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This paper analyzes the preferences for reducing the negative impacts of landslides. Negative consequences of landslides include impacts on transport infrastructure, humans, the environment and important societal services. We apply a choice experiment. The analysis is based on 6048 observations from 504 participants in a web panel. The overall finding is that reducing the risk of landslides would have a positive impact on individuals’ utility, and that individuals prioritize preventing negative consequences on human health and safety over maintaining societal services, environmental status, and preventing damages to transport infrastructure, which seems to be least pressing. Results indicate that prioritizations of citizens differ from the prioritizations of public authorities, whose risk assessment model for evaluating the consequences of landslides gives equal weight to the different impacts.

For the transport sector to become more sustainable, substantial technological and behavioural changes are required. Increased understanding about household choices related to more green alternatives in transportation is needed in order for policy makers to make efficient policies in the future. The main purpose of this paper is to analyze which factors that determines the fuel choice between ethanol and gasoline for owners of flex-fuel vehicles (FFVs). We evaluate how the self-reported fuel choice is influenced by the relative price, as well as individual differences in norms and perceptions about environmental and quality attributes of ethanol. Data was collected through a survey sent to Swedish FFV owners and is analyzed in a binary choice and a LCM framework. Results show that price, perceptions about quality, age and environmental attitudes influence the self-reported willingness to choose ethanol. Furthermore, results show that preferences are not homogenous, three groups are identified; price conscious respondents, ethanol skeptical respondents and respondents with pronounced environmental concern. However, although the motive for introducing and subsidizing ethanol was to reduce climate and environmental impacts, the group that chooses ethanol based on climate and environmental motives is small. The results further reveal that the debate about motor damages from ethanol have had a long lasting effect on the willingness to choose ethanol. Thus, it is necessary to try to prevent or mitigate concerns regarding e.g. potential technical or ethical issues when promoting future technologies or fuels aimed at a sustainable transportation sector.

Oral health is a complex issue associated with social and behavioral factors and general health. Therefore, this study aims to explore Swedish older adults’ perceptions of oral health and its influence on general health, based on the World Dental Federation's (FDI) definition and framework of oral health. The study adopted a descriptive qualitative design. Data were collected from semi-structured individual and focus group interviews with older adults (n = 23) and were analyzed with deductive direct content analysis. The study was evaluated using the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. The older adults described the importance of good oral health in the physical, social, emotional, and mental aspects of their daily lives. The findings also indicate that older adults described oral health as multifaceted and agreed with the FDI's definition and framework of oral health. Therefore, the study findings might provide healthcare professionals with new knowledge and further insight into older adults’ perceptions of oral health and its influence on their well-being and general health. CC BY 4.0Attribution 4.0 International (CC BY 4.0)© The Author(s) 2022.Copyright © 2022 by Vårdförbundet First published online September 13, 2022Corresponding author: Maria Snögren, School of Health Sciences, University of Skövde, Högskolevägen, Box 408, 541 28 Skövde, Sweden. Email: maria.snogren@his.se

Background: In coming decades, the number of people affected by illnesses who need palliative care will rise worldwide. Registered Nurses are in a central position in providing this care, and education is one of the necessary components for meeting coming requirements. However, there is a lack of knowledge about palliative care in undergraduate nursing education curricula, including the extent of the education provided and the related pedagogical methods. Aim: The aim was to investigate the extent, content and pedagogical methods used and to explore lecturers’ experiences of being responsible for teaching and learning about palliative care for undergraduate nursing students on nursing programmes at Swedish universities. Setting: All 24 universities responsible for providing undergraduate nursing education in Sweden participated. Participants: One lecturer with in-depth knowledge about palliative care or end-of-life care education participated in the quantitative (n = 24) and qualitative (n = 22) parts of the study. Method: A mixed-method research study with an explorative design was used. Descriptive statistics were used to analyse quantitative data, and content analysis for qualitative, with both also analysed integratively. Results: Few undergraduate nursing programmes included a specific course about palliative care in their curricula, however, all universities incorporated education about palliative care in some way. Most of the palliative care education was theoretical, and lecturers used a variety of pedagogical strategies and their own professional and personal experience to support students to understand the palliative care approach. Topics such as life and death were difficult to both learn and teach about. Conclusions: There is a need for substantial education about palliative care. Lecturers strive on their own to develop students’ understanding and increase the extent of palliative care education with innovative teaching strategies, but must compete with other topics. Palliative care teaching must be prioritised, not only by the universities, but also by the national authority. CC BY-NC-ND 4.0© 2021 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.First published: 28 December 2021

The purpose of this paper is to analyze and compare the impacts of land-use policies on wind power deployment at the regional levels in Germany and Sweden. We use data for the period 2008–2012, and...

The chemical stabilization, or immobilization, of trace elements (metals and metalloids; TE) in contaminated soil has been studied for decades. A vast number of scientific publications are available on the method performance in laboratory settings, reporting that the application of various soil amendments to contaminated soil reduces TE mobility, bioavailability and toxicity. The most commonly used soil amendments include organic matter, iron oxides, phosphates, ashes, and lately biochar, alone or in combination with each other and/or lime. Most of the implemented field studies show a certain degree of improvement in soil and/or vegetation status following amendment. Regardless the positive performance of the technique in the laboratory, field validations and demonstrations remain scarce. The establishment of a field experiment often involves permits from authorities and agreements with site owners, both of which are considerably more time-consuming than laboratory tests. Due to conservative institutional structures, public authorities have been slow to adopt alternative remediation technologies, especially when the total TE concentration in soil remains the same and all of the associated risks are not yet convincingly described. For this reason, researchers should also focus on enhancing public knowledge of alternative remediation techniques so that future projects which aim to demonstrate the effectiveness of in situ immobilization techniques under natural conditions will be supported.

Background: The Västerbotten Intervention Programme (VIP) is a public health promotion programme in northern Sweden aimed at preventing cardiovascular diseases. Its positive effects on disease risk factors and on the risk of coronary heart disease itself have been reported, although the evidence is not unequivocal. Since only historical controls have been used, effects from sources other than the programme have largely been uncontrolled for and health-related quality of life (QoL) has not been evaluated.Methods: By using the neighbouring county of Norrbotten (NB) as a reference population, we compare QoL in Västerbotten (VB) and NB. In 2014, the World Health Organization’s Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) Study was implemented in northern Sweden, where random samples from VB and NB were examined. In total, 1112 participants between the ages of 40 to 74 participated: 516 in VB, and 594 in NB. Their QoL was measured with the three-level EuroQol 5-dimension (EQ-5D-3L) questionnaire. Differences in mean QoL between VB and NB were analysed via the Student’s t-test and the Pearson chi-square test.Results: Average QoL measured by the EQ-5D index was 0.798 in VB and 0.811 in NB, i.e. a difference of 0.013 (p = 0.2; confidence interval/CI -0.009 to 0.036). For participants aged 45–54, the QoL was lower in VB than in NB, showing a difference of 0.048 (p = 0.041; CI 0.002 to 0.0094). In NB, QoL decreased with age – a pattern not seen in VB. Men had higher QoL than women, and participants with a university education had higher QoL than those without one. The vertical visual analogue scale (EQ VAS) showed similar results. Participants from NB and from VB did not differ regarding age, gender or level of education.Conclusions: We found similar levels of health-related QoL in VB and NB.Trial registration: Not applicable

Background: Undergraduate nursing students encounter patients at the end of life during their clinical training. They need to confront dying and death under supportive circumstances in order to be prepared for similar situations in their future career. Aim: To explore undergraduate nursing students' descriptions of caring situations with patients at the end of life during supervised clinical training. Methods: A qualitative study using the critical incident technique was chosen. A total of 85 students wrote a short text about their experiences of caring for patients at the end of life during their clinical training. These critical incident reports were then analysed using deductive and inductive content analysis. Findings: The theme ‘students’ transformational learning towards becoming a professional nurse during clinical training’ summarises how students relate to patients and relatives, interpret the transition from life to death, feel when caring for a dead body and learn end-of-life caring actions from their supervisors. Implications: As a preparation for their future profession, students undergoing clinical training need to confront death and dying while supported by trained supervisors and must learn how to communicate about end-of-life issues and cope with emotional stress and grief.

Two systems working in parallel have contributed to implementation difficulties in Swedish water governance. While the old system is designed to be predictable and stable over time, the new system is intended to be transparent and holistic, guided by the principles of Integrated Water Resource Management. The paper disentangles the challenges in Swedish water governance and proposes a blueprint for future research. The proposed research project is unique in the sense that it explores the imbalances between the new and the old water governance systems from a multi-disciplinary perspective, elaborating upon the clashes between the traditional, nationally based regulatory system and the new holistic water governance system from legal, political and economic perspectives.

Background: The Västerbotten intervention program (VIP), is a public health promotion program in northern Sweden with the aim of preventing cardiovascular disease. Positive effects on risk factors and risk of coronary heart disease have been reported although the evidence is not unequivocal. Since only historical controls have been used, effects from other sources than the program have largely been uncontrolled for and health related quality of life (QoL) has not been evaluated. Aim: By using the neighbouring county of Norrbotten (NB) as the reference population, we compare QoL in Västerbotten (VB) and in NB. Method: The Northern Sweden MONICA survey in 2014 examined a random sample from the two counties. QoL was measured with the EQ-5D-3L. In total, 1112 subjects participated aged 40-74 years, 516 in VB and 594 in NB. Results: Average QoL measured by the EQ-5D-index was 0.798 in VB and 0.811 in NB, a difference of 0.013 (p=0.2, CI -0.009 to 0.036). For subjects aged 45-54 years, the QoL was lower in VB than in NB, a difference of 0.048 (p=0.041; CI 0.002 to 0.0094). In NB, QoL decreased with age, a pattern not seen in VB. Men had higher QoL than women, and university educated had higher QoL than those without university education. EQ-VAS showed similar results. Subjects from NB and from VB did not differ regarding age, gender and level of education. Conclusion: We found similar levels of QoL in VB and in NB.

The ecological and social impacts of wind power plants affect the provision of ecosystem services in many ways, mainly with respect to cultural services as well as habitat provision. These challenges need to be considered when a proper institutional framework for the deployment of wind power is to be designed to mitigate trade-offs between different ecosystem services. Understanding how the current institutional framework affects the spatial allocation of wind turbines and the related impacts on ecosystem services is a first step towards this insight. Using the cases of Germany and Sweden, we show that both noninstitutional and institutional factors may have a significant impact on the distribution of wind turbines. Their relative importance varies with geographical and regulatory contexts.

The article evaluates whether the participatory arrangements in Swedish water management following from the European Union's Water Framework Directive (WFD) contribute to legitimacy by increased learning and knowledge-generation. In contrast to most evaluations of collaborative arrangements, we use a three-tiered approach analyzing actors, processes and structures jointly, which allows us to more fully consider the merits and challenges facing this new management system. Based on original data collected from the Water councils in one of five Swedish Water Districts, we conclude that the prospects for learning and legitimacy-creation in Swedish water management are favorable. Despite the absence of decision-making power, a majority of the participants find the management system overall positive and meaningful, as new knowledge is collected and distributed through the Water councils. Thus, the management processes seem to work in favor of reaching the overarching goal of internal legitimacy, i.e. among the participating stakeholders. The main challenge, following our data, is for the new management system to serve as an arena for broad public involvement. As long as only a small number of stakeholders partake in the Water councils, the potential for creating external legitimacy for this new governance system is limited.

Aim: To describe Swedish first-year undergraduate nursing students' attitudes toward care of dying patients. Possible influences such as age, earlier care experiences, care education, experiences of meeting dying patients and place of birth were investigated. Method: The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) was used in six universities. Descriptive statistics and regression analysis were used. Results: Some 371 students (67.3%) reported overall positive attitude toward caring for dying patients (total mean FATCOD 119.5, SD 10.6) early in their first semester. Older students, students with both earlier care experience and earlier education, those with experience of meeting a dying person, and students born in Sweden reported the highest scores, a more positive attitude. Conclusion: Age, earlier care experience and education, experiences of meeting a dying person and place of birth seems to affect students' attitudes toward care of the dying and need to be considered among nursing educators.

In both academic literature and flood risk management practices, it is argued that governance initiatives are needed to enhance the flood resilience of urban agglomerations. Multiple levels of governance will be involved in this activity. However, thus far, the literature has hardly addressed what mechanisms are required to coordinate the different levels of managing urban flood resilience, and what factors account for these mechanisms. Our aim is to address this knowledge gap. Here, we examine six in-depth case studies undertaken in urban agglomerations in different European countries: Dordrecht, the Netherlands; Hull, UK; Geraardsbergen, Belgium; Karlstad, Sweden; Wroclaw, Poland; and Nice, France. The case studies reveal the ways in which multiple levels of governance are involved in managing urban flood resilience. Coordination among governance levels is achieved by proactive policy entrepreneurs, the use of bridging concepts, clear rules, and the provision of resources. These mechanisms seem to be universally applicable, but their characteristics appear to be highly dependent on more general institutional, economic, geographical, and cultural contextual factors.

The aim of this implementation study is to describe nurses' experiences of supporting patient learning using the model called 'The challenge to take charge of life with long-term illness'.Supporting patient learning for those suffering from a long-term illness is a complex art in nursing. Genuine learning occurs at a deep and existential level. If the patient's resistance to illness can be challenged and reflected upon, the patient may take charge of his/her life.The project lasted for 2 years and was initiated by a former patient on an assisted haemodialysis ward and involved 14 registered nurses. The project began with a session to review patients' learning and the didactic model. Monthly reflective meetings and group supervisions were held that focused on the nurses' experiences of supporting patient learning. Notes were written during these reflective meetings and group sessions.Data collected from interviews, notes and written stories were subjected to phenomenological analysis.Three aspects of nurses' experiences of the learning support approach were assessed: To have the courage to listen sincerely, a movement from providing information to supporting learning, and to let the patient indicate the direction. The approach resulted in an increased focus on genuine dialogue and the courage to encourage patients to take charge of their health process.The changes in nurses' approach to learning support reveal that they shift from providing information on the disease, illness and treatment to strengthening and supporting the patient in making decisions and taking responsibility. For nurses, the change entails accepting the patient's goals and regarding their own role as supportive rather than controlling. The didactic model and involved supervision contributed to the change in the nurses' approach.The didactic model might be useful in caring for persons with long-term illness, making the care more person-centred and enhancing the patient's self-care ability.

This paper explores preferences among the general public in Sweden for attributes related to the establishment of wind power farms. The method applied is a choice experiment where people are asked to choose between two hypothetical wind farms characterized by different attributes. Five attributes are included in the experiment: (i) type of landscape, (ii) type of ownership, (iii) the degree of local participation in the planning process, (iv) the choice to transfer revenue to the society in a pre-specified way, and (v) a monetary cost in terms of an additional electricity certificate fee. The data are analyzed with multinomial logit, random parameter logit, and latent class models. The results indicate that consumers in Sweden are more likely to accept the higher renewable electricity certificate fee if: (a) wind power farms in areas used for recreational purposes are substantially avoided, (b) the establishment is anchored by whole or partial ownership in the local community and, (c) the locals are involved in the planning and implementation process. Our policy simulation exercise shows that respondents are willing to pay a higher electricity fee corresponding to about 0.6 Euro cents per kWh to avoid wind farms located in the mountainous area and private ownership.

This paper estimates public and private preferences towards economic, environmental and sociocultural values associated with a planned large-scale onshore wind-power development in northern Sweden, and analyses the most important determinants of the individual's Willingness to Pay (WTP) for reducing the negative impact associated with the establishment. Sociocultural effects were deemed the most important in the private sample, whereas new job opportunities are valued most highly in the public sample. We further find that ascription to moral and social norms together with individuals’ perceptions related to general and institutional trust constitutes significant determinants of WTP.

The Visual Analogue Scale (VAS) is one of the most widely used pain assessment scales in clinical practice and research. However, the VAS is used less frequently in midwifery than in other clinical contexts. The issue of how people interpret the meaning of the VAS endpoints (i.e. no pain and worst imaginable pain) has been discussed. The aim of this study was to explore midwifery students' conceptions of 'worst imaginable pain'.A sample of 230 midwifery students at seven universities in Sweden responded to an open-ended question: 'What is the worst imaginable pain for you?' This open-ended question is a part of a larger study. Their responses underwent manifest content analysis.Analysis of the midwifery students' responses to the open-ended question revealed five categories with 24 sub-categories. The categories were Overwhelming pain, Condition-related pain, Accidents, Inflicted pain and Psychological suffering.The midwifery students' conceptions of 'worst imaginable pain' are complex, elusive and diverse.

Aim: To describe nursing students' reasoning about emotionally demanding questions concerning the care of dying patients. Methods: The Frommelt Attitude Toward Care of the Dying (FATCOD) Scale was completed by students at the beginning of their education, and there was great variation in the responses to five items. At a follow-up measurement in the second year, an open-ended question, ‘How did you reason when completing this question?’, was added to each of the these five items. Qualitative content analysis was used to analyse the responses. Results: Of 140 students who completed the FATCOD, 111 provided free-text responses. The analysis of these responses revealed three themes: death perceptions, the students' understanding of their current situation, and the nurse's responsibility. Conclusion: This study provides useful information on students' reasoning about emotionally demanding questions relating to the care of dying patients. Such knowledge is valuable in helping students to overcome their fear and fulfil their expectations concerning their future proficiency.

The results from a semi-experimental study of Swedish students’ stated willingness to purchase emission allowances for carbon dioxide are presented. Drawing heavily on recent developments in the literature on integrating norm-motivated behaviour into neoclassical consumer theory, it is assumed that individuals have a preference for maintaining a self-image as a responsible (and thus norm-compliant) person. The results indicate that students’ willingness to purchase carbon allowances is determined by both price and the presence of norms: those who feel personally responsible for contributing to reducing climate damages also appear more inclined to buy allowances. The empirical findings are consistent with the notion that a person's beliefs about others’ stated willingness to purchase carbon allowances imply improvements in their own self-image and ultimately behavioural change. This suggests that information campaigns that attempt to influence beliefs about others’ intentions could promote ‘green’ consumer...

The amount of installed wind power varies significantly across municipalities although the financial support for wind power production and the technology available is identical in all Swedish munic ...

Assessment of women's labor pain is seldom acknowledged in clinical practice or research. The words "aching" and "hurting" are frequently used by women to describe childbirth pain. The aim of this study was to determine the quantitative meanings midwifery students attribute to the terms "hurt", "ache" and "pain". Data was collected by self-administered questionnaire from students at seven Swedish midwifery programs. A total of 230 filled out and returned a completed questionnaire requesting them to rate, on a visual analog scale, the intensity of "hurt", "ache" or "pain" in the back, as reported by a fictitious parturient.The midwifery students attributed, with substantial individual variation, different quantitative meanings to the studied pain descriptors.To be able to communicate about pain with a woman in labor, it is essential that the midwife be familiar with the value of different words and what they mean to her as this may affect her assessment when the woman describes her pain.

Nursing education needs to prepare students for care of dying patients. The aim of this study was to describe the development of nursing students' attitudes toward caring for dying patients and their perceived preparedness to perform end-of-life care. A longitudinal study was performed with 117 nursing students at six universities in Sweden. The students completed the Frommelt Attitude Toward Care of the Dying Scale (FATCOD) questionnaire at the beginning of first and second year, and at the end of third year of education. After education, the students completed questions about how prepared they felt by to perform end-of-life care. The total FATCOD increased from 126 to 132 during education. Five weeks' theoretical palliative care education significantly predicted positive changes in attitudes toward caring for dying patients. Students with five weeks' theoretical palliative care training felt more prepared and supported by the education to care for a dying patient than students with shorter education. A minority felt prepared to take care of a dead body or meet relatives.

Contains fulltext : 162744pub.pdf (Publisher’s version ) (Open Access) ABSTRACT. In many countries, flood defense has historically formed the core of flood risk management but this strategy is now evolving with the changing approach to risk management. This paper focuses on the neglected analysis of institutional changes within the flood defense strategies formulated and implemented in six European countries (Belgium, England, France, the Netherlands, Poland and Sweden). The evolutions within the defense strategy over the last 30 years have been analyzed with the help of three mainstream institutional theories: a policy dynamics-oriented framework, a structure-oriented institutional theory on path dependency, and a policy actors-oriented analysis called the advocacy coalitions framework. We characterize the stability and evolution of the trends that affect the defense strategy in the six countries through four dimensions of a policy arrangement approach: actors, rules, resources, and discourses. We ask whether the strategy itself is changing radically, i.e., toward a discontinuous situation, and whether the processes of change are more incremental or radical. Our findings indicate that in the European countries studied, the position of defense strategy is continuous, as the classical role of flood defense remains dominant. With changing approaches to risk, integrated risk management, climate change, urban growth, participation in governance, and socioeconomic challenges, the flood defense strategy is increasingly under pressure to change. However, these changes can be defined as part of an adaptation of the defense strategy rather than as a real change in the nature of flood risk management. 11 p.

This paper elicits local and semi-local citizens’ preferences for water quality attributes explicitly related to the water framework directive. A river basin in southeast of Sweden is used as a case study. The sample consists of 502 respondents living in the municipalities through which the river passes, or neighboring municipalities. By the use of a choice experiment tailored to the specific case study area, the paper analyzes public attitudes and willingness to pay for selected attributes related to water quality management. The attributes and their corresponding levels are based on real criteria for ecological water status, used in the implementation of the WFD in the river basin. Although participants live in or close to the catchment area, the results reveal a general lack of knowledge and interest in matters related to the environmental quality of the river. All attributes included in the choice experiment proved to have a statistically significant impact on the choice probabilities. There was however no significant evidence that the preferences differ between respondents with regard to self reported previous experience or knowledge about the water body, nor with regard to differences in recreational habits in the area. The results can potentially be used as inputs in practical policy making with its inevitable trade offs and priorities.

The Water Framework Directive (WFD) explicitly acknowledges the role of economics in the process of reaching the environmental quality objectives. The purpose of this paper is to discuss the implem ...

Struggling to retain the living space: Patients´ stories about their lives as living alone with severe chronic obstructive pulmonary disease

The objective of this paper is to analyze the role of technology learning in European wind power generation in the presence of public R&D. A Cobb–Douglas cost function is employed to derive a learning curve model for wind power, thus illustrating how the investment costs for this technology are influenced by global learning-by-doing, scale effects, and a European R&D-based knowledge stock. We assume that public R&D expenses targeting wind power add to the above stock, and these R&D outlays are in turn hypothesized to be influenced by technology cost levels, the opportunity cost of public R&D as well as by government budget constraints. We estimate the learning and the R&D model, respectively, using a panel data set covering five European countries over the time period 1986–2002. The empirical results confirm the importance of both learning-by-doing and public R&D support in the cost reduction process, and governments' R&D expenses have declined in response to lowered investment costs. This is efficient in the sense that public funds are best targeted at technologies which are far from being commercial. The results also illustrate that governments in Europe have been sensitive to the opportunity cost of public R&D in the energy R&D budget process.

The purpose of this paper is to analyze Swedish households’ willingness to increase their daily efforts to save electricity. The analysis builds on a broad theoretical framework, which embraces both economic and norm-based motivations in explaining household behavior. The paper pays particular attention to the role of information about the availability of different behavioral changes that can be undertaken at the household level. The empirical results are based on a postal survey that was sent out to 1200 Swedish households, and the econometric analysis is carried out within a so-called ordered probit framework. Our results indicate that costs, environmental attitudes and social interactions are all important determinants of electricity saving activities within Swedish households. We tested the hypothesis that information about available savings measures that is presented in a more concrete and specific way is more likely to affect (stated) behavior than is more general information, and the data collected support this notion. The paper ends by discussing some implications of these results for the design of future informative policy measures in the energy-efficiency field.

The purpose of this paper is to provide an econometric analysis of the most important determinants of Swedish households' choice to pay a price premium for “green” electricity. We draw on recent developments in the literature on integrating norm-motivated behavior into neoclassical consumer theory, and assume that individuals have a preference for keeping a self-image as a morally responsible person. Consumer behavior in the “green market place” will then be heavily determined by how purchases of different goods affect this self-image. The analysis is based on postal survey responses from 655 Swedish households, which are analyzed within a binary choice econometric framework. The results indicate that the impact of choosing “green” on the household budget largely influences the choice between “green” and “brown” electricity, as does the degree of perceived personal responsibility for the issue and the felt ability to affect the outcome in a positive way. We find limited support for the notion that perceptions about others' behavior in general affect individual moral norms and ultimately expressed behavior, but this is also complemented by the influence of explicit social influence. The difficulty in observing others' purchases makes it however difficult to distinguish between social and moral norms in the case of “green” electricity.

The overall purpose of this paper is to analyze the factors affecting households' decisions to: (a) switch to a new electricity supplier; and (b) actively renegotiate the electricity contract with the prevailing supplier. The study is based on 536 survey responses from Swedish households and they are analyzed econometrically using probit regression techniques. The analysis is based on a theoretical framework, which embraces both economic and psychological motives behind household decision-making. The results show that households that anticipate significant economic benefits from choosing a more active behavior are also more likely to purse this, while those with smaller potential gains (e.g., households without electric heating) are less likely to change supplier and/or renegotiate their contracts. The impact of overall electricity costs and knowledge about these is particularly important for the latter decision, while respondents that perceive relatively high search and information costs are less likely to switch to an alternative electricity supplier. Moreover, constraints on time, attention, and the ability to process information, may lead to optimizing analyses being replaced by imprecise routines and rules of thumb, and the benefits of the status quo appear to represent one of those simplifying rules. This also opens up for other influences on households' activity such as social interaction and media discourses that raise the attention level. Our results show that these influences are more likely to affect households' choice to switch to new service providers, i.e., the one area of the two investigated here that put the most demand on people's ability to search for and process information.

Recently, the Swedish government adopted a national planning goal of a yearly wind power generation of 10 TWh by 2015, implying a substantial increase from the current 0.6 TWh level. In this paper, we provide an economic assessment of the potential for future wind power investments in Sweden in close conjunction with an analysis of the legal, attitudinal and policy-related uncertainties that face a wind mill investor. It is shown that the economics of Swedish wind power is negatively affected by: (a) the lack of policy stability; (b) public criticism at the local level; and, in particular, (c) the legal provisions governing the assessment of the environmental impacts of wind mills and the planning procedures for mill location. While national and global energy policies as well as the general public point out wind power as particularly environmentally friendly, most of the objections to its expansion at the local level tend to have environmental origins. The interests of those who object to wind mill installations gain strong legal protection, and the municipal territorial planning monopoly in Sweden implies that it is hard to make national energy policy goals heard at the local implementation stage. Compared to its competitors, wind power is the technology that tends to have the most to loose from the risk and uncertainties created by this investment environment. The paper identifies and discusses a number of ways in which the national policy interests could be strengthened at the local level. We discuss the role of citizen participation, as well as solutions within the realms of the legal system. Moreover, since the diffusion of wind power encounters the most strident legal and attitudinal obstacles where it interferes with competing land uses, a move offshore appears to be an efficient strategy from the perspective of a wind mill investor. A stronger political commitment to wind power expansion in legal provisions as well as in the form of long-run stability in policy instrument implementation will probably be necessary to attain the 2015 policy goal.

Aim To describe Swedish nursing students' perceptions of caring for dying people after the first year of a three year in a nursing programme at three university nursing schools in Sweden. Methods Interviews (n=17) were undertaken with nursing students at the end of their first year. A phenomenographic approach was used to design and structure the analysis of the nursing students' perceptions. Results The analysis resulted in five categories: 1) from abstract to reality, 2) from scary to natural, 3) increased knowledge can give bad conscience, 4) time limits versus fear of end-of-life conversations, and 5) meeting with relatives. Conclusion Nursing students need to be prepared both theoretically and within practice to encounter death and dying and to care for dying persons. By combining their theoretical knowledge of dying and death with their own encounters of death and dying people in practice, the students can be supported to develop an understanding of dying and death as a natural part of life rather than something frightening.

Background Pain assessment in people living with dementia is a challenge due to the complexity of pain and dementia and the difficulties in self-reporting. In home healthcare, nurses are frequently involved in pain assessment situations and there is a need to explore how home healthcare teams’ manage pain assessment in this setting. Aim The study aimed to explore home healthcare teams’ experiences of pain assessment among care recipients with dementia. Design An exploratory qualitative design was used. Methods Open-ended individual interviews were conducted with thirteen registered nurses and ten nursing assistants, working in three different home healthcare teams in one municipality in western Sweden. Philosophical hermeneutics was utilised to interpret the home healthcare teams’ experiences. Results Four interpretations emerged: the need for trusting collaboration, the use of multiple assessment strategies, maintenance of staff continuity in care and assessment situations, and the need for extended time to assess pain. Conclusions The home healthcare teams recognise pain assessment in people with dementia as involving a complex interaction of sensory, cognitive, emotional and behavioural components in which efforts to acquire understanding of behavioural changes mainly guides their assessments. The solid team coherence between registered nurses and nursing assistants aided the assessment procedure. To assess pain, the teams used multiple methods that complemented one another. However, no systematic routines or appropriate evidence-based pain tools were used. Implications for Practice The team members'concern for care recipients when assessing pain is evident and needs to be acknowledged by the organisation which is responsible for the quality of care. Future studies should focus on further exploration of nurses’ experiences with pain and dementia in home healthcare settings and address what nurses identify and how they deal with their findings. It is imperative to investigate how organisations and nurses can ensure best practices and how the implementation of evidence-based routines for assessing pain may aid in pain assessment situations.

There exists a political goal in Sweden and elsewhere to increase the use of renewable energy and wind power seems to be a favourable choice from an environmental perspective. However, although the public generally expresses a positive attitude towards wind power, the experience often shows that specific wind power projects face resistance from the local population. This paper analyses the attitudes towards wind power among the electricity consumers as well as the foundations of these attitudes. Results are based on a postal survey that was sent out to 1000 Swedish house owners. According to the results, the public is generally positive towards wind power. The probability of finding an average individual in support of wind power decreases with age and income. People with an interest in environmental issues are, however, more likely to be positive towards wind power than the average respondent and the results do not support the NIMBY-hypothesis. In addition, people that are more inclined to express public preferences are also more likely to be positive towards wind electricity than people who are less inclined to do so. These results imply, for instance, that the potential of markets for “green” electricity may be limited, other support schemes is thus required if the politically stated goal to increase wind power capacity is to be fulfilled.

Aim: To describe first-year nursing students' experiences of witnessing death and providing end-of-life care. Methods: This study is part of a larger longitudinal project. Interviews (n=17) were conducted with nursing students at the end of their first year of education. To analyse the interviews (lived-experience descriptions), a thematic analysis, ‘a search for meaning’ ( Van Manen, 1997 ) was applied. Results: The results are presented within the framework of four separate themes: (1) The thought of death is more frightening than the actual experience, (2) Daring to approach the dying patient and offering something of oneself, (3) The experience of not sufficing in the face of death and (4) Being confronted with one's own feelings. Conclusion: Nursing students require continuous support and opportunity to reflect and discuss their experiences about caring for dying patients and confronting death throughout the entirety of their education. In addition, teachers and clinical supervisors need to give support using reflective practice to help students to develop confidence in their capacity for caring for dying patients.

Nurses' attitudes toward caring for dying persons need to be explored. The Frommelt Attitude Toward Care of the Dying (FATCOD) scale has not previously been used in Swedish language.The objectives of this study were to compare FATCOD scores among Swedish nurses and nursing students with those from other languages, to explore the existence of 2 subscales, and to evaluate influences of experiences on attitudes toward care of dying patients.A descriptive, cross-sectional, and predictive design was used. The FATCOD scores of Swedish nurses from hospice, oncology, surgery clinics, and palliative home care and nursing students were compared with published scores from the United States, Israel, and Japan. Descriptive statistics, t tests, and factor and regression analyses were used.The sample consisted of 213 persons: 71 registered nurses, 42 enrolled nurses, and 100 nursing students. Swedish FATCOD mean scores did not differ from published means from the United States and Israel, but were significantly more positive than Japanese means. In line with Japanese studies, factor analyses yielded a 2-factor solution. Total FATCOD and subscales had low Cronbach α's. Hospice and palliative team nurses were more positive than oncology and surgery nurses to care for dying patients.Although our results suggest that the Swedish FATCOD may comprise 2 distinct scales, the total scale may be the most adequate and applicable for use in Sweden. Professional experience was associated with nurses' attitudes toward caring for dying patients.Care culture might influence nurses' attitudes toward caring for dying patients; the benefits of education need to be explored.

The objective of this article is to review a number of important theoretical and empirical challenges in measuring technology learning (learning-by-doing rates) in the energy sector. Particular attention is paid to the case of wind power, a technology that is believed to be a key in complying with future climate policy targets and that has been in focus in many previous learning studies. The article discusses the following challenges: (a) the incorporation of other drivers of cost reduction beyond that of cumulative experience, including the roles of returns-to-scale and RD (b) the geographical domain of technology learning and RD (c) the interaction between technology diffusion and learning-by-doing; and (d) the overall character of the process of technological progress. We also draw on the existing empirical literature on wind power learning rates to illustrate different ways to model learning, as well as some central results in previous work.