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This article builds on a classroom study and interviews with facilitators and students on a travelling Folk High School course on global justice and development, an education that raises awareness about colonial history and contemporality. The study explores how the concept of being 'in and against' presents itself in the narratives of the research participants, and what those narratives can say about institutional and global conditions for transnational popular educational engagement. The results mirror the ambiguities of criticising the global, structural, and institutional conditions, while also relying on the same prerequisites, to conduct the course. It shows how working in and against the classroom, as expressed from the different perspectives of the students and the facilitators, entails countering both global and institutional material orders as well as prevailing hegemonic knowledge, and working in and against a gendered, classed, and racialized classroom.

Purpose: Learning new vocabulary has been identified as a challenge for students with (developmental) language disorder ((D)LD). In this study, we evaluate the effects of two active learning methods, (a) retrieval practice (RP) and (b) rich vocabulary instruction (RVI), in a group of students with (D)LD in secondary school. Method: A quasi-experimental counterbalanced within-subject design was used to compare and evaluate the effect of RP and RVI on learning Tier 2 vocabulary, with target and control words as dependent measures. Eleven students with (D) LD (M[subscript age] = 14.9 years) attending a language unit participated. RP and RVI were implemented in regular classroom activities during 16 lessons (eight lessons/instructional condition). Learning was assessed by comparing performance on a pretest session 1-2 weeks prior, with posttest performance 1 week after each instructional condition. Results: The learning gain for RP was superior to that for RVI, both with respect to the Bayesian probabilistic estimations for target words relative to control words and in direct comparison with RVI. Only weak evidence was found for RVI with respect to the Bayesian probabilistic estimations for target words relative to control words. Conclusions: All participants showed positive learning gains following RP, whereas the outcome for RVI was more diverse. This initial work suggests that RP promotes larger learning gains relative to RVI and promotes learning across language profiles. This study extends previous studies by exploring the implementation of RP in regular classroom activities and by using more complex to-be-learned material (Tier 2 words).

The testing effect, defined as the positive effect of "retrieval practice" (i.e., self-testing) on long-term memory retention relative to other ways to support learning, is a robust empirical phenomenon. Despite substantial scientific evidence for the testing effect, less is known about its effectiveness in relation to individual differences in cognitive ability. In the present study, we examine whether the effect of retrieval practice is beneficial independent of cognitive ability using behavioral and brain imaging data. In a within-subject design, upper-secondary students learned Swahili-Swedish word pairs through retrieval practice and study. The testing effects were assessed at a direct test and for a subsample after 1- and 4-weeks retention intervals, respectively. Another subsample performed the 1-week retention test during functional MRI (fMRI). Memory retention was analyzed in relation to an educationally relevant composite score dividing participants into low, intermediate, and high cognitive-ability groups. We provide behavioral evidence that the testing effect is independent of cognitive ability. The fMRI findings confirmed a general effectiveness of retrieval practice by showing that brain regions associated with successful retrieval of conceptual representations and semantic processing were more strongly engaged after retrieval practice in all cognitive-ability groups. It is argued that the advantages of retrieval practice should be conveyed to all teachers and students.

Retrieval practice is a learning technique that is known to produce enhanced long-term memory retention when compared to several other techniques. This difference in learning outcome is commonly called "the testing effect". Yet there is little research on how individual differences in personality traits and working memory capacity moderate the size of the retrieval-practice benefits. The current study is a conceptual replication of a previous study, further investigating whether the testing effect is sensitive to individual differences in the personality traits Grit and Need for Cognition, and working memory capacity. Using a within-subjects design (N = 151), participants practiced 60 Swahili-Swedish word pairs (e.g., adhama-honor) through retrieval practice and re-studying. Learning was assessed at three time points: five minutes, one week, and four weeks after practice. The results revealed a significant testing effect at all three time points. Further, the results showed no association between the testing effect and the personality traits, or between the testing effect and working memory, at any time point. To conclude, retrieval practice seems to be a learning technique that is not moderated by individual differences in these specific personality traits or with working memory capacity, thus possibly beneficial for all students.

Purpose: The suicidal process contains both observable and non-observable phases, and patients have described the process as characterized by loneliness and darkness. Ambulance clinicians encounter patients in all phases of the suicidal process but little is known on what meaning this encounter has to the patients. The aim of this study was to elucidate meanings of encountering ambulance clinicians while being in a suicidal process. Methods: Data were collected through fifteen individual interviews with eight participants who had lived experiences of encountering ambulance clinicians. Inductive design using phenomenological hermeneutical approach was used. Findings: Patients are impacted by the clinicians, both in how they find their value in the situation, but also in expected trajectory. Three themes; 'Being impacted by representatives of society', 'Being unsure of one´s own value' and 'Regaining hope in moments of togetherness' generated the main theme ´Navigating oneself through the eyes of the other´. Conclusion: The way ambulance clinicians communicate impacts how patients navigate themselves in the ambivalence about living or dying, and the encounter either consolidate a feeling of being a burden, or instil hope of an endurable life. Through conversation, clinicians could support the patients in taking the first steps in the journey of recovery. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to explore how health care providers at youth clinics (YCs) in Sweden engage with, focus on, and navigate across the mental health youth space, while upholding the core bedrock principle of "youth-centeredness". Methods: Qualitative interviews were conducted with 21 health care professionals working in three YCs located in three different regions of Sweden. Data were analysed using reflexive thematic analysis informed by the work of Braun and Clarke. Results: The three themes were: 1) "youth mission—at the core of the YCs" work and challenged by a stronger involvement in mental ill health'; 2) "YCs" unique and complementary role in the youth mental health system: a holistic perspective, team work, and a focus on normalization', and 3) "Caught between a rock and a hard place: to treat at a care level that is not optimal for the young users" needs or to refer within an unreliable system'. Conclusion: This study reflects the individuality and key features of YCs, their widening roles within the mental health sphere, and the challenges faced in maintaining and expanding the characteristic "youth-centred" approach while expanding their work with mental health. [ABSTRACT FROM AUTHOR]

Although many studies have investigated teaching in one-to-one computing classrooms, not many have considered the material dimension as equally important to the human dimension. Thus, by using a sociomaterial perspective, we aim to broaden the discussion about emergent teaching practices in Nordic classrooms where students use tablets as personal devices. We therefore provide three vignettes from ethnographic classroom studies in Sweden, Finland and Denmark. These illustrate how tablets were used in specific classrooms. In our qualitative analysis of the vignettes, we draw on the concept of patterns of relations to describe the dynamic entanglements of the emergent teaching and learning practices. These are patterns of 1) interrogation, 2) spacemaking and 3) materialisation. Our findings show that tablets do not enter empty learning spaces but are woven into and participate in forming ways of teaching in one-to-one classrooms. Teachers must therefore learn to engage with and manage complex relationships rather than learn how to use an iPad.

Given previous findings on test enhanced learning, the present study examined the implementation of this practice in terms of quizzing, during the progress of a course. After completing the university course, 88 Swedish teacher students were asked to answer an adapted Retrieval Practice and Test Anxiety Survey. The results showed that students perceived quizzing to improve learning, and reduce test anxiety. Nonetheless, based on students' misconceptions regarding why quizzing actually enhances learning, it is suggested that implications of test enhanced learning was not fully conveyed. It is for educational purpose imperative to not forget this application.

An increased interest in health, diet, and physical activity exist among young people, in this study termed 'fitness hype'. Viewing the body and health as commodities can be understood as part of a healthism discourse. In this study, we explored how Swedish high school students perceive and negotiate the trend regarding exercise, diet and body ideals. Semi-structured interviews were conducted with ten high school students, aged 16-18 years, from various educational programs and with varying levels of physical activity. Using qualitative content analysis, we developed one overarching theme "navigating life satisfaction in the face of an 'unhealthy fitness hype'". Four additional, interrelated categories showed how the young people negotiated this developing trend through: (1) the quest for social recognition and value, (2) social media sets the standards, (3) the paradox of strong and skinny as the new standard, and (4) the need for new safety nets. Our results highlight the young people's perceptions of an excessive and influential focus on health and exercise in contemporary society. They described a fitness hype as exorbitant and unhealthy ideals of body and exercise, and understood this as problematic. Social media was seen as contributing to this hype as a powerful arena for 'the quest for social recognition and value'. While not all the young people felt negatively affected by the fitness hype, they perceived its influence on their lives. Further, body and fitness ideals were gendered. Teenage girls faced the paradox of shaping themselves as 'strong "and" skinny'. Social ties were recognized as an important safety net, particularly classmates, sports mates, and coaches. Knowledge of these problems from the perspective of young people is crucially needed among health professionals and educators. Further research should explore additional support strategies, and young people's experiences of fitness hype among additional youth groups.

Aim: To explore healthcare workers' experiences of the changed caring reality during the COVID‐19 pandemic in Sweden. Design: An online fully mixed‐methods design. Methods: A web‐based self‐reported questionnaire with fixed and open‐ended answers collected data from March to April 2021, analysed in three steps. First, free‐text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta‐inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting. Results: Meta‐inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post‐traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy. Conclusions: Forcing oneself to perform beyond one's limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID‐19 pandemic and to prevent mental health illness in future crisis. Patient or Public Contribution: No patient or public contribution. Summary: The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta‐analyses and systematic reviews. In‐depth understanding on experiences and how symptoms of post‐traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post‐traumatic stress disorder. Implications for Practice/Policy: This study might guide how to prepare for resilience in future emergencies. [ABSTRACT FROM AUTHOR]

Understanding the media as co-producer of education policy is at the centre of this study. The media's strong focus on education crisis in recent decades serves as a background. The aim is to investigate education discourses that are dominantly actualised in media texts during electoral periods, and to analyse how they construct education and subjectify teachers. A further aim is to be responsive to discourses that are alternative to those dominating. Theories with reference to Foucault, Deleuze and New Media Theory are used. Two text bodies from a Swedish newspaper in the electoral years of 1998 and 2014 are analysed. The findings indicate a changed media apparatus in 2014 due to digitalisation, a dichotomisation of education that increases over time, the construction of an educational crisis evident in 1998 and despotically set in 2014, where teachers, who are positioned as heroes in 1998, are blamed and held accountable in 2014. There are some scarce and murmurs of alternative discourses in the hyper-textual media apparatus of 2014 that bring hope of a different educational policy debate to come.

Collaborative digital textbooks--comprehensive materials covering entire curriculums--are developing from being books in pdf format to becoming collaborative digital environments where teachers and students can communicate, engage in feedback and discussions, share and manipulate materials, test knowledge, and monitor results. This study investigates how these digital environments are used in school practice: How are the collaborative tools used to improve learning? Thirteen seventh- and eighth-grade classes, 370 students and 30 teachers in five Swedish secondary schools, were investigated over 1,5 years by means of questionnaires, classroom observations and interviews with teachers and students. Here, questionnaire results are presented, while observations and interviews serve to provide contextual insights. Collaborative tools were very little used; often teachers and students were not even aware of their existence. Most use was individual, students were left alone with the digital material. Students read or listened to the text and did not actively engage in learning by e.g. making notes or marking text. Most teachers did not use the material actively to help students understand and learn, most did not even check student results on automated tests. We conclude that the teachers have not incorporated the new, collaborative design of the digital textbook into their thinking regarding tools for teaching and learning and still regard it as a static book. This suggests that making full use of digital tools requires new ways of thinking of teaching, and that it takes more than providing digital tools to achieve this end.

A multitude of different technologies are used in school today. Some are provided by the school and others are brought by the individual teacher or student. In addition, different applications are available. In this study the focus is on student-initiated uses of technology and how it conditions learning. Based on a case study with surveys, interviews and an observational time study, it is shown that students appear to be the most frequent users of technology in the classroom and for the most part initiate its use. We also show that they often initiate uses directed towards communication and inquiry. Against the prevailing understanding that students mainly use technology for extra-curricular activities, we found that most of the student-initiated technology and applications related to the task in hand and were therefore not regarded as problematic by teachers or students. However, with regard to student-initiated uses of social media, games and communicative applications the picture is more diverse. In this context, teachers and students complain that such use may distract students, although some regard it as rewarding, for example due to the informal learning or time for contemplation and relaxation that results. We conclude by questioning the dichotomies of curricular-non-curricular and intended-unintended learning and we argue for the need to add contemplation to the taxonomy used for understanding the educational use of information technologies as conditions for learning.

Retrieval practice is known to lead to better retention of a to-be-learned material than restudy (i.e., the testing effect). However, few studies have investigated retrieval practice in relation to working memory capacity (WMC) and personality characteristics such as grittiness (Grit) and need for cognition (NFC). In two experiments, we examined retrieval practice and restudy of Swahili-Swedish word pairs in relation to individual differences in Grit and NFC. In Experiment 1, using a between-subjects design, a significant main effect of retention interval was qualified by a Group Retention Interval interaction. However, there were no effects of Grit or NFC. In Experiment 2, a within-subjects design was used, and a measure of WMC was included. The analyses revealed a testing effect; but again, WMC, Grit, and NFC were not significantly associated with performance. These results indicate that retrieval practice levels out the playing field regarding WMC, NFC, and Grit.

Background: Youth mental health is a major health concern in almost every country. Mental health accounts for about 13% of the global burden of disease in the 10-to-19-year age group. Still there are significant gaps between the mental health needs of young people and the quality and accessibility of available services. Collaboration between health and social service actors is a recognized way of reducing gaps in quality and access. Yet there is little scientific evidence on how these collaborations are applied, or on the challenges of cross-boundary collaboration in the youth mental health space. This study aims to explore how collaboration is understood and practiced by professionals working in the Swedish youth mental health system. Methods: We conducted 42 interviews (November 2020 to March 2022) with health and social care professionals and managers in the youth mental health system in Sweden. Interviews explored participants' experience and understanding of the purpose, realization, and challenges of collaboration. Data were analysed under an emergent study design using reflexive thematic analysis. Results: The analysis produced three themes. The first shows that collaboration is considered as essential and important, and that it serves diverse purposes and holds multiple meanings in relation to professionals' roles and responsibilities. The second addresses the different layers of collaboration, in relation to activities, relationships, and target levels, and the third captures the challenges and criticisms in collaborating across the youth mental health landscape, but also in growing possibilities for future development. Conclusion: We conclude that collaboration serves multiple purposes and takes many shapes in the Swedish youth mental health system. Despite the many challenges, participants saw potential in further building collaboration. Interestingly our participants also raised concerns about too much collaboration. There was scepticism about collaboration directing attention away from young people to the professionals, thereby risking the trust and confidentiality of their young clients. Collaboration is not a panacea and will not compensate for an under-resourced youth mental health system. [ABSTRACT FROM AUTHOR]

In this article, the authors explored how laptops used in 1:1 classrooms affect cooperation and collaboration practices. Based on an observational time study, the authors found that the most common activity in 1:1 classrooms is group work using the computer. They also found that, despite what the concept 1:1 alludes to about one student working with one computer, most laptop use takes on other forms such as two students working with one computer (1:2) or two students working together using two laptops (2:2). The findings reported in this article about the various different collaboration arrangements have implications for both research and practice. For practice, because teachers can arrange activities based on an awareness of the different student--laptop constellations that emerge when students are given a laptop. Research is likewise informed about the various group work constellations and can build on this knowledge for further analysis of the pros and cons with the different collaborative forms.

Pupils in Sweden are socialized in commercial off-the-shelf games, and, therefore, game-oriented formal education can constitute a foundation for further socialization of pupils excluded in school. However, digital illiteracy and traditional views among school staff forced a regression from the game-oriented formal trial education in this study back to the traditional education form. Research questions were as follows: How did the pupils act upon the consequences of the regression? How can these acts inform the design of education in digital culture? These questions were addressed using ethnography over 3 years. The pupils' acts differed depending on their socialization in school and in games. While the game-oriented formal education included all in the socialization process, the regression caused half of the pupils to drop out. The pupils' acts are discussed with a conceptual framework. Conclusions show the need for digital literacy and understanding pupils' perspectives on education among school staff.

The aim of this study was to examine the performance of fifth-grade children in the reproduction of the content of a new text directly after they had read it (immediate recall) and one week later (delayed recall), as well as to investigate the relationship between performance, self-reported memory strategies, and working memory capacity (WMC). The results revealed that more complex strategies are associated with better performances, and that children with a high WMC outperformed children with a lower WMC in immediate and delayed text recall tasks. Hierarchical regression analyses showed that memory strategy and WMC are the strongest predictors for both immediate and delayed recall tasks. It is argued that one can use self-reported memory strategies to estimate strategy proficiency. Awareness of the importance of memory strategies and children's WMC in education are further discussed.

There is a debate about the advantages and disadvantages of using social media in education. Drawing on interviews and surveys with students and teachers in three Swedish schools, this study finds that students as well as teachers find much of the students' social media use distractive to learning. We investigate this by means of an interpretative study of students' and teachers' experiences. We find that concerns relate to how social media use makes students less social, how weaker students are more likely to get distracted, how teachers lack strategies for tackling the problem and how the responsibility of the use is delegated to the students. We discuss how the distractive use of social media is made possible as a result of education policies requiring a higher degree of individual work, individual responsibility, and educational choices for students. Teachers and school leaders need to jointly reclaim the students and coping strategies for the distractive use are urgently needed.

In this article, we discuss residential staff in Sweden. Here, residential care is part of the municipal child welfare system, which covers services targeting juvenile delinquency as well as other residential care services. Children and young people placed in Swedish residential care have diverse needs, from mainly supportive needs to advanced behavioral problems, and the field consists of open and secure residential care units. There is limited knowledge about the staff working in residential care. This article helps to fill this knowledge gap by giving an overall picture of staff educational attainments, age and gender in Swedish residential care between the years of 2008–2020. To reason about staff qualifications, we use theoretical concepts from sociological theory on professions. Findings show that residential care in Sweden can be analyzed as a pre-professional field, dominated by staff with low levels of education. In addition, we show that the field is dominated by women – even if the proportion of men is higher than in other areas of social work – and that the majority of staff are between 30 and 64 years old. Some differences between open and secure residential care were found, the most notable concerning educational levels and gender. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular disorders (TMD) are common and therefore managed by dentists on a daily basis. However, patients with TMD consistently go undetected and therefore untreated in dentistry. The reasons for these shortcomings have not been fully explored, specifically with regard to patients' perspectives. Therefore, this study aimed to explore patients' experiences of TMD and related treatment, with special focus on the experiences of having TMD, factors related to seeking care, and perspectives on received treatment. Methods: Purposive sampling was used to recruit adult patients at the Public Dental Health services (PDHS) in the Region of Västerbotten, Sweden, during 2019. Individual semi-structured interviews were conducted and analysed using Qualitative Content Analysis. Sixteen patients were interviewed (ten women and six men, 20–65 years). The interviews probed the patients' perspectives of having TMD, seeking care, and receiving treatment. All participants were also examined according to the Diagnostic Criteria for TMD (DC/TMD) and qualified for at least one DC/TMD diagnosis. Results: The data analysis led to the main theme Seeking care when the situation becomes untenable, but dental care fails to meet all needs. The patients expressed worry and social discomfort because of the symptoms but still strived to have an as normal daily life as possible. However, severe symptoms and associated consequences compelled them to seek professional help. Experiences of distrust together with challenges to access the PDHS were identified and related to the patients' unfulfilled expectations. Conclusions: Patients' reported experiences indicate that receiving timely and appropriate care is more of an unfulfilled expectation than the current state of management of patients with TMD in dentistry. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the relationship between working memory capacity and mathematical performance measured by the national curriculum assessment in third-grade children (n = 40). The national tests concerned six subareas within mathematics. One-way ANOVA, two-tailed Pearson correlation and multiple regression analyses were conducted. The results showed that working memory could be deemed as a predictor for the overall mathematical ability. However, the significance of working memory contributions varied for the different mathematical domains assessed. Working memory contributed most to basic mathematical competencies. Algorithms were not explained significantly by working memory. The contributions of different working memory resources varied as a function of the mathematical domain, but in certain respects the variance was shared across the elements and both visuo-spatial and phonological abilities seem important for mathematic performance. We suggest that individuals' working memory capacity is important to take into consideration in learning. (Contains 4 tables.)

Introduction: The Swedish government has decided to introduce national tests in primary education. Swedish pupils in general have few tests and a recognised possible adverse effect of testing is test anxiety among pupils, which may have a negative impact on examination performance. However, there has been little research on effects of testing on young children within the Swedish context. The current study explores the experience of test anxiety related to achievement in mathematics and Swedish in a sample of 40 grade 3 pupils. Method: A modernised standardised test for measuring children's test anxiety. Academic achievement in various mathematical and Swedish domains. Results: Test anxiety, in particular its subcomponent autonomic reactions, is related to poor performance in Swedish. In mathematics there is an especially marked relationship between the subtest Written arithmetic and test anxiety, particularly its subcomponent anxious thoughts. Conclusion: Test anxiety seems not to be a general problem in present Swedish young sample, however, cautions need to be taken regarding the acquiring of algorithms and number of tests given. (Contains 4 tables.)

Specifically, 69.8%, 67.7%, and 69.0% of patients prescribed adjustable-dose BUD/FORM maintenance, fixed-dose BUD/FORM maintenance, and intermittent BUD/FORM, respectively, did not claim SABA during follow-up (Table 1). Adjustable-dose BUD/FORM maintenance: physician-indicated temporary titration of BUD/FORM maintenance therapy to a maximum daily dose in the event of deteriorating asthma control plus an as-needed SABA reliever. [Extracted from the article]

Background: Dynamic spirometry is an important investigation to differentiate between impaired and normal lung function. This study aimed to evaluate the results of lung function testing in a cohort of subjects from Northern Sweden without any known heart or pulmonary disease. Our focus was to compare with two reference materials that have showed differences in the age-dependency of lung function in Swedish subjects. Methods: The study population consisted of 285 healthy adults (148 males, 52%) between 20–90 years of age. The subjects had been randomly selected from the population register for inclusion in a study investigating cardiac function in heart-healthy subjects, but were also assessed with dynamic spirometry. At least seven percent reported smoking. Sixteen subjects presented with pulmonary functional impairments and were excluded from the current study. The sex-specific age-dependency in lung volumes was estimated using the LMS model, where non-linear equations were derived for the mean value (M), the location (L) or skewness, and the scatter (S) or coefficient of variation. This model of the observed lung function data was compared with reference values given by the original LMS model published by the Global Lung Initiative (GLI), and with the model from the recent Obstructive Lung Disease In Norrbotten (OLIN) study, where higher reference values were presented for Swedish subjects than those given by the GLI model. Results: No differences were found in the age-dependency of pulmonary function between the LMS model developed in the study and the OLIN model. Although the study group included smokers, the original GLI reference values suggested significantly lower normal values of FEV1 (forced expiratory volume) and FVC (forced vital capacity), and consequently fewer subjects below the lower limit of normality, than both the rederived LMS and OLIN models. Conclusions: Our results are in line with previous reports and support that the original GLI reference values underestimate pulmonary function in the adult Swedish population. This underestimation could be reduced by updating the coefficients in the underlying LMS model based on a larger cohort of Swedish citizens than was available in this study. [ABSTRACT FROM AUTHOR]

Background: In Sweden, persistent physical and psychological health problems occur in about three in ten women who sustain severe perineal trauma (SPT) during childbirth. As most Swedish women work outside the home, the question of if and how SPT-related morbidity influences working life needs exploration. This study aims to qualitatively explore how women with persistent SPT-related morbidities experience and conceptualise their problems concerning working life. Further, we theorise the findings by applying Simone de Beauvoir's feminist framework of immanence and transcendence as well as authentic and inauthentic life. Methods: Ten interviews with women recruited via a Swedish social media community for perineal trauma were analysed according to Charmaz's constructivist approach to grounded theory. Results: The theoretical model and related core category 'Negotiating the ambiguity of an (in)authentic working life' reflected the women's negotiations of immanence as 'the silent covert object' versus transcendence as the 'the resourceful overt subject'. The model also mirrored the conflict of (in)authenticity in working life. An inauthentic working life was experienced when women were denied their subjectivity at work or constructed themselves as subjects in denial of their SPT. On the other hand, women who acknowledged their SPT and were constructed as subjects by 'others' achieved an authentic working life despite SPT. Conclusions: The conflicting gendered process of 'the silent covert object' versus 'the resourceful overt subject' problematised women's vulnerability at work. Aspects that enable subjectification and transcendence are essential for policymakers, employers, healthcare services, and society to eradicate the taboo of SPT and create a working environment characterised by understanding, support, and flexibility. Further, access to adequate care, sick leave, and occupational rehabilitation are essential. Such measures support transcendence towards an authentic working life and, consequently, a more gender-equal working environment that does not deprive women of career opportunities due to a physical ailment. [ABSTRACT FROM AUTHOR]

Background: The prevalence of elder abuse has only rarely been investigated in Sweden and never in a hospital setting. Therefore, the aims of this study were to: 1) Estimate the prevalence of elder abuse and life-course victimization among hospitalized older adults in Sweden, 2) Explore factors associated with elder abuse in the same sample, and 3) Explore the associations between life-course victimization and mental ill-health.Methods: The study was conducted at a university hospital in Sweden. Adults over the age of 65 years admitted to a medical or geriatric acute care ward during spring 2018 were consecutively recruited. The participant rate was 44% (n = 135/306). Participants were assessed via a face-to-face interview about their experiences of elder abuse and abuse earlier in life. Mental ill-health was measured using a self-administered depression assessment (Patient Health Questionnaire-9), along with information about medications and diagnoses retrieved from medical records.Results: Altogether, 40.7% (n = 55) of the participants reported some form of abusive experience during their life course. The prevalence of elder abuse was 17.8% (n = 24), and 58% (n = 14) of elder abuse victims also reported victimization earlier in life. Being abused before the age of 65 was the only background factor associated with elder abuse (OR = 5.4; 95% CI 1.9-15.7). Reporting abusive experiences both before and after the age of 65 was associated with current anti-depressant medication (OR = 6.6; 95% CI 1.1-39.2), a PHQ-9 result of 10 or more (OR = 10.4; 95% CI 2.1-51.0), and nine or more symptom diagnoses (OR = 4.0, 95% CI 1.0-16.1). Being abused only before or after the age of 65 was not significantly associated with any mental ill-health outcome measure.Conclusions: Elder abuse and victimization earlier in life are highly prevalent among hospitalized older patients, and our findings underline the importance of a life-course perspective both in research on elder abuse and in clinical practice. Identifying and caring for older adults who have been subjected to abuse should be a priority in health care. [ABSTRACT FROM AUTHOR]

Background: In order to estimate the prevalence and understand the spread of SARS-CoV-2 in Sweden, the Public Health Agency of Sweden, with support from the Swedish Armed Forces, conducted a series of point prevalence surveys between March and December 2020.Methods: Sampling material and instructions on how to perform self-sampling of the upper respiratory tract were delivered to the homes of the participants. Samples were analysed by real-time PCR, and the participants completed questionnaires regarding symptoms.Findings: The first survey in the Stockholm region in March 2020 included 707 participants and showed a SARS-CoV-2 prevalence of 2.5%. The following five surveys, performed on a national level, with between 2461 and 2983 participants, showed SARS-CoV-2 prevalences of 0.9% (April), 0.3% (May), 0.0% (August), 0.0% (September), and 0.7% (December). All positive cases who responded to questionnaires reported experiencing symptoms that occurred from 2 weeks before the date of sampling up to and including the date of sampling.Interpretation: None of the individuals shown to be PCR-positive were asymptomatic at the time of sampling or in the 14 days prior to sampling. This is in contrast to many other surveys in which a substantial proportion of positive cases have been reported to be asymptomatic. Our surveys demonstrate a decreasing ratio between notified cases and the observed prevalence throughout the year, in line with increasing testing capacity and the consecutive inclusion of all symptomatic individuals in the case definition for testing. [ABSTRACT FROM AUTHOR]

Individual perspectives of long-term consequences decades after anterior cruciate ligament (ACL) injury are unexplored. We addressed experiences and the impact on life of former athletes >20 years post-ACL injury. Individual interviews, analysed using Grounded Theory, were conducted with 18 persons injured mainly during soccer 20–29 years ago. A theoretical model was developed with the core category Re-orientation towards acceptance, overarching three categories illustrating the long-term process post-injury. Initially the persons felt like disaster had struck; their main recall was strong pain followed by reduced physical ability and fear of movement and re-injury. In the aftermaths of injury, no participant reached the pre-injury level of physical activity. Over the years, they struggled with difficult decisions, such as whether to partake or refrain from different physical activities, often ending-up being less physically active and thereby gaining body weight. Fear of pain and re-injury was however perceived mainly as psychological rather than resulting from physical limitations. Despite negative consequences and adjustments over the years, participants still found their present life situation manageable or even satisfying. ACL injury rehabilitation should support coping strategies e.g., also related to fear of re-injury and desirable physical activity levels, also with increasing age. More than 20 years after the ACL injury, the individuals despite re-orientation towards acceptance and a settlement with their life situation, still had fear of both pain and re-injury of the knee, with concerns about physical activity and gaining of body weight. Patients with ACL injury may need better individual guidance and health advice on how to remain physically active, to find suitable exercises and to maintain a healthy body weight. Education related to pain, treatment choices, physical activity, injury mechanisms in participatory discussions with the patient about the ACL injury may be beneficial early in the rehabilitation process to avoid catastrophizing and avoidance behaviour. ACL injury rehabilitation needs to address coping strategies incorporating the psychological aspects of suffering an ACL injury, including fear of movement/secondary injury, in order to support return-to-sport and/or re-orientation over time. [ABSTRACT FROM AUTHOR]

Background: Longitudinal, real-world data on the management of metastatic breast cancer is increasingly relevant to understand breast cancer care in routine clinical practice. Yet such data are scarce, particularly beyond second- and third-line treatment strategies. This study, therefore, examined both the long-term treatment patterns and overall survival (OS) in a regional Swedish cohort of female patients with metastatic breast cancer stratified by subtype in routine clinical practice during a recent eight-year period and correlation to current treatment guidelines.Methods: Consecutive female patients with metastatic breast cancer  clinically managed at Uppsala University Hospital, Uppsala, Sweden, during 2009-2016 and followed until the end of September, 2017 (n = 370) were included and, where possible, classified as having one of five, intrinsic subtypes: Luminal A; Luminal B; human epidermal growth factor receptor 2-positive (HER2+)/ estrogen receptor-positive (ER+); HER2+/estrogen receptor-negative (ER-); or triple negative breast cancer (TNBC). Treatment patterns and OS were estimated by subtype using time-to-event methods.Results: A total of 352/370 patients with metastatic breast cancer (mean age 67.6 years) could be subtyped: 118 (34%) were Luminal A, 119 (34%) Luminal B, 31 (8%) HER2+/ER-, 38 (11%) HER2+/Luminal, and 46 (13%) TNBC. The median number of metastatic treatment lines was 3. Most patients were on active treatment during follow-up (80% of the observation period), except for patients with TNBC who were on treatment for 60% of the observation time. Overall, 67% of patients died whilst on treatment. Among all patients (n = 370), median OS was 32.5 months (95% CI = 28.2-35.7). The 5-year survival rate was highest for HER2+/Luminal (46%) patients, followed by Luminal B (29%), Luminal A (28%), HER2+/ER- (21%), and TNBC (7%). Increasing age and number of metastatic sites also predicted worse survival.Conclusions: Metastatic breast cancer patients in Sweden, irrespective of subtype, generally receive active treatment until time of death. Survival varies considerably across subtypes and is also associated with patient characteristics. Regardless of differences in treatment patterns for Luminal A and B patients, long-term OS was the same. [ABSTRACT FROM AUTHOR]

In the last two decades, surgical techniques for intracorporeal urinary diversion have been developed with the aim of reducing surgical morbidity. Although increasing constantly, the numbers of urologists offering intracorporeal neobladder reconstruction remain limited due to the complex nature of the procedure. In this article, we aim to provide a detailed description of the surgical technique we currently use at our institution. This technique was initially developed and perfected at the Karolinska Institutet in Sweden starting in 2003. It is a reproducible surgical approach with standardized and well-defined surgical steps. We give a detailed description of the surgical steps and provide tips and tricks to address specific situations and to increase efficiency. We also review the indications, the preoperative considerations, equipment necessary, postoperative considerations, and clinical outcomes for this procedure. Finally, we provide an accompanying didactic surgical video. We believe that this standardized approach can be learned and reproduced safely by motivated robotic surgeons. [ABSTRACT FROM AUTHOR]

Climate change allows species to expand polewards, but non‐changing environmental features may limit expansions. Daylength is unaffected by climate and drives life cycle timing in many animals and plants. Because daylength varies over latitudes, poleward‐expanding populations must adapt to new daylength conditions. We studied local adaptation to daylength in the butterfly Lasiommata megera, which is expanding northwards along several routes in Europe. Using common garden laboratory experiments with controlled daylengths, we compared diapause induction between populations from the southern‐Swedish core range and recently established marginal populations from two independent expansion fronts in Sweden. Caterpillars from the northern populations entered diapause in clearly longer daylengths than those from southern populations, with the exception of caterpillars from one geographically isolated population. The northern populations have repeatedly and rapidly adapted to their local daylengths, indicating that the common use of daylength as seasonal cue need not strongly limit climate‐induced insect range expansions. [ABSTRACT FROM AUTHOR]

Background: Sweden has provided around 300 youth clinics (YCs) to address the health needs of young people since the 1970s. During the last few years, and as part of an effort to strengthen mental healthcare for young people, YCs' role in the provision of mental healthcare has been widely debated. With such debates as background, the aim of this study is to analyse Swedish YCs' responses to the mental (ill) healthcare needs of young people, from the perspective of national level stakeholders.Methods: We used thematic analysis of interviews with eight national level stakeholders in the field of youth mental health in Sweden. Building upon the concept of biomedicalization we examined the discourses on mental (ill) health, healthcare and youth that such responses reproduce.Results: YCs engage in the three simultaneous, but at times contradictory, responses of protecting, managing and bending boundaries. Remaining true to their mission as a health-promotion service compels them to protect their boundaries and limit the type of mental health issues they address. However, the perceived malfunctioning of specialized services has led them to bend these boundaries to allow in more young people with severe mental health problems. Caught between protecting and bending boundaries, the response of managing boundaries to decide who should be allowed in and who should be sent elsewhere has emerged as a middle-way response. However, it is not free from conflicts.Conclusion: Building upon the concept of biomedicalization, this study poses two questions. The first relates to whether it is possible to support young people and their health without reinforcing discourses that represent young people as collectively at risk, and if so how this can be done. The second relates to the provision of mental healthcare for young people, and the need to identify conditions for integrating diagnosis and treatment within YCs, without hindering their holistic and youth-centred approach. [ABSTRACT FROM AUTHOR]

Background: Symptom control has not improved in Swedish asthma patients during the last two decades. Guidelines recommend annual reviews for asthma patients treated with maintenance inhaled corticosteroids (ICS). We aimed to describe how visit patterns in an ICS-treated asthma population in Sweden were related to applicable asthma guidelines. Methods: Swedish electronic health data for incident asthma patients, ≥ 18 years, with at least one ICS collection (index date) between 2006 and 2017 were included. Exacerbations were defined as hospitalizations, emergency visits, or collection of oral corticosteroids (OCS). Probability of an asthma-related regular follow-up visit and probability of a follow-up visit after an exacerbation, both within 15 months, were estimated using the cumulative incidence function, time-to-event analysis, and incident rate ratios. Results: In 51,349 asthma patients (mean age 47.6 years, 63% females), 17,573 had a regular asthma visit in primary or secondary care within 15 months after the index, yielding an overall probability of a visit of 37.4%. Patients with a follow-up visit had higher ICS collection and lower OCS collection than patients without regular visits. Among 22,097 patients with acute exacerbations, the probability of a visit within 15 months after an exacerbation was 31.0%. The probability of having a visit increased during the study period. Conclusion: Only one-third of ICS-treated asthma patients, regardless of asthma severity, had a regular or post-exacerbation follow-up visit within a 15-month period. The consequences of this lack of adherence to guidelines need further evaluation to secure optimal asthma management. [ABSTRACT FROM AUTHOR]

Background: Elder abuse is underreported and undertreated. Methods for prevention and intervention are being developed, but the knowledge guiding such measures is often insufficiently based on the victims' own voices due to a paucity of studies. The aim of this study was therefore to explore experiences of elder abuse among the victims themselves.Methods: Consecutive inpatients ≥ 65 years of age at a hospital clinic in Sweden were invited to participate, and 24 victims of elder abuse were identified. Semi-structured qualitative interviews were conducted, and transcripts were analyzed using qualitative content analysis.Results: The analysis generated four themes that together give a comprehensive picture of elder abuse from the participants' subjective perspectives. The participants' experiences of abuse were similar to previous third-party descriptions of elder abuse and to descriptions of abuse among younger adults, but certain aspects were substantially different. Vulnerability due to aging and diseases led to dependance on others and reduced autonomy. Rich descriptions were conveyed of neglect, psychological abuse, and other types of abuse in the contexts of both care services and family relations.Conclusions: Elder abuse is often associated with an individual vulnerability mix of the aging body, illnesses, and help dependence in connection with dysfunctional surroundings. As individual differences of vulnerability, exposure to violence, and associated consequences were so clear, this implies that components of prevention and intervention should be individually tailored to match the needs and preferences of older victims. [ABSTRACT FROM AUTHOR]

In many countries, there are calls for children to be allowed to participate in social work decision-making. This article analyses child participation vis-à-vis social assistance (SA), which is a municipal cash benefit representing the last safety net. In Sweden, SA is part of the professional field of social work and national policy recommends that children are consulted. The aim is to analyse local policies and practices regarding child participation, and the data are based on case studies in six social service offices. Unlike most participation studies, children's participation is conceived as an institutional pressure and the concept of decoupling is used to examine how local authorities relate to participation. The findings show that in local policies there is a general openness towards participation, but in practice no efforts are being made to promote participation. The absence of participation is analysed as deriving from organisational barriers (practices are adult-centred and child welfare units are seen as responsible for participation) and the scepticism of social workers (participation is an infringement on parental obligations and children should be protected from involvement in financial issues). The article ends with a discussion on the decoupling and adequacy of children's participation in settings comparable with Swedish SA. [ABSTRACT FROM AUTHOR]

Purpose: In addition to incisional hernia, inguinal hernia is a recognized complication to radical retropubic prostatectomy. To compare the risk of developing inguinal and incisional hernias after open radical prostatectomy compared to robot-assisted laparoscopic prostatectomy. Method: Patients planned for prostatectomy were enrolled in the prospective, controlled LAPPRO trial between September 2008 and November 2011 at 14 hospitals in Sweden. Information regarding patient characteristics, operative techniques and occurrence of postoperative inguinal and incisional hernia were retrieved using six clinical record forms and four validated questionnaires. Results: 3447 patients operated with radical prostatectomy were analyzed. Within 24 months, 262 patients developed an inguinal hernia, 189 (7.3%) after robot-assisted laparoscopic prostatectomy and 73 (8.4%) after open radical prostatectomy. The relative risk of having an inguinal hernia after robot-assisted laparoscopic prostatectomy was 18% lower compared to open radical retropubic prostatectomy, a non-significant difference. Risk factors for developing an inguinal hernia after prostatectomy were increased age, low BMI and previous hernia repair. The incidence of incisional hernia was low regardless of surgical technique. Limitations are the non-randomised setting. Conclusions: We found no difference in incidence of inguinal hernia after open retropubic and robot-assisted laparoscopic radical prostatectomy. The low incidence of incisional hernia after both procedures did not allow for statistical analysis. Risk factors for developing an inguinal hernia after prostatectomy were increased age and BMI. [ABSTRACT FROM AUTHOR]

Background: In the current study, the approach of 'utopia as method' was combined with the concept 'landscapes of care' to explore collective imaginaries of caring landscapes in relation to young people living in rural northern Sweden, while focusing specifically on what such landscapes should ideally look like, and how various strategies could help to realise the visions.Methods: The research was conducted using a modified concept mapping methodology comprising three phases of data collection and analysis. This facilitated the integration of tacit knowledge and utopian visions of young people, professionals and policymakers living and working in various parts of northern Sweden.Results: The results indicated that caring landscapes should: 'provide services responsive to young people's wishes and needs', 'be organised around values of safety, equity and youth participation', and 'rework metro-centredness' in order to care for, with and about rural youth.Conclusions: The findings can be viewed as an imaginary reconstitution of communities in rural northern Sweden, but also as hypothetical building blocks to be used for developing caring landscapes and a 'good countryside' where young people have the possibility to live a good life in decent health. [ABSTRACT FROM AUTHOR]

Management of patients with temporomandibular disorders (TMD) appears to be more challenging than for other dental conditions. This study aimed to explore the decision‐making process in TMD management, and thereby to conceptualize the decision‐making process in dentistry. Individual semi‐structured interviews were conducted during 2018 and 2019 with a purposive sample of 22 general dental practitioners from the Public Dental Healthcare Services and private practices in the Region of Västerbotten, Northern Sweden. The interviews were analysed using the Grounded Theory approach of Charmaz. Data analysis resulted in the core category 'Combining own competence and others' expectations in the desire to do the right thing'. The dentists showed interest in and a desire to apply professional knowledge, but also reflected on challenges and complexity in the decision‐making process for TMD. The challenges were primarily related to organisational factors and lack of self‐confidence. This identifies a need for re‐organisation of daily clinical management in dentistry, and a need for more postgraduate training to improve self‐confidence. The complexity of the decision‐making process for TMD makes the study findings applicable in other dental situations. [ABSTRACT FROM AUTHOR]

Pre-oxygenation using high-flow nasal oxygen can decrease the risk of desaturation during rapid sequence induction in patients undergoing emergency surgery. Previous studies were single-centre and often in limited settings. This randomised, international, multicentre trial compared high-flow nasal oxygen with standard facemask pre-oxygenation for rapid sequence induction in emergency surgery at all hours of the day and night. A total of 350 adult patients from six centres in Sweden and one in Switzerland undergoing emergency surgery where rapid sequence induction was required were included and randomly allocated to pre-oxygenation with 100% oxygen using high-flow nasal oxygen or a standard tight-fitting facemask. The primary outcome was the number of patients developing oxygen saturations <93% from the start of pre-oxygenation until 1 min after tracheal intubation. Data from 349 of 350 patients who entered the study were analysed (174 in the high-flow nasal oxygen group and 175 in the facemask group). No difference was detected in the number of patients desaturating <93%, five (2.9%) vs. six (3.4%) patients in the high-flow nasal oxygen and facemask group, respectively (p = 0.77). The risk of desaturation was not increased during on-call hours. No difference was seen in end-tidal carbon dioxide levels in the first breath after tracheal intubation or in the number of patients with signs of regurgitation between groups. These results confirm that high-flow nasal oxygen maintains adequate oxygen levels during pre-oxygenation for rapid sequence induction. [ABSTRACT FROM AUTHOR]

While sexual consent has been a hot topic during recent years in the Swedish context, there is a lack of empirical studies on the issue. The aims of this study were to analyse how adults in Sweden experience and make sense of sexual (non)consent in sexual encounters, and to contribute to a conceptual discussion of 'sexual consent', especially in relation to a Foucauldian understanding of power and subjectivity. The analysis is based on 31 interviews with adults living in Sweden. Participants describe consenting to sex due to being exposed to interpersonal forms of power, ranging from violence and clear violations of consent to nagging and being subjected to pressure from others. But they also feel pressure and give consent to sex based on self-regulation and disciplinary forms of power, connected to normative ideals about 'the good relationship', monogamy and heterosexuality, men and women, and age. Our Foucauldian analytical lens allowed us to explore and challenge understandings of autonomous, rational subjects who communicate consent on the basis of authentic feelings. It also provided an analytical strategy for analysing and understanding the complex power relations that matter in the negotiation of sexual consent. [ABSTRACT FROM AUTHOR]

In recent years, scholars have called for studies exploring how key concepts originating from the children's rights discourse are understood in local contexts. In Sweden, national policy advocates that a child perspective should guide social assistance (SA), a cash benefit constituting society's last safety net. The study analyses the child perspective as an idea (i.e. an ambiguous principle), which is translated (i.e. reformulated and interpreted) at the local level. The findings indicate multiple and partly inconsistent translations of a child perspective. The study argues that it is unclear what adopting a child perspective implies for children in families receiving SA. [ABSTRACT FROM AUTHOR]

In what has become quite a turbulent quasi‐market for residential care for children and youth, providers now compete for public contracts. To create visibility and attract customers, many providers use marketing activities to project the desired impression of themselves to maintain or strengthen their market position. In this article, we analyse how companies that provide residential care for children manage the impressions they project on their websites and in advertisements. The results reveal that residential care providers use a range of impression management strategies to enhance their organizational image and to respond to potentially damaging or threatening images. The information providers choose to disclose leaves customers—in this case, the social workers responsible for choosing and purchasing care on behalf of clients—with rather limited opportunities to evaluate the quality of care. This is a significant problem considering other, more reliable, sources of information are difficult to access. [ABSTRACT FROM AUTHOR]

From the perspective of psychiatric and mental health nurses in Sweden, this discussion paper aims to position psychiatric and mental health nursing as a transformative force contributing to enforcing person-centered values and practices in health care. We argue the potential impact of psychiatric and mental health nursing on service user health and recovery, nursing student education and values, and the organization and management of health care. Psychiatric and mental health nursing is discussed as a caring, reflective, and therapeutic practice that promotes recovery and health. Implications for nursing education, research, management, and practice are outlined. [ABSTRACT FROM AUTHOR]

Background: This study emerges as a response to the lack of youth perspectives when it comes to discussions about access to and experiences of health and social services in rural areas. It subsequently contributes to the literature by positioning young people at the centre of this debate, and by taking a more holistic approach to the topic than is typically the case. Specifically, based on the idea that a good life in proper health for young people may be contingent on notions of care that are bounded up in multi-layered social and spatial environments, the aim of this study was to explore what characterises 'landscapes of care' for rural youth. Methods: In this qualitative study, the participants included young people and professionals residing in five diverse areas across the northern Swedish 'peripheral' inland. Individual interviews (16 in total) and focus group discussions (26 in total) were conducted with 63 youth aged 14–27 years and with 44 professionals operating across sectors such as health centres, school health, integration units, youth clinics and youth clubs. Following an emergent design and using thematic analysis, we developed one main theme, 'landscapes of care and despair', comprising the two themes: '(dis)connectedness' and 'extended support or troubling gaps'. Results: The findings illustrate how various health-promoting and potentially harmful aspects acting at structural, organisational and interpersonal levels contributed to dynamic landscapes characterised simultaneously by care and despair. In particular, our study shows how rural youths' feelings of belongingness to people and places coupled with opportunities to participate in society and access practical and emotional support appear to facilitate their care within rural settings. However, although the results indicate that some in the diverse group of rural youth were cared for and about, a negative picture was painted in parallel. These aspects of despair included youths' senses of exclusion and marginalisation, degrading attitudes towards them and their problems, as well as recurrent gaps in the provision and practices of care. Conclusions: To gain a more comprehensive understanding about the health of rural youth, this study highlights the benefits investigating 'care-ful' and 'uncaring' aspects bounded up in dynamic and multi-layered landscapes. [ABSTRACT FROM AUTHOR]

Background: Stress-induced exhaustion disorder (SED) is a primary cause for sickness absence among persons with mental health disorders in Sweden. Interventions involving the workplace, and supporting communication between the employee and the supervisor, are proposed to facilitate return to work (RTW). The aim of this study was to explore experiences of persons with SED who participated in a dialogue-based workplace intervention with a convergence dialogue meeting performed by a rehabilitation coordinator. Methods: A qualitative design based on group interviews with 15 persons with SED who participated in a 24-week multimodal rehabilitation program was used. The interviews were analyzed with the methodology of grounded theory. Results: The analysis resulted in a theoretical model where the core category, restoring confidence on common ground, represented a health promoting process that included three phases: emotional entrance, supportive guidance, and empowering change. The health promoting process was represented in participant experiences of personal progress and safety in RTW. Conclusions: The intervention built on a health-promoting pedagogy, supported by continuous guidance from a rehabilitation coordinator and structured convergence dialogue meetings that enhanced common communication and collaboration with the supervisor and others involved in the RTW process. The intervention balanced relationships, transferred knowledge, and changed attitudes about SED among supervisors and colleagues in the workplace. The inclusion of a rehabilitation coordinator in the intervention was beneficial by enhancing RTW and bridging the gaps between healthcare, the workplace, and other organizational structures. In addition, the intervention contributed to a positive re-orientation towards successful RTW instead of an endpoint of employment. In a prolonged process, a dialogue-based workplace intervention with convergence dialogue meetings and a rehabilitation coordinator may support sustainable RTW for persons with SED. [ABSTRACT FROM AUTHOR]

The purpose of our study was to investigate time trends in treatment pattern and prognostic factors for overall survival (OS) in epidermal growth factor receptor (EGFR) targeting tyrosine kinase inhibitors (TKIs) treated nonsmall cell lung cancer (NSCLC) patients. Utilizing Swedish nationwide registers, we identified all Stage IIIB–IV NSCLC patients treated with EGFR TKIs and followed them from diagnosis (2010–2015) until death or end of observation (2016). Multivariable Cox regression analyses were performed to test associations of patient‐, tumor‐related factors with OS. Of 9,992 Stage IIIB–IV NSCLC patients, the 1,419 (14%) who initiated EGFR TKI treatment during observation were younger (median age 68 vs. 71 years), less ≥1 comorbidities (34% vs. 46%), more often female (59% vs. 47%), Stage IV (89% vs. 85%) and adenocarcinoma (85% vs. 66%) compared to non‐TKI treated patients. After TKI initiation, 7% (n = 100) of the patients switched, 4% (n = 62) rechallenged a TKI treatment, 65% (n = 919) discontinued and 24% (n = 338) had died. A more recent diagnosis demonstrated shorter time to EGFR TKI initiation, prolonged treatment length and longer median OS (15.3 months 2010–2011; 14.4 months 2012–2013; 18.6 months 2014–2015). Prognostic factors for longer OS when treated with EGFR TKIs were younger age, adenocarcinoma, less advanced clinical stage and less comorbid disease. In conclusion, during the observation period, survival improved for EGFR TKI treated NSCLC patients, as did the accessibility for targeted therapies for these patients. What's new? In non‐small cell lung cancer (NSCLC), have treatment results with EGFR TKIs improved over time? In this study, the authors found that the answer is yes. Patients with a more recent diagnosis had a shorter time to initiation of treatment, prolonged treatment durations, and longer overall survival (OS) compared to patients diagnosed in earlier years. Prognostic factors for longer OS included younger age, adenocarcinoma, earlier clinical stage, and less comorbid disease. In view of targeted therapy options for EGFR‐related tumors, further understanding regarding real‐world utilization of contemporary treatment is needed. [ABSTRACT FROM AUTHOR]

The working conditions of flight attendants (FAs) often involve extended and irregular working hours, short rest periods, difficulties in planning for breaks and high demands of service provision. Moreover, work schedules including early check-in, shifts during circadian low and time-zone transitions imply constant exposure to alterations in circadian systems and related health risks. The aim of this explorative study was to investigate how the organisation of work, time and place influence the food and meal situation of FAs when at work, focusing on patterns, form and social context of meals. The research questions posed were how food and meals at work were characterised and perceived among the FAs, and what strategies were adopted to manage the food and meal situation. Qualitative, semi-structured interviews were conducted with fourteen FAs working in Scandinavia. The results indicated that the organisation of work, time and place have a major influence on the meal situation at work, and how food and meals are perceived and managed by FAs. The work was defined as fragmented and inconsistent regarding time and place resulting in scattered meals and a more snack-based form of eating. The meal situation was characterised by irregularity as well as unpredictability. Eating took place when food was available and when there was enough time to eat, rather than being guided by hunger or social context. Various strategies such as eating in prevention, using emergency food, avoiding certain food and drinks or eating little or nothing at all were used to manage the unpredictability of the meal situation as well as the gap between organisational and individual times. The findings demonstrated the individual responsibility to solve the meal at work, e.g. to solve organisational times. [ABSTRACT FROM AUTHOR]

Objective To analyse patient and professional perceptions about (in)equity of care and rehabilitation of chronic pain patients from primary health care to assessment at a specialty rehabilitation clinic. Setting and methods This qualitative study consists one focus group interview with eight general practitioners who refer patients to pain rehabilitation clinics, 10 individual interviews with patients who were assessed at a pain rehabilitation clinic and seven interviews with professionals participating in multimodal assessment teams at a pain rehabilitation clinic. Interview analysis was conducted by the grounded theory method. Results The core category Via Dolorosa, the way of suffering and pain, captured how gender and sociocultural context may contribute to advantages and disadvantages during patient journeys from primary health care to a pain rehabilitation clinic. Patients and professionals perceived pain as a low-ranking illness, and women and men used different gendered strategies to legitimise the pain and to be taken seriously. Being 'a proper patient ready to change' and having 'likeness' between patients and professionals were viewed as advantageous in rehabilitation of pain patients. Patients with higher educational levels were perceived as easier to interact with and had better access to health care. Professional thoughts about gender norms influenced the rehabilitation options. The rehabilitation programme was seen by several professionals to be better suited for women than men, which could lead to unequal care. Conclusion From an equity and gender perspective, our study highlights the complexity in rehabilitation of chronic pain patients - both from patient and professional perspectives. Awareness of gendered and the biased preconceptions and norms is crucial when professionals struggle to offer equitable health care and rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Little is known concerning what may influence surgeon satisfaction with a surgical procedure and its associations with intraoperative factors. The objective was to explore the relationships between surgeons' self-assessed satisfaction with performed radical prostatectomies and intraoperative factors such as technical difficulties and intraoperative complications as reported by the surgeon subsequent to the operation.Methods: We utilized prospectively collected data from the controlled LAPPRO trial where 4003 patients with prostate cancer underwent open (ORP) or robot-assisted laparoscopic (RALP) radical prostatectomy. Patients were included from fourteen centers in Sweden during 2008-2011. Surgeon satisfaction was assessed by questionnaires at the end of each operation. Intraoperative factors included time for the surgical procedure as well as difficulties and complications in various steps of the operation. To model surgeon satisfaction, a mixed effect logistic regression was used. Results were presented as odds ratios (OR) with 95% confidence intervals (CI).Results: The surgeons were satisfied in 2905 (81%) and dissatisfied in 702 (19%) of the surgical procedures. Surgeon satisfaction was not statistically associated with type of surgical technique (ORP vs. RALP) (OR 1.36, CI 0.76; 2.43). Intraoperative factors such as technical difficulties or complications, for example, suturing of the anastomosis was negatively associated with surgeon satisfaction (OR 0.24, CI 0.19; 0.30).Conclusions: Our data indicate that technical difficulties and/or intraoperative complications were associated with a surgeon's level of satisfaction with an operation. [ABSTRACT FROM AUTHOR]