Beroende eller oberoende? : En kvalitativ studie av hur äldre hjälptagare ser på att ha hjälp och stöd

Dependency or independence? A qualitative study of how elderly home-help recipients regard having help and support Knowledge on elderly people’s understandings of dependence and independence is relatively scarce even though there is plenty of gerontological research on related topics. Although we know how to define and measure different types of dependency, we know, in fact, very little about how elderly home-help recipients themselves regard their situation in terms of dependency, independence and autonomy. This article aims to shed light on home-help recipients’ understandings of these constructs and on how they make sense of their situation. The analysis is based on 29 semi-structured interviews with people between the ages of 77 and 93. The findings show how these home help recipients differentiate between having help and support and being dependent on other people. Through the separation of aspects of these understandings, such as the reason why they accept help and support and how they regard the situation of being helped and assisted, three ways of regarding the situation have been identified, which stress the variability of the social construction of dependency and independence that these elders uphold. Some home-help recipients construct themselves as independent, others as autonomous and able selves, while a third group construct themselves as powerless.

Repliker : Replik på Jenny Westerstrands recension

Sociologisk Forsknings digitala arkiv

The kidney in different stages of the cardiovascular continuum

Patients with chronic kidney disease are at higher risk of developing cardiovascular disease. The complex, interaction between the kidney and the cardiovascular system is incompletely understood, particularly at the early stages of the cardiovascular continuum. The overall aim of this thesis was to clarify novel aspects of the interplay between the kidney and the cardiovascular system at different stages of the cardiovascular continuum; from risk factors such as insulin resistance, inflammation and oxidative stress, via sub-clinical cardiovascular damage such as endothelial dysfunction and left ventricular dysfunction, to overt cardiovascular death. This thesis is based on two community-based cohorts of elderly, Uppsala Longitudinal Study of Adult Men (ULSAM) and Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). The first study, show that higher insulin sensitivity, measured with euglycemic-hyperinsulinemic clamp technique was associated to improve estimated glomerular filtration rate (eGFR) in participants with normal fasting plasma glucose, normal glucose tolerance and normal eGFR. In longitudinal analyses, higher insulin sensitivity at baseline was associated with lower risk of impaired renal function during follow-up. In the second study, eGFR was inversely associated with different inflammatory markers (C-reactive protein, interleukin-6, serum amyloid A) and positively associated with a marker of oxidative stress (urinary F2-isoprostanes). In line with this, the urinary albumin/creatinine ratio was positively associated with these inflammatory markers, and negatively associated with oxidative stress. In study three, higher eGFR was associated with better endothelial function as assessed by the invasive forearm model. Further, in study four, higher eGFR was significantly associated with higher left ventricular systolic function (ejection fraction). The 5th study of the thesis shows that higher urinary albumin excretion rate (UAER) and lower eGFR was independently associated with an increased risk for cardiovascular mortality. Analyses of global model fit, discrimination, calibration, and reclassification suggest that UAER and eGFR add relevant prognostic information beyond established cardiovascular risk factors in participants without prevalent cardiovascular disease. Conclusion: this thesis show that the interaction between the kidney and the cardiovascular system plays an important role in the development of cardiovascular disease and that this interplay begins at an early asymptomatic stage of the disease process.

Simple Question, Complex Answer : Pathways Towards a 50% Decrease in Building Energy Use

Addressing building energy use is a pressing issue for building sector decision makers across Europe. In Sweden, some regions have adopted a target of reducing energy use in buildings by 50% until 2050. However, building codes currently do not support as ambitious objectives as these, and novel approaches to addressing energy use in buildings from a regional perspective are called for. The purpose of this licentiate thesis was to provide a deeper understanding of most relevant issues with regard to energy use in buildings from a broad perspective and to suggest pathways towards reaching the long-term savings objective. Current trends in building sector structure and energy use point to detached houses constructed before 1981 playing a key role in the energy transition, especially in the rural areas of Sweden. In the Swedish county of Dalarna, which was used as a study area in this thesis, these houses account for almost 70% of the residential heating demand. Building energy simulations of eight sample houses from county show that there is considerable techno-economic potential for energy savings in these houses, but not quite enough to reach the 50% savings objective. Two case studies from rural Sweden show that savings well beyond 50% are achievable, both when access to capital and use of high technology are granted and when they are not. However, on a broader scale both direct and indirect rebound effects will have to be expected, which calls for more refined approaches to energy savings. Furthermore, research has shown that the techno-economic potential is in fact never realised, not even in the most well-designed intervention programmes, due to the inherent complexity of human behaviour with respect to energy use. This is not taken account of in neither current nor previous Swedish energy use legislation. Therefore an approach that considers the technical prerequisites, economic aspects and the perspective of the many home owners, based on Community-Based Social Marketing methodology, is suggested as a way forward towards reaching the energy savings target.

'Moving On' and Transitional Bridges : Studies on migration, violence and wellbeing in encounters with Somali-born women and the maternity health care in Sweden

During the latest decade Somali-born women with experiences of long-lasting war followed by migration have increasingly encountered Swedish maternity care, where antenatal care midwives are assigned to ask questions about exposure to violence. The overall aim in this thesis was to gain deeper understanding of Somali-born women’s wellbeing and needs during the parallel transitions of migration to Sweden and childbearing, focusing on maternity healthcare encounters and violence. Data were obtained from medical records (paper I), qualitative interviews with Somali-born women (II, III) and Swedish antenatal care midwives (IV). Descriptive statistics and thematic analysis were used. Compared to pregnancies of Swedish-born women, Somali-born women’s pregnancies demonstrated later booking and less visits to antenatal care, more maternal morbidity but less psychiatric treatment, less medical pain relief during delivery and more emergency caesarean sections and small-for-gestational-age infants (I). Political violence with broken societal structures before migration contributed to up-rootedness, limited healthcare and absent state-based support to women subjected to violence, which reinforced reliance on social networks, own endurance and faith in Somalia (II). After migration, sources of wellbeing were a pragmatic “moving-on” approach including faith and motherhood, combined with social coherence. Lawful rights for women were appreciated but could concurrently risk creating power tensions in partner relationships. Generally, the Somali-born women associated the midwife more with providing medical care than with overall wellbeing or concerns about violence, but new societal resources were parallel incorporated with known resources (III). Midwives strived for woman-centered approaches beyond ethnicity and culture in care encounters, with language, social gaps and divergent views on violence as potential barriers in violence inquiry. Somali-born women’s strength and contentment were highlighted, and ongoing violence seldom encountered according to the midwives experiences (IV). Pragmatism including “moving on” combined with support from family and social networks, indicate capability to cope with violence and migration-related stress. However, this must be balanced against potential unspoken needs at individual level in care encounters.With trustful relationships, optimized interaction and networking with local Somali communities and across professions, the antenatal midwife can have a “bridging-function” in balancing between dual societies and contribute to healthy transitions in the new society.

Violence and reproductive health preceding flight from war : accounts from Somali born women in Sweden

Background: Political violence and war are push factors for migration and social determinants of health among migrants. Somali migration to Sweden has increased threefold since 2004, and now comprises refugees with more than 20 years of war experiences. Health is influenced by earlier life experiences with adverse sexual and reproductive health, violence, and mental distress being linked. Adverse pregnancy outcomes are reported among Somali born refugees in high-income countries. The aim of this study was to explore experiences and perceptions on war, violence, and reproductive health before migration among Somali born women in Sweden. Method: Qualitative semi-structured individual interviews were conducted with 17 Somali born refugee women of fertile age living in Sweden. Thematic analysis was applied. Results: Before migration, widespread war-related violence in the community had created fear, separation, and interruption in daily life in Somalia, and power based restrictions limited access to reproductive health services. The lack of justice and support for women exposed to non-partner sexual violence or intimate partner violence reinforced the risk of shame, stigmatization, and silence. Social networks, stoicism, and faith constituted survival strategies in the context of war. Conclusions: Several factors reinforced non-disclosure of violence exposure among the Somali born women before migration. Therefore, violence-related illness might be overlooked in the health care system. Survival strategies shaped by war contain resources for resilience and enhancement of well-being and sexual and reproductive health and rights in receiving countries after migration.

The Nurse Professional Competence (NPC) scale : self-reported competence among nursing students on the point of graduation

BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated. RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs). SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.

Defining the links between retail price strategies and price tactics

Retailers tend to become trapped in a price-promotion war where price issues are dealt with on a short-term basis, indicating almost solely tactical choices. Since price is the only part of the marketing mix providing direct revenues to the organisation, it should also be of strategic importance for the retailer. Not only in practice are price tactics often separated from pricing strategies, it is also the case in research where these are often studied in isolation from each other probably due to their individual complexity. This paper contributes to both the research area and practice by discussing these two complex areas together, and the essence of both strategy and tactics are defined. By considering the planning horizon for the retailer this paper further contributes by defining the links between price strategy and price tactic. The conclusion shows the importance of clearly establishing which analytical level is being analysed.

Mot ökad diskursivitet? : Skrivutveckling speglad i provtexter från årskurs 5 och årskurs 9

Drawing onobservations in texts from the national test in Swedish, the report discusses tworelated questions: 1) whether students develop their writing abilities betweengrades 5 and 9, two measuring points in the system of national tests in Swedish,and 2) how this development might be measured. In the study, two samples ofschool texts – from grades 5 and 9 respectively – were compared in terms of textlength, sentence length and genre match at a macro level. A more detailedanalysis of lexical concentration and text structure was performed on a narrowersample of twenty texts from each school grade. The comparison showed that theolder pupils write longer texts, with longer sentences and a more varied textstructure. The younger children, however, produce texts with higher lexicalconcentration – which might be construed as a higher degree of textual content –and they follow the given genre instructions more closely.

Gymnasisters skrivande : En studie av genre, textstruktur och sammanhang

Students in upper secondary school write in a number of different genres, and do this in school contexts as well as in their spare time. The study presented here is an overview of this activity and the genres concerned. The theoretical framework of the study is that of genre theory whereby genre is understood as a socially situated concept. The study is based on 2 000 texts gathered from students on different study programmes all over Sweden in the school year of 1996-97. The texts were written in different situations. The most important distinction made here is between test texts (i.e. texts from national tests) and self-chosen texts, which may come from schoolwriting or spare-time writing. The texts are categorized according to genre. This text inventory shows a repertoire of 33 different genres in the text material. A small number of genres, such as story, book-review and expository essay dominate the school writing. The test genres differ from this pattern in that they clearly imitate texts with a genuine communicative intent. The most frequent genres are studied further and each of them is demonstrated by an interpretative reading. This reading shows that the genres differ considerably with respect to genre character and stability of text structure. A quantitative study of text length and variation in vocabulary further shows that texts written by two categories of students, those on vocationally oriented programmes and those on programmes preparing for higher education, differ significantly. Reference cohesion is studied in a smaller sample of the texts. This lexico-semantic mechanism of cohesion proves to exhibit an interrelation with variation in vocabulary as well as with text type. One particular cohesive tie, inference, shows different patterns in texts written by the two categories of students mentioned above.

Swedbank är ett skräckexempel : Swedbank is a terrible example

Debattartikel

Ungrare, ungerska och ungersk kultur i Sverige och Finland : en översikt

Gästredaktör för denna volym: docent Ulla Melander Marttala, Institutionen för nordiska språk vid Uppsala universitet</p>

"Ungerska för rötternas skull" : Språkval och identitet bland andragenerationens ungrare i Sverige och Finland

This thesis is a comparative sociolinguistic study which describes and compares language choice among people with Hungarian background in Sweden and Finland and studies their views on the importance of the Hungarian language and Hungarian cultural heritage for identity. The future prospects of language maintenance and language shift and differences between the Swedish-Hungarians and the Finnish-Hungarians are discussed. A survey was completed among 50 Swedish-Hungarian informants and 38 Finnish-Hungarian informants during 2006. The survey was supplemented by in-depth interviews with 15 informants during 2007. The majority language, either Swedish or Finnish, is much more active in the second-generation Hungarians’ lives than Hungarian is. Hungarian is mostly used in the domain of family relations. The language choices made today are dependent on the informant’s situation during childhood, particularly the parents’ usage of the language and the ability to learn and use Hungarian, chiefly gained through contact with the parents’ mother country and other Hungarian speakers. For some informants, having Hungarian roots forms the sole foundation for belonging, while for others it is this heritage combined with the culture, the ability to use the language or specific character traits. The Hungarian background is most often seen as a treasure offering diversity in life. Finnish-Hungarians are generally more positive about their Hungarian background, have better competence in the language and a greater awareness of the culture than Swedish-Hungarians. The Hungarian language plays a central though often symbolic role. The most important conditions for minority language preservation are language competence together with the desire and opportunity to use it; whereof the largest deficit among second-generation Hungarians is knowledge of the Hungarian language. Only one-fourth of the informants have all of the conditions necessary to be able to maintain the language, which means that Hungarian is an endangered minority language in Sweden and Finland.

The use of capital budgeting and cost of capital estimation methods in Swedish listed companies

In this paper Swedish listed companies’ use of capital budgeting and cost of capital estimation methods in 2005 and 2008 are examined. The relation between company characteristics and choice of methods is investigated and both within-country longitudinal and cross-country comparisons are made. Larger companies seem to have used capital budgeting methods more frequently than smaller companies. When compared to U.S. and continental European companies, Swedish listed companies employed capital budgeting methods less frequently. In 2005 the most common method for establishing the cost of equity was by asking the investors what return they required. By 2008 CAPM was instead the most utilised method, which could indicate greater sophistication. The use of project risk when evaluating investments also seems to have gained in popularity, while the use of company risk declined. Overall, the use of sophisticated capital budgeting and cost of capital estimation methods seem to be rising and the use of less sophisticated methods declining.