients with LBP was expressed by physiotherapists. Conclusions: Several barriers and facilitators influence the implementation of a best practice physiotherapy MoC for LBP in primary care, which need to be considered in future implementation and sustainability processes. [ABSTRACT FROM AUTHOR]

We identified clusters of atypical sensory functioning adults with ASC by hierarchical cluster analysis. A new scale for commonly self-reported sensory reactivity was used as a measure. In a low frequency group (n = 37), all subscale scores were relatively low, in particular atypical sensory/motor reactivity. In the intermediate group (n = 17) hyperreactivity, sensory interests and sensory/motor issues were significantly elevated in relation to the first group, but not hyporeactivity. In a high frequency subgroup (n = 17) all subscale scores were significantly elevated and co-occurrence of hyper- and hyporeactivity was evident. In a population sample, a cluster of low scorers (n = 136) and high scorers relative to the other cluster (n = 26) was found. Identification of atypical sensory reactivity is important for targeting support.

The study compares mothers' conversation with their 4-year-old children about two past events in two autonomy-oriented (35 German and 42 Swedish families), one relatedness-oriented (22 Cameroonian Nso families) and one autonomy-relatedness oriented (38 Estonian families) contexts. German mothers were rather similar to Swedish mothers in talking a lot, providing a lot of information and engaging children into conversation, but they differed from Swedish mothers by talking more about social content. Swedish children were more independent conversational partners to their mothers than other children, including German children. Estonian mothers' contribution to conversation was similar to Cameroonian Nso mothers, except that they asked a lot of open-ended questions to engage children in conversations. Estonian children did not differ from Swedish and German children in their contribution to conversations. Compared to Swedish mothers, past event talk of Estonian mothers was characterized by a bigger proportion of talk devoted to social content, but also to the child, mental states and non-social content. It was characteristic of Cameroonian Nso mothers that they focused more on other people and actions, and their conversational dominance was larger. Differences in reminiscing were consistent with different cultural models of self and the type of autonomy--psychological or action--promoted.

Background: Cervical cancer is a global disease and it is well established that cervical cancer is caused by human papillomavirus (HPV). In Sweden self-sampling for HPV is now used as a complement to sampling performed by a midwife. However, there is a lack of knowledge on how older women perceive the self-sampling compared to the sampling performed by a midwife. Therefore, the aim of the study was to describe how women, aged 64 years and older, perceived the process of self-sampling and sampling performed by a midwife for HPV-testing. Methods: Eighteen women were included in a qualitative interview study, and a phenomenographic approach was used for the analysis of the interviews. Results: Three descriptive categories emerged: Confidence in sampling, Facilitating participation and Being informed. Within the categories, eight conceptions emerged describing the variation relating to how the women perceived the process of self-sampling and sampling performed by a midwife. Conclusions: Women in this study describe confidence in self-sampling for HPV-testing and that the self-sampling was saving time and money, both for themselves and for society. Information in relation to an HPV-positive test result is of importance and it must be kept in mind that women affected by HPV may feel guilt and shame, which health care professionals should pay attention to. This knowledge can be used in education of health care staff. Trial registration: https://researchweb.org/is/fourol/project/228071. Reg. no 228,071. [ABSTRACT FROM AUTHOR]

Background: Sensory reactivity in people with autism spectrum conditions (ASC) has been found to differ in comparison to reactivity in people without ASC. In this study sensory experiences of high-functioning individuals with ASC were explored and described. Method: Interview data from 15 participants with a diagnosis of ASC were analysed by content analysis. Results: Seven aspects of sensory experiences were identified: Being hyper- and hypo-reactive, reacting to general overload, having strong stimuli preferences, managing attentiveness to stimuli, managing sensory/motor stimuli, and dealing with consequences of sensory reactions in daily life. Conclusions: The categorisation of sensory reactivity in this study can guide clinicians on how to pose questions about sensory issues to individuals with ASC. The assessment of spectrum-specific sensory experiences in high-functioning ASC and their association with other social and nonsocial features of ASC are goals for further research.

Several municipalities in Sweden organize senior summer camps where older adults can meet and where loneliness and social isolation can be mitigated. Few studies, however, examine how the older adults themselves describe the experience in retrospect and how it might have influenced their daily lives after the stay. This study aims to fill this gap by examining how older adults who participated in a senior summer camp experience the impact the stay has had on their lives. The study has a descriptive qualitative design that uses a phenomenographic approach to explore the variations in the older adults' conceptions of how their participation at the senior summer camp may have affected them. Nineteen older adults aged between 66 and 94 years were interviewed. Three descriptive categories emerge: "Mitigating loneliness," 'Developing as a person' and 'Gaining inspiration.' The study shows that the older adults experience that the stay at the summer camp has had lasting effects on their quality of life. The sense of community at the camp helped them break the experience of loneliness, they improved their self-confidence and gained a positive attitude to life, that it is worth living and that there is much left to experience, regardless of their age. [ABSTRACT FROM AUTHOR]

Aim: Climate change and habitat loss are the main threats to forest biodiversity. Deadwood bryophyte communities are composed of species with different functional traits and are affected by these processes. Grouping species depending on their traits can help to anticipate community responses to global change, and to potential conservation actions. Location: National scale of Sweden. Taxon: Deadwood bryophyte species (15 liverworts and 8 mosses). Methods: Generalized linear mixed-effects models were applied to test for differences in projected relative changes in habitat suitability (matching species' requirements) among species with contrasting traits under varying climate and forest scenarios during the years 2020-2100. Projections were based on ensembles of species distribution models (GLM, Poisson point-process, MaxEnt), climate scenarios and national scenarios of forest management and conservation. Results: Shoot length was the best predictor of projected future changes in habitat suitability. Habitat suitabilities for small, short-lived species will decline in a warmer and wetter macroclimate, whereas those for large, perennial species will increase. We expect stronger habitat suitability decreases for obligate than for facultative dead-wood species. Increasing the proportion of set-aside forests from 16% to 32%, and reducing the harvest levels in production forests, mitigated negative habitat trends of several sensitive species. However, the potential benefits of increased conservation were even larger for species with traits favoured by climate change, suggesting that these actions will also enhance the spread of these species. Main conclusions: Climate change is expected to lead to shifts in boreal bryophyte communities towards large, competitive species and to an overall decrease in diversity. High investment in conservation actions seems necessary to maintain diversity. This should include increasing the area of forest set aside beyond 16%, and reducing harvest levels in production forests. However, whilst these actions may prevent species extinctions, at least in the short term, changes in community structure seem inevitable. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to describe patient experiences of received primary care for low back pain (LBP) according to the BetterBack Model of Care (MoC) with a focus on illness beliefs and self-management enablement. Methods: Individual interviews were conducted with 15 adults 4–14 months after receiving treatment according to the BetterBack MoC for LBP in primary care in Sweden. Data were analysed using content analysis. Results: When analysing the data, the following theme emerged; "Participant understanding of their treatment for low back pain and self-management strategies—a matter of support systems", comprising the following categories: "Knowledge translation", "Interaction and dialogue", "The health care professional support" and "Form organization". Participants experienced that they had better knowledge about their LBP and received tools to better manage their health condition. The participants expressed good communication with the treating physiotherapist and provided suggestions to further improve the treatment of LBP. Conclusions: Participants experienced that they had gained new knowledge about their health problems and after the treatment they had the tools to handle their back problems. This suggests that the BetterBack MoC may be used as a basis for a support system to provide valuable tools for self-management for patients with low back pain. [ABSTRACT FROM AUTHOR]

Background: There has been an increasing demand for emergency medical services (EMS), and a growing number of patients are not conveyed; i.e., they are referred to levels of care other than ambulance conveyance to the emergency department. Patient safety issues have been raised regarding the ability of EMS to decide not to convey patients. To improve non-conveyance guidelines, information is needed about patients who are not conveyed by EMS. Therefore, the purpose of this study was to describe and compare the proportion and characteristics of non-conveyed EMS patients, together with assignment data.Methods: A descriptive and comparative consecutive cohort design was undertaken. The decision of whether to convey patients was made by EMS according to a region-specific non-conveyance guideline. Non-conveyed patients' medical record data were prospectively gathered from February 2016 to January 2017. Analyses was conducted using the chi-squared test, two-sample t test, proportion test and Mann-Whitneys U-test.Results: Out of the 23,250 patients served during the study period, 2691 (12%) were not conveyed. For non-conveyed adults, the most commonly used Emergency Signs and Symptoms (ESS) codes were unspecific symptoms/malaise, abdomen/flank/groin pain, and breathing difficulties. For non-conveyed children, the most common ESS codes were breathing difficulties and fever of unclear origin. Most of the non-conveyed patients had normal vital signs. Half of all patients with a designated non-conveyance level of care were referred to self-care. There were statistically significant differences between men and women.Conclusions: Fewer patients were non-conveyed in the studied region compared to national and international non-conveyance rates. The differences seen between men and women were not of clinical significance. Follow-up studies are needed to understand what effect patient outcome so that guidelines might improve. [ABSTRACT FROM AUTHOR]

Background: Implementing clinical guidelines is challenging. To facilitate uptake, we developed a model of care (BetterBack Model of Care) and an implementation strategy to support management of low back pain in primary care. The aim of this study was to evaluate physiotherapists´ confidence, attitudes and beliefs in managing patients with low back pain before and after a multifaceted implementation of the BetterBack Model of Care. A further aim was to evaluate determinants of implementation behaviours among physiotherapists.Methods: This clinical trial was an experimental before and after study within a hybrid type 2 effectiveness-implementation trial. The primary outcome was Practitioner Self-Confidence Scale (PCS), secondary outcomes were the Pain Attitude and Beliefs Scale for Physiotherapists (PABS-PT) and Determinants of Implementation Behaviour Questionnaire (DIBQ). Data was analysed using repeated measures ANOVA and pairwise comparisons.Results: One hundred sixteen physiotherapists answered a questionnaire before, directly after, as well as 3 and 12 months after implementation of the Model of Care. PCS improved over time with a large effect size post implementation (ηp2 = 0.197, p < 0.001). Changes in PABS-PT were only significant after 12 months with higher biopsychosocial orientation, (ηp2 = 0.071, p < 0.01) and lower biomedical orientation, (ηp2 = 0.136, p < 0.001). Directly after the workshop, after 3 and 12 months, physiotherapists had high ratings on all DIBQ domains, (scores > 50) implying that all were potential facilitators of the implementation. However, after 3 months, all domains had significantly decreased except for organisation, social influence and patient expectation domains. However, after 12 months, organisation and social influence domains had significantly decreased while domains such as knowledge, skills and beliefs about capabilities returned to initial levels.Conclusions: Physiotherapists´ confidence and biopsychosocial orientation increased after implementation and may have the potential to improve management of low back pain in primary care. The implementation behaviour showed mostly facilitating patterns but changed over time, pinpointing a need to repeatedly monitor these changes. This can inform the need for changes of implementation efforts in different phases and support sustainability strategies.Trail Registration: ClinicalTrials.gov NCT03147300 3 May 2017, prospectivly registered. [ABSTRACT FROM AUTHOR]

Aim: To explore Swedish healthcare professionals' (HCPs) clinical experiences of the informed consent process (ICP) and to compare experiences between the professions.Methods: In this nationwide study six paediatric oncologists (POs) and eight research nurses (ReNs) from all Swedish paediatric oncology centres were interviewed. The material was analysed using Grounded theory, a qualitative constant comparative method.Results: The participants' main concern was how to fulfil research obligations without putting too much strain on a family in acute crisis, which led to the core category of balancing values and obligations of both healthcare and research. To handle the challenges the participants' struggled to safeguard the families from psychological harm, tried to adjust to the families, and gradually introduced research while building trust. The conceptual model developed in the study highlights potential consequences of this balancing act with a risk of diminishing the family's autonomy through HCPs acting authoritatively (in particular POs) or with overprotection (in particular ReNs).Conclusion: Paediatric oncology is a research integrated healthcare environment. The HCPs need personal, professional and institutional support regarding ICP-related ethical issues, decisions and implications in this intertwined context. Furthermore, HCPs need to be aware of the potential long-term risk of developing professional moral distress. [ABSTRACT FROM AUTHOR]

The aim of the present study was explore why the informants were feeling lonely and considered themselves to be in need of attending a senior summer camp, and how the informants were experiencing loneliness before they went to the senior summer camp. Interviews was made with nineteen older adult people (15 women and 4 men). A phenomenological inspired approach was used for the analysis of the interviews. Eight themes resulted: Hard to make new friends, Other circumstances making it hard to be social, Feel very lonely even if they lead rich social lives, Loss of loved ones, Do not want to do things alone, Friends make a difference, Do not feel lonely but need a change and Loneliness occurs at certain times. Through this analysis, we have gain insights to better understand loneliness as a multifaceted phenomenon that is associated with both personal circumstances and social situations. Many of the informants experienced being very lonely, even if they lead rich social lives. The experience of loneliness was connected to not having anyone they can turn to in confidence or to share experiences with and the need to belong to something or the need of a change in everyday life. [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]

Aims and objectives: To explore ambulance nurses' (ANs) experiences of non‐conveying patients to alternate levels of care. Background: Increases in ambulance utilisation and in the number of patients seeking ambulance care who do not require medical supervision or treatment during transport have led to increased nonconveyance (NC) and referral to other levels of care. Design: A qualitative interview study was conducted using an inductive research approach. Methods: The study was conducted in a region in the middle of Sweden during 2016–2017. Twenty nurses were recruited from the ambulance departments in the region. A conventional content analysis was used to analyse the interviews. The study followed the COREQ checklist. Results: The ANs experienced NC as a complex and difficult task that carried a large amount of responsibility. They wanted to be professional, spend time with the patient and find the best solution for him or her. These needs conflicted with the ANs' desire to be available for assignments with a higher priority. The ANs could feel frustrated when they perceived that ambulance resources were being misused and when it was difficult to follow the NC guidelines. Conclusion: If ANs are expected to nonconvey patients seeking ambulance care, they need a formal mandate, knowledge and access to primary health care. Relevance to clinical practice: This study provides new knowledge regarding the work situation of ANs in relation to NC. These findings can guide future research and can be used by policymakers and ambulance organisations to highlight areas that need to evolve to improve patient care. [ABSTRACT FROM AUTHOR]

Background/aims: Community-based day centres in Sweden are well-established arenas for psychiatric rehabilitation, but little is known of the attendees’ perception of the quality of the service provided. The aim of the study was thus to describe and investigate the quality of the services in community-based day centre for people with psychiatric disabilities. Methods: A sample of 218 attendees in 14 community-based day centre services in Sweden completed the Quality in Psychiatric Care - Daily Activities (QPC-DA). Results: The results showed that people with psychiatric disabilities perceived the quality of community-based day centre services as high. Most notably, quality of service was rated higher by those with lower educational level, had waited shorter time to attend the centre, and had better mental and physical health. However, particularly aspects of a secluded environment and participation (information) may be areas with potential for improvement. Conclusion/significance: From an occupational science perspective, the results adhere to the importance of occupational balance, with periods of rest/privacy during the time at the centre. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the quality of housing support provided in housing services for people with psychiatric disabilities living in ordinary housing with housing support from the residents' perspective, by using the QPC-H instrument. A sample of 174 residents in ordinary housing, receiving housing support from 22 housing support services in nine Swedish municipalities, participated in this study. The results show that the quality of psychiatric care in housing services was mainly rated highly as measured with the QPC-H instrument. The dimensionsEncounterandSecluded Environmentwere the aspects that were rated as the two with the highest quality of housing service. The dimensionsParticipationandSecure Environmentwere rated as those with the lowest quality. There were more residents who totally disagreed with the statements in the dimensionsParticipationandHousing Specificthan in the other dimensions. The perceived lower quality inEncounter, Participation, Supportand theHousing Specificdimensions was associated with a low frequency of psychiatric outpatient clinic contacts. A conclusion is that the support staff could be more observant regarding the residents' need for support and also talk more with them about what could be done to assist them. It also seems important that the support staff discuss with the residents regarding how they can help them to feel more secure in their accommodation. [ABSTRACT FROM PUBLISHER]

Purpose - The purpose of this paper is to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Housing (QPC-H) and briefly describe the residents' perception of quality of housing support. Design/methodology/approach - A sample of 174 residents from 22 housing support services in nine Swedish municipalities participated in the study. Confirmatory factor analysis (CFA) revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the Quality in Psychiatric Care (QPC) family of instruments. Findings - CFA revealed that the QPC-H consisted of six dimensions and had a factor structure largely corresponding to that found among other instruments in the QPC family of instruments. The internal consistency of the factors was acceptable except in the case of secure and secluded environment, probably due to few numbers of items. With this exception, the QPC-H shows adequate psychometric properties. Social implications - The residents' ratings of quality of housing service were generally high; the highest rating was for secluded environment and the lowest for participation. This dimension would thus seem to indicate an important area for improvement. Originality/value - The QPC-H includes important aspects of residents' assessment of quality of housing service and offers a simple and inexpensive way to evaluate housing support services from the residents' perspective. [ABSTRACT FROM AUTHOR]

Background/aimsThe aim of the present study was to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care – Daily Activities (QPC–DA) and to briefly describe the day centre attendees’ perception of the quality at community-based day centre services.MethodsA sample of 218 attendees from 14 community-based day centre services in seven municipalities in Sweden participated in the study.ResultsConfirmatory factor analysis revealed that the QPC–DA consists of six dimensions and has a factor structure that to a large extent corresponds to that found in other studies of quality in psychiatric care settings, such as inpatient, outpatient, forensic inpatient, and housing support for people with psychiatric disabilities. The internal consistency of the factors was satisfactory and thus the QPC–DA showed adequate psychometric properties. The attendees’ ratings of quality of community-based day centre services were generally high. The highest rating was for the encounter dimension and the lowest for the participation and the secluded environment dimensions, indicating areas for improvement.Conclusion/significanceThe QPC–DA includes important aspects of the attendees’ assessment of quality of community-based day centre services and offers a simple and inexpensive way to evaluate quality from their perspective. [ABSTRACT FROM PUBLISHER]

A total of 54 patients treated in psychiatric observation and intensive in-patient care units completed the questionnaire Quality in Psychiatric Care – In-patient (QPC-IP). The patients rated the quality highest in the dimension Encounter and lowest in the dimension Discharge. Those patients who knew who their doctor was, or where to complain, having prescription of medication, being discharged to their own homes, having a planned contact after treatment or having a supportive talk, rated significantly higher quality of care. Demographic factors were shown to have had only a minor impact on quality of care. Using the QPC-IP gave valuable information about patient's perceptions of quality of care and identified areas important to improve. [ABSTRACT FROM PUBLISHER]

Purpose: The aim of the study was to compare primary total hip arthroplasty (THA) implantations between different countries in terms of THA number per inhabitant, age, and procedure type and to compare the survival curve including all THAs using hip arthroplasty registers. Methods: THA registers were compared between different countries with respect to the number of primary implantations per inhabitant and age, procedure type and survival curve. We performed a literature search for all national hip arthroplasty registers providing annual reports for 2009 or, if not available, a more recent period. The data from these reports were analysed in terms of number, age distribution and procedure type of primary THAs and survival curves. Results: We identified nine hip arthroplasty registers, which comprised sufficient data to be included. A large variation was found in the annual number of primary THA implantations per inhabitant. The procedure type varied greatly as well, e.g. in Sweden 67 % are cemented THAs whereas in Emilia-Romagna (Italy) 89 % are cementless THAs. Conclusions: This study revealed large differences in terms of the annual number of primary THAs per inhabitant and primary THA procedure type across countries. These data can be used to rank local primary THA implantations within an international context. [ABSTRACT FROM AUTHOR]

The article discusses a study to evaluate the efficacy of different study designs on the outcome of data within the European Randomized Study of Screening for Prostate Cancer (ERSPC). Data was collected from the Gothenburg centre and the Rotterdam centre. The findings indicated that an efficacy trial with informed consent prior to randomization would have provided a better screening bias, and an effectiveness trial with consent after randomization will effectively estimate mortality reduction.

Accessible summary This paper describes Swedish outpatients' perception of the quality of psychiatric care they received. A large number of patients (1340) from 15 outpatient clinics participated in the study., A newly developed and tested questionnaire, the Quality in Psychiatric Care - Out-Patient, was used., The patients' highest ratings were for Encounter (staff-patient interaction), the lowest were for Discharge. Most notably, quality of care was rated higher by women, older people, those with a partner, those with a lower educational level and those who were gainfully employed. In relation to the visit to the clinic, higher quality of care was associated with shorter waiting time, better information and meeting with fewer professions. Older people and those gainfully employed reported better mental health. The longer the waiting time and the greater the number of professions met, the poorer mental health was reported., The conclusion was that although a majority of the patients rated the quality of outpatient care as high, aspects of it remain unsatisfactory. The Quality in Psychiatric Care - Out-Patient offers an easy way to assess patients' perception of the quality of care they receive as an outpatient and has a useful role to play in quality-assurance evaluations., Abstract The influence of demographic characteristics on patients' ratings of the quality of psychiatric outpatient care has been given little attention in research. The aim of the present study is to elucidate the quality of psychiatric care among outpatients and investigate demographic and clinical factors associated with the way in which this quality is perceived. A sample of 1340 outpatients from 15 general adult psychiatric clinics in Sweden completed the Quality in Psychiatric Care - Out-Patient (QPC-OP), with a response rate of 71%. The patients' highest ratings were for Encounter; the lowest were for Discharge. Most notably, quality of care was rated higher by women, older people, those with a partner, those with a lower educational level and those who were gainfully employed. In regard to visits to the clinic, higher quality of care was associated with shorter waiting time, better information and fewer professions encounters. Older people and those gainfully employed reported better mental health. Thus the QPC-OP was associated with both demographic and clinical factors. In particular, 'wanting to come back to the clinic' was the single strongest predictor of quality. [ABSTRACT FROM AUTHOR]

The article discusses spatial planning and intrinsic understandings of infrastructures. The author compares changes in the understandings of infrastructures by the public administrations of Sweden, France and Germany. Presented are the results of the comparison, that show that there are key differences such as between urban and rural areas have been replaced by relational distinctions. Also mentioned is that the accessibility of the infrastructures have become the main criteria for achieving adequate supply of infrastructures.

ABSTRACT The purpose of the present study was to test the psychometric properties and dimensionality of the Quality in Psychiatric Care - Outpatient (QPC-OP) instrument, in order to determine whether the model of QPC that is applicable to the inpatient clinic is also applicable to the outpatient clinic, and to briefly describe the patients' perceptions of quality of psychiatric outpatient care. A sample of 1340 outpatients from 15 general adult psychiatric clinics in Sweden participated in the study. A confirmatory factor analysis revealed that the QPC-OP consists of eight dimensions, and has a factor structure largely corresponding to that of the QCP - Inpatient instrument. The internal consistency of the factors was generally acceptable, except in the case of two, where there were not enough items. Thus, the QPC-OP shows adequate psychometric properties. The patients' ratings of quality of care were generally high; the highest rating was for 'encounter' and the lowest for 'discharge'. The quality of discharge was rated as the lowest among the eight dimensions in 14 of the participating outpatient clinics. Thus, this dimension would seem to indicate an important area for improvement. The QPC-OP includes important aspects of patients' assessments of quality of care, and offers a simple and inexpensive way to evaluate psychiatric outpatient care. [ABSTRACT FROM AUTHOR]

A new program of Compton scattering on deuterium is under way at the tagged-photon facility at MAX-Lab in Lund, Sweden. We will measure differential cross sections between 60° and 150° over the photon energy range 60–115 MeV in 5 MeV steps, with the ultimate goal of obtaining new precision information on the electric and magnetic polarizabilities of the neutron. [ABSTRACT FROM AUTHOR]

Background. Despite a significant reduction in the prevalence of dental caries, childhood tooth decay is still a public health problem in both developed and developing countries. Objective. The aim of this study was to evaluate the caries preventive effect of an oral health programme for preschool children living in a low socioeconomic multicultural area in the city of Malmö, Sweden. Methods. Eight hundred and four 2-year-old children were enrolled and recalled every third month between ages 2 and 3 and semi-annually between ages 3 and 5 years. From an outreach facility, parents were instructed on oral health with a focus on toothbrushing and diet, and provided fluoride tablets free of charge. Participants completed a clinical examination and a structured interview at age of 5 years, at which point 651 children (81%) remained in the programme. The results of the intervention group were compared with a non-intervention reference group consisting of 201 5-year-old children from the same district. Results. In the intervention group, 96% attended four or more of their scheduled appointments, and mean caries prevalence was significantly lower than in the reference group (5.4 deft vs. 6.9 deft; P < 0.001). The prevented defs fraction was 27%. Parents’ daily assistance with toothbrushing and administering fluoride tablets was significantly better in the intervention group than in the reference group ( P < 0.05). Conclusion. This study demonstrated that the early start of oral health programme had a significant beneficial effect on caries prevalence after 3 years. [ABSTRACT FROM AUTHOR]

Background The incidence of prostate cancer has increased substantially since it became common practice to screen asymptomatic men for the disease. The European Randomized Study of Screening for Prostate Cancer (ERSPC) was initiated in 1993 to determine how prostate-specific antigen (PSA) screening affects prostate cancer mortality. Variations in the screening algorithm, such as the interval between screening rounds, likely influence the morbidity, mortality, and quality of life of the screened population. Methods We compared the number and characteristics of interval cancers, defined as those diagnosed during the screening interval but not detected by screening, in men in the screening arm of the ERSPC who were aged 55-65 years at the time of the first screening and were participating through two centers of the ERSPC: Gothenburg (2-year screening interval, n = 4202) and Rotterdam (4-year screening interval, n = 13301). All participants who were diagnosed with prostate cancer through December 31, 2005, but at most 10 years after the initial screening were ascertained by linkage with the national cancer registries. A potentially life-threatening (aggressive) interval cancer was defined as one with at least one of the following characteristics at diagnosis: stage M1 or N1, plasma PSA concentration greater than 20.0 ng/mL, or Gleason score greater than 7. We used Mantel Cox regression to assess differences between rates of interval cancers and aggressive interval cancers at the two centers. All statistical tests were two-sided. Results The 10-year cumulative incidence of all prostate cancers in Rotterdam versus Gothenburg was 1118 (8.41%) versus 552 (13.14%) (P<.001), the cumulative incidence of interval cancer was 57 (0.43%) versus 31 (0.74%) (P = .51), and the cumulative incidence of aggressive interval cancer was 15 (0.11%) versus 5 (0.12%) (P= .72). Conclusion The rate of interval cancer, especially aggressive interval cancer, was low in this study. The 2-year screening interval had higher detection rates than the 4-year interval but did not lead to lower rates of interval and aggressive interval prostate cancers. [ABSTRACT FROM AUTHOR]

Features Nordic Clearinghouse for Media and Communication Reasearch (Nordicom), a supranational research organization at Gothenburg University of Sweden. Services offered; Structures and organization; Goals; Budgets; Plans; Contact details.

The aim of this study was to compare rectal sedation with diazepam and rectal sedation with midazolam with regard to sedative effect, treatment acceptance, and amnesia. Ninety children, 1.5-3.5 years of age, consecutively referred for extractions of traumatized primary incisors were randomly sedated with diazepam (0.7 mg/kg body weight) or midazolam (0.3 mg/kg body weight). The study design was randomized and double-blind. The level of sedation (state of mind) was assessed prior to and 10 and 60 min after administration of the drug by use of a behavioral scale (Wilton). The children's acceptance of procedures was assessed using another behavioral scale (Holst) during administration of the sedative, application of topical anesthesia, injection of a local anesthesia, and extraction. Amnesia was evaluated by the parents on the following day, with the child being asked standardized questions. Parental ratings of the child's and their own distress during and after treatment were made on a visual analog scale (VAS). No differences were found between the sedatives concerning level of sedation during treatment, acceptance of procedures, or amnesia. At discharge, 60 min after administration of the sedative, the children receiving diazepam were significantly more agitated (P = 0.006). Parental rating on a VAS of the child's discomfort after treatment was significantly higher in the diazepam group (P = 0.006). There was a tendency for children with poor acceptance of the rectal administration to display a more negative acceptance of the dental treatment. In conclusion, the present results, in combination with known pharmacological advantages, indicate that midazolam is preferable in outpatients when sedation is needed and amnesia is desirable. [ABSTRACT FROM AUTHOR]

Abstract: Background: Prediction models need external validation to assess their value beyond the setting where the model was derived from. Objective: To assess the external validity of the European Randomized study of Screening for Prostate Cancer (ERSPC) risk calculator (www.prostatecancer-riskcalculator.com) for the probability of having a positive prostate biopsy (P(posb)). Design, setting and participants: The ERSPC risk calculator was based on data of the initial screening round of the ERSPC section Rotterdam and validated in 1825 and 531 men biopsied at the initial screening round in the Finnish and Swedish sections of the ERSPC respectively. P(posb) was calculated using serum prostate specific antigen (PSA), outcome of digital rectal examination (DRE), transrectal ultrasound and ultrasound assessed prostate volume. Measurements: The external validity was assessed for the presence of cancer at biopsy by calibration (agreement between observed and predicted outcomes), discrimination (separation of those with and without cancer), and decision curves (for clinical usefulness). Results and limitations: Prostate cancer was detected in 469 men (26%) of the Finnish cohort and in 124 men (23%) of the Swedish cohort. Systematic miscalibration was present in both cohorts (mean predicted probability 34% versus 26% observed, and 29% versus 23% observed, both p <0.001). The areas under the curves were 0.76 and 0.78, and substantially lower for the model with PSA only (0.64 and 0.68 respectively). The model proved clinically useful for any decision threshold compared with a model with PSA only, PSA and DRE, or biopsying all men. A limitation is that the model is based on sextant biopsies results. Conclusions: The ERSPC risk calculator discriminated well between those with and without prostate cancer among initially screened men, but overestimated the risk of a positive biopsy. Further research is necessary to assess the performance and applicability of the ERSPC risk calculator when a clinical setting is considered rather than a screening setting. [Copyright &y& Elsevier]

Purpose: Evaluating the quality of psychiatric care from the patient's perspective is crucial to measure the effectiveness of the provided care. This study aimed to translate the original Swedish Quality in Psychiatric Care - Inpatient (QPC-IP) instrument into Faroese, adapting it to the specific context of psychiatric inpatient care in the Faroe Islands, conducting a detailed evaluation of its psychometric properties, and to describe patients' perception of quality of psychiatric care., Materials and Methods: Following a thorough translation and back-translation, the content validity of the Faroese QPC-IP was confirmed by a group of Faroese patients. Subsequently, the instrument was completed by 61 psychiatric inpatients., Results: Item total correlations revealed that most items strongly correlated with their intended dimensions, mirroring the original Swedish version. However, a noteworthy exception was found in the discharge dimension, leading to the exclusion of an item related to helping find an occupation; this task was not performed by the ward. While the internal consistency of the overall scale was excellent, specific dimensions exhibited lower consistency., Conclusions: The translation and cultural adaptation of the Faroese QPC-IP proved satisfactory. The psychometric evaluation affirmed a shared understanding of the quality of psychiatric care in both Faroese and Swedish cultural contexts. As a result, the Faroese QPC-IP emerges as a valuable instrument for assessing the quality of psychiatric care in the Faroe Islands. Its utility extends to quality assurance initiatives and contributes to cross-cultural research examining the quality of psychiatric care from the patient's perspective.

Purpose: This study evaluates the dimensionality and differential item functioning of SCL-9S, a short version of the Symptom Checklist-90-R (SCL-90-R), on patients in psychiatric care., Material and Methods: Based on the factor structure of the Swedish standardization and validation of the SCL-90-R, a nine-item index (SCL-9S) was developed consisting of the items most indicative for each of the nine subscales in SCL-90-R. Rasch analysis was used to evaluate the SCL-9S on a sample of 668 psychiatric outpatients and 167 inpatients across four Swedish regions., Results: The evaluation revealed that the SCL-9S was unidimensional, the items represented different levels of severity across a general psychological distress dimension, and the scale showed equity (no differential items functioning) across gender and patient groups., Conclusion: The SCL-9S is a fast, structurally valid, and reliable tool for screening general psychological distress among men and women in psychiatric in- and outpatient services, and in combination with other instruments, it will be useful in epidemiological studies.

The study describes and compares perceived quality of care among patients and staff using the Quality in Psychiatric Care-Forensic In-Patient and the Quality in Psychiatric Care-Forensic In-Patient Staff questionnaires. The questionnaires are both based on the perception of the quality of the forensic psychiatric care given to the patients, but the wording is adjusted to fit patients or staff. The study sample consisted of 66 patients and 202 staff members from 12 forensic units in Sweden. Using multiple regression analyses to adjust for demographic variables, it was found that patients perceived the quality of support and secluded environment lower than did staff, whereas staff had lower perceptions than patients of the quality of secure environment. The combination of these questionnaires provides new possibilities for assessing the quality of forensic psychiatric care and evaluating interventions, important factors in the management and planning of forensic care.

The aim of this study was to evaluate the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Forensic In-Patient and to describe the quality of psychiatric care among forensic in-patients. The study group consisted of patients all receiving care during 2 weeks in September 2009 and meeting the inclusion criteria. A sample of 134 in-patients from 34 forensic wards in Sweden participated. Confirmatory factor analysis revealed a seven-factor structure, and 69% of the patients reported the quality of care as high. The highest rating was for the secluded environment dimension, and the lowest was for the participation dimension. The Quality in Psychiatric Care-Forensic In-Patient is a reliable and valid measurement instrument recommended for use in evaluating quality in forensic in-patient care.

Purpose: The principal aim of this paper is to develop an instrument to measure quality of care in the psychiatric setting from an in-patient perspective and to describe quality of care by means of this instrument. A further aim is to investigate the influence of background variables and expectations on the experience of care., Design/methodology/approach: The instrument "Quality in psychiatric care" consists of two parts: one for measuring the patient's expectations regarding quality of care, the other for measuring his or her experiences regarding it. The instrument was derived from an earlier interview study of patients' perceptions of the quality of psychiatric care. A sample of 116 patients from eight in-patient wards in Sweden participated in the present study., Findings: Results indicate a generally high quality of care. Experienced quality of care was significantly lower, however, than expectations in all the dimensions of the instrument: total dimension, dignity, security, participation, recovery and environment. Patients who perceived that the time of discharge was consistent with the stage of their illness experienced significantly higher Recovery; patients with good psychiatric health experienced this too, but also significantly higher participation., Research Limitations/implications: This new instrument needs to be further tested before the psychometric properties can be established., Originality/value: The value of the research is that instruments for measuring the quality of in-patient psychiatric care from the patient's perspective and with a theoretical foundation are less common.

Quality of care is a multidimensional concept and has been given different meanings in the literature. The aim in the present study was to describe how the psychiatric care staff and care associates perceived the concept of quality of care in the case of psychiatric care. Ten staff and 10 associates were interviewed. Qualitative method with a phenomenographic approach was used for the analysis. Four descriptive categories emerged: The patient's dignity is respected, The patient's participation in the care, The patient's recovery, and The patient's care environment plays an important role. Quality of care was perceived as a positive concept and as being of great importance for the patient's health and conditions of living. The results were of importance with regard to the forthcoming development of an instrument to measure the quality of psychiatric care.