Dalarna University's logo and link to the university's website

Background: During 2014 over 200 different languages were spoken in Sweden, and by the end of 2017 approximately 20 % of the population was foreign born. 110 000 healthcare injuries, many of them due to failure in communication were reported by the nursing association (2017). The evident language barriers create a lack of trust and confidence between patient and nurse. To overcome the identified language barriers interpreters have become a necessary tool in order to exchange information and create a trusting relationship between patients and nurses.

Aim: To explore the nurses experiences and perceptions of existing language barriers and the use of interpreters within healthcare.

Method: A literature review of fifteen scientific articles. These were identified in the databases PubMed and Cinahl through searches for relevant articles with appropriate keywords.

Results: Nurses consider language barriers to be the biggest obstacle to good communication, which often lead to misunderstandings and misinterpretations. The identified problem of communication is experienced as time consuming and the nurses perceive more planning to be needed when dealing with patients with a different mother tongue. Furthermore, it presents a severe challenge to maintain good care and establish an understanding of the patient’s story. Nurses prefer to use an interpreter on site, however interpreters by phone are more accessible. More than one underlying cause is linked to nurse’s skepticism to use interpreters. To mention one many nurses doubt the accuracy of the interpretation. Moreover, nurses acknowledge their need of further training and education in the use of interpreters.

Conclusion: The result identified is based upon nurse’s first hand experiences of language barriers and the use of interpreters. The literature review has provided insightful knowledge and increased the understanding of language barriers and the use of interpreters in health care. The research will be an asset in future careers and provide help in overcoming set problem.

BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults.

METHODS: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity).

FINDINGS: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m2 per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese.

INTERPRETATION: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults.

FUNDING: Wellcome Trust, AstraZeneca Young Health Programme.

Background.  Older people currently constitute the largest patient group visiting emergency departments worldwide and are often accompanied by carers and/or relatives. The aging part of the population is increasing which leads to a greater strain on the health care system. While emergency departments offer acute care services to the general population, they are not well suited for the particular needs of older people and their relatives. Being aware of the issues older people and their relatives face during visits to the emergency department can help to deliver better suited care for this growing part of the population.  Aim. The aim of this literature review is to investigate older peoples’ and relatives’ experiences of visiting emergency departments.  Methods. The method of this study is a literature review of 14 articles from Australia, Europe, North America and South America. The databases used to find the articles were CINAHL and PubMed. Results. Results were divided into positive and negative themes. The six negative themes that emerged were: Lack of communication; Lack of patient involvement; Long waiting times; Lack of attentiveness; Inadequate physical environment and inadequate management of needs and symptoms. The positive theme that emerged was that emergency departments as reliable and easily accessible health care facilities. Conclusions. Older people and their relatives see their emergency department experience as mostly negative, exposing a need for better communication practices, positive person-centred interactions between health care staff and patients as well as their relatives and changes to the physical environment and health care system of the emergency department.

Jag har undersökt hur förskollärare beskriver att de stödjer flerspråkiga barn i att utveckla både det svenska språket och deras modersmål. I och med att det befinner sig alltmer flerspråkiga barn i de svenska förskolorna är mitt syfte med studien att ta reda på fem förskollärares uppfattningar om flerspråkiga barns språkutveckling och vilka verktyg de beskriver att de använder i arbetet med att stimulera barns språkutveckling. Metoden för denna studie är kvalitativa intervjuer där jag har intervjuat fem förskollärare som arbetar på två olika förskolor. Studiens resultat diskuteras utifrån forskning om hur förskollärare arbetar med flerspråkiga barns språkutveckling. I resultatdiskussionen har även resonemang förts i relation till den sociokulturella teorin. Resultatet visar att förskollärarna menar att barn behöver kunna sitt modersmål så att de kan lära sig eller utveckla ett andraspråk i förskolan. Därför behövs det modersmålslärare som stödjer barnen i att utveckla modersmålet. Förskollärarna beskriver att de använder sig av vardagliga situationer för att stimulera barnens språk.

Syftet med studien är att studera flerspråkiga barns modersmålsutveckling i förskolan och hur pedagogerna kan hjälpa barnen med sitt modersmål när pedagogerna har svenska som sitt förstaspråk. Studien tar ett sociokulturellt perspektiv på lärande och metoden som använts för att samla in material för studien är kvalitativ intervju med fyra pedagoger från två förskolor. Slutsatsen från studien visade sig att pedagogerna använder olika sätt att stötta och utveckla flerspråkiga barnens modersmål och andraspråkutveckling genom att använda olika uttryckningsformer, till exempel upprepningar, bilder, symboler och kroppsspråk. Pedagogerna lyfter upp också att barnen känner trygghet när pedagogerna använder barnens modersmål, vilket gjorde att pedagogerna lärde sig enkla ord på barnens språk för att underlätta kommunikationen mellan barnen och pedagoger och mellan barn och barn.

OBJECTIVE: To explore maternal near miss and death after emergency cesarean delivery in Somaliland, including the impact of the prerequisite for family consent.

METHODS: A facility-based, mixed-methods study was conducted to assess all maternal near misses and deaths recorded at a referral hospital that provided services to women from all regions of Somaliland. The data sources comprised a quantitative prospective cross-sectional study using the WHO near-miss tool (performed from August 1 to December 31, 2015) and qualitative interviews with 17 healthcare providers working at the referral hospital who were in direct contact with the women in labor (performed from January 15 to March 15, 2015).

RESULTS: Of the 138 maternal near misses and deaths recorded, 50 (36%) were associated with emergency cesarean delivery. The most frequent maternal complication was severe pre-eclampsia (n=17; 34%), and the most frequent underlying causes were hypertensive disorders (n=31; 62%) and obstetric hemorrhage (n=15; 30%). Healthcare providers were often prevented from performing emergency cesarean delivery until the required consent had been received from the woman's extended family.

CONCLUSION: Maternity care in Somaliland must be improved, and the issue of legal authority for consent examined, to ensure both safe and timely provision of emergency cesarean delivery. This article is protected by copyright. All rights reserved.

We present the fourth Fermi Large Area Telescope catalog (4FGL) of gamma-ray sources. Based on the first eight years of science data from the Fermi Gamma-ray Space Telescope mission in the energy range from 50 MeV to 1 TeV, it is the deepest yet in this energy range. Relative to the 3FGL catalog, the 4FGL catalog has twice as much exposure as well as a number of analysis improvements, including an updated model for the Galactic diffuse gamma-ray emission, and two sets of light curves (one-year and two-month intervals). The 4FGL catalog includes 5064 sources above 4 sigma significance, for which we provide localization and spectral properties. Seventy-five sources are modeled explicitly as spatially extended, and overall, 358 sources are considered as identified based on angular extent, periodicity, or correlated variability observed at other wavelengths. For 1336 sources, we have not found plausible counterparts at other wavelengths. More than 3130 of the identified or associated sources are active galaxies of the blazar class, and 239 are pulsars.

Background: Eighteen of Sweden's population suffers from long-term pain. The unmeasured data in the presence is not known. Among the older population, 54% of women and 38% prevalence of men, have long-term pain. The pain affects several factors, everything from inferior well-being and physical fatigue, to the impact on social life and work. The costs for society are estimated to cost SEK 87.5 billion annually in direct and indirect costs. Complementary and alternative medicine is a collective term for treatments that are not part of the traditional medical treatment. Examples of treatments include massage, acupuncture, transcutaneous electrical nerve stimulation (TENS), cognitive behavioral therapy (KBT) and meditation/yoga. Aim: To describe patients' experiences and the positive effect of alternative and complementary medicine of long-term pain. Method: A literature review based on 14 scientific articles with qualitative or quantitative approach. Searches have been conducted in CINAHL and PubMed. Results: Three main themes emerged in the result, which was increased wellbeing, pain relief and increased mobility. The studies indicate that the patients experienced good pain relief and increased quality of life both physically and mentally during treatment with complementary and alternative medicine. Patients who have not achieved pain relief through traditional care, experienced good pain relief with complementary and alternative medicine. Conclusion:  Complementary and alternative medicine can be an alternative to traditional treatment and sometimes even a first alternative for several reasons, among other things to avoid side effects from drugs.

We used national surveys to study how older persons’ changing household patterns influence the gender balance of caregiving in two countries with distinct household structures and cultures, Spain and Sweden. In both countries, men and women provide care equally often for their partner in couple-only households. This has become the most common household type among older persons in Spain and prevails altogether in Sweden. This challenges the traditional dominance of young or middle-aged women as primary caregivers in Spain. In Sweden, many caregivers are old themselves. We focus attention to partners as caregivers and the consequences of changing household structures for caregiving, which may be on the way to gender equality in both countries, with implications for families and for the public services.

The aim of this study was to investigate the factor structure of the revised dental beliefs survey (DBS-R) in a group of regular dental patients. The study group consisted of 278 patients (mean age 54 yr), 61% of whom were women. The DBS-R item mean value was 1.6. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were performed. The initial PCA among the 28 DBS-R items showed four factors with eigenvalues of > 1 explaining 67% of the total variance. Five different CFA models were tested. The final model revealed a four-factor solution with one second-order factor (i.e. a hierarchical CFA). Thus, the latent second-order variable, 'dental beliefs', explains the variance from all DBS-R items through the four first-order factors labeled 'ethics', 'belittlement', 'communication and empathy', and 'control and anxiety'. The results suggest a somewhat different factor structure of DBS-R than previously reported for dental-fear patients. Hence, the underlying factor structure of the DBS-R may differ between different patient groups. The results point towards the use of the original 28-item DBS-R and interpreting the scale as measuring an overall construct of 'dental beliefs' and thus patients' attitudes and feelings related to dentists and dentistry.

Introduction: Diabetes Mellitus is a chronic disease that is linked to suffering

and lack of quality of life. Self-care is essential to reduce the negative

consequences. Less than half of all patients achieve good self-care. Some of the

reasons are limited knowledge of diabetes and poor self-care compliance. The

introduction of ICT in diabetes care was started to improve clinical outcomes and

quality of life for patients with diabetes type 2. Aim: To describe how information

and communication technology can promote self-care in distance for patients with

diabetes mellitus type 2. Methods: Literature study, in which the articles were

searched in CINAHL, PubMed and Web of Science. Articles included were 15

articles with a quantitative, qualitative and mixed method. Results: The results

showed that information and communication technology such as internet,

computer and mobile phone-based self-care program promoted self-care in patients

with diabetes type 2 by increasing knowledge, awareness, motivation and

improving lifestyle change. Conclusion: Information and communication

technology can facilitate the daily challenges for patients with type 2 diabetes

because it covers the knowledge gap and increases patient awareness and

motivation for self-care.

Syftet med den här studien är att bidra till kunskap om hur förskollärare i förskolan arbetar med konflikt och konflikthantering vid samlingar. Till min undersökning har jag använt mig av olika kvalitativa forskningsmetoder, observation och intervjuer för att få inblick i hur förskolläraren hanterar barnens konflikter. Resultatet visar hur förskollärarna betonar vikten av att kommunicera med barnen, samt att skapandet av goda relationer är avgörande för att förebygga och lösa konflikter. Resultatet visade också att vissa barn klarar av att lösa konflikter på egen hand men att de även behöver stöd och hjälp från förskolläraren i vissa situationer. Min slutsats är att förskollärarnas generella strategier för konfliktlösning är att lyssna på alla inblandade och bekräfta barnens känslor för att sedan hjälpa dem att lösa konflikten.

Trots att ett flertal åtgärder riktats för att förbättra situationen för de som faller offer för hedersvåld finns det en koherens om att mycket lite faktiskt hänt inom området. Syftet med uppsatsen var främst att undersöka hur Socialtjänsten, polisen och frivilliga jourer behandlar hederskonflikter och varför det uppstått ett misslyckande i att hjälpa de utsatta. Undersökningen tillämpades utefter den kvalitativa innehållsanalysen. En viktig slutsats från projektet är att det främst krävs en kunskapsutveckling inom området om det skall vara möjligt att nå framsteg. En annan förutsättning är att införliva en fungerande integrationspolitik i Sverige.

The internet has revolutionized the way we socialize, and as a consequence the way to love. The new communication technologies have facilitated intercultural relationships. Nowadays family relations are one of the major factors in immigration to European countries. Family relations means persons who arrive as family dependents and in accordance with laws regulating family reunification. This thesis aims to apply the classical assimilation theory stated by Milton Gordon (1964), which formulates a series of assimilation stages through which an individual must pass in order to be completely assimilated. In accordance with this theory, marriage is the final phase for a newcomer to fully incorporate into the host society. Thus, based on this presumption and other contemporary theories, the present study has analysed how women who get involved in intercultural marriages based on internet meeting experience these assimilation stages and evaluated the resources used by respondents to incorporate themselves into Swedish society. The main goal of the study was to determine if jumping to the last stage of assimilation does assure the incorporation in the social or/and labour spheres and the findings demonstrate that even though husbands are a valuable resource for assimilation, several cultural issues in Swedish society make it difficult to assure success for the newcomers. On the other hand, Sweden is a country with a strong national sentiment and the assimilation of immigrants still is an important issue to deal with. The Swedish Integration Board has disappeared and major projects for integration have been left in the hands of the municipalities or the Migration Board, institutions that still do not know how to deal with this dilemma.

Syftet med denna studie är att synliggöra hur förskollärare beskriver traditionella könsroller men också om det i deras beskrivningar går att urskilja olika diskurser och i så fall vilka. Då vi utgår från ett socialkonstruktionistiskt perspektiv är förskollärarnas beskrivningar viktiga för att förstå de diskurser som inom förskolans verksamhet skapas rörande könsroller, då dessa i sin tur påverkar vilka normer och värderingar de barn som där vistas tar till sig och för vidare. Diskursbegreppet är i denna studie ett nyckelbegrepp och vårt resultat kommer att behandlas i en kritisk diskursanalys. Metoden som använts för att samla in för studien relevant data är kvalitativa, semistrukturerade intervjuer. I vårt resultat blev en tydlig individdiskurs synlig vilken vi tolkat vara förskolans rådande diskurs och den som styrdokumenten genom sin utformning och innehåll uppmanar till. Vi fann även uttryck för en könsneutral diskurs liksom en gruppdiskurs. Dessa tre diskurser verkar parallellt och tycks många gånger leda till motsättningar i det praktiska arbetet. Detta går i linje med tidigare forskning. Vår studie visar att även de förskolor som har som ambition att erbjuda en könsneutral verksamhet omedvetet tenderar att utgå ifrån en manlig norm. Studien pekar också på att, trots att en individdiskurs är önskvärd, så utformas arbetet med att motverka traditionella könsroller ofta på ett sätt som upprätthåller dikotoma könsroller.

Syftet med vår studie var att belysa pedagogers olika innebörder av begreppet fri lek i förskolans praktik. Vi ville därmed lyfta deras synsätt på och förhållningssätt till den fria leken i förskolans verksamhet. För att nå vårt syfte med studien valde vi att använda oss av en kvalitativ forskningsmetod som innebar att vi intervjuade pedagoger som arbetade i förskolans verksamhet. Detta gav oss en möjlighet att synliggöra vilka olika innebörder pedagoger lägger i begreppet fri lek i förskolans verksamhet. Vi har i denna studie valt att inspireras av diskursanalys som metodansats, det valet grundar sig i att det ger oss möjligheten att få en bredare syn på barns fria lek, och därmed kunna synliggöra flera olika innebörder av begreppet. Det insamlade materialet för studien analyserades utifrån fyra olika teoretiska analysverktyg för att uppnå vårt syfte med studien. Resultatet för denna studie är att begreppet fri lek är brett, komplext och mångsidigt, samt att vi många gånger tror att vi pratar om samma sak när vi egentligen pratar om helt olika saker. En till slutsats vi gör för denna studie är att den fria leken i förskolans verksamhet inte är barns fria lek, det är lek där barnen har större inflytande på val av aktivitet, men den är inte fri från institutionen ramar och regler. Resultatet för studien visar även att barns fria lek får större utrymme i utomhusmiljön i jämförelse med inomhusmiljön.

I denna uppsats har jag haft att syftet försöka tydliggöra hur lärare upplever den praktiska verkligen rörande arbetet med att genomföra delar av skolans uppdrag: att främja demokra-tiska värderingar, förankra de mänskliga rättigheterna samt att motverka främlingsfientlighet. För att kunna göra detta ville jag undersöka vilka möjligheter och hinder lärare, verksamma inom grundskolan, upplevde i sitt arbete med att genomföra denna del av skolans lagstadgade uppdrag.

Som utgångspunkt för att genomföra denna undersökning använde jag följande frågeställning:

Vilka möjligheter och/eller hinder ser grundskolelärare i sitt arbete med att genomföra det lagstadgade uppdraget att främja demokratiska värderingar, förankra de mänskliga rättigheterna och arbeta med värdegrunden i praktiken?

Genom att använda mig av kvalitativa semistrukturerade intervjuer samlade jag empiri för att besvara min frågeställning.

Det jag kom fram till, och tillika svaret på min frågeställning var att, lärarna upplevde stora möjligheter att arbeta med värdegrundsfrågor utifrån sin egen drivkraft och vilja och ibland med hjälp av eldsjälar på skolan. Dock lyfter de fyra stora hinder i detta arbete: avsaknad av strukturer, avsaknad av tid, känslan av att det är ett, av ledningen, oprioriterat arbetsområde och avsaknad av tydlig styrning.

Syfte

Syftet var att ta reda på vad elitaktiva inom längdskidor anser vara en bra idrotts- och träningsmiljö.

Metod

Metoden som används är uppdelad i två olika ansatser. Den första ansatsen är inom den kvantitativa forskningen och utformades som en enkätstudie, där längdskidåkare har fått svara på frågor om sin träningsmiljö. Den andra delen av uppsatsen är utformad som en kvalitativ studie med semistrukturerade intervjufrågor baserat på ett mindre urval av de som svarat på enkäten. Detta skedde efter att resultatet av den kvantitativa studien blivit analyserat, för att utforma en intervjumall från enkätsvaren, i syfte att försöka få en djupare förståelse av detta problemområde.

Resultat

Resultatet visar att det finns en stor komplexitet i uppfattningen om vad som anses vara en bra träningsmiljö för längdskidåkare. Dock kan det urskiljas att vissa faktorer som viktigare än andra, till exempel vikten av att ha träningskamrater och god sparring för att kunna utvecklas. Värdet av att ha en tränare ansågs också viktigt. Resultaten visar även hur den elitaktive upplever sin träningsmiljö i dag och vad som efterfrågas.

Slutsatser

Det framkom tydligt att bristen på hjälp upplevs stor bland seniorer inom längdskidor. Att steget mellan junior och eventuellt gå på ett skidgymnasium, till att bli senior upplevs alldeles för stort, att det inte finns tillräcklig stödfunktioner, skolor eller träningsgrupper att tillgå som senior.

Syftet med examensarbetet har varit att utifrån ett intersektionellt perspektiv ta reda på vilken betydelse kommunikationen har vad gäller barns status, positionering och rollfördelning i en flerspråkig förskolemiljö. För att genomföra undersökningen har observationer som metod använts. Ett intersektionellt perspektiv handlar om att synliggöra korsande maktobalanser utifrån variabler såsom exempelvis kön, etnicitet, klass, sexualitet, ålder och funktionsförmåga. Dessa över- och underordningar i samhället skapas, reproduceras och upprätthålls och görs till så kallade sanningar. Genom makt kan man kontrollera andra människors handlingar. Barn utövar ständig makt och kontroll genom kommunikation med varandra, där de försöker behålla eller höja sin sociala status. De barn som deltagit i undersökningen har överlag lekt flickor för sig och pojkar för sig, där könsöverskridande lek förekommit i liten skala. Pojkarna har i större utsträckning försökt ta sig in i flickornas lek än vice versa. Flickorna har över lag tagit mer plats och haft högre status i förhållande till pojkarna, vilket främst skulle kunna bero på flickornas högre ålder.

Objective: Explore general practitioners’ (GPs’) views on and experiences of working with care managers for patients treated for depression in primary care settings. Care managers are specially trained health care professionals, often specialist nurses, who coordinate care for patients with chronic diseases.

Design: Qualitative content analysis of five focus-group discussions.

Setting: Primary health care centers in the Region of Västra Götaland and Dalarna County, Sweden.

Subjects: 29 GPs.

Main outcome measures: GPs’ views and experiences of care managers for patients with depression.

Results: GPs expressed a broad variety of views and experiences. Care managers could ensure care quality while freeing GPs from case management by providing support for patients and security and relief for GPs and by coordinating patient care. GPs could also express concern about role overlap; specifically, that GPs are already care managers, that too many caregivers disrupt patient contact, and that the roles of care managers and psychotherapists seem to compete. GPs thought care managers should be assigned to patients who need them the most (e.g. patients with life difficulties or severe mental health problems). They also found that transition to a chronic care model required change, including alterations in the way GPs worked and changes that made depression treatment more like treatment for other chronic diseases.

Conclusion: GPs have varied experiences of care managers. As a complementary part of the primary health care team, care managers can be useful for patients with depression, but team members’ roles must be clear.

BACKGROUND: Although the rising pandemic of obesity has received major attention in many countries, the effects of this attention on trends and the disease burden of obesity remain uncertain.

METHODS: We analyzed data from 68.5 million persons to assess the trends in the prevalence of overweight and obesity among children and adults between 1980 and 2015. Using the Global Burden of Disease study data and methods, we also quantified the burden of disease related to high body-mass index (BMI), according to age, sex, cause, and BMI in 195 countries between 1990 and 2015.

RESULTS: In 2015, a total of 107.7 million children and 603.7 million adults were obese. Since 1980, the prevalence of obesity has doubled in more than 70 countries and has continuously increased in most other countries. Although the prevalence of obesity among children has been lower than that among adults, the rate of increase in childhood obesity in many countries has been greater than the rate of increase in adult obesity. High BMI accounted for 4.0 million deaths globally, nearly 40% of which occurred in persons who were not obese. More than two thirds of deaths related to high BMI were due to cardiovascular disease. The disease burden related to high BMI has increased since 1990; however, the rate of this increase has been attenuated owing to decreases in underlying rates of death from cardiovascular disease.

CONCLUSIONS: The rapid increase in the prevalence and disease burden of elevated BMI highlights the need for continued focus on surveillance of BMI and identification, implementation, and evaluation of evidence-based interventions to address this problem.

Background: Today’s older people drink more alcohol than earlier cohorts of older people. Social integration has been identified as an important factor for older people’s drinking, but the association is complex. This study investigates both high and low levels of social integration and their associations with longitudinal patterns of alcohol consumption among older women and men.

Methods: Longitudinal nationally representative data of older Swedish women and men aged over 65 – the Swedish Level of Living Survey (LNU) and Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) – from 2010/2011 and 2014 (n = 1048). Associations between social contacts and social activities at baseline and longitudinal patterns of drinking frequency were examined with multinomial logistic regression analyses. Results: Men reported drinking alcohol more often than women, but the most common drinking frequency among both women and men was to drink monthly or less. Drinking habits were generally stable over time. People with high levels of social activity at baseline were more likely to have a stable daily or weekly drinking frequency or increased drinking frequency over the four-year follow-up period, particularly women. People with low levels of social contacts and/or social activities were less likely to have a stable daily or weekly drinking frequency, compared to people in the low and stable drinking frequency group.

Conclusions: Alcohol consumption is embedded in a social context, older people drink in social situations and social integration predicts continued drinking patterns.

Background: Cancers can affect both sexes at any age and it is estimated that at least one in three people will be diagnosed with cancer at some point in their lives. In the diagnosis of cancer, the care can have two orientations, curative or palliative. When curative care no longer is possible, the care is transferred to palliative care, which means that the focus is primarily on symptom relief, promoting quality of life and well-being. People may have different wishes and goals at the end of life and in order for the quality of life to be promoted, the individual wishes should be taken into account. Quality of life is individual and includes the factors that affect the individual and is a subjective assessment of the individual's social, emotional, material and physical well-being.Aim: To describe factors that can affect the quality of life of patiens with cancer in a late stage of palliative care from a patient perspective.Method: The study is conducted as a literature review based on 15 quantitative and 7 qualitative scientific articles. Data searches have been performed in the CINAHL and PubMed databases.Results: The results showed that there are 6 main categories that make up the factors that affect the quality of life, these are background factors, social factors, palliative care environment, psychological factors, physical factors and existential factors.Conclusion: Younger individuals experience a poorer quality of life than older people. Where the individual is cared for and the care environment was an important factor in promoting a good quality of life at the end of life. Depression and anxiety were factors that negatively affected the individual. The physical symptoms such as pain were strongly associated with poorer quality of life.

Syftet med denna studie var att få mer kunskap om hur pedagoger i förskolan resonerar kring och vilken uppfattning de har om arbetet med uppdraget att motverka traditionella könsmönster och könsroller. Studien har en fenomenografisk ansats där pedagogernas olika uppfattningar har samlats in genom semistrukturerade intervjuer. Resultatet visar på att pedagogerna uppfattar att de ser och bemöter barnen som individer och att uppdraget handlar om att barnen ska få samma möjligheter oavsett kön. Att ha kunskaper om genus och jämställdhet uppfattade pedagogerna som betydelsefullt i arbetet och att vara självkritisk och medveten om olika förväntningar är en förutsättning för detta arbete.

Det konkreta arbetet med uppdraget gestaltar sig genom att pedagogerna blandar material och organiserar miljön på ett sådant sätt att barnen kan leka över könsgränserna. Vidare så visar resultatet på en uppfattning hos pedagogerna om att barnen behöver få samtala och reflektera över könsroller och könsmönster med hjälp av exempelvis litteratur eller utifrån det barnen säger och gör. En slutsats som kan dras utifrån denna studie är att kunskaper om genus och jämställdhet samt att kritiskt granska sig själv och verksamheten ses som viktiga aspekter i arbetet.

Aim: The aim of this literature review was to, from a patient point of view, identify factors within the specialized palliative care that constituted good care from the.Method: A systematic literature review was undertaken. Fifteen articles were reviewed. Thirteen of these were qualitative and two were quantitative.Results: Four categories were identified: self determination, capability of the nurse, nursing relations and maintaining dignity.The patients self determination was a central part of nursing. Delegating control and self determination from a patient to a nurse is also a form of self determination.Capable nurses instill trust and gave patients the opportunity of more alternatives when it came to choices concerning the care of the patient.A good relation with the nurse could give the patient a feeling of being important and being a part of something bigger, despite lack of family or friends. Important factors regarding patient-nurse relations were continuity and nurse accessibility.Maintaining dignity included being seen as the human being that the patient was before the terminal illness was diagnosed.Conclusion: Patients noted several factors as important for good palliative care. These could be summarized as self determination, nurse capability, nursing relations and maintaining dignity.

Over the last few years, several studies have suggested that interdisciplinary collaborations in teaching is beneficial to students’ learning process. The Swedish National Agency for Education (Skolverket) encourages Swedish teachers to work interdisciplinary, but the question is if interdisciplinary collaborations could result in higher grades?    This study has found that the 408 students who participated in interdisciplinary collaborations within their science or biology courses have been graded significantly higher than the 474 students who did not. The 408 were also graded significantly higher in their science/biology courses compared to their medium grade in their diploma than the students within the non interdisciplinary course. However, students in high school (gymnasium) programmes that specifically prepared them for university studies were found to have been graded significantly lower in their science/biology courses compared to their medium grade, in their diploma, when their courses included interdisciplinary collaborations.      This study could be interpreted as an indication that interdisciplinary collaborations within general-science or biology courses could affect students’ grades.  

Syftet var att undersöka vilka egenvårdsråd och effekterna av dessa som finns beskrivna i litteraturen vid NAFLD samt hur följsamheten av dessa beskrivs. Studien utfördes som en litteraturöversikt som inkluderade 16 artiklar, alla med kvantitativ ansats. Resultatet visade att livsstilsförändringar i form av fysisk aktivitet och ändrade matvanor var det bästa sättet för att minska NAFLD. Viktminskning hade en god effekt på NAFLD och även små viktminskningar reducerade mängden fett i levern. Det framkom även att fysisk aktivitet utan viktminskning var effektivt för att reducera mängden fett i levern. Vidare visade det sig att följsamheten ökade med individuellt utformade program och kontinuerlig stöttning. Förutsättningar för att uppnå livsstilsförändringar ökade med realistiskt uppsatta mål.

Varje år är det cirka 38 000 personer som vårdas för hjärtsjukdom. Personer som genomgått en hjärtinfarkt kan få problem med sina sexuella relationer som en följd av sjukdomen, medicinering eller på grund av ångest. Syfte: att beskriva vanligt förekommande känslor inför sexuellt samliv hos personer med hjärtsjukdom samt beskriva hur sexualrådgivning kan erhållas av vårdpersonalen. Studien genomfördes som en litteraturöversikt. Artiklar söktes i databasen Cinahl samt genom sökmotorn Elin. Sjutton vetenskapliga artiklar, både kvantitativa och kvalitativa granskades. Resultat: personer med hjärtsjukdom känner ofta rädsla och oro inför sexuell aktivitet. Rädsla över att utlösa en hjärtinfarkt, eller till och med att dö. Även partnern till den hjärtsjuke kan känna oro och rädsla över sin maka eller make. Rådgivningen är ofta otillräcklig och bristfällig. Även där är den bristfällig till den hjärtsjukes partner. Diskussion: vården behöver bli bättre på att ta upp detta ämne till diskussion. Problemet behöver synliggöras så att personer med hjärtsjukdom och deras partner kan känna sig trygga med att återuppta sitt sexuella samliv. Slutsatsen är att sexualrådgivning till personer med hjärtsjukdom är ett eftersatt område inom sjukvården. För att förbättra vården och livskvaliteten hos personer med hjärtsjukdom behövs mer utbildning av vårdpersonalen samt utformning av riktlinjer för sexuell rådgivning.

Syftet med föreliggande undersökning var att identifiera faktorer som bidrog till känslan av "yrkesstolthet" hos anställda vid Försäkringskassan Dalarna inkluderande personalens tillfredsställelse med yrkesrollen. Sammanlagt 163 personer, 123 kvinnor och 40 män, från 25 till 66 år (X= 49,8 år) deltog i undersökningen. Denna genomfördes med hjälp av General Nordic Questionnaire for Psychological and Social Factors at Work (QPS Nordic) inkluderande 123 frågor samt 9 frågor gällande yrkesrollen. Frågorna besvarades väsentligen med hjälp av en 5-gradig skala av Likert-typ. Huvudresultatet uträknades med hjälp av Cronbachs Alpha, Principal Component Analysis och multipel regressionsanalys. Det konstaterades att beroendevariabeln "yrkesstolthets" variation förklarades till 62,7% av oberoende-variablerna "interaktionsintelligens" "yrkesrealism", "arbetstillfredsställelse" och "arbetsengagemang". Även kön, ålder, utbildning och yrkeserfarenhet hade betydelse.

Är poliser mer spänningssökande än andra? Det är frågan som ligger till grund för studien där syftet är att jämföra poliser med lärare i vilken utsträckning de söker spänning. Studien genomfördes med hjälp av ett frågeformulär bestående av 28 påståenden som kommer ifrån redan vedertagna skalor. Dessa är Eysenck Personality Inventory och Zuckerman’s Sensation Seeking Scale. 62 personer deltog i studien varav hälften var lärare och hälften poliser. Poliserna fick signifikant högre poäng än lärarna på de påståenden som handlade om att ta risker och fatta snabba beslut. Lärarna fick i sin tur signifikant högre poäng på de påståenden som handlar om impulsivitet gällande resor. Den slutsats man kan dra av denna studie är att poliser söker sig till arbeten som i sig innebär mer spänning medan lärare i större utsträckning söker spänning utanför arbetet.

Background: Dementia impairs cognitive functions, such as memory and

speech, changing a person’s life forever. Providing person-centred care to these

persons intend to retain their identities, dignity and autonomy. Such care demands

time, devotion and good knowledge of the caring nurse. Dementia is expected to

increase in the future and therefore nurses will have to face new challenges.

Aim: To describe nurses’ experience of providing person-centred care for people

with dementia.

Method: A literature review of 15 articles, published between 2009-2016, that

have been read and analysed through content-analysis.

Results: Nurses experience a positive change in their attitudes, when providing

person-centred care to people with dementia, as they gained better understanding

of their patients’ dignity and integrity. Education, training and support from

management were seen as key factors for providing up-to-date care. Time was

viewed as a hindrance for person-centred care, and often led to nurses prioritizing

other routines. Two common outcomes of person-centred care were increased

satisfaction as well as emotional burnout.

Conclusion: Since dementia is increasing and nurses find person-centred care

time-consuming, there is a risk of such care becoming poor. To prevent this nurses

need good leadership and education.

Syftet med denna studie var att beskvirva kvinnors upplevelse, erfarenhet, behov av egenvård vid urinläckage samt om de klarade att träna bäckenbottenmuskulaturen som en del i sin egenvård. Hur kan barnmorskors och distriktssköterskors samarbete förbättras. Metod: I denna enkätstudie som gjordes i en stad i Dalarna där 51 kvinnor besökte vårdcentralernas barnmorskor och BHV- sköterskor (barnhälsovård) under fyra veckor. De kom på planerade besök till barnmorskor för efterkontroll eller cellprovtagning (30-40 år) eller till BHV-sköterskor för 18 månaders kontroll av sin baby där de besvarade enkäterna. Barnmorskorna besvarade enenkät om hur de informerade kvinnorna om bäckenbottenträning för att åtgärda eller förhindra urinläckage. Resultat: Kvinnorna hade fåttinformation om bäckenbottenträning av barnmorskorna verbalt eller skriftligt men användandet av informationen om bäckenbottenträning för att förhindra urinläckage genomfördes inte regelbundet. De flesta i denna studie ansåg att de inte hade några problem med urinläckage eller mycket sällan. De läckte urin övervägande sällan vid aktivitet och de flesta använde inte knipövningar regelbundet. Diskussion: Hur kan vården öka förståelsen för preventiv egenvård med bäckenbottenträning för att minska urinläckage. Skulle ett ökat samarbete mellan barnmorskor och distriktssköterskor underlätta för kvinnor att med egenvård lättare hantera inkontinensproblem?

Suicides by drowning have received limited attention by researchers. A recent finding that almost one-third of all drowning deaths in Sweden were classified as suicide instigated this study. We identified 129 cases of suicide by drowning in Northern Sweden and analyzed the circumstances and the psychiatric history prior to the suicide. Information was obtained from autopsy, police and medical records, as well as from the National Inpatient Register. One-third of the suicide victims had previously attempted suicide and half of the victims had been hospitalized due to mental health problems. One-third of these had left the hospital less than one week before the suicide. Alcohol and psychoactive drugs were present in 16% and 62% of the cases, respectively. A history of mental disorder and previous suicide attempt (s), especially by drowning, is an ominous combination necessitating efficient clinical identification, treatment and follow-up if a complete suicide is to be prevented.

The Learning Study inquires teaching and learning in relation to a specific object of learning. The meaning of knowing the specific object of learning is specified in the research process – in the planning and analysis of the pre-test as well as in designing and analysis of research lessons. In this symposium the focus will be on different aspects of the knowledge generation in a Learning Study concerning the meaning of knowing what is expected to be known. By inquiring teaching and learning of a specific content our knowledge regarding that content will be differentiated and deepened. The meaning of knowing a specific object of learning is a dynamic knowledge object – depending on the specific group of students in interaction with a specific content. Each new group of students will make it possible to discern new aspects of the learning object. By analyzing student difficulties as well as interactions in the classroom new aspects of the learning object will be discerned. In the symposium four different Learning Studies from different school subjects will be presented. The meaning of knowing will be explored and discussed from different angles – from the perspective of the learners (in the pre-tests) and  the teachers (in the teacher discussions) as well as from how it is constituted in the classroom interaction (documented in the videos from the research lessons).

Chair: Ingrid Carlgren

Discussant: Ference Marton

Contributions:

Pernilla Ahlstrand – Learning Study as a way to inquire about progress in acting and presence on stage.

Theatre is a subject in upper secondary school in Sweden as part of the national aesthetic program. The new kind of syllabus is organized in relation to content areas as well as subject specific capabilities for the students to develop. The syllabus also includes criteria for the assessment of students’ capabilities – to be used when giving marks to the students and working with formative assessment or assessment for learning (Black & Wiliam, 1998, Gipps 1995. The criteria are expressed in general, non-subject specific terms. This is for example formulated as the difference between a simple and complex way of being able to express something in the theatre syllabus. In my research I investigate how learning study as a research approach and phenomenography as a method of analyzing pretests can be used as another and deepened way to describe different levels of knowing in relation to the national criteria.

Theatre knowledge and the way knowledge is transferred is in previous research to a great extent described as tacit (Lagerström 2005, Järleby 2003, Johansson 2012). This gives theatre teachers even further challenges, trying to formulate what is described as tacit knowing (Polanyi 1958/1998 &1967/2009, Johannessen 1988, 1999, 2002, Janik 1995, 1996, Schön 1983).

The capability of being present was found suitable as an object of learning, as it is something that teachers have experienced difficulties with when teaching and instructing. Presence is a core quality in acting and it is one of the criteria teachers agree on being of great importance when assessing a student but in what way can the knowing of the capability of being present be described?

It will be discussed whether an outcome space (in relation to filmed material) can be a way to develop teachers and students understanding of the meaning of knowing as a help to work with assessment for learning.

Eva Björkholm - The meaning of knowing how to construct a  linkage mechanism. Discerning aspects of the object of learning by analyzing classroom interactions

This presentation describes a Learning Study within primary technology education focusing on the capability to construct a specific linkage mechanism. What one has to know in order to be able to construct a linkage mechanism is, however, not self-evident. The study reported here explores the meaning of this specific knowing. The study was conducted in collaboration with two primary school teachers and their two classes (children aged 6-7 years). Throughout the whole study step by step, starting with the analysis of the pre-test, followed by three cycles of planning and evaluation of research lessons, and the analysis of post-test, the meaning of the object of learning was specified (Marton & Pang, 2006; Carlgren, 2012). The presentation will focus on knowledge generated from the video recorded lessons by analyzing the classroom interactions and students’ difficulties that were made visible through these interactions. Teacher-student interactions as well as student-student interactions were analyzed. By analyzing students’ difficulties regarding the specific object of learning, critical aspects of the expected knowing were discerned and in this way the meaning of knowing what is expected to be known was made explicit.

The results are presented in the form of critical aspects of what it means to know how to construct a linkage mechanism for this group of students. The critical aspects identified in the pre-test were further elaborated in the research lessons and by analyzing the classroom interactions in terms of student difficulties, additional aspects that were critical for students’ learning were identified. By gradually identifying the critical aspects, the collective understanding of the meaning of the object of learning was developed and specified.

Jenny Frohagen – The meaning of knowing how to make expressions in artifacts: generating knowledge through designing lesson tasks   

The school subject sloyd derives from a practical knowledge tradition which covers knowing in craft and art (Mäkelä, 2011; Hasselskog, 2010; Borg, 2001). However, sloyd teachers express difficulties when trying to explain and deal with aesthetic aspects when teaching sloyd (Fransson, 2010; Borg, 2007). There has been a tendency of trivializing the subject content into a shallow form of craft knowledge understood as ‘merely’ working with traditional craft techniques (Borg, 2008; Skolverket, 2005). There is a need to articulate the aesthetical features of knowing in sloyd. In my contribution I will present results from a Learning Study in sloyd focusing on the knowing of interpreting symbolic expressions in sloyd artefacts.

In my presentation I will focus on how the iterative process of designing (short) lesson tasks given to the students during the research lessons and also in pre- and post-tests in each cycle, can be a way of understanding the object of learning. Since explicit tests of the students knowing are rarely found in sloyd education, conducting Learning Studies in sloyd can be a meaningful way of developing subject specific tasks. In this Learning Study different designs of tasks has been explored during the process as a way to inquire the knowing of interpreting symbolic expressions in sloyd artefacts. The results from this study show how the articulation of an object of learning in sloyd can be specified and validated throughout the process of designing and carrying out subject specific tests and lesson tasks. Depending on how the object of learning was articulated, the tasks/tests changed focus and the meaning of the knowing differed. By analyzing the students learning outcomes and redesigning the pre- and post-test in a Learning study as well as the given lesson tasks, new aspects of the learning object can be discerned.

Gunn Nyberg – The meaning of knowing how to move in specific ways: embodied understanding as somatic grasping

The subject physical education has a tradition of being a ‘practical’ subject. However, practical forms of knowing such as for example bodily awareness and capability to move (e.g. jumping, running or dancing) do not, neither for teachers nor pupils, seem to be a main issue of learning in PE (Tinning, 2010; Redelius et al, 2009,). The knowing involved in moving is not easily articulated and may, according to Polanyi (1954), “often result in explaining away quite genuine practices or experiences” (p. 385). The aim of this study is to explore and articulate the meaning of knowing how to move in a specific way exemplified through a movement called ‘house hop’.

The study takes as it’s starting point an epistemological perspective on capability to move corresponding with Ryle’s (1949) “knowing how”, not separating mental and physical skills. Accordingly, a phenomenographic analysis of students’ experiencing of the learning object (‘house hop’) have been used.

The paper draws mainly on data from video recordings of the pre-test and transcripts of two video recorded lessons from a Learning Study in upper secondary school. The findings show the meaning of knowing house hop as different ways of knowing the movement as well as several aspects to discern in order to know the movement in a powerful way.

This presentation will focus on how students’ experiencing of a movement are expressed in their way of moving. Taking this as a starting point when teaching and learning movements can contribute to an approach to capability to move as comprising mental and physical processes as one process. Conceiving the knowing involved in ‘house hopping’ (as well as other ways of moving) this way could also contribute to a discussion concerning subject specific knowledge in PE and particularly it’s ‘practical’ dimension.

Background: In today's society, depression is considered a world problem. A reduced desire for life, low self-esteem, tiredness and low energy are a few of the symptoms that a person with depression and depressive symptoms suffer from. The use of physical activity in various forms is recommended as a treatment for depression and depressive symptoms in elderly people. Person-centered care aims to ensure that the individual's own experience of health is in focus which increases the well-being of a person suffering from depression or depressive symptoms.Purpose: The purpose of the literature review is to investigate the effect of physical activity in elderly people with depression and depressive symptoms.Method: The degree project was carried out as a literature review. 14 articles were searched in the PubMed and CINAHL databases with keywords designed from the purpose. The articles were reviewed based on Dalarna University's review template and compiled based on different quality grades. Articles with medium and high quality were included. The results were categorised and compiled based on similarities and differences that emerged from the analysis.Results: The results of the literature review are shown to have an effect in depression and depressive symptoms in elderly people. Being physically active through an assigned individual exercise program, training in groups or in the form of yoga was shown to be able to positively affect the depressive symptoms and depression. The intensity of exercise and frequency may have an impact on the effect of depressive symptoms or depression.Conclusion: The effect of physical activity in various forms has been shown to reduce depressive symptoms in elderly people.

Stora delar av skolpolitiken har den senaste tiden bestått av ordning och reda med allt fokus på de mätbara kunskapsresultaten. Politikerna framhåller att kunskapsmålen sätts främst och pekar på vikten av att ha höga förväntningar på eleverna, men även ett tydligt pedagogiskt ledarskap och goda relationer mellan lärare och elev samt en gemensam värdegrund och tydliga regler betonas.

Min studie belyser faktorer som kan antas vara avgörande för den studerade skolans prisbelönta framgångar mot främlingsfientlighet och kränkande behandling. Lärarnas värdegrundsarbete genomsyrande det dagliga arbetet Det finns samarbete mellan skolans olika klasser, en tydlig och drivande ledning samt en utveckling av elevhälsoteamet. Jag formulerade två forskningsfrågor som skulle hjälpa mig att få svar på mitt syfte: Vad är det i den utvalda skolans rektor, speciallärare samt några få utvalda elever anser sig ha lyckats med när det gäller skolans värdegrund samt frågan om det finns några viktiga faktorer i värdegrundsarbetet att beakta och i så fall vilka?

För att få svar på mina forskningsfrågor intervjuade jag rektor och en speciallärare samt fem slumpvalda elever i årskurs 6. Resultatet visar bland annat att det finns en röd tråd av syften och medvetenhet i hela verksamheten. Den visar också på stor elevdelaktighet. Man identifierar snabbt konflikter och tar aktivt ställning och försöker göra något åt detta. Skolan hjälper eleverna att hantera konflikter med bl.a. DRACON, ett konflikthanteringsprogram. Skolan synliggör skolans uppdrag, värdegrund, hälsa och lärande tydligt för eleverna. Den visar även på ett stort gemensamt engagemang och kompetens hos lärarna, där alla pedagoger eftersträvar samma sak och i lika hög grad.

Syftet med denna studie är att undersöka hur SO-lärare i åk 4-6 beskriver att de arbetar för att skapa ett interkulturellt klassrum. Genom intervjuer med sex olika lärare besvaras studiens två frågeställningar: Hur beskriver SO-lärare i åk 4-6 att de arbetar för att inkludera elever med annat modersmål än svenska och deras tidigare kunskaper i undervisningen? Hur tycker SO-lärare i åk 4-6 att läromedlen i SO-undervisning förhåller sig till det interkulturella perspektivet?Den här uppsatsen utgår från det interkulturella perspektivet. De tidigare forskningarna inom detta ämne har man haft fokus på vilka faktorer som elever med annat modersmål gynnas av. De forskarna som presenteras i detta arbete belyser vikten av att stärka andraspråkselevernas första språk.Resultatet visade att interkulturellt klassrum skapas genom att uppmärksamma och välkomna elevers olika kulturer. Resultaten visade även att lärarna behöver mer kunskap om det interkulturella perspektivet.

Background: Stroke is a collective name for conditions that occur when the oxygen supply to the brain are disturbed as a result of a blockage or cerebral haemorrhage. The condition affects 15 million people annually making stroke one of the foremost the cause of death in the world. Stroke can contribute to major injuries which can be life changing for the person and the family. The nurse has an important role in providing support and care to the patient and informing and supporting relatives through this change.Aim: To describe family caregivers experience of life after strokeMethod: A literature review where 14 qualitative articles have been analyzed, the articles are taken from the databases Psycinfo, PubMed and CINAHL.Results: Three main categories were developed in the results. The categories was changed relationships and roles within the family, An everyday life with limitations and the consequences of a life in change..Conclusion: The literature review showed that relatives felt that life changed significantly after a family member's stroke diagnosis. The changed life situation made it difficult for relatives to restore a balance in everyday life. Through careful planning before hospital discharge, the nurse can identify which support measures are relevant for the family to have a functioning everyday life. The nurse should also be aware of the need for physical and emotional support in the meeting with relatives. The nurse can offer training, workshops or other forums where relatives can talk and meet families in similar situations. This can thus increase the nurse's ability to promote the health and well-being of relatives.

Family caregiving of people with dementia is expected to increase due to a declining public care and a growing number of people suffering from dementia. There is a need for better understanding of the life situation of family caregivers in order to give them the right support. The aim of this literature study is to emphasize the life situation of relatives caring for persons with dementia disease.  The methodological approach is thematic analysis av 15 qualitative studies that have been identified after a literature search conducted in three databases. The results are presented in three main themes and five sub-themes. The themes highlight the family caregivers, their experience and the strategies they use to cope with everyday life. The study concludes that the life situation of the family caregivers is individualized. Their support needs are varying according to the development of the dementia disease and the circumstances before the illness.

Med utgångspunkt i fyra följeforskningsprocesser, där vi själva medverkat, diskuterar vi följeforskning som företeelse och rollen som följeforskare. Vår artikel ska ses som ett empiriskt exempel i anslutning till den debatt som Göran Brulin, Karin Sjöberg och Lennart Svensson initierade genom artikeln ”Gemensam kunskapsbildning för regional tillväxt”.