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Amid escalating global sustainability challenges, tourism and hospitality (T&H) has emerged as an important arena for understanding and fostering pro-sustainable consumer behaviour. The hedonic priorities and complexity of decision-making in T&H often exacerbate the gap between stated attitudes and actual pro-sustainable behaviour, which contributes to issues like climate change. However, these contexts also offer opportunities to better understand and influence pro-sustainable behaviour through tailored interventions.

Behavioural interventions like nudges have shown promise in terms of guiding behaviour towards desirable outcomes by modifying decision-making environments based on behavioural economics. However, gaps remain with regard to understanding pro-sustainable behaviours across diverse T&H settings and developing effective interventions that T&H providers can implement to enhance informed consumer choices without compromising their experience.

This thesis addresses these gaps by using a mixed-method field experimental approach to study pro-sustainable behaviour in two distinct T&H contexts: donations for mountain-biking trails in Rörbäcksnäs, Dalarna (Sweden), and climate-friendly food choices in restaurants in the Swedish locations of Sälen, Dalarna, and Stockholm. Each setting involved two field experiments – testing social norms and carbon label interventions – which together constitute four independent papers. This field experimental approach not only provides insights into real-life behavioural processes but also incorporates providers’ perspectives on promoting pro-sustainable options, informing the design of context-relevant interventions.

The findings culminate in a framework that researchers, providers, and policymakers can use to design and test behavioural interventions that foster pro-sustainable consumer behaviour in T&H and other out-of-home consumption domains. Methodologically, this framework emphasises the importance of collaborative design and iterative adaptation of interventions based on field experiments, to effectively bridge theory and practice in T&H sustainability. Theoretically, the research offers new insights into pro-sustainable consumer behaviour, highlighting the significant influence of social norms and contextual factors across diverse T&H settings. Practically, the study stresses the need to align interventions with the context-specific goals of consumer segments, showcasing the value of tailored social norm interventions, carbon labels, and staff engagement in promoting pro-sustainable choices while preserving the overall consumer experience.

The increasing gang-related criminality is a serious growing social phenomenon and constitutes one of the most urgent challenges in today's society. The study increases the understanding of the exit process, which can strengthen support efforts and reduce costs through the continued development of effective methods in social work. By studying two autobiographies, the study aims to investigate the psychological and social processes in the experiences of former gang criminals leaving gang-related crime. The study uses system theory to analyze relevant data. The analysis identified two central themes: inner navigation and social structures and relationships. What primarily emerges in connection with that is doubt, group dynamics, loyalty bonds, the creation of a new identity, and life changes. The results show loyalty to criminal gangs versus the pursuit of independence in one's own life during the process of leaving the gang.

The study aims to investigate the importance of organizational culture for the reporting of misconduct in disability care, focusing on one team in one group home providing support to individuals with challenging behavior. Using a case study design and a qualitative approach, semi-structured interviews and vignette cases were conducted with care staff and the unit manager. The interview material was analyzed using thematic analysis. The results show that there are variations in how staff define misconduct, leading to uncertainty about what should be reported. Relationships and group dynamics play a role in reporting tendencies, with fear of "frame" colleagues and inadequate feedback emerging as barriers. The study also highlights practical difficulties with the reporting systems.

Purpose: The purpose is to investigate perceptions of the older woman as a victim of violence and how the exposure to violence can be understood based on ageist perceptions of social workers in elderly care and how these affect the social workers' work with older women who experience domestic violence. Method: The study has a qualitative study design with semi-structured interviews where data is analyzed based on an abductive approach. Results: Results show that older people are not associated with violence. Domestic violence in older women is seen as something that has been going on for a long time and thus normalized, while neglect and psychological violence are considered common forms of violence in older women. Older women receive support in the form of special housing to escape violence.

This study aims to investigate how family law social workers mitigate the risk of children experiencing loyalty conflicts during cooperation dialogues with parents.The study is based on semi-structured interviews with seven family law socialworkers from various Swedish municipalities, the collected data was analyzed qualitatively using thematic analysis. The analysis resulted in three main themes:‘life in the shadow of parental conflicts’, ‘parents have the ambition, but sometimes exhibit a deficiency in their ability’, and ‘building bridges as family law socialworkers’. The findings indicate that family law social workers address loyalty conflicts by informing parents and introducing the child as a subject in the conversation – both verbally and, when appropriate, physically. While parents acknowledge the impact of conflict on their child, the conflict itself often hinderscooperation. In conclusion, the study highlights that family law social workers perceive cooperation dialogues as a challenging yet crucial preventive method. 

This study explores the social, emotional, and health-related consequences of witnessing intimate partner violence during childhood, as well as the available support interventions for adults with such experiences. Children who witness violence are at an increased risk of mental health issues, behavioral problems, and trauma. Legal challenges may complicate the protection of these children. This study is based on a scoping review analyzing 13 scientific articles. The findings are presented through three main themes: growing up in a violent environment, long-term psychosocial consequences, and support interventions in adulthood. Systems theory and the concept of resilience serve as theoretical frameworks to understand the interactions between individuals and their environment. The study concludes that children who witness violence should be recognized as a particularly vulnerable group. Support interventions should focus on strengthening both individuals' internal coping mechanisms and external support structures through evidence-based methods.

BACKGROUND: The maternity continuum of care (MCC) is an integral component of universal health coverage and a crucial strategy for reducing maternal and neonatal mortality. Despite its importance, MCC coverage remains low in low- and middle-income countries (LMICs), including Ethiopia, which bear the highest burden of maternal and neonatal mortality. This underscores the need for proactive interventions. In this perspective, the primary health care (PHC) approach holds significant potential for enhancing MCC. Exploring demand- and/or supply-side opportunities for improving MCC within the PHC system could help inform policy, practice, and further research. However, there is limited evidence on these aspects in Ethiopia. Therefore, this study aims to explore demand- and/or supply-side opportunities for MCC enhancement within the PHC system in northwest Ethiopia.

METHODS: We conducted a qualitative study using an interpretive description approach within the PHC system in northwest Ethiopia from March 3 to November 27, 2022. Data collection included four key informant interviews, three focus group discussions with 29 participants, and 28 in-depth interviews, all selected through maximum variation sampling. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed using reflexive thematic analysis in ATLAS.ti version 7.1.4 software.

RESULTS: Three themes and 11 sub-themes have emerged. These include: (1) PHC structural enhancement with its categories: onsite mentorship, decentralized ambulance service platform, structural networks, and expansion of the scope of frontline PHC facilities; (2) PHC input enhancement with its categories: expansion of the maternity service workforce and technological advancements; and (3) PHC maternity service delivery enhancement with its categories: community engagement, approaches for reducing wait times, tailored maternity service provision in conflict-affected communities, flexible schedules for maternity service, and integrated midwifery model of care.

CONCLUSIONS: This study finds that there are several structural, input, and service delivery opportunities for enhancing the MCC within the PHC system in northwest Ethiopia. These opportunities indicate potential pathways to strengthen PHC resilience for MCC. Widespread utilization of these opportunities could significantly improve the existing MCC within the PHC system. We also recommend further research to assess the impact of these opportunities on MCC.

BACKGROUND: Evidence-based healthcare recommendations exist for tobacco use, harmful alcohol consumption, low physical activity, and poor diet. However, the uptake of these recommendations in Swedish primary healthcare is poor, and the potential benefits for patients are not fully realized. Our aim was to evaluate the effect (i.e. the uptake) of a 12-month multifaceted implementation strategy to achieve a more health-promoting practice. We hypothesized that primary healthcare centers receiving this strategy would increase and sustain their health-promotion practices to a significantly greater extent than control centers, from baseline to the 6-month follow-up.

METHODS: In a non-randomized parallel group study, 5 intervention centers and 5 matched control centers were compared regarding health-promotion activities delivered in relation to visits to each center. The intervention centers received a multifaceted implementation strategy over at least 12 months based on established strategies, the Astrakan model of leading change, and findings from pre-implementation studies. The main strategies were: using external and internal facilitators to combine bottom-up and top-down perspectives, and emphasizing leadership responsibility for change. Medical record data on health-promotion activities, including prescribed physical activity and use of lifestyle screening forms, were collected monthly for 2 years: 6 months before and after implementation, and during the implementation phase. The implementation strategy effect was estimated using generalized linear mixed models.

RESULTS: During the 12-month implementation phase, the intervention and control sites had 135 002 and 160 987 healthcare visits, respectively; conducted 8839 and 6171 health-promotion activities, respectively; and administered 2423 and 282 lifestyle screening forms, respectively. A statistically significant higher relative uptake rate of health-promotion activities was found in intervention sites compared to control sites after the implementation period compared to before. The effect increased during the active phase, with the intervention sites having on average 1.07 and 2.0 times the uptake rate of the control sites at 1 and 12 months, respectively; this effect was largely maintained during the 6-month post-intervention phase. A significant absolute effect, in terms of difference in predicted uptake per 1000 visits, was evident 7 months into the implementation phase.

CONCLUSION: This multi-faceted implementation strategy was successful in achieving a more health-promoting practice. (ClinicalTrials.gov ref: NCT04 799,860, 03/04/2021, https://clinicaltrials.gov/study/NCT04799860 ).

TRIAL REGISTRATION: This study is part of the Act in Time project, registered at ClinicalTrials.gov on 4 March 2021 (ref: NCT04 799,860).

The study aims to investigate how deacons in the Church of Sweden contribute to promoting and supporting individuals' existential health through their work with conversation groups. This leads to an increased knowledge about the significance of existential conversations for promoting existential health from a diaconal perspective. The study applies a qualitative design, which includes seven semi-structured interviews with deacons in the Church of Sweden. Through the study's abductive approach, the data are primarily analyzed in relation to systems theory and empowerment. The results indicate that, through their flexible working methods, deacons contribute to promoting and supporting existential health for the individual through conversation groups. Besides, they show that the deacons experience challenges in reaching out to everyone in the society. Conversation groups bring hope and community, which further promote and strengthen existential health.

In the early school years and in all school subjects, language is of great importance for development and learning. English today is a global language, and it is used to communicate with others on the internet, via books and movies or just listening to songs. English is a part of everyday life. Because of this I became curious about how primary school children acquire a new language as currently in the Swedish primary school context there is no specific number on how many hours you should teach English or what you should teach. Therefore, the purpose of the study is to contribute to research about teachers attitudes of ELI.

In exploring this study’s purpose, this thesis looks at the various ways of teaching language of which the theoretical starting point is the theory of Second language acquisition as well as Input hypothesis and Usage-based learning. Primary data in my study was collected through interviews of a qualitative and semi-structured nature with six respondents from various ages, teaching years and locations. I used a mix methods approach which included evaluating interview responses according to an adapted Likert scale developed from different predetermined qualifiers. The interviews went through a total of three different levels of coding to detect small, subtle differences in the answers.

The results of this study show that even if a teacher came across as very positive in the interviews, analysis of their responses through my mixed methods design revealed an underlying tone of hesitance to early language input (ELI). Also, age and experience play a larger role than first expected. 

Voting plays a key part of any democracy. Voters may vote for candidates, which best represent their interest of share their opinions. However, this assumption supposes that voters have the necessary knowledge to make an informed decision. Candidates in municipal elections, often cannot foster enough resources to sufficiently inform the electorate about their agenda. Thus,such elections, which may be classified as low information elections, see voters, unable to make an informed decision. In many cases, voters get to know the names of candidates, just at the ballot. In order to make an as good as possible choice, voters have to rely on certain cues, derived from the information on the ballot. This information may be age, gender, or political party. In many cases ballots also include occupational information. While certain scholar argue that occupational information does not play any significant role in voter decision-making. Others claim that this statement should be regarded as the most significant cue. In particular as occupations, who reflect a certain reputation may yield higher electoral success than others. This study thus tries to establish whether such a relationship exists. By analyzing a sample of 1420 candidates in German low-information elections, using a simple regression model, it can be seen that occupational information does not influence electoral success. Furthermore, that there is no clear relationship between the reputation of an occupation and electoral success. Party affiliation, however do display such a relationship.

Background and objectives:The drop-out rate for inpatient treatment for substance use disorder continues to be a significant issue. To increase the knowledge about drop out in different settings, this study’s objective was to quantify the association for the previously identified risk factors of age, sex, and time in treatment at a private care institution offering substance use disorder treatment in Sweden.

Design and methods:This retrospective cohort study of clinical record data included all 1334 adult clients who were discharged from substance use disorder treatment between 1 January 2014, to 30 June 2022, at one privately operated treatment institution. Drop out was defined as treatment terminated before the planned end. The association between three potential risk factors and drop out was analysed in a multivariable logistic regression model. Estimates were reported as marginal risk ratios (95% confidence intervals).

Results:Of 1334 discharged clients, 34% dropped out, corresponding to 38% of females and 33% of males. Approximately 52% of clients dropped out within 30 days, 42% dropped out between 30 and 89 days, and around 15% from 90 days and onwards. In the multivariable model, both time in treatment (3.08 [2.34, 3.83] for 30 to 89 days vs 90 days and 3.55 [2.72, 4.39] for <30 days vs ⩾90 days) and age (1.19 [1.14, 1.23] for one decade) showed a strong inverse association with drop out. The results did not support an association between sex and drop out (1.05 [0.89, 1.22]).

Conclusion:The risk for drop out is higher earlier in the treatment and for younger clients, so to reduce the drop out at private institutional care it is important to implement extensive interventions early in the treatment programme to increase the motivation for clients, particularly younger ones, to remain in treatment.

This paper explores the collaborative methodology of conducting working participant observation in a team setting to study the experiences of hotel housekeepers in Sweden. It aims to refine and extend the method of working participant observation by highlighting the benefits of a team approach to intensive ethnographic fieldwork. Drawing on critiques of 'traditional' geographical methods that rely heavily on interviews, the researchers immersed themselves in the physical labour of housekeeping alongside housekeepers, engaging their own bodies as research instruments. The research team navigated the complexities of embodied labour, reflecting on how their own identities (gender, age, nationality) influenced interactions and observations. The study emphasises the importance of collective reflection and dialogue between researchers, who debriefed each other daily, transforming individual experiences into shared analytical insights. Taking this approach challenges methodological conservatism by integrating feminist and intersectional perspectives and demonstrates how working participant observation can provide deeper understandings of workplace hierarchies, bodily labour, and power dynamics. By focusing on the bodily presence of both researchers and workers, the study highlights the unique insights gained through participatory, team-based ethnographic research in service work.

In support planning and decision-making processes within social work and healthcare, user participation is emphasised as a core principle. However, the concept of user participation remains ambiguously defined, and a gap persists between the intentions outlined in the literature and policies on the one hand and practical implementation on the other. This dissertation focuses on adults with comorbidity of substance use problems and mental illness/ADD/ADHD or autism within the context of establishing a coordinated individual plan (CIP) – a process that involves collaboration among social service and healthcare staff and the user (i.e. the individual receiving support). The aim of this thesis is to explore how user participation is understood and can be facilitated in CIP.         

In the thesis, a predominantly qualitative approach supplemented by questionnaire data is used. In the first study, a grounded theory approach based on individual interviews with users is used to explore how adults with comorbidity perceive participation in social services. In the second study, data from future workshops and present-and-future stories workshops is analysed to explore staff perspectives on challenges and potential solutions related to user participation, shared decision-making and support coordination in CIP. Following the first two studies, an innovation designed to increase user participation through shared decision-making – namely, a revised CIP process with a new form for documentation – was introduced to staff via training sessions across three sites. In the third study, barriers to and facilitators of the implementation process of this innovation are explored using an approach inspired by explanatory mixed methods that combines staff questionnaires with individual and focus group interviews with staff. Finally, in the fourth study, individual interviews are conducted with users and staff to explore their experiences of the revised CIP process.      

This thesis contributes to an understanding of user participation as a relational process characterised by mutual trust, knowledge-sharing and working together over time. This understanding applies to the shaping of mutual trust not only between users and staff but also among staff members, as this thesis supports an understanding of the importance of staff relations in facilitating user participation in the CIP process. Knowledge sharing and working together over time are shown to be facilitated by the revised CIP process and new form for documentation. Despite these promising experiences with the revised CIP process, several barriers to the implementation are identified, including perceptions of the complexity of the innovation, time constraints and challenges in communication across organisational boundaries. This thesis stresses the importance of prioritising relational processes, with knowledge sharing being built on mutual trust between users and staff and among staff members, in order to unlock CIP’s full potential for coordinated support with user participation. 

Objectives: This study sought to summarize and synthesize research on women who are or have been subjected to men's violence in close relationships, and their experiences of contacts with social workers. Method: The study design was an inductive scoping review. Searches were conducted in January and February 2025 in the databases Social Services Abstracts, Sociological Abstracts, SwePub, Applied Social Sciences Index and Abstracts (ASSIA), and Google Scholar. Inclusion criteria: publications on abused women’s experiences of encounters with social workers; studies conducted in Sweden; Swedish or English language; published from 2005 onwards qualitative interview studies. Results: The search yielded 1124 unique publications, of which twelve met the quality and relevance criteria. The data were synthesized using thematic analysis, resulting in three main themes: Resistance in the encounter; The unequal stance; and The positive recognition. The study found that women exposed to violence often experience resistance and a lack of recognition for their situation in their contact with social workers.

INTRODUCTION: Ageing right care(fully) is a transnational research study which explores and maps an understanding of the care pathways between ageing in place and hospital at home policy and practices for older adults in Israel, the Netherlands and Sweden. The countries are suited to be compared where they have growing, ageing populations, a focus on healthcare reform and several policies to reduce the cost of care for older populations. Ageing in place is a government-led policy that is often associated with choice; however, there is a recent debate about whether ageing in place is a universal desire for all older adults. Research shows that the care pathway between the hospital and the home, associated with ageing in place, can impact well-being, especially if the built, social and technological environments do not meet the healthcare needs and preferences of older adults. This is significant as new programmes for digital hospital at home innovations are being developed as part of a global transformation in healthcare systems. The aim of the study is to compare different approaches to ageing in place and hospital at home care in different regions. The multiapproach study explores the demographics, policy structure, decision-making process and the crucial role of the built, social and technological environments along the hospital to home care pathways of older adults.

METHODS AND ANALYSIS: The mixed-method, comparative study includes a new multienvironment theoretical contribution explored across a three-phase research method to understand the care pathways of older adults ageing in place receiving hospital at home care. The first phase compares each country's population and policy structures relating to ageing in place, hospital discharge, home hospitalisation and at-home care for older adults. The second phase maps patient journeys of older adults living in each country through the perspective of the older adult, caregivers and care professionals. The third phase explores the synergies between the knowledge gained through phases 1 and 2-from a policy and a personal level-and mobilises the knowledge into policy recommendations and implementation guidelines.

ETHICS AND DISSEMINATION: The comparative study has been approved by the Sheba Medical Centre in Israel (SMC-1330-24), the Ethics Committee of Tel Aviv University (0009216-2), the Humanities and Social Science Ethics Committee at the University of Twente in the Netherlands (240040) and the Swedish Ethical Review Authority (Dnr 2024-07569-01). The results will be shared with end-users, including citizens, carers, healthcare policymakers, planners, architects and designers, through social media, publications, workshops and international conferences. This future-focused research approach will allow stakeholders to rethink and imagine ways that health and care systems can be personalised and responsive to the future needs of older adult populations.

Anticipating clinical transitions in bipolar disorder (BD) is essential for the development of clinically actionable predictions. Our aim was to determine what is the earliest indicator of the onset of depressive symptoms in BD. We hypothesized that changes in activity would be the earliest indicator of future depressive symptoms. The study was a prospective, observational, contactless study. Participants were 127 outpatients with a primary diagnosis of BD, followed up for 12.6 (5.7) [(mean (SD)] months. They wore a smart ring continuously, which monitored their daily activity and sleep parameters. Participants were also asked to complete weekly self-ratings using the Patient Health Questionnaire (PHQ-9) and Altman Self-Rating Mania Scale (ASRS) scales. Primary outcome measures were depressive symptom onset detection metrics (i.e., accuracy, sensitivity, and specificity); and detection delay (in days), compared between self-rating scales and wearable data. Depressive symptoms were labeled as two or more consecutive weeks of total PHQ-9 > 10, and data-driven symptom onsets were detected using time-frequency spectral derivative spike detection (TF-SD²). Our results showed that day-to-day variability in the number of steps anticipated the onset of depressive symptoms 7.0 (9.0) (median (IQR)) days before they occurred, significantly earlier than the early prediction window provided by deep sleep duration (median (IQR), 4.0 (5.0) days; p <.05). Taken together, our results demonstrate that changes in activity were the earliest indicator of depressive symptoms in participants with BD. Transition to dynamic representations of behavioral phenomena in psychiatry may facilitate episode forecasting and individualized preventive interventions.

The everyday lives of young children with speech sound disorder (SSD) are not well described, with few studies taking a holistic view with interaction in focus. The aim of this study was to investigate how SSD affects communicative activity and participation in everyday life of four children in a Swedish context. The study involved 4 triads: 4 children with SSD aged 4 to 7, their parents (n = 4), grandmothers (n = 2) and pedagogues, i.e. preschool teachers (n = 2). The research design was a case series, including speech language tests, questionnaires and structured interviews. The International Classification of Functioning, Disability and Health (ICF) served as an analytical framework. Results showed reduced speech intelligibility in all children. Interrupted thought processes, tantrums and social withdrawal were negative effects of the SSD. Having a friend in the out-of-home environment was a facilitating factor, enabling the children with SSD use their full capacity in social interaction. When knowledge about SSD is shared in all environments, all forces that influence the child positively may be aligned in a collaborative effort and a holistic understanding can be reached. To accomplish this, ICF serves as a valuable conceptual framework.

The planet is experiencing global warming, with an increasing number of heat waves worldwide. Cities are particularly affected by the high temperatures because of the urban heat island (UHI) effect. This phenomenon is mostly explained by the land cover changes, reduced green spaces, and the concentration of infrastructure in urban settings. However, the reasons for the UHI are complex and involve multiple factors still understudied. Air pollution is one of them. This work investigates the link between particulate matter ≤2.5 μm (PM_2.5) and air temperature by convergent cross-mapping (CCM), a statistical method to infer causation in dynamic non-linear systems. A positive correlation between the concentration of fine particulate matter and urban temperature is observed. The causal relationship between PM_2.5 and temperature is confirmed in the most urbanized areas of the study site (Quito, Ecuador). The results show that (i) the UHI is present even in the most elevated capital city of the world, and (ii) air quality is an important contributor to the higher temperatures in urban than outlying areas. This study supports the hypothesis of a non-linear threshold effect of pollution concentration on urban temperature.

Background: Immigrant and refugee adolescents often face traumatic experiences and are vulnerable to mental health problems, such as post-traumatic stress disorder (PTSD), anxiety and depression. Yet, they also show remarkable resilience in the face of these stressors. Research is still scarce on how both mental health problems and resilience dynamically interplay in immigrant and refugee adolescents' development.Objective: We aimed to identify latent profiles of immigrant and refugee adolescents' wellbeing, consisting of externalizing and internalizing symptoms, PTSD (intrusion and avoidance), and resilience, and analyse the demographic and contextual determinants of these profiles.Method: We employed cross-sectional survey data from the RefugeesWellSchool project for 1607 immigrant and refugee adolescents (mean age 15.3 years, SD 2.15, 42.3% girls) from six European countries: Belgium, Denmark, Finland, Norway, Sweden, and the United Kingdom. Latent profile analysis and three-step procedure with BCH weights were used to identify the wellbeing profiles and their determinants.Results: Results identified four adolescent wellbeing profiles: (1) Low symptoms (49.7%, n = 791); (2) High symptoms with intrusion (10.6%, n = 169); (3) Moderate symptoms (26.9%, n = 428); and (4) Resilient avoidant (12.8%, n = 203). Older participants, those with refugee background, shorter residence in the host country, more experiences of daily stressors or discrimination, or low family support were less likely to belong to the Low symptoms or Resilient avoidant groups (p ≤ .001).Conclusions: The profiles reflected distinct differentiation of intrusive and avoidance dimensions of the PTSD-symptoms. Intrusion clustered with high level of other mental health problems, whereas avoidance co-occurred with high resilience. Experiences related to immigration, stressors, and family support were crucial determinants of the wellbeing profile membership. Future interventions should utilize information obtained by person-centered studies to create better targeted and tailored support for immigrant and refugee adolescents.

BACKGROUND: The adoption of eHealth accelerated during the COVID-19 pandemic. Inequalities in the adoption of eHealth during the COVID-19 pandemic have been reported, but there are few such studies among people with impairment.

OBJECTIVES: This study aimed to investigate self-reported use and difficulty in the use of eHealth before the COVID-19 pandemic compared to during late social distancing restrictions in Sweden, among people with and without impairment, as well as between different types of impairment.

METHODS: A cross-sectional survey was distributed twice by snowball sampling to people with self-reported impairment and a general population matched by age, gender, and county. Use and difficulty in the use of six eHealth services were compared between groups using chi-square test and logistic regression with year interaction terms, reported as odds ratio adjusted (aOR) for gender and age with 95% CI.

RESULTS: The surveys included 1631 (in 2019) and 1410 (in 2021) participants with impairment, and 1084 (in 2019) and 1223 (in 2021) participants without. Participants with impairment, compared to those without impairment, reported less use and more difficulty in booking health care appointments online, digital identification, and the Swedish national web portal for health information and eHealth services (1177.se), both before and during the pandemic (P=.003 or lower). Video health care appointments were the exception to this disability digital divide in eHealth as video appointment adoption was the most likely among participants with attention, executive, and memory impairments (interaction term aOR 2.10, 95% CI 1.30-3.39). Nonuse and difficulty in the use of eHealth were consistently associated with language impairments and intellectual impairments. For example, language impairments were inversely associated with use of the logged-in eHealth services in 1177.se in 2021 (aOR 0.49, 95% CI 0.36-0.67) and were associated with difficulty in the use of 1177.se in 2019 (aOR 2.24, 95% CI 1.50-3.36) and the logged-in eHealth services in 1177.se in 2021 (aOR 1.89, 95% CI 1.32-2.70). Intellectual impairments were inversely associated with the use of the logged-in eHealth services in 1177.se in 2021 (aOR 0.19, 95% CI 0.13-0.27).

CONCLUSIONS: This repeated cross-sectional survey study, including participants with diverse types of impairment and a control group without impairment, reveals persisting disability digital divides, despite an accelerated adoption of eHealth across the pandemic. eHealth services were not accessible to some groups of people who were identified as being at risk of severe disease during the COVID-19 pandemic. This implies that all people could not use eHealth as a measure of infection protection.

There is a lack of scoping reviews on friluftsliv in higher education in Norway. The aim of this paper is to contribute with such a review and to discuss research about friluftsliv from educational and historical perspectives. Our research questions are: What characterizes research on friluftsliv in higher education in Norway? How is contemporary research on friluftsliv related to educational ideals, and to theory about the function of education? 37 publications were included in the study, none of these were published before 2008. The results show that most publications applied a qualitative methodology. Through an abductive approach to qualitative content analysis, we constructed the following research themes in our study: (1) student learning, (2) leadership and personal growth, (3) conceptions of nature and sustainability, and (4) critique of neoliberalism. We found that origi-nal ideas about ecophilosophy and eco-education are poorly elucidated, and that little research has been done on topics related to diversity and inclusion in friluftsliv in higher education. The results of the study are discussed in relation to educational ideals in friluftsliv studies, as well as to theory about the functions of education.

The purpose of this dissertation is to examine the linguistic preferences of French journalists towards anglicisms in written language. Therefore, the use of nine anglicisms related to information technology and their respective French equivalents has been researched in French press publications from 2020 until 2022. The research has been conducted with the aid of Europresse – a website that facilitates academic research in press publications. The main corpus includes a French journal Le Figaro, its supplements (Madame Figaro and Figaro Étudiant), a French magazine related to information technology and innovations (Stratégies), its supplement (Stratégies Le 13h), and a magazine related to a different field (Sport Stratégies). The results of this study show that all the anglicisms chosen for this research are used more often by the French journalists in press publications than their French equivalents. Moreover, almost all the terms of English origin, which have been selected for this study, gained in popularity. The only French term used more often over the course of three years is formation en ligne – the French equivalent of e-learning. The actions taken by governmental organizations to limit the number of English borrowings in common use thus tend to have a minor impact on the linguistic choices of the French journalists as far as the written language is concerned.

To recognize and identify older adults exposed to domestic abuse case managers need to raise the issue with their clients. The purpose of this study was to examinethe factors that influence case managers’ questions to older adults about domestic abuse and their views on asking such questions. A survey study was conducted with case managers (n=64) working in Dalarna County, with a response rate of 69.6%. The results showed that the largest proportion (n=24, 37.5%) of casemanagers rarely ask questions about domestic abuse. How frequently they asked questions was associated with greater confidence in handling cases of domestic abuse and a higher prioritization of the issue. The largest proportion of case managers felt neutral about discussing the subject with a client, while greater comfort in discussing domestic abuse was linked to greater confidence in handling such cases, receiving sufficient education/training on domestic abuse and a higher prioritization of the issue. It is important that case managers work in an organization that provides them with the confidence and skills that enable them to ask older adults about domestic abuse.

The aim of this thesis is to assess the application of underground pumped hydro storage technology to increase the integration of renewable energy production in the Moroccan national grid. This thesis does not look at the specific details necessary for the construction of a UPHS, it only considers the selection of deep underground mines. A future scenario is addressed in this study, the characteristics of the scenario are based on official announcement from the government of Morocco, such as the announcement of a project that aims to increase solar energy production on the chosen site for the case study. First, data collection is carried out for the selection of an area of study in Morocco. The chosen area has three characteristics: Electricity generation through renewable sources, the presence of deep underground areas that can be used for the construction of UPHS, and the presence of transmission lines that allow the transport of energy between the generating unit to the storage unit. The second part of the work focuses on doing calculations to investigate the possibility of implementing a PHS in the selected area. The study shows that the using of pumped hydro storage in out of used mines in Morocco will contribute to increasing the share of the renewable electrical energy production in the national grid as well as shift the peak load and stabilize the grid from the intermittent electrical energy production nature of the renewable resources.

Denna studie syftar till att undersöka hur makt och identitet uttrycks i mötet mellan sfi-elever och sfi-lärare samt språkcoacher. Fyra semistrukturerade intervjuer genomfördes och analyserades utifrån en kritisk diskursanalys. Ett makt- och identitetsperspektiv tillämpades i analysen. Resultatet visar att lärarna upplevde att de hade en naturlig maktposition, medan språkcoacherna inte gjorde det – trots att en analys av resultatet visade att språkcoacherna besatt viss makt. Lärarna förhöll sig relativt avslappnat till auktoritetsrollen, men klargjorde att de hade en ledande ställning gentemot eleverna. Alla informanter arbetade identitetsstärkande med eleverna, på olika vis. 

Syftet med studien var att belysa, förskollärares erfarenheter och användandet av visuellt stöd i förskolan, samt hur det visuella stödet påverkade barn med och utan funktionsvariation, i deras språkutveckling. Undersökningen utgick utifrån den sociokulturella teorin, som handlar om att lärande sker i socialt samspel. Enligt förskolans läroplan (Skolverket, 2018, s.14) ska varje barn ges förutsättningar att utveckla ett nyanserat talspråk och kunna kommunicera med andra. I studien utfördes semistrukturerade intervjuer, vilka genomfördes med fem förskollärare från fem olika förskolor. På samtliga fem förskolor använder förskollärarna sig av visuellt stöd. Data analyserades utifrån en kvalitativ analys. Resultatet visade att förskollärarna arbetade med visuellt stöd utifrån barnens förutsättningar, för att främja barnens möjligheter till att kommunicera sina behov och förskollärarna använde även tecken och bilder för att utveckla barnens språk. Arbetssättet för att främja språkutveckling skilde sig inte för barn med och utan funktionsvariation. Förskollärarna upplevde utifrån sitt arbete att utmaningarna med det visuella stödet, var att det visuella stödet uppfattades olika av barnen, eftersom barn är olika och upplever därmed det visuella stödet olika. Dessutom beskrevs vad bilder kan förmedla och uppfattas av betraktaren som en utmaning. Slutsatsen av undersökningen var att det behövs mer granskning och dokumenterad forskning, för att säkerställa att barn med eller utan funktionsvariation kan gynnas av visuellt stöd i sin språkutveckling.

Photovoltaic (PV) systems are critical for renewable energy expansion, potentially surpassing hydropower as the number one renewable energy source globally by 2029. However, accurate PV performance modeling in high latitudes remains challenging due to unique climatic conditions and solar irradiance variability. This thesis addresses these challenges by assessing the accuracy of PV power prediction in the building energy simulation software IDA ICE and investigating the “inverse problem”, Global Tilted Irradiance (GTI) reverse transposition and separation. Two studies were conducted and are presented in this thesis: (1) a validation of IDA ICE simulations using data from two BAPV and one BIPV system, measured in Borås, Sweden, (latitude 57.7) and (2) an evaluation of GTI reverse transposition and separation models, based on data measured in Glava, Sweden, (latitude 59.5). Results show that PV simulation integrated in the IDA ICE whole building energy models is comparably accurate to that of stand-alone PV design tools, though further studies are needed to evaluate performance under shading conditions and for simulation of colored PV. Furthermore, two suitable GTI reverse transposition and separation models were identified for application at high latitudes. These were the proposed optimization model with ENGERER2 and HAY & DAVIES transposition and the established PEREZ-DRIESSE model. 

Background: Fibromyalgia is characterized by generalized pain, often leading to a significant decrease in physical function and quality of life. Physical exercise is considered crucial in rehabilitation and self-efficacy for exercise is important in changing and maintaining exercise behaviour. Aim: The present study aims to examine exercise self-efficacy (ESE) in women with fibromyalgia who performed resistance exercise or relaxation therapy. Method: Secondary analysis of a 15-week randomized controlled trial comparing progressive resistance exercise with relaxation therapy in 130 Swedish women with fibromyalgia. Correlation analysis between ESE at baseline and several variables was performed. Comparative analysis of those in the intervention group who reached 80% of 1RM loads and those who did not regarding ESE at baseline was performed. Between-group analysis of change in ESE from baseline to post-intervention was performed. Results: Weak correlations were found between ESE and symptom duration (rs=-0.185), physical activity level (rs=0.237), fear avoidance beliefs (rs=-0.237), mental component of health-related quality of life (rs=0.177), symptoms of depression (rs=-0.186) and symptoms of anxiety (rs=-0.195). ESE at baseline did not differ between those who reached 80% of 1RM loads and those who did not. Progressive resistance exercise significantly increased ESE compared to relaxation therapy, with an effect-size of 0.85. Conclusion: ESE weakly correlates with several aspects of health, physical activity, and fear-avoidance. Resistance exercise with progression according to self-efficacy principles improves ESE compared to relaxation therapy. ESE do not determine successful load progression. Low ESE is not an obstacle for resistance exercise in women living with fibromyalgia.

Accurate separation of global tilted irradiance (GTI) becomes importantwhen the measured irradiance is used for quality control or PV simulationpurposes, for which the latter often requires global horizontalirradiance (GHI), or diffuse and beam irradiance fractions. This studypresents an evaluation of irradiance reverse transposition and separationmodels for the application with GTI in high latitudes. The evaluationis made based on measured and quality controlled six-second irradiancefrom latitude 59.53°N, containing GTI at 30°, 40°, and 90° tiltangles, as well as GHI and diffuse horizontal irradiance (DHI). Basedon a literature review, two specialized GTI reverse transposition andseparation models - GTI-DIRINT and Perez-Driesse - and four GHIseparation models were chosen for evaluation. The latter were testedin an optimization loop developed for this study that utilizes existingGHI separation models combined with transposition models for reversetransposition and separation of GTI. Specifically, the separation modelsErbs, Skartveit1, Engerer2, and Yang4 were tested with Hay &Davies and Perez1990 transposition.The models were investigated using both statistical evaluation metricsand Diebold-Mariano test to compare measured and predicted GHI and DHI. An evaluation with measured data showed that for GTI reversetransposition and separation at high latitudes, the use of the proposedoptimization model with Engerer2 in combination with Hay & Daviestransposition, or the Perez-Driesse model is recommended. This isbased on overall good ranking and low bias of GHI prediction with -2.0W/m2 and -2.3 W/m2, respectively.

Automobile dependence and its externalities pose significant sustainability issues in both urban and rural areas. However, the existing literature mainly focuses on cities, with limited evidence from cases in the countryside. Travelling in rural areas requires attention, as most tourists rely on private cars to travel to and within these places. Also, cars are still widely accepted as "the rural transport solution", which hinders the transition to more sustainable transport systems. In this paper I present empirical evidence on the extent to which domestic tourists depend on their cars for travel to and within Sälen, a rural destination in Sweden. According to a Public Participation GIS (PPGIS) survey conducted among tourists in Sälen, 89% of visitors travelled to the destination by car, while none of them used collective transport. Moreover, interviews conducted with stakeholders involved in transport planning and management in Sälen have revealed challenges in providing alternative mobility options, such as public transport, to the destination. Furthermore, even though the destination offers a ski bus transport system for trips within the destination, the survey results indicate that most tourists still prefer to travel by private car within Sälen. The use of private cars for tourist travel has resulted in externalities, particularly congestion during peak times. This view is shared by stakeholders and supported by the results of the tourist survey. These findings have implications for rural (tourism) policy, as they show that developing alternative mobility infrastructure is not enough to shift tourists' automobile dependency in rural areas.

BACKGROUND: Identifying cognitive impairment at an early stage is important to enable preventive treatment and lifestyle changes. As gait deviations precede cognitive impairment, the aim of this study was to investigate if step parameters during different Timed Up and Go (TUG) conditions could discriminate between people with different cognitive ability.

METHODS: Participants (N = 304) were divided into the following groups: (1) controls, n = 50, mean age:73, 44% women; (2) Subjective cognitive Impairment (SCI), n = 71, mean age:67, 45% women; (3) Mild Cognitive Impairment (MCI), n = 126, mean age: 73, 42% women; and (4) dementia disorders, n = 57, mean age: 78, 51% women. Participants conducted TUG and two motor-cognitive TUG-conditions: TUG while naming animals (TUGdt-NA) and reciting months in reverse order (TUGdt-MB). Tests were video recorded for data extraction of valid spatiotemporal parameters: step length, step width, step duration, single step duration and double step duration. Step length was investigated with the step length/body height ratio (step length divided by body height). Logistic regression models (adjusted for age, sex and education) investigated associations between step parameters and dichotomous variables of groups adjacent in cognitive ability: dementia disorders vs. MCI, MCI vs. SCI, and SCI vs. controls. Results were presented as standardized odds ratios (sORs), with 95% confidence intervals (CI⁹⁵) and p-values (significance level: p < 0.05). The areas under the Receiver Operating Characteristic curves were presented for the step parameters/conditions with the highest sORs and, where relevant, optimal cutoff values were calculated.

RESULTS: Step length showed greatest overall ability to significantly discriminate between adjacent groups (sOR ≤ . 67, CI⁹⁵: .45-.99, p = ≤ . 047) during all group comparisons/conditions except three. The highest sOR for step-length was obtained when discriminating between SCI vs controls during TUGdt-MB (sOR = .51, CI⁹⁵:.29- .87, p = .014), whereby the area under the curve was calculated (c-statistics = .700). The optimal cut-off indicated a step length of less than 32.9% (CI⁹⁵ = 22.1-43.0) of body height to identify SCI compared with controls.

CONCLUSIONS: The results indicate that step length may be important to assess during TUG, for discrimination between groups with different cognitive ability; and that the presented cut-off has potential to aid early detection of cognitive impairment.

TRIAL REGISTRATION NUMBER: NCT05893524 (retrospectively registered 08/06/23).

Assigned reading materials in Swedish universities are often in English. Therefore, pupils planning to pursue higher education need to develop a good receptive knowledge of English academic vocabulary. However, previous research indicates that upper secondary pupils completing obligatory English instruction may lack sufficient knowledge of English academic vocabulary. This study further explores Swedish pupils’ knowledge of receptive English academic vocabulary, focusing on how it is influenced by word frequency and word class types, two factors found to impact L2 learner vocabulary knowledge. Moreover, we examine correlations between vocabulary test scores on word frequency and word class types and self-reported extramural English activities. Ninety-three pupils at a Swedish upper secondary school completed a vocabulary test and a questionnaire about their extramural English activities. The results showed that pupils performed significantly better on high-frequency words than low-frequency words. An analysis of how high- and low-scoring pupils answered different questions revealed some different tendencies in their receptive English academic vocabulary knowledge. We also found that low scorers performed more poorly on verbs than nouns and adjectives. Moreover, engagement in extramural English activities, such as reading and social media, was positively correlated with the vocabulary test scores, most consistently with scores on verbs. Based on the findings we discuss the need for pedagogical strategies for effective teaching of English academic vocabulary, including well-planned integration of extramural English activities into the English classroom. Such pedagogic support could help Swedish upper secondary pupils develop English academic vocabulary needed for success in higher education. 

With approximately 360 million L1 and two billion L2 English speakers, varieties of English proliferate (Jenkins 2015), but English language education overwhelmingly focuses on one or two privileged varieties (e.g. as Forsberg et al. 2019 note in Europe). As a result, learners are often ill-prepared to understand and negatively disposed towards speakers of varieties other than standardized US and UK Englishes (Jeong et al. 2021). Research-based teaching methods and tools to address this issue are limited, reflecting the longstanding monolingual bias in the study of second language acquisition (Ortega 2014). 

Therefore, six easy-to-implement in-class lessons of approximately twenty minutes each were developed and delivered over three weeks of a first-year high school intermediate-level English class in Sweden (16- and 17-year-olds). These lessons drew on contact theory (Allport, 1954; Pettigrew & Tropp 2006), especially indirect contact (White et al. 2021), and high-variability perceptual training (Baese-Berk et al. 2013) to provide both positive portrayals of Global English speakers from varied national and linguistic backgrounds and practice understanding them.  Learners also engaged in discussion of questions that related speakers’ messages to their own experience. Pre-and post-tests of the class that completed these activities (N=27) showed improved comprehension of Global Englishes speakers who were not featured in the activities and rated the accents as more pleasant and easier to understand. A same-level class that took the pre- and post-tests but completed their regular class activities (N=18) showed no such improvement.

The presentation will begin by reviewing research demonstrating the need for such training, followed by an explanation of contact theory and high-variability perceptual training and how they can be used. We will then provide the actual training materials, the results of the study, and discussion of how additional materials can be developed, for example to address comprehension and attitudes relating to varied US Englishes.

Syftet med denna studie är att undersöka hur fyra läromedel för högstadiet i ämnet svenska främjar elevinteraktion i klassrummet. Genom en kombination av kvantitativ och kvalitativ innehållsanalys kartläggs antalet interaktiva uppgifter och deras karaktär i läromedlen Liber Svenska 7–9, Kontakt 7–9, Svenska impulser 9 och Spegla språket 9. Resultatet visar att läromedlen varierar i sin fördelning av individuella och interaktiva uppgifter, där Svenska impulser och Spegla språket erbjuder flest interaktiva moment. Interaktiva uppgifter präglas främst av språket som medierande redskap, medan gestaltning är den kategori som finns minst representerad i samtliga lätomedel. Även kategorierna scaffolding och material som medierande stöttning förekommer i mindre utsträckning. Studien identifierar även att Kontakt särskiljer sig genom att ofta uppmana till helklassdiskussioner, vilket kan påverka förutsättningarna för jämställd elevinteraktion. Slutsatsen är att läromedlen erbjuder olika möjligheter till elevinteraktion, men elevers faktiska upplevelser påverkas också av den enskildes lärarens val i undervisningen.

Denna studie granskar tre läromedel för svenska mot gymnasieskolan, med syftet att ta reda på hur kön och genus framställs genom diskurser samt att jämföra dessa. Metoden följer en komparativ kvalitativ ansats och tillämpar en kritisk diskursanalys med ett genusperspektiv. Studiens frågeställning söker efter diskurser som på något sätt förhåller sig till kvinnor och män respektive manligt och kvinnligt. Resultatet visar att alla tre läromedel innehåller fyra diskurser som har namngetts till: den genusneutrala, den inflytelserike individen, mäns och kvinnors språkanvändning, det sjukdomsdrabbade könet samt de omhändertagande. Bara ett läromedel inkluderar även diskursen om den risktagande mannen. Studiens resultat uppmärksammar att diskurser har varierande syn på kön och genus, vilket ger upphov till en diskursiv spänning både inom diskurserna själva och diskurser emellan. I resultatdiskussionen tas resultatet upp och sätts i relation till styrdokument, teoretiskt ramverk samt tidigare forskning om läromedel och svenskämnesdidaktik. Diskussionen tar även upp förslag på hur studiens resultat kan användas när läromedel ska behandlas i klassrummet. Därefter följer en metoddiskussion som lyfter studiens potentiella styrkor och svagheter i metodval. Avslutningsvis presenteras förslag till vidare forskning inom området.

Neurodegenerative disorders such as dementia and Parkinson's disease (PD) affect millions of individuals globally and are characterized by progressive cognitive decline and motor impairments. As life expectancy and the number of older people increases, the number of people with these disorders is expected to increase. Currently, neurodegenerative disorders have no cure, making early diagnosis crucial for effective management and timely intervention. Gait analysis offers a non-invasive, inexpensive, and useful method for neurodegenerative disorders detection. Gait abnormalities, particularly under dual-task (dt) conditions, are early cognitive and motor decline indicators.

This thesis aims to investigate the potential of movement analysis for the discrimination of neurodegenerative disorders compared to healthy control (HCs) persons, with a specific focus on dementia and PD. By employing machine learning techniques, the research evaluates the effectiveness of these methods in distinguishing between HCs and those with dementia or PD. This thesis utilized various traditional machine learning and deep learning models applied to the movement data. The models implemented across the studies are Support Vector Machines (SVM), Logistic Regression (LR), Random Forest (RF), Decision Trees (DT), Convolutional Neural Networks (CNN), Long Short-Term Memory networks (LSTM), and a hybrid CNN-LSTM architecture. Movement features extracted from the datasets were applied to those models.

For dementia, utilizing video-based data obtained from the Uppsala-Dalarna Dementia and Gait project (UDDGait™), the study performed pose estimation using YOLOV8, followed by feature engineering. In the current study, movement features, including velocity, acceleration, number of steps, cadence, stride length, total time, and joint angles (knee and hip) were computed and used in the machine learning algorithms to differentiate the groups. The dataset comprised 64 individuals with dementia and 67 HCs. The participants performed the Time-Up-and-Go tests (TUG) under single task and dt paradigms. Following the UDDGait study protocol, the test performance was documented with two synchronized video cameras. In the dt conditions, participants completed the TUG test while simultaneously performing a verbal/cognitive task, which involved naming animals (TUGdt-NA) and reciting the months in reverse order (TUGdt-MB). For PD, gait features were extracted from a sensor-based dataset comprising 93 individuals with the disease and 73 HCs. The vertical ground reaction force (VGRF) was recorded for nearly two minutes using 16 sensors placed beneath each foot (8 per foot).

The results demonstrate that movement features extracted from video data, especially under dt conditions, are effective in distinguishing between HCs and those with dementia. The SVM algorithm achieved the highest accuracy of 88.5% and recall of 92.5% in dt animal naming (TUGdt-NA). For the PD study, the results demonstrate that RF obtained the highest accuracy and recall of 96%. The findings from these studies suggest that movement analysis using machine learning models offers a promising non-invasive, automated, and simple tool for the discrimination of dementia and PD compared to HCs. Future research could explore multimodal fusion approaches (i.e., speech and gait analysis) to enhance the accuracy and generalizability of these methods in clinical settings.

This thesis investigates the impact of migration on the sense of self. It does so through the lens of self-continuity, a psychological concept that focuses on maintaining a subjective and diachronic sense of connection to the self. The analysis focuses on the experiences of two protagonists from works by Aleksandar Hemon: Jozef Pronek, a refugee navigating the complexities of immigrant life in the United States, and Vladimir Brik, who returns to Bosnia after establishing himself in America. Through their narratives, the thesis explores the dislocation of the self and resulting mental health crises that arise from their migrations: Pronek’s forced displacement due to war and Brik’s voluntary return home, with the emphasison how their journeys impact their self-continuity. By applying psychological criticism to migration literature, this study contributes to a deeper understanding of how migrant experiences shape personal narratives and wellbeing, demonstrating the protagonists’ use of autobiographical reasoning in creating a narrative identity and the recovery of self-continuity