Gestaltningsförslag av utemiljö vid Villa Roos Park

I det här examensarbetet undersöks hur en avgränsad del av utemiljön vid Vardaga Villa Roos Park (i regi av omsorgsföretaget Vardaga, fortsättnings vis benämnt Villa Roos Park), ett särskilt boende för personer med demenssjukdom, kan utvecklas med stöd av EBD, evidensbaserad design av utemiljöer i vårdsammanhang (Bengtsson et al., 2018). Frågeställningarna som besvaras är hur en avgränsad del av utemiljön vid Villa Roos Park kan utvecklas med stöd av evidens baserad design och vilka växter som är lämpliga utifrån målgruppens särskilda behov. Syftet har varit att utarbeta en övergripande designlösning för att visa hur utemiljön i högre utsträckning kan användas och integreras i aktiviteter med fokus på växtlighetens positiva betydelse för upplevelsen av trädgården. Utgångspunkten för kandidatarbetet har varit kursen Hälsoträdgårdar, inom pro grammet Trädgårdsingenjör design, SLU. Där gav en fördjupningsdel möjlighet att lära mer om personer med demenssjukdom och deras behov i kontakt med utemiljön. Arbetet inleds med en kort beskrivning av begreppet hälsoträdgård. Fakta om demenssjukdomar och hur personer påverkas av demenssjukdom har också sammanställts, för förståelse av målgruppens behov. En teoretisk bakgrund beskriver de analysmodeller som använts (se sidan 3). Arbetets resultatdel fokuserar kring designprocessen med stöd av EBD (Bengtsson et al., 2018). Processen har genomförts i tre steg där steg ett inbegrep undersökning av miljön med platsbesök, platsdokumentation och samtal med verksamhetschef om önskemål för utveckling av den avgränsade delen av trädgården. Resultat av undersökningar och information sammanställdes. Ett antal brister i den nuvarande utemiljön identifierades och ett antal önskemål om trädgårdens användning framkom. Utifrån indelning under rubrikerna Brister i utemiljön och Önskemål för trädgårdens utveckling gavs i steg två förslag till åtgärder. Dessa samlades under tre teman med utgångspunkt i QET, Quality evulation tool (Bengtsson & Grahn, 2014). QET-verktyget behandlar platsens möjlighet att anpassas utifrån evidensbaserade designteorier i vårdsammanhang. I det tredje steget och som resultat av designprocessen presenteras ett gestaltningsförslag i form av en övergripande illustrationsplan med tillhörande växtförslag. Gestaltningen bygger på de tre temana, utifrån vilka fem trädgårdsrum skapats: Gångstråk, Innergård, Stilla trädgård, Köksträdgård och Regnträdgård. Trädgårdsrum har skapats för sociala aktiviteter, sinnesstimulans och möjlighet till motion såväl som för lugn och ro i en mer kravlös miljö. Genomgående läggs fokus på orienterbarhet och säkerhet (ibid). Flera faktorer har beaktats gällande växtvalen: Trädgården har försetts med en vintergrön struktur och växter har valts som tydliggör årstidsväxlingar och skapar skönhetsvärden året om. Växter har valts för att vara välbekanta (Grönt kulturarv 2020) och för färg, doft och smak. Växter som gynnar pollinatörer och bidrar till en upplevelserik och varierad miljö är också betydelsefulla. I köksträdgården kan en mängd aktiviteter ske knutna till odling, skötsel och skörd. Frukt, bär, grönsaker och örter är därför viktiga inslag i trädgården. Växters behov utifrån ståndort, skötsel och särskilda växtval för översvämningsytan har varit andra faktorer att beakta, liksom att undvika giftiga växter (Giftinformationscentralen 2014) och alltför pollenspridande växter (Astma- & allergilinjen u. å.). Resultatet av arbetet tydliggjorde att en mängd faktorer behöver beaktas gällande utformning av miljöer för personer med demens. Växtlighetens positiva betydelse för utemiljöer i vård sammanhang kan inte nog understrykas. Om rätt förutsättningar ges vid utformandet av utemiljön, så att den kan samspela med såväl omgivning som arkitektur på bästa sätt, ges den även möjlighet att stödja varje brukare utifrån individuella behov.This thesis examines how a limited part of the outdoor environment at Vardaga Villa Roos Park (under the auspices of the care company Vardaga, hereafter referred to as Villa Roos Park), a nursery home for people suffering from dementia, can be developed with the support of EBD, evidence-based design of outdoor environments in care context (Bengtsson et al., 2018). The questions that are answered are how a limited part of the outdoor environment at Villa Roos Park can be developed with the support of evidence-based design and which plants that are suitable based on the target group’s special needs. The purpose has been to prepare an overall design solution to show how the outdoor environment can be used and integrated to a greater extent in activities with a focus on the positive significance of vegetation for the experience of the garden. The starting point for the bachelor’s thesis has been the course Health Gardens, within the program Garden Engineer Design, SLU. There, an in-depth section provided the opportunity to learn more about people with dementia and their needs in contact with the outdoor environment. The introdction of the thesis is a brief description of the concept of health gardens. Facts about dementia and how people are affected by dementia have also been compiled, to understand the needs of the target group. A theoretical background describes the analysis models used (see page 3). The results part of the work focuses on the design process with the support of EBD (Bengtsson et al., 2018). The process has been implemented in three steps, where step one included an investigation of the environment with site visits, site documentation and conversations with the operations manager about wishes for the development of the delimited part of the garden. The result of surveys and information were compiled. A number of deficiencies in the current outdoor environment were identified and a number of requests for the use of the garden emerged. Based on the division under the headings Deficiencies in the outdoor environment and Requests for garden development, proposals for souloutions were given in step two. These were assembled under three themes based on QET, Quality evulation tool (Bengtsson & Grahn, 2014). The QET tool processes the site’s ability to adapt based on evidence-based design theories in healthcare contexts. In the third step and as a result of the design process, a design proposal is presented in the form of an overall illustration plan with associated plant proposals. The design is based on the three themes, from which five garden rooms have been created: Walkway, Courtyard, Quiet garden, Kitchen garden and Rain garden. Garden rooms have been created for social activities, sensory stimulation and the opportunity for exercise as well as for peace and quiet in a more unpretentious environment. Throughout, the focus is on orientability and security (ibid). Several factors have been taken into account regarding the plant choices: The garden has been provided with an evergreen structure and plants have been chosen that clarify seasonal changes and create beauty values all year round. Plants have been chosen to be familiar (Grönt kulturarv 2020) and for color, aroma and taste. Plants that benefit pollinators and contribute to an experiential and varied environment are also important. In the kitchen garden, a variety of activities can take place related to cultivation, care and harvesting. Fruits, berries, vegetables and herbs are therefore important elements in the garden. The needs of plants based on location, care and special plant choices for the rain garden have been other factors to consider, as well as avoiding poisonous plants (Giftinformationscentralen 2014) and overly pollen-spreading plants (Astma- & allergilinjen u. å.). The results of the work made it clear that a number of factors need to be taken into account regarding the design of environments for people with dementia. The positive significance of vegetation for outdoor environments in care contexts cannot be overemphasized. If the right conditions are given for designing a health-care garden, so that it can interact with both the environment and architecture in the best way, it can also support each user based on individual needs

Ett rättssäkert tvångsomhändertagande - En rättsvetenskaplig uppstats om begreppet "annat socialt nedbrytande beteende" i 3§ 1st LVU

Compulsory treatment of children and young people is a controversial and debated subject. My paper concerns the legal certainty of a necessary prerequisite in §3 section 1 in the Care of young persons act, hereafter referred to as (CYPA). The purpose of this paper is to clarify which behaviors this necessary prerequisite applies to. The rule statutes the foundation of compulsory care, in relation to children and young persons’ own behavior. The necessary prerequisite I'm analyzing is called “other socially destructive behavior”. In the first part of the paper I present that the paper is written with a legal dogmatic method and from two perspectives; a developmental perspective and a legal certainty perspective. After a brief explanation of the emergence of the compulsory care, I discuss what the concept of the “legal certainty” is. In the essay I find that the term does not have a fixed meaning, instead it varies. It turns out, that in order to have a serious debate it’s important to clarify the definition of legal certainty. The essay explains how §3 section 1 is legally applicable. First the applicable law is outlined, according to how it’s defined in the law, legislative history and in the legal literature. After this it’s described how the application of the necessary prerequisite is used in the established practice. It’s uncertain whether some of the current behaviours that youths and children are using in this society are included in the necessary prerequisite. Therefore I discuss a few court cases to see how the application looks today. In the last part of the essay an analysis follows. The questions set out are here answered. I conclude that the concept of the legal certainty is ambiguous and that the application of the necessary prerequisite sometimes lacks legal certainty. Finally, I highlight my understanding of the necessary prerequisites general form. But this does not exclude the need for some clarification of the term.Tvångsvård av barn och unga är, och har länge varit, kontroversiellt. Min uppsats behandlar, ur ett rättsutvecklings- och rättssäkerhetsperspektiv, ett rekvisit i 3§ 1st lagen med särskilda bestämmelser om vård av unga (LVU). Syftet är att råda klarhet i vilka beteenden som faller under detta rekvisit. 3§ 1st LVU stadgar grunderna för tvångsomhändertagande på grund av barn och ungas eget beteende. Rekvisitet jag analyserar benämns ”annat socialt nedbrytande beteende”. I uppsatsens första del framförs att uppsatsen utarbetats efter en rättsdogmatisk metod. Efter en kort redogörelse för tvångsvårdens framväxt diskuterar jag vad begreppet rättssäkerhet innebär. Jag konstaterar att begreppet inte har en fastställd betydelse utan att innebörden varierar. För att föra en seriös debatt bör man precisera vad man avser med begreppet, vilket jag också gör. I uppsatsen redogörs för LVU:s tillämpning i förhållande till 3§ 1st. Först förklaras gällande rätt så som den ser ut enligt lag, förarbeten och doktrin. Efter detta beskrivs hur tillämpningen av rekvisitet ”annat socialt nedbrytande beteende” ser ut i rättspraxis. Det är oklart huruvida vissa aktuella beteenden som barn och unga har i dagens samhälle faller in under rekvisitet. Därför analyserar jag ett antal domar för att se hur tillämpningen ser ut idag. I analysen besvarar jag de frågeställningar som uppställts i inledningen. Jag konstaterar att begreppet rättssäkerhet är mångtydigt och att tillämpningen av rekvisitet ”annat socialt nedbrytande beteende” ibland brister i rättssäkerheten. Slutligen framhäver jag min förståelse för rekvisitets generella utformning. Denna förståelse utesluter dock ej behovet av en viss precisering

Två frivårdskontors syn på den procentuella skillnaden, vad gäller kontraktvårdsdomar

The aim of this paper is to spread some light over contract treatment from the perspective of the District Courts, Social Services and Probation Services, and understand the reason for local variation of the number of people sentenced to contractual treatment. Essential questions asked in this paper are; What advantages and disadvantages are known by the cooperating parties regarding contract treatment in comparison to prison? What parameters are considered when the cooperating parties decide upon contract treatment? What impact does the shared responsibility of cost have? What do the respondents think is the reason for the local variation? In order to answer the essential questions a qualitative and descriptive method has been used to highlight the main question of our study; What is the reason for the local variation in number of contract treatment sentences in Halmstad and Ystads district courts? The paper shows that the local variation between the Probation Services districts is dependent on the conditions to propose a contract treatment. In Halmstad it is not conditioned for the Probation Services to have a responsibility agreement with the Social Services to the same extent as for the Probation Services in Ystad

In governments we trust : Enacting trust in Finnish and Swedish state-owned enterprises

The Swedish and Finnish states are significant owners of enterprises. In both countries, the results for the state-owned enterprises (SOE) are compiled into an annual report presented to the Parliament. It is a way to report on financial performance as well as a way to build trust and legitimize state ownership. The document is thus a meeting point and place of negotiation foreconomic and political discourse.The aim of this paper is to increase understanding of how trust is enacted on microlevel when governments produce these documents and thus strive to create trust for state-owned enterprises.We analyse and compare the processes of producing these annual reports in Finland and Sweden. The data of the study consist of six interviews with key actors involved in the process of producing the report in Sweden and Finland. In addition, the annual reports from 2014–2018 have been analysed. We apply a mixed-method approach to the data.The process of creating the report is governed by the OECD Guidelines on CorporateGovernance of state-owned enterprises as well as by national guidelines which emphasize the need of consistent reporting annually and writing in a way understandable for the general public. The routines involve individuals as well as agencies which leaves room for interpretations. The study focuses on how the different actors involved in the process interpret and enact the task andhow they justify a particular process, design and genre. Special attention is paid to how UN’s sustainability goals are seen in this context. In a trustworthy report, various expectations are considered as well as the need to construct trust in general. Moreover, the processes in two countries are compared.The analysis describes a process which has not yet been studied. It shows how the international policy has been interpreted and how it is enacted in each country. In the Swedish case the actors combine the practices from corporate annual reports with motivations for state-owned enterprises, for some of them financial targets and for some both financial and societal targets.The corporate annual report serves as a role model for the government report on SOEperformance. In the Finnish case, the process and the genre are strictly steered by the context, i. e. the annual report being a document approaved by the Parliament. The authors of the texts highlight their role as representatives of the owner and as portfolio manager. Apart from that, the process of producing the SOE annual report is not linked to the corporate annual reporting.The study contributes with knowledge about trust building, institutional routines and the interface between financial, societal and sustainability targets

Effect on rooting by- and analysis of water based extracts of woody and herbaceous shoots of Salix smithiana Willd.

Cuttings of Lonicera xylosteum L. were treated with willow extract to study the response in rooting capacity. The extracts were prepared by mixing chopped pieces of Salix x smithiana Willd. with water in a warring blender. The investigation comprised 2 types of salix extracts based on differences and dynamics between twigs in winter dormancy and twigs with new shoots. To explore the rooting response, three tests were made. First, cuttings were treated with extract from salix in comparison with a control treated with water. Secondly, a rooting test was made with cuttings treated with extract from salix, IBA and the combination IBA + extract from salix. Finally a rooting test were made to assure that the extracts analyzed in the laboratory were complete and not missing any fraction important to rooting capacity that might have stayed in a column. Culturing tests showed that salix extract from winter twigs gave more roots than a control but the roots were not longer. The combination with IBA and salix extract (50/50, IBA 2500 ppm) gave white, thin, well divided roots while plain IBA solution (5000 ppm) gave short yellowish roots. The culturing test also showed that there is a difference between extract from winter twigs and extract from new shoots. Chemical analyses on the salix extract were made by HPLC – DAD combined with a fluorescence detector. Ester hydrolyses was performed on all samples. Detection was then possible and certain chemical substances were distinct. The following substances were found in salix extract: D-Salicin, Catechin, Ellagic acid and Saligenin. D-Salicin was found only in extract from winter twigs. One of the main substances in the salix extract revealed by the HPLC – DAD analysis could not be identified. Further experimentation would be interesting. Primarily, the combination IBA and salix extract should be tested on cuttings from plants normally difficult to root such as birch, beech walnut etc. Substances in salix extract which could be interesting are salicin, saligenin and their metabolites. Increased knowledge in this area could be very important and useful in future horticulture.Sticklingar av Lonicera xylosteum L. behandlades med extrakt av pil för att studera effekten på rotningsförmågan. Extraktet framställdes av klippta bitar av Salix x smithiana Willd. mixade med vatten. Undersökningen omfattade 2 typer av salixextrakt baserade på skillnad och dynamik mellan kvist i vinter vila och kvist med nya skott. För att utvärdera rotningsresponsen gjordes tre jämförande rotningsförsök med sticklingar behandlade med salixextrakt. Försöket utvärderades mot en kontroll med sticklingar behandlade med vatten. Kompletterande rotningsförsök gjordes med sticklingar behandlade med salixextrakt, IBA och med kombinationen IBA + salixextrakt. Ett slutgiltigt odlingsförsök gjordes för att säkerställa att kemiska analyser gjordes på ett extrakt med full verkan och att ingen viktig beståndsdel som påverkar rotningen fastnat i någon kolonn. Odlingsförsök visar att salixextrakt från vinterkvist ger fler rötter men att rötterna inte är längre. Kombinationen med IBA och salixvatten (50/50, IBA 2500 ppm) ger vita, tunna, välförgrenade rötter medan ren IBA-lösning (5000 ppm) ger korta gulaktiga rötter. Odlingsförsöken visar också att det finns en skillnad mellan extrakt från vinterkvist och extrakt från nya skott. Kemiska analyser av salixextraktet gjordes i HPLC – DAD kombinerad med fluorescence detektor. Esterhydrolys utfördes på alla prov. Detektion var därefter möjlig och vissa kemiska ämnen kunde säkerställas. Ämnen i salixextrakt som påträffades var D-Salicin, Catechin, Ellagsyra och Saligenin. D-Salicin hittades endast i extrakt från vinterkvist. Ett av ämnena i salixextrakten med tydligt utslag i HPLC – DAD analysen kunde inte identifieras. Att utveckla försöket skulle vara intressant. Främst skulle kombinationen IBA och salixextrakt prövas på sticklingar som vanligtvis är svåra att rota som björk, bok, valnöt etc. Ämnen i salixextraktet som kan visa sig intressanta i sammanhanget kan antas vara salicin, saligenin och metaboliter från dessa. Ökad kunskap kring dessa frågor kan visa sig vara viktiga och användbara i framtida hortikultur

Exploration of some personal factors with the International Classification of Functioning, Disability and Health Core Set for Stroke

Objective: The aim of this study was to explore the influence of personal factors (i.e. age, gender, place of residence and time since onset of stroke) on self-perceived functioning and environmental factors, using the International Classification of Functioning, Disability and Health (ICF) Core Set for Stroke (extended version) as a framework. Design: Cross-sectional study. Participants: A total of 243 community-dwelling persons (53% men) with prior stroke (6 months to 13 years) with a mean age of 68 years (age range 24-95 years). Methods: Regression analysis of 4 personal factors (age, gender, place of residence, and time since onset of stroke) was used to explore their influence on different components, domains and categories of functioning and environmental factors, evaluated with the extended version of the Comprehensive ICF Core Set for Stroke. Results: The personal factors had statistically significant predictive values for almost all the categories, domains and components of functioning and environmental factors examined in this study. These factors influence self-perceived functional outcome and environmental factors in terms of being barriers or facilitators in various ways. Conclusion: Personal factors, such as age, gender, place of residence and time since onset of stroke, influence self-perceived functioning and environmental factors.publishersversionPeer reviewe

Increased prevalence of seropositivity for non-gastric Helicobacter species in patients with autoimmune liver disease

Various Helicobacter species have been isolated from the stomach, intestinal tract and liver of a variety of mammalian and some avian species, and Helicobacter DNA has been detected in human bile and liver samples. An immunoblot assay was established to analyse serum antibody responses to non-gastric Helicobacter species in patients with autoimmune liver diseases, in comparison with healthy individuals. Sera from 36 patients with primary sclerosing cholangitis (PSC), 21 with primary biliary cirrhosis, 19 with autoimmune chronic hepatitis and 80 blood donors were analysed by immunoblot, using cell-surface proteins from Helicobacter pullorum, Helicobacter bilis and Helicobacter hepaticus as antigens. Prior to testing, sera were cross-absorbed with a whole-cell lysate of Helicobacter pylori. Antibody reactivity to various proteins of these three Helicobacter species was measured by densitometric scanning and results were processed by computer software to estimate antigenic specificity. Results were also compared with antibody response to H. pylori. For H. pullorum, reactivity to at least two of the proteins with molecular masses of 48, 45, 37, 20 and 16 kDa, for H. hepaticus, reactivity to the 76, 30 and 21 kDa proteins and for H. bilis, reactivity to the 22 and 20 kDa proteins, seemed to have high specificity. Positive immunoblot results with sera from patients with PSC to antigens of H. pullorum, H. bilis and H. hepaticus were found in 38, 22 and 25 of cases, respectively, and from patients with other autoimmune liver diseases, in 30, 22 and 22 of cases, respectively. Prevalence of serum antibodies to non-gastric Helicobacter species was significantly higher in patients with autoimmune chronic liver diseases than in healthy blood donors (P < 0.001). Increased antibody levels to enterohepatic Helicobacter species raise questions concerning an infectious role of these emerging bacterial pathogens in human autoimmune liver diseases

Construct Validity of the Swedish Version of the Revised Piper Fatigue Scale in an Oncology Sample—A Rasch Analysis

AbstractObjectivesFatigue is a common and distressing symptom in cancer patients due to both the disease and its treatments. The concept of fatigue is multidimensional and includes both physical and mental components. The 22-item Revised Piper Fatigue Scale (RPFS) is a multidimensional instrument developed to assess cancer-related fatigue. This study reports on the construct validity of the Swedish version of the RPFS from the perspective of Rasch measurement.MethodsThe Swedish version of the RPFS was answered by 196 cancer patients fatigued after 4 to 5 weeks of curative radiation therapy. Data from the scale were fitted to the Rasch measurement model. This involved testing a series of assumptions, including the stochastic ordering of items, local response dependency, and unidimensionality. A series of fit statistics were computed, differential item functioning (DIF) was tested, and local response dependency was accommodated through testlets.ResultsThe Behavioral, Affective and Sensory domains all satisfied the Rasch model expectations. No DIF was observed, and all domains were found to be unidimensional. The Mood/Cognitive scale failed to fit the model, and substantial multidimensionality was found. Splitting the scale between Mood and Cognitive items resolved fit to the Rasch model, and new domains were unidimensional without DIF.ConclusionsThe current Rasch analyses add to the evidence of measurement properties of the scale and show that the RPFS has good psychometric properties and works well to measure fatigue. The original four-factor structure, however, was not supported

Cardiovascular risk with androgen deprivation therapy for prostate cancer: Potential mechanisms.

Androgen deprivation therapy (ADT) is frequently used for the treatment of advanced prostate cancer. ADT is associated with numerous side effects related to its mode of action, namely the suppression of testosterone to castrate levels. Recently, several large retrospective studies have also reported an increased risk of diabetes and cardiovascular disease in men receiving ADT, although these risks have not been confirmed by prospective randomized trials. We review the literature to consider the risk of cardiovascular disease with different forms of ADT and examine in detail potential mechanisms by which any such risk could be mediated. Mechanisms discussed include the metabolic syndrome resulting from low testosterone level and the potential roles of testosterone flare, gonadotropin-releasing hormone receptors outside the pituitary gland, and altered levels of follicle-stimulating hormone. Finally, the clinical implications for men prescribed ADT for the treatment of advanced prostate cancer are considered