Fear causes tears – perineal injuries in home birth settings : a Swedish interview study

Background: Perineal injury is a serious complication of vaginal delivery that has a severe impact on the quality of life of healthy women. The prevalence of perineal injuries among women who give birth in hospital has increased over the last decade, while it is lower among women who give birth at home. The aim of this study was to describe the practice of midwives in home birth settings with the focus on the occurrence of perineal injuries. Methods: Twenty midwives who had assisted home births for between one and 29 years were interviewed using an interview guide. The midwives also had experience of working in a hospital delivery ward. All the interviews were tape-recorded and transcribed. Content analysis was used. Results: The overall theme was "No rushing and tearing about", describing the midwives' focus on the natural process taking its time. The subcategories 1) preparing for the birth; 2) going along with the physiological process; 3) creating a sense of security; 4) the critical moment and 5) midwifery skills illuminate the management of labor as experienced by the midwives when assisting births at home. Conclusions: Midwives who assist women who give birth at home take many things into account in order to minimize the risk of complications during birth. Protection of the woman's perineum is an act of awareness that is not limited to the actual moment of the pushing phase but starts earlier, along with the communication between the midwife and the woman.

Push or pull? : The relationship between quality of care and use of complementary and alternative medicine among patients with lung cancer in Sweden

Little is known about relationships between quality of care (QoC) and use of complementary and alternative medicine (CAM) among patients with lung cancer (LC). Purpose: This study examines CAM-use among patients with LC in Sweden, associations between QoC and CAM-use among these patients, and reported aspects of LC-care perceived as particularly positive and negative by patients, as well as suggestions for improving QoC. Methods: Survey data from 94 patient members of the Swedish LC patient organization about CAM-use and QoC as measured by the instrument “Quality from the patient’s perspective” were analyzed. Results: Fifty (53%) LC-patients used CAM, with 40 of the CAM-users reporting that CAM helped them. The most common CAMs used were dietary supplements and natural remedies, followed by prayer. Significantly more patients reported using prayer and meditation for cure than was the case for other types of CAM used. Less than half the CAM-users reported having spoken with staff from the biomedical health care system about their CAM-use. Patients provided numerous suggestions for improving LC-care in a variety of areas, aiming at a more effective and cohesive care trajectory. No differences in QoC were found between CAM-users and non-CAM-users, but differences in CAM-use i.e. type of CAM, reasons for using CAM, and CAM-provider consulted could be associated with different experiences of care. Conclusions: It is important to recognize that CAM-users are not a homogeneous group but might seek different types of CAMs and CAM-providers in different situations depending on experiences of care.

Essays on firm dynamics in the Swedish wholesale trade sector

This thesis consists of a summary and five self-contained papers addressing dynamics of firms in the Swedish wholesale trade sector. Paper [1] focuses upon determinants of new firm formation in the Swedish wholesale trade sector, using two definitions of firms’ relevant markets, markets defined as administrative areas, and markets based on a cost minimizing behavior of retailers. The paper shows that new entering firms tend to avoid regions with already high concentration of other firms in the same branch of wholesaling, while right-of-the-center local government and quality of the infrastructure have positive impacts upon entry of new firms. The signs of the estimated coefficients remain the same regardless which definition of relevant market is used, while the size of the coefficients is generally higher once relevant markets delineated on the cost-minimizing assumption of retailers are used. Paper [2] analyses determinant of firm relocation, distinguishing between the role of the factors in in-migration municipalities and out-migration municipalities. The results of the analysis indicate that firm-specific factors, such as profits, age and size of the firm are negatively related to the firm’s decision to relocate. Furthermore, firms seems to be avoiding municipalities with already high concentration of firms operating in the same industrial branch of wholesaling and also to be more reluctant to leave municipalities governed by right-of-the- center parties. Lastly, firms seem to avoid moving to municipalities characterized with high population density. Paper [3] addresses determinants of firm growth, adopting OLS and a quantile regression technique. The results of this paper indicate that very little of the firm growth can be explained by the firm-, industry- and region-specific factors, controlled for in the estimated models. Instead, the firm growth seems to be driven by internal characteristics of firms, factors difficult to capture in conventional statistics. This result supports Penrose’s (1959) suggestion that internal resources such as firm culture, brand loyalty, entrepreneurial skills, and so on, are important determinants of firm growth rates. Paper [4] formulates a forecasting model for firm entry into local markets and tests this model using data from the Swedish wholesale industry. The empirical analysis is based on directly estimating the profit function of wholesale firms and identification of low- and high-return local markets. The results indicate that 19 of 30 estimated models have more net entry in high-return municipalities, but the estimated parameters is only statistically significant at conventional level in one of our estimated models, and then with unexpected negative sign. Paper [5] studies effects of firm relocation on firm profits of relocating firms, employing a difference-in-difference propensity score matching. Using propensity score matching, the pre-relocalization differences between relocating and non-relocating firms are balanced, while the difference-in-difference estimator controls for all time-invariant unobserved heterogeneity among firms. The results suggest that firms that relocate increase their profits significantly, in comparison to what the profits would be had the firms not relocated. This effect is estimated to vary between 3 to 11 percentage points, depending on the length of the analyzed period. 

The Development of Swedish Tourism Public Policy 1930-2010

In this article, the development and changes in Swedish public policy relating to tourism from the 1930s to 2010 is described and interpreted from a political economy perspective. A case study, compiled from mainly secondary sources, is analyzed from a theoretical framework based on regulation theory. The purpose with this study is to increase the understanding of how the macro political economy context has influenced the policy-making in tourism in Sweden, but also to make a contribution to an area which seems to be quite neglected when it comes to research. The changes are analyzed according to the three periods denoted as pre-Fordism (mid-19th century-1930s), Fordism (1930s-1970s) and post-Fordism (1970s to present). It is observed how the general changes between these periods regarding aspects such as regulation and deregulation, and the degree of state involvement, have affected tourism policy making. The tourism policy making has changed from being insignificant, to a high degree of state involvement including planning, control and supervision, to a situation where the market rather than government regulation is considered as state of the art. 

Extended local labor markets due to high speed trains : Visualization of estimations in the Swedish national travel demand forecasting tool, SAMPERS

Wider economic benefits resulting from extended geographical mobility is one argument for investments in high-speed rail. More specifically, the argument for high-speed trains in Sweden has been that they can help to further spatially extend labor market regions which in turn has a positive effect on growth and development. In this paper the aim is to cartographically visualize the potential size of the labor markets in areas that could be affected by possible future high-speed trains. The visualization is based on the forecasts of labor mobility with public transport made by the Swedish national mobility transport forecasting tool, SAMPERS, for two alternative high-speed rail scenarios. The analysis, not surprisingly, suggests that the largest impact of high-speed trains results in the area where the future high speed rail tracks are planned to be built. This expected effect on local labor market regions of high-speed trains could mean that possible regional economic development effects also are to be expected in this area. However, the results, in general, from the SAMPERS forecasts indicaterelatively small increases in local labor market potentials.

Heuristic optimization of the p-median problem and population re-distribution

This thesis contributes to the heuristic optimization of the p-median problem and Swedish population redistribution.   The p-median model is the most representative model in the location analysis. When facilities are located to a population geographically distributed in Q demand points, the p-median model systematically considers all the demand points such that each demand point will have an effect on the decision of the location. However, a series of questions arise. How do we measure the distances? Does the number of facilities to be located have a strong impact on the result? What scale of the network is suitable? How good is our solution? We have scrutinized a lot of issues like those. The reason why we are interested in those questions is that there are a lot of uncertainties in the solutions. We cannot guarantee our solution is good enough for making decisions. The technique of heuristic optimization is formulated in the thesis.   Swedish population redistribution is examined by a spatio-temporal covariance model. A descriptive analysis is not always enough to describe the moving effects from the neighbouring population. A correlation or a covariance analysis is more explicit to show the tendencies. Similarly, the optimization technique of the parameter estimation is required and is executed in the frame of statistical modeling. 

Out-of-town shopping and its induced CO2-emissions

Planning policies in several European countries have aimed at hindering the expansion of out-of-town shopping centers. One argument for this is concern for the increase in transport and a resulting increase in environmental externalities such as CO2-emissions. This concern is weakly founded in science as few studies have attempted to measure CO2-emissions of shopping trips as a function of the location of the shopping centers. In this paper we conduct a counter-factual analysis comparing downtown, edge-of-town and out-of-town shopping. In this comparison we use GPS to track 250 consumers over a time-span of two months in a Swedish region. The GPS-data enters the Oguchi’s formula to obtain shopping trip-specific CO2-emissions. We find that consumers’ out-of-town shopping would generate an excess of 60 per cent CO2-emissions whereas downtown and edge-of-town shopping centers are comparable.

On administrative borders and accessibility to public services: : The case of hospitals in Sweden.

An administrative border might hinder the optimal allocation of a given set of resources by restricting the flow of goods, services, and people. In this paper we address the question: Do administrative borders lead to poor accessibility to public service such as hospitals? In answering the question, we have examined the case of Sweden and its regional borders. We have used detailed data on the Swedish road network, its hospitals, and its geo-coded population. We have assessed the population’s spatial accessibility to Swedish hospitals by computing the inhabitants’ distance to the nearest hospital. We have also elaborated several scenarios ranging from strongly confining regional borders to no confinements of borders and recomputed the accessibility. Our findings imply that administrative borders are only marginally worsening the accessibility.

Part-time employment within the Swedish retail business : – A study of part-time employment from a management perspective

Research question: How has the presence of PT employees affected the role of managers in the Swedish food retail business? Research purpose: The purpose of this paper was to describe the change that accompanies part-time employment from a management perspective, and particularly, describe how the presence of part-time employment has influenced the role of the manager within the Swedish food retail business. Conceptual framework: The main focused in this chapter is directed towards the role of managers. The basis of the conceptual framework consist of the model developed by Mintzberg including the ten managerial roles and Quinn's eight leadership roles and how the presence of PT employments might affect these roles. Methodology: In this paper, the authors adopted a qualitative design and used narrative inquiry as a research strategy in order to gain a deep understanding of the context. Semi- structured interviews have been collected through a self-selection sampling and the total number of participants was ten. Conclusions: Based on the findings of this paper the presence of PT employees have not influenced and changed the role of managers. The changes that have influenced and caused the change of the role of the managers constitutes of the increased workload, the delegations of tasks and responsibilities, changed positions, the change of the organisational structure of the individual store, and the increased workforce.

Acupuncture with manual and electrical stimulation for labour pain : a longitudinal randomised controlled trial

Background: Acupuncture is commonly used to reduce pain during labour despite contradictory results. The aim of this study is to evaluate the effectiveness of acupuncture with manual stimulation and acupuncture with combined manual and electrical stimulation (electro-acupuncture) compared with standard care in reducing labour pain. Our hypothesis was that both acupuncture stimulation techniques were more effective than standard care, and that electro-acupuncture was most effective.  Methods: A longitudinal randomised controlled trial. The recruitment of participants took place at the admission to the labour ward between November 2008 and October 2011 at two Swedish hospitals. 303 nulliparous women with normal pregnancies were randomised to: 40 minutes of manual acupuncture (MA), electro-acupuncture (EA), or standard care without acupuncture (SC). Primary outcome: labour pain, assessed by Visual Analogue Scale (VAS). Secondary outcomes: relaxation, use of obstetric pain relief during labour and post-partum assessments of labour pain. The sample size calculation was based on the primary outcome and a difference of 15 mm on VAS was regarded as clinically relevant, this gave 101 in each group, including a total of 303 women.  Results: Mean estimated pain scores on VAS (SC: 69.0, MA: 66.4 and EA: 68.5), adjusted for: treatment, age, education, and time from baseline, with no interactions did not differ between the groups (SC vs MA: mean difference 2.6, 95% confidence interval [CI] -1.7-6.9 and SC vs EA: mean difference 0.6 [95% CI] -3.6-4.8). Fewer number of women in the EA group used epidural analgesia (46%) than women in the MA group (61%) and SC group (70%) (EA vs SC: odds ratio [OR] 0.35; [95% CI] 0.19-0.67).  Conclusions: Acupuncture does not reduce women's experience of labour pain, neither with manual stimulation nor with combined manual and electrical stimulation. However, fewer women in the EA group used epidural analgesia thus indicating that the effect of acupuncture with electrical stimulation may be underestimated. These findings were obtained in a context with free access to other forms of pain relief.

Relative durations of post-vocalic consonants in readaloud Spanish by native Swedish L2-learners

Prosody is said to be a persistent feature in foreign accents, particularly in the speech of adult learners. Native Swedish speakers have been reported to lengthen vowels in Spanish as well as post-vocalic consonants in English and German, more than native speakers of the respective languages. The aim of the present study is to examine whether native Swedish learners of Spanish produce increased postvocalic consonant durations in a reading aloud exercise. The text contains certain words that could be expected to trigger complementary consonant lengthening in native Swedish speakers. The result shows that there is no general tendency for native Swedes to lengthen post-vocalic consonants more than native speakers of Spanish in the present speech material. There are examples of longer consonant durations in the speech of the native,Swedish subjects, but it could be a coincidence. A conclusion is that the text used in the study, and probably Spanish as a language, contains few words that are ideal for triggering lengthening of post-vocalic consonants in native Swedish speakers.

Dialectal Speech in Literature and Translation : Bachelor Degree Thesis in English Linguistics

This essay studies how dialectal speech is reflected in written literature and how this phenomenon functions in translation. With this purpose in mind, Styron's Sophie's Choice and Twain's The Adventures of Huckleberry Finn are analysed using samples of non-standard orthography which have been applied in order to reflect the dialect, or accent, of certain characters. In the same way, Lundgren's Swedish translation of Sophie's Choice and Ferres and Rolfe's Spanish version of The Adventures of Huckleberry Finn are analysed. The method consists of linguistically analysing a few text samples from each novel, establishing how dialect is represented through non-standard orthography, and thereafter, comparing the same samples with their translation into another language in order to establish whether dialectal features are visible also in the translated novels. It is concluded that non-standard orthography is applied in the novels in order to represent each possible linguistic level, including pronunciation, morphosyntax, and vocabulary. Furthermore, it is concluded that while Lundgren's translation intends to orthographically represent dialectal speech on most occasions where the original does so, Ferres and Rolfe's translation pays no attention to dialectology. The discussion following the data analysis establishes some possible reasons for the exclusion of dialectal features in the Spanish translation considered here. Finally, the reason for which this study contributes to the study of dialectology is declared.

Movies and meaning : studying audience, fiction film and existential matters

In what ways and under what circumstances can a movie be a resource for individuals and their thoughts about existential matters? This central research question has been investigated using a both quantitative and qualitative approach. First, a questionnaire was distributed amongst 179 Swedish students to provide a preliminary overview of film habits. The questionnaire was also used as a tool for selecting respondents to individual interviews. Second, focus group and individual interviews were conducted, with viewers choosing their favourite movie of all time. In the study socio-cognitive theory and a schema-based theoretical tool is adopted to analyze how different viewers make use of movies as cultural products in an interplay between culture and cognition in three contexts; a socio-historic process, a socio-cultural interaction with the world and inner psychological processes. The viewers in the study seem to be inspired by movies as a mediated cultural resource, promoting the development of a personal moral framework with references to values deeply fostered by a humanistic tradition. It is argued that these findings support theories discussing individualised meaning making, developing ‘self-expression values’ and ‘altruistic individualism’ in contemporary western society.

Representation and interpretation : textbooks, teachers, and historical culture

This article presents a study of how contemporary Swedish lower secondary school textbooks present the emergence of the Cold War and how 10 active lower secondary school history teachers interpreted a quotation that was ambiguous in relation to the general narrative in the studied Swedish textbooks, seeking to analyse textbooks both from the perspectives of content and reception. Applying a theoretical framework of uses of history, the study finds that the narratives presented in the studied textbooks are what could be called traditional in the sense that they do not acknowledge perspective and representation in history. While the interviewed teachers generally acknowledged that textbook narratives are representations of history and contingent on perspective, few teachers extended this to include how their own views affect their interpretations, suggesting an intermediary appreciation of the contextual contingency of historical narratives.

Abilities and Cultural Understanding through Literature in the EFL Classroom : - A Literature Review

The English language can be seen as a lingua franca of contemporary times. Its spread and use in the globalized world has affected most levels of society and it can be argued that, in current times, English is synonymous with communication. This need for communication has shaped the English as a Foreign Language (EFL) syllabus, which is evident in the Swedish national steering documents for the educational system. For the upper secondary school these documents show an emphasis on communication, on cultural understanding, and also on the use of literature within the EFL classroom. The need to possess communicative abilities and cultural understanding, in connection with the use of literature, has sparked an interest to investigate if and how literature itself can be used as a tool to develop and improve EFL students’ communicative skills and cultural understanding. This literature review thesis analyzes five international research articles from different geographical parts of the Globe. The findings are categorized, compared, synthesized, and finally discussed in order to answer the research questions asked, and also compared with the English subject syllabus for the Swedish upper secondary school. The findings indicate that the analyzed articles share a consensus, to a varied degree, regarding the positive aspects of literature use in the EFL setting. The arguments are that communicative skills and cultural understanding are intertwined - enabling each other to exist, develop, and improve. One cannot exist fully without the other, and literature is a good tool to use to develop and improve these abilities. Literature can help develop all skills needed to acquire and produce both written and spoken English, and it also enables cultural understanding and a broadening of the mind. Where the articles differ somewhat is in the ideas of why literature is a good tool, how to implement literature in the classrooms, and what some of the negative aspects might be. The thesis also brings the lack of Swedish studies within EFL to the readers’ attention, as well as the need to do more research focusing on the students’ perspectives towards literature use in the EFL setting.