Omvårdnadskompetensens betydelse för patientsäkerheten i vårdorganisationen : En litteraturstudie

Introduktion: Vårdorganisationer ska tillgodose patientsäker vård av hög kvalitet på ett så effektivt sätt som möjligt. Patienter drabbas dock i stor omfattning av vårdskador som skulle kunna undvikits om adekvata åtgärder vidtagits vid deras kontakt med hälso- och sjukvården. Sjuksköterskorna utför omvårdnadshandlingar med de givna resurser som vårdorganisationen tillhandahåller. Syfte: Att belysa betydelsen av sjuksköterskors omvårdnadskompetens för patientsäkerheten ur ett organisatoriskt perspektiv. Metod: Polit och Becks (2017) niostegsmodell har använts med ett deduktivt arbetssätt. Ramverket har varit förutbestämda patientsäkerhetsindikatorer (trycksår, fall, nosokomiala infektioner, misslyckande att rädda och mortalitet) samt Donabedians (1988) begreppsmodell. Tio kvantitativa artiklar har använts till resultatet. Resultat: Sjuksköterskors omvårdnadskompetens har visat sig genom procentandelen sjuksköterskor i omvårdnadsgruppen, omvårdnadstiden som patienter får av sjuksköterskor samt kandidatexamen och klinisk erfarenhet hos sjuksköterskorna. Vid en ökning av omvårdnadskompetensen så minskade vårdskador oavsett avdelningens karaktär. Konklusion: Mer än hälften av vården består av omvårdnad där sjuksköterskor leder omvårdnadsarbetet. Sammansättningen av omvårdnadsgrupper har en avgörande roll för patientsäkerheten. Procentandel sjuksköterskor i omvårdnadsgruppen bör vara omkring 85- 88%. För att öka patientsäkerheten krävs mer evidens och datainsamling kring vilka omvårdnadshandlingar som påverkar vårdutfall utifrån struktur, process och vårdutfallsnivå. Detta skulle stärka sjuksköterskeprofessionens betydelse och underlätta för verksamheter och beslutsfattare vid kvalitetsförbättring av vården.

Factors facilitating a national quality registry to aid clinical quality improvement : findings of a national survey

Objectives: While national quality registries (NQRs) are suggested to provide opportunities for systematic follow-up and learning opportunities, and thus clinical improvements, features in registries and contexts triggering such processes are not fully known. This study focuses on one of the world's largest stroke registries, the Swedish NQR Riksstroke, investigating what aspects of the registry and healthcare organisations facilitate or hinder the use of registry data in clinical quality improvement. Methods: Following particular qualitative studies, we performed a quantitative survey in an exploratory sequential design. The survey, including 50 items on context, processes and the registry, was sent to managers, physicians and nurses engaged in Riksstroke in all 72 Swedish stroke units. Altogether, 242 individuals were presented with the survey; 163 responded, representing all but two units. Data were analysed descriptively and through multiple linear regression. Results: A majority (88%) considered Riksstroke data to facilitate detection of stroke care improvement needs and acknowledged that their data motivated quality improvements (78%). The use of Riksstroke for quality improvement initiatives was associated (R2=0.76) with ‘Colleagues’ call for local results’ (p=<0.001), ‘Management Request of Registry data’ (p=<0.001), and it was said to be ‘Simple to explain the results to colleagues’ (p=0.02). Using stepwise regression, ‘Colleagues’ call for local results’ was identified as the most influential factor. Yet, while 73% reported that managers request registry data, only 39% reported that their colleagues call for the unit's Riksstroke results. Conclusions: While an NQR like Riksstroke demonstrates improvement needs and motivates stakeholders to make progress, local stroke care staff and managers need to engage to keep the momentum going in terms of applying registry data when planning, performing and evaluating quality initiatives.

En sjukdom af högst elakt släckte : Återfallsfebern på Sveaborg och i Karlskrona 1788-1790

Sommaren 1788 drabbades den svenska flottan av en svårartad febersjukdom. Febern, som senare definierats som febris recurrens el. återfallsfeber, hade sitt ursprung i den ryska flottan. Besättningen ombord skeppet Vladislav, krigsbytet från slaget vid Hogland, bar på ett stort antal smittade klädlöss. Efter flottans ankomst till Sveaborg spred sig sjukdomen snabbt bland manskapet, men även bland fästningens garnison. Förhållandena inom militären, både inom lantarmén och framför allt inom flottan, var gynnsamma för epidemiers spridning. De trånga utrymmena, den ensidiga kosten, det undermåliga dricksvattnet, den bristande hygienen: allt gynnade uppkomsten och spridningen av olika epidemier. Manskapets försämrade allmäntillstånd gjorde, att sjukdomarna blev mera förödande än vad de i andra förhållanden skulle ha varit. Bristen på manskap och material under Gustav III:s ryska krig var enormt, bl.a. var bristen på medicinsk personal och -utrustning skriande. Då flottan och armén drabbades av en epidemi av katastrofala dimensioner stod myndigheterna hjälplösa. Epidemin visaqr tydligt hur illa förberett hela kriget var och hur misskött flottans sjukvård var. På Sveaborg var förhållandena fruktansvärda. Halva garnisonen uppges ha avlidit, och det låg travar av lik överallt. Kaserner m.fl. byggnader adapterades till provisoriska lasarett och det rådde brist på allt. De medicinska myndigheterna representerades av den till fästningen skickade andra fältläkaren, som tillsammans med läkarna på fästningen gjorde sitt bästa i enlighet med tidens vårdmetoder. Då den svenska örlogsflottan i november seglat över tilll Karlskrona spred sig epidemin i staden. Sjukdomen grasserade också bland de civila. Då sjukdomens orsak och utbredningssätt var okända, kunde man varken hindra epidemin från att spridas eller genomföra adekvata vårdmetoder. Tvärtom, med de hemförlovade båtsmännen spred sig sjukdomen även till de övriga delarna av riket. Under 1789 var flottan p.g.a. de många sjukdomsfallen närmast operationsoduglig. Under vårvintern och våren 1790 avtog epidemin. Epidemin var ett svårt medicinskt problem. För att utreda situationen i Karlskrona skickade den tillförordnade regeringen, utredningskommissionen och Collegium medicum sina egna representanter till staden. De olika läkarnas sjukdomssyner grundade sig främst på tron om sjukdomars uppkomst genom miasma och förbättrandet av luftkvaliteten sågs som en väsentlig vårdform. I arbetet jämförs de olika myndigheternas och några av de på platsen varande läkarnas syn på sjukdomens art, dess orsaker och ursprung. De flesta härleder sjukdomen till den ryska flottan, och nämner någon form av smitta. Som främsta sjukdomsorsak nämns dock miasma och de rekommenderade vårdformerna representerade den humoralpatologiska synen. Förste amiralitetsläkaren Arvid Faxe representerar dock en annan åsikt, i det att han enbart tror på sjukdomens överföring via smitta. Epidemin var också ett politiskt problem. Epidemin var en lokal angelägenhet ända till dess att flottans operationer hämmades av manskapsbristen, varefter den blev ett ärende på högsta nivå. Kungen ingrep sommaren 1789 genom att grunda en kommision med rätt vidsträckta befogenheter. I Karlskrona verkar de militära myndigheterna och läkarna ha misstrott och skuldsatt varandra för katastrofen, och förhållandet mellan de till staden sända utredarna och militärerna var likaså inflammerat. Genom källorna återspeglas rivalitet, avund och inbördes konkurrens. Personalbristen var svår, och den skyldiga söktes utanför den egna kretsen. Den danskfödde apotekaren med sina påstott otjänliga mediciner blev en ypperlig syndabock. Örlogsflottan beräknas i sjukdomar ha förlorat omkring 10.000 man i döda, huvudsakligen i Karlskrona (civila inberäknade). Armén och Skärgårdsflottan uppges likadeles ha mist omkring 10.000 man, medan antalet i strid stupade armésoldater endast var ca 1500. Sammanlagt antas alltså ca 20.000 människor ha mist livet; både i återfallsfeber, men även i andra, samtidigt grasserande farsoter. I denna siffra är inte de övriga delarna av riket inberäknade. Epidemin i fråga kan alltså på goda grunder anses vara det svenska 1700-talets största medicinska katastrof.

Hur sjuksköterskan och vården påverkas av hög arbetsbelastning

Syftet med denna litteraturöversikt var att belysa hur den höga arbetsbelastning som förekommer inom dagens sjukvård påverkar sjuksköterskan och vården av patienten. Artikelsökning genomfördes i databasen Science Direct. Sammanlagt inkluderades 10 artiklar i studien, fem kvalitativa och fem kvantitativa. Resultatet visade att en hög arbetsbelastning påverkade sjuksköterskan på flera områden. Till exempel så fick hon inte den tid hon behövde med patienten för att göra ett tillfredsställande arbete. Den höga arbetsbelastningen påverkade sjuksköterskan då hon inte alltid hann med att ge den önskade vården. Det fanns även faktorer i arbetsmiljön som underlättade hennes arbete som ett väl fungerande samarbete med kollegorna. Sjuksköterskor var också beroende av ett bra kollegialt stöd och behövde få tid för att ta söka ny kunskap. Sjuksköterskans arbetsbelastning bör vara så att hon kan hantera och ha kontroll över sitt arbete. Kommunikationen mellan den anställde och ledningen var viktig, för att sjuksköterskan skulle kunna ge en vård av hög kvalitet.

”Nog är det så att bratsen i Danderyd har det lättare…” : En komparativ intervjustudie om uppfattningar om utbildning och välfärdspolitik i Sverige, Tyskland och USA

Syftet med uppsatsen var att undersöka individers attityder till och uppfattningar av deras lands välfärdspolitik; i USA, Tyskland och Sverige. Vidare undersöktes om och hur respektive individ tror att deras tillgång till välfärdstjänster skulle ha sett annorlunda ut i ett annat välfärdspolitiskt system. Upplevelsen av tillgången till och kvaliteten på välfärdstjänstområdena ”sjukvård”; ”inkomsttrygghet – arbetslöshets- och sjukförsäkring”; ”utbildning” samt ”ålderdom – pensionsförsäkring och vård” undersöktes, med fokus på utbildning. Samt hur individerna själva ansåg att det borde vara. Sex individer ifrån Sverige, Tyskland och USA; två från respektive land, intervjuades. Resultaten visade att den ena svenska respondenten är nöjd med det svenska välfärdssystemet då det inte finns klasskillnader, enligt honom. Den andra respondenten från Sverige är mer kritisk. Även den ena intervjupartnern från Tyskland var kritisk mot det tyska välfärdssystemet, men samtidigt tyckte den att mycket, inom till exempel sjukvården och med bidrag, fungerar bra. Den andra tyska respondenten ställde sig mycket positiv till det tyska välfärdssystemets och ansåg att alla medborgare har samma möjligheter. Respondenterna från USA är dock negativa till ländernas välfärdssystem och kritiserar sjukvården, utbildningen och bidragssystemets bristande förmåga att erbjuda likvärdig tillgänglighet och kvalitet. Den statliga välfärdstjänst som respondenterna var mest positiva till var utbildning. Alla respondenter var för att staten skulle erbjuda likvärdiga utbildningsmöjligheter till alla. Mest misstänksamma var man mot bidrag och arbetslöshetsersättning som de flesta misstänkte att det förekom fusk med. Dessa resultat stämmer väl överens med tidigare forskning av mer kvantitativ karaktär och erbjuder en djupare insyn i individens resonemang i de olika frågorna.

Barndom som präglar vuxenlivet : Samband mellan traumatiska barndomsupplevelser och psykosocial hälsa/ohälsa i vuxen ålder

SAMMANFATTNING: Flera internationella undersökningar om samband mellan vissa traumatiska barndomsupplevelser och psykosocial hälsa/ohälsa som vuxen, har tidigare genomförts. De flesta studier har dock utförts inom kliniska populationer med begränsat antal studerade faktorer. Då det endast finns ett fåtal svenska studier inom detta ämnesområde, har syftet med denna studie varit att undersöka om det finns samband mellan å ena sidan barndomsupplevelser av känslomässiga, fysiska och sexuella övergrepp, känslomässig och fysisk försummelse samt idealisering av familj och psykosociala hälso/ohälsoindikatorer i vuxen ålder å andra sidan. De senare är tillgången till nätverk respektive anknytning, olika indikationer på alkoholproblem såsom konsumtionsnivå, tecken på beroende och skadligt drickande, psykisk ohälsa i form av ångest respektive depression samt social misstro. Då upplevelser från barndomen är retrospektiva konstruktioner, togs som ett undersyfte upp om det finns systematiska validitetsproblem såsom minimering och benägenhet att svara på ett socialt önskvärt sätt. Undersökningen är kvantitativ och baseras på gruppenkäter som besvarats av studenter vid Mittuniversitetet. Resultaten visar att det fanns klara samband mellan olika traumatiska barndomsupplevelser och olika former av hälso/ohälsotillstånd i vuxen ålder. Multivariata analyser visar att sexuella och fysiska övergrepp är relaterade till ökade tecken på alkoholproblem, känslomässiga övergrepp och ångest, medan känslomässig försummelse är relaterat till depression, mindre socialt nätverk och till mindre grad av anknytning. Förhoppningen är att studien skall bidra till teoriutvecklingen om hur barndomsproblem påverkar problemen i vuxen ålder.

[Den musikindustriella förändringen fortsätter och en tjänstebaserad musikekonomi börjar ta form] [in Swedish]

Det har nu gått mer än tio år sedan en student vid Northeastern University i USA lanserade den första fildelningstjänsten som blev framgångsrik bland den breda allmänheten (e.g. Alderman 2001). Lanseringen av tjänsten, som kallades Napster, ses ofta som inledningen på ett av de mest dramatiska decennierna i musikbranschens historia. En lång rad internetbaserade tjänster som följt i Napsters spår har gjort det möjligt att sprida musik till miljontals användare utan att upphovsmän och rättighetsinnehavare fått någon ersättning. Katt-och-råtta-leken mellan lagstiftning och teknik har varit intensiv och har utvecklats till ett av decenniets allra hetaste diskussionsämnen bland politiker och ledarskribenter. Försäljningen av inspelad musik har sjunkit dramatiskt och musikbranschen har tvingats ifrågasätta många väletablerade sanningar. Det här kapitlet belyser ett antal fundamentala aspekter av denna förändring och utforskar några av den ”nya” musikbranschens viktigaste karaktäristika. Under den tid som musikbranschen har beforskats har vanligtvis betoningen legat på fonogrammen, det vill säga den del av branschen som rör produktion och konsumtion av inspelad musik. På grund av branschens förändrade struktur kommer dock det här kapitlet att vidga perspektivet en smula och även inkludera musikbranschens andra delar som exempelvis konserter och förlagsverksamhet...

Modernismens förespråkare : Gösta Stenman och hans konstsalong

This dissertation, based on material from Stenman s vast private archive, examines the role played by Swedish-speaking Finnish art dealer Gösta Stenman (1888-1947) and his art gallery, Stenmans Konstsalong, in the Finnish and Swedish art worlds from 1911 to 1947. This archive is examined here for the first time. The analytical framework used for this empirical study derives from Pierre Bourdieu s sociological theories. An art-sociological approach allows for the inclusion of more mechanisms at work in the art world than are typically embraced in such inquiries. This approach provides a fuller understanding of how Stenman attained his standing and central role in the art world in Finland as well as Sweden; enabling us to appreciate how he came to occupy such a prominent position in current art historical writing. All of these issues constitute new areas of research. Taking his cues from the contemporary art world of Paris, Stenman became the year 1914 a modern art dealer like no other in the Nordic countries. This dissertation represents the first academic investigation into his operations, strategies, and objectives, offering insight into not only the art dealer himself but also the functioning of the art market one of the most vital aspects of the art world. A by-product of this work, is that the modern art market in Finland is portrayed, including essential issues related to its growth and development as well as how it altered the conditions under which art could be produced, exhibited and promoted and what this entailed for the art world at large, artists and patrons alike. This first systematic analysis of the operations of Stenman s Konstsalong offers greater understanding of the art worlds of Sweden and Finland in the early twentieth century. The work also looks at how an agent of the art market could move between the fields of art in Sweden and Finland. The manner in which Stenman promoted individual artists, including his relationships with Tyko Sallinen, Helene Schjerfbeck, Juho Mäkelä, Jalmari Ruokokoski, Siri Derkert, Esther Kjerner, Eva Bagge, and many others, also falls within this purview. Stenman s contract with Sallinen from 1913 stands out as a new phenomenon in Finnish art promotion, whereby an artistic career became established via a far-sighted, strategic promotional program. The case study of Stenman s promotion of Schjerfbeck in Sweden provides evidence of the increasingly advanced nature of Stenman s strategies. The title of the dissertation, The Promoter of Modernism, attempts to convey that Stenman was the consummate modernist, modern in his thoughts, his actions, and his approach to art. Keywords: Gösta Stenman, Stenmans konstsalong, Stenmans dotter, art market, modernism, collecting, Novembergruppen, Helene Schjerfbeck, Tyko Sallinen, Juho Mäkelä, Jalmari Ruokokoski, Wäinö Aaltonen, Siri Derkert, Åke Göransson, Esther Kjerner, Eva Bagge.

Historiebruk kring Nådendal : och den kommemorativa anatomin av klostrets minnesplats

This thesis examines the ruins of the medieval Bridgettine (Birgittan) monastery of Naantali (Vallis Gratiae, f. 1443) in Finland and the transformation of the site into a national heritage and a memory landscape. It was archaeologically surveyed in the 19th century by Professor Sven Gabriel Elmgren (1817 1897). His work was followed by Dr. Reinhold Hausen (1850 1942), who excavated the site in the 1870s. During this time the memories of Saint Bridget (Birgitta) in Sweden were also invented as heritage. Hausen published his results in 1922 thus forming the connection with the next generation of actors involved with the Naantali site: the magnate Amos Anderson (1878 1961), the teacher Julius Finnberg (1877 1955) and the archaeologist Juhani Rinne (1872 1950). They erected commemorative monuments etc. on the Naantali site, thus creating a memory landscape there. For them, the site represented the good homeland in connection with a western-oriented view of the history of Finland. The network of actors was connected to the Swedish researchers and so-called Birgitta Friends, such as state antiquarian Sigurd Curman (1879 1966), but also to the members of the Societas Sanctae Birgittae and the Society for the Embellishment of Pirita, among others. Historical jubilees as manifestations of the use of history were also arranged in Naantali in 1943, 1993 and 2003. It seems as if Naantali is needed in Finnish history from time to time after a period of crisis, i.e. after the Crimean War in the 1850s, the civil war of 1918, during World War II and also after the economic crisis of the early 1990s. In 2003, there was a stronger focus on the international Saint Bridget Jubilee in Sweden and all over Europe. Methodologically, the thesis belongs to the history of ideas, but also to research on the use of history, invented traditions and lieux de mémoire. The material for the work consists of public articles and scholarly texts in books or newspapers and letters produced by the actors and kept in archives in Finland, Sweden and Estonia, in addition to pictures and erected commemorative monuments in situ in the Western Finnish region. Keywords: Nådendal, Naantali monastery, Bridgettines, St. Bridget, use of history, lieux de mémoire, invented traditions, commemorative anatomy, memory landscape, Saint Bridget jubilees , S. G. Elmgren, R. Hausen, A. Anderson, J. Finnberg, J. Rinne, S. Curman, High Church Movement, Pirita, Vadstena.

En förutbestämd sanning : Barnamord och delaktighet i 1700-talets Finland belysta genom kön, kropp och social kontroll

The study analyses the prevention or endorsing of the crime of infanticide in Finland 1702 1807, rather than the result. Also the impacts of the female body, biology of childbirth and experiences of pregnancy are examined, together with insights from modern medical research. Circumstances are reconstructed by a critical reading of judicial records on all levels of the judicial system. In all 269 cases of infanticide and 142 accessory crimes within the jurisdiction of the Turku court of appeal are studied, with particular focus on exceptionally well recorded cases of 83 accused women and 41 women and men accused of being party to the crime. Secondary sources are medical and jurisprudential writings, the public debate on infanticide, broadsheets and letters asking the King for pardon. Infanticide was considered murder by law. Unmarried women were predetermined as the main culprits. Nevertheless, deliberate infanticides were rare and committed mostly in accomplice. The majority of the infanticides studied were cases where inexperienced and unmarried women accidentally had given birth alone and usually to a dead child. Unaware that the pain they were experiencing was in fact a labour, the accused women instinctively sought solitude to push out the child. Some misunderstood the birth as an urgent need to defecate. The unexpected delivery ended in hiding the baby without remorse. This crime was promoted by several factors in Finnish rural culture, amongst others that also married women hid their pregnancy. The immediate household members did not necessarily know about the childbirth and failed to help the woman. This typical pattern in most cases of infanticide in 18th century Finland is also recorded in modern cases of unknown pregnancies. Fear of accountability prevented witnesses testifying to the actual course of events. The truth remained elusive. With only a few exceptions, the women were sentenced to death or imprisonment. The majority of those accused of accomplice were acquitted. However, too harsh sentences for accidents affected the reporting of the crime. Criminal politics failed to curtail infanticide as the crime was unsatisfactorily addressed by law, society and the judicial system.

Idyll eller verklighet? : Albert Edelfelt och Gunnar Berndtson i det moderna genombrottets ambivalens

Idyll or Reality? Albert Edelfelt, Gunnar Berndtson and the ambivalent breakthrough of modernity Albert Edelfelt (1854-1905) and Gunnar Berndtson (1854-1895) have much in common. In this dissertation, I study their paintings of local peasants and fishermen and of the gentry’s summer in the county of Uusimaa in southern Finland, in the context of Nordic history of ideas. The breakthrough of modernity, with its attention on debating social problems, provides a novel angle into the oeuvres of the two artists. My focus is on the paintings which emerge in the collision of the public discussion of social matters and the values of the artists’ manorial milieu. The artists’ relation to the public discussion is scrutinized through two of the main topics: the question of the common people and democracy, and the question of equality between men and women. My dissertation is a contextual study which is based on the analysis of the artworks of Edelfelt and Berndtson, on their letters, and on the study of drama and fiction of their time. The notion “liberté, egalité, fraternité” is linked to the breakthrough of modernity. Both artists were aware of the ideal of equality. They used the means and the themes of contemporary art in their presentations, but their pictures contain the ideal of an earlier epoch: the hardworking, but still complacent common people. This conception of the common people is also reflected in the poems of J. L. Runeberg. Women of the late 19th century challenged woman’s primary role as wife and mother. In Edelfelt’s and Berndtson’s depictions of the gentry enjoying summer, women and children have the main role. Notwithstanding the debate of the breakthrough of modernity they depicted women almost without exception as good mothers. Their paintings often depict lazy days in the sunshine, which were, in reality, rare moments for the mistress of the house. Edelfelt’s and Berndtson’s subjects from the Uusimaa countryside coincide with the topics of the breakthrough of modernity, but both the pictures of the common people and the depictions of the gentry enjoying summer, are a retouched picture of reality, often an idyll, in which the public discussion of social matters is evident only materially or not at all.

Gustaf III inför sina undersåtar : Konsten att härska och politikens kulturhistoria

The dissertation analyses the political culture of Sweden during the reign of King Gustav III (1771-1792). This period commonly referred to as the Gustavian era followed the so-called Age of Liberty ending half a century of strong parliamentary rule in Sweden. The question at the heart of this study engages with the practice of monarchical rule under Gustav III, its ideological origins and power-political objectives as well as its symbolic expression. The study thereby addresses the very nature of kingship. In concrete terms, why did Gustav III, his court, and his civil service vigorously pursue projects that contemporaneous political opponents and, in particular, subsequent historiography have variously pictured as irrelevant, superficial, or as products of pure vanity? The answer, the study argues, is to be found in patterns of political practice as developed and exercised by Gustav III and his administration, which formed a significant part of the political culture of Gustavian Sweden. The dissertation is divided into three parts. The first traces the use and development of royal graces chivalric orders, medals, titles, privileges, and other gifts issued by the king. The practice of royal reward is illustrated through two case studies: the 1772 coup d état that established Gustav III s rule, and the birth and baptism of the crown prince, Gustav Adolf, in 1778. The second part deals with the establishment of the Court of Appeal in Vasa in 1776. The formation of the Appeals Court was accompanied by a host of ceremonial, rhetorical, emblematic, and architectural features solidifying its importance as one of Gustav III s most symbolic administrative reform projects and hence portraying the king as an enlightened monarch par excellence. The third and final part of the thesis engages with war as a cultural phenomenon and focuses on the Russo-Swedish War of 1788-1790. In this study, the war against Russia is primarily seen as an arena for the king and other players to stage, create and re-create as well as articulate themselves through scenes and roles adhering to a particular cultural idiom. Its codes and symbolic forms, then, were communicated by means of theatre, literature, art, history, and classical mythology. The dissertation makes use of a host of sources: protocols, speeches, letters, diaries, newspapers, poetry, art, medals, architecture, inscriptions and registers. Traditional political source material and literary and art sources are studied as totalities, not as separate entities. Also it is argued that political and non-fictional sources cannot be understood properly without acknowledging the context of genre, literary conventions, and artistic modes. The study critically views the futile, but nonetheless almost habitual juxtaposition of the reality of images, ideas, and metaphors, and the reality of supposedly factual historical events. Significantly, the thesis presumes the symbolic dimension to be a constitutive element of reality, not its cooked up misrepresentation. This presumption is reflected in a discussion of the concept of role , which should not be anachronistically understood as roles in which the king cast himself at different times and in different situations. Neither Gustav III nor other European sovereigns of this period played the roles as rulers or majesties. Rather, they were monarchs both in their own eyes and in the eyes of their contemporaries as well as in all relations and contexts. Key words: Eighteenth-Century, Gustav III, Cultural History, Monarchs, Royal Graces, the Vasa Court of Appeal, the Russo-Swedish War 1788–1790.

Makt, konst, elit - konstfältets positioner, relationer och resurser i 1940- och 1950-talens Helsingfors

The dissertation examines the power mechanisms and institutional power hierarchies of the 1940s-1950s era arts elite in Helsinki and their influence on issues of taste in the visual arts. For the purposes of this study, the elite is understood to consist mainly of the board members of the principal elected bodies in the field of the arts. The theoretical framework employed is based on Pierre Bourdieu s field theory and the network perspective. The author has examined what the key, pervasive valuations were that governed the exercising of power by the arts elite in issues of taste, involving determination of who was an acknowledged artist and what was good art. The dissertation demonstrates that this exercising of power was governed by certain collective practices which maintained the illusion that the exercising of power was democratic and based on artistic quality. These practices were the corporate system, using artistic arguments in issues of taste, and using networks in the exercising of power. The struggle in the field of the arts was about who ultimately was entitled to define the value of contemporary art; the issue did not arise regarding historical art. Artists managed to gain a leading position as gatekeepers in issues regarding contemporary art. The author discusses a number of conflicts in the field of the arts that highlight the institutional hierarchies and the capital held by the various players. The structural changes that occurred in administration in the field of cultural production in the 1950s led to the separation of bureaucratic competence on the one hand and aesthetic competence on the other. There was a hierarchy in the field of the arts between institutions, between instruments of legitimisation, and between the symbolic and social capital of players in the field. The hierarchy in the arts ultimately depended on how well the elite could influence tastes through the instruments at their disposal. The various instruments of legitimisation grants, purchases, etc. were ranked differently in the evaluation of acknowledged artists and good art. The dissertation discusses what values, in the form of types of symbolic capital, the arts elite embraced and what role these played in the elite s exercising of power, with particular focus on gender, language, region and economic capital. The aesthetic capital of an artist was of only minor importance in the exercising of power by the arts elite. The dissertation further discusses the points of contact between the arts elite and players in other fields, such as the economic, media and consumer fields. When the arts elite, through the Academy of Fine Arts, became an active player in the art market, this led to a hierarchy where the division between acknowledged and not-acknowledged galleries became sharper.

Betydelser i barnfamiljsbroschyrer : Systemisk-funktionell analys av den tänkta läsaren och institutionen

This thesis concerns Swedish and Finland-Swedish brochures to families with children, presenting family allowances from the social insurance institutions in the two countries. The aim of the study is to analyse what meanings are conveyed with reference to the conceivable reader and the institution in the brochures. The material consists of information brochures in Swedish from Kela, the social insurance institution of Finland, and Försäkringskassan, the Swedish social insurance agency, issued during 2003–2006. The general theoretical framework is systemic-functional linguistics (SFL) as presented by Halliday & Matthiessen (2004) and Holmberg & Karlsson (2006). The study consists of a quantitative study of the lexical choices of the social insurance brochures. Furthermore, a qualitative process and participant analysis is annotated with the UAM Corpus tool and the results are quantified. Speech functions and modal auxiliaries are analysed qualitatively. The analysis shows that material and relational processes are most common. The relational and verbal processes are used more in the Sweden-Swedish brochures, while the material processes are more common in the Finland-Swedish brochures. The participants in the brochures are the institution, mentioned by its name, and the conceivable reader, directly addressed with “you” (du). In addition, the referent “child” is often mentioned. The participants assigned for the reader are Actor, Receiver, Carrier and Speaker. In the Finland-Swedish texts, the reader is often an Actor, while the reader in the Sweden-Swedish texts is a Carrier. Thus, the conceivable reader is an active participant who takes care of his or her own matters using the internet, communicates actively to the institution and has legal rights and obligations. The institution is visible in the texts but does not have an active role as the name of the institution is mostly used in circumstances. The institution is not often a participant, but when it is, it is Actor, Receiver, Listener and Carrier, expecting the clients to address it. Speech functions are performed in different ways. For instance, questions structure the reading process and commands are realised by modal auxiliaries, not by imperatives. The most common modal auxiliary is kan (can, may), and another common auxiliary is ska (shall, must). Statements are surrounded by subordinate clauses and adverbs that describe situations and criteria. The results of the study suggest that the brochures in the two countries are similar, in particular when produced in similar ways, that is, when the Finland-Swedish texts are not translated. Existing differences reflect the differences in the institutions, the social insurance systems and the cultural contexts. KEYWORDS: Finland-Swedish, Swedish, comparative analysis, SFL, discourse analysis, administrative language, institutional discourse, institutional communication

Drag på parnassen. Två sextiotalsstudier. : Del I: Medelklass med mänskligt ansikte. Medelklassradikalism i fyra romaner av Christer Kihlman, Jarl Sjöblom, Marianne Alopaeus och Ulla-Lena Lundberg. Del II: Modernistdebatten. Sak, person och fält i en finlandssvensk litteraturdebatt år 1965.

The objective of my dissertation Pull (or Draught, or Moves) at the Parnassus , is to provide a deeper understanding of Nordic Middle Class radicalism of the 1960 s as featured in Finland-Swedish literature. My approach is cultural materialist in a broad sense; social class is regarded a crucial aspect of the contents and contexts of the novels and literary discussions explored. In the first volume, Middle Class With A Human Face , novels by Christer Kihlman, Jarl Sjöblom, Marianne Alopaeus, and Ulla-Lena Lundberg, respectively, are read from the points of view of place, emotion, and power. The term "cryptotope" is used to designate the hidden places found to play an important role in all of these four narratives. Also, the "chronotope of the provincial small town", described by Mikhail Bakhtin in 1938, is exemplified in Kihlman s satirical novel, as is the chronotope of of war (Algeria, Vietnam) in those of Alopaeus and Lundberg s. All the four novels signal changes in the way general "scripts of emotions", e.g. jealousy, are handled and described. The power relations in the novels are also read, with reference to Michel Foucault. As the protagonists in two of them work as journalists, a critical discussion about media and Bourgeois hegemony is found; the term "repressive legitimation" is created to grasp these patterns of manipulation. The Modernist Debate , part II of the study, concerns a literary discussion between mainly Finland-Swedish authors and critics. Essayist Johannes Salminen (40) provided much of the fuel for the debate in 1963, questioning the relevance to contemporary life of the Finland-Swedish modernist tradition of the 1910 s and 1920 s. In 1965, a group of younger authors and critics, including poet Claes Andersson (28), followed up this critique in a debate taking place mainly in the newspaper Vasabladet. Poets Rabbe Enckell (62), Bo Carpelan (39) and others defended a timeless poetry. This debate is contextualized and the changing literary field is analyzed using concepts provided by sociologist Pierre Bourdieu. In the thesis, the historical moment of Middle Class radicalism with a human face is regarded a temporary luxury that new social groups could afford themselves, as long as they were knocking over the statues and symbols of the Old Bourgeoisie. This is not to say that all components of the Sixties strategy have lost their power. Some of them have survived and even grown, others remain latent in the gene bank of utopias, waiting for new moments of change.