Depressive symptoms over higher education and the first years in the profession : a longitudinal investigation in Swedish nursing students

Background and aims: A substantial part of the population attends higher education, which makes the welfare of students a matter of concern for public health. There are indications of a high prevalence of mental distress and depressive symptoms in students, as well as an increase over the past decades. If this is an effect of education, the demographic composition of student groups or changes in mental health at the societal level is uncertain. The overall objectives of this thesis were to investigate prevalence of depression and to follow change in depression symptoms over higher education and the first professional years. The specific aims were: 1) to investigate prevalence of depression and associations with demographic and education related factors in first year students (study I), 2) to investigate effects of time in higher education and work establishment on depressive symptoms, and to map change over the period (study II), and 3) to investigate risk of conflicting demands between education/work and private life (work-home conflict) over time in higher education and work establishment, and the association with depressive symptoms (study III). Methods: The data came from LANE (a Longitudinal Analysis of Nursing Education), a national cohort of 1,700 nursing students who responded to annual questionnaires from 2002 to 2007. Study I was cross sectional and we used data from the baseline questionnaire collected during the first year of education. Depression was measured by the Major Depression Inventory and presence calculated according to a DSM-IV based algorithm. Associations with socio-demographic and educational factors were tested in logistic regressions. Study II and III were longitudinal, and for both we used data from five consecutive years: three in education and two post graduation. In study II we measured degree of depressive symptoms by summing the symptoms reported in the Major Depression Inventory. Change over time was analysed in a linear mixed model for repeated measures. In study III we measured two directions of work-home conflict: work → home and home → work conflict by single items. Depressive symptoms were measured as in study II. Change over time was analysed using generalized estimating equations and linear mixed models. Results: Study I showed that 10.2% (5.7% men and 10.7% women) reported depression in their first year of education. Younger age (<30), immigration from outside Europe, high workload, dissatisfaction with the education, low self efficacy and work-home conflict were associated with higher risk of depression. Prior work experience, less need of financial support and salaried work during term time were associated with less risk. In study II we found an increase in level of depressive symptoms over time in education, but a decrease to levels similar to baseline a year after graduation and work entry. Symptom levels differed between groups of different age, family status and prior nurse assistant training, but the pattern of change was similar across groups. Study III revealed that the experience of work-home conflict also increased over education, but a year after graduation and work entry the risk was lower than at any time in education. Respondents who were parents reported conflict more often. The association between work-home conflict and depressive symptoms was strong and consistent over the whole period of investigation. Conclusions: The students investigated were a heterogeneous group consisting both of young adults and individuals with extensive experience of adult life. As a group, 10.2% reported depression in their first year of education, but the overall risk was affected by age and gender. The findings of an increase on depressive symptoms over education and a decrease a year after graduation and work entry show that there is an effect of heightened distress over education, but that it is transitional and abates once the graduate has had time to accommodate to the profession. Moreover, many students, especially parents, found it difficult to balance the demands of education with those of private life and experienced work-home conflict. The strong association with depressive symptoms suggests that measures to reduce work-home conflict, especially in education programs with many mature students, could help alleviate distress

Upplevelser av stöd i IPS

Personer med psykiska funktionsnedsättningar har påvisade svårigheter att etablera sig på den reguljära arbetsmarknaden. Genom ett arbetsrehabiliterande program enligt IPS ges stöd till denna målgrupp med målsättningen att finna ett passande arbete för klienten. Studiens syfte var att beskriva en samlad bild av klienters och arbetsgivares upplevelser av stöd inom IPS. Studien hade en kvalitativ ansats, där semistrukturerade intervjuer med utgångpunkt i PEO-modellens begrepp genomfördes. Studiens urvalsgrupp bestod av sex deltagare; tre arbetsgivare och tre klienter. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys. Det stöd som ges genom IPS framställs överlag som tillfredställande av studiens deltagare. Många olika aspekter av stödet har synliggjorts, men framförallt har denna studie bidragit med ny kunskap kring arbetsgivarens roll och kompetens inom IPS. Studiens resultat bekräftade även vikten av det klientcentrerade arbetet och stödet som gavs av arbetscoachen. Studiens författare identifierar att det finns ytterligare behov av forskning kring arbetsgivarens roll och kompetens, för att på så sätt synliggöra och även kunna förbättra det stöd som ges av arbetsgivaren

En studie om omvårdnadspersonal: diskurser kring kön, status och yrkesidentiteter

Denna uppsats behandlar om en ökning av antalet män inom omvårdnadspersonalen påverkat yrkets identitet och personalens vilja att höja yrkets status. Vi har utifrån fem semistrukturerade intervjuer och femton enkäter analyserat hur personalen på ett äldreboende i en kommun i Skåne ser på sig själva, sitt yrke och sin arbetssituation samt hur de ser på utbildning som ett verktyg att påverka dessa. Vi analyserar materialet utifrån diskurser kring kön, professionalisering, vård samt yrkesidentiteter. Resultatet av vår undersökning visade på att samtliga informanter ansåg att det var män inom äldreomsorgen spelar en viktig roll exempel på detta var mäns logik. Det visade även på att informanterna hade en traditionell föreställning om kön och genus samt att önskan att höja yrkets status var hög

Konstruktioner av de posit(h)iva - En kritisk diskursanalys av den svenska HIV-debatten

Constructions of the posit(h)ive - a critical discourse analysis of the HIV debate in Sweden The aim of this study was to examine how newspapers in Sweden contribute to construct the HIV-positive subject and categorize people living with HIV. Due to the international critique against the Swedish HIV legislation, a debate has taken place concerning responsibilities put on people living with HIV. The main critique against the Swedish legislation has been the counterproductive effects of disclosure laws, which are believed to create stigma and marginalisation for HIV-positive people without diminishing the spread of the virus. This study is based on 71 articles concerning HIV, published in five of the major Swedish newspapers during the years 2011-2012. We used Norman Faircloughs three-dimensional approach on critical discourse analysis, as both method and as theory, which includes the study of discourse as text, discourse practice and social practice. We also used theories pdfpertaining to social categorization. In the corpus three main discourses were identified, discourses about (de)criminalization, responsibility and guilt. We found that the subject positions for people living with HIV tend to vary depending on discourse, as the subject positions are both identified as victims of social stigmatization and perpetrators due to criminalization

The complexity of kidney disease and diagnosing it – cystatin C, selective glomerular hypofiltration syndromes and proteome regulation

Estimation of kidney function is often part of daily clinical practice, mostly done by using the endogenous glomerular filtration rate (GFR)-markers creatinine or cystatin C. A recommendation to use both markers in parallel in 2010 has resulted in new knowledge concerning the pathophysiology of kidney disorders by the identification of a new set of kidney disorders, selective glomerular hypofiltration syndromes. These syndromes, connected to strong increases in mortality and morbidity, are characterized by a selective reduction in the glomerular filtration of 5–30 kDa molecules, such as cystatin C, compared to the filtration of small molecules <1 kDa dominating the glomerular filtrate, for example water, urea and creatinine. At least two types of such disorders, shrunken or elongated pore syndrome, are possible according to the pore model for glomerular filtration. Selective glomerular hypofiltration syndromes are prevalent in investigated populations, and patients with these syndromes often display normal measured GFR or creatinine-based GFR-estimates. The syndromes are characterized by proteomic changes promoting the development of atherosclerosis, indicating antibodies and specific receptor-blocking substances as possible new treatment modalities. Presently, the KDIGO guidelines for diagnosing kidney disorders do not recommend cystatin C as a general marker of kidney function and will therefore not allow the identification of a considerable number of patients with selective glomerular hypofiltration syndromes. Furthermore, as cystatin C is uninfluenced by muscle mass, diet or variations in tubular secretion and cystatin C-based GFR-estimation equations do not require controversial race or sex terms, it is obvious that cystatin C should be a part of future KDIGO guidelines.publishedVersio

Change in depressive symptoms over higher education and professional establishment - a longitudinal investigation in a national cohort of Swedish nursing students

<p>Abstract</p> <p>Background</p> <p>There are indications of a high prevalence of psychological distress among students in higher education and also that distress increases over the course of study. However, not all studies on student distress controlled for sociodemographic differences and few followed development of distress over an extended period through professional establishment. We investigated if there is an independent effect of time in education and the first two years in the profession on depressive symptoms and mapped change over the period in a national cohort of students.</p> <p>Methods</p> <p>Data came from LANE, a nation-wide longitudinal panel survey of Swedish nursing students (N = 1700) who responded to annual questionnaires over five years from 2002 to 2007. Depressive symptoms were measured by the Major Depression Inventory and change over time analysed in a linear mixed effects model for repeated measures.</p> <p>Results</p> <p>There was a significant change in level of depressive symptoms over time: an increase from the first to later years in education and a decrease to levels similar to baseline after graduation and a year in the profession. The change in symptoms remained significant after adjustment for sociodemographic factors (p < 0.01). Symptom levels differed due to age, gender, household composition and prior nurse assistant training but change over time was similar in all groups. The correlation among the repeated measures, representing within individual correlation over time, varied between 0.44-0.60.</p> <p>Conclusions</p> <p>The findings indicate an independent but transitional effect of time in education and professional establishment on depressive symptoms. We think heightened distress over education abates as the graduate accommodates to the profession. Nevertheless, within education, the differences in depressive symptoms associated to demographic factors can help identify student groups more vulnerable to distress. Also, as individual differences in distress seem to persist over time, perhaps students highly distressed in the beginning of education can be helped by awareness among educators of the elevated levels of distress in late education.</p

Development of the principles of war in small states. : The case of Sweden.

ABSTRACT: The aim of this essay is to analyze whether the development of the Principles of War in small states´ doctrine has been influenced by the doctrinal development of alliances after the start of an international cooperation. The author suggests that the development of the Principles of War can be understood through theories of doctrinal development. The theory used for this analysis states that small states depend on alliances, such as NATO, and therefore adapt their doctrine to better match the doctrine of the alliance. Since the Principles of War are the foundation of doctrine, such an adaption should lead to an adaption of the Principles of War as well. The analysis will be made using Swedish Army field manuals as a basis. These will be compared to NATO´s, in order to see whether or not Sweden has adapted its Principles of War following its membership of the Partnership for Peace. The results show that today the Swedish Principles of War are more similar to NATO´s than they were in 1982, which suggests that they have been adapted to better match those used by NATO. Although this essay does not analyze the reasons why, the results imply that theories of doctrinal development also include the development of principles of war. Analysis of the reasons why could be used as a basis for further research.SAMMANFATTNING: Syftet med denna uppsats är att analysera huruvida utvecklingen av krigföringens principer i småstaters doktriner har influerats av den doktrinära utvecklingen i allianser efter ett påbörjat internationellt samarbete.   Författaren föreslår att utvecklingen av krigföringens principer kan förstås genom teorier avseende doktrinutveckling. Teorin som används för uppsatsens analys anger att små stater är beroende av allianser med exempelvis NATO, och därför måste anpassa sina doktriner så att de bättre matchar alliansens doktriner. Eftersom krigföringsprinciperna är en stor del av doktriner, bör en sådan doktrinanpassning leda till en anpassning av krigföringens principer också.   Analysen kommer att göras utifrån svenska arméreglementen, vilka kommer att jämföras med NATOs, för att undersöka huruvida Sverige har anpassat sina krigföringsprinciper till att bättre matcha NATOs efter dess medlemskap i Partnership for Peace.   Resultaten visar att de svenska krigföringsprinciperna är mer lika NATOs idag än vad de var 1982, vilket tyder på att de har anpassats för att bättre matcha de som används av Nato. Även då denna uppsats inte analyserar orsakerna till varför, så indikerar resultaten att teorier om doktrinutveckling även omfattar utvecklingen av krigföringens principer. Analys av anledningar till varför skulle kunna användas som en grund för vidare forskning

Gemenskap i bröd och kropp : En kontextuell analys av Första Korinthierbrevet 10:17

In First Corinthians, Paul tries to convince his readers to stay faithful to their congregation and to work together to achieve unity and solidarity within their Christian context. In 8:1 - 11:1, he warns them of the secular temptation to participate in polytheist temples and to take part in the pagan meals there. My main question in this essay is to examine what Paul means that the people in the congregation are ”one body”. How is that possible by sharing the one loaf? Christians share their unity in the worship of God and cannot, Paul asserts, at the same time accept invitations to dine in the pagan temple because that is the same thing as sharing the worship of pagans. Nevertheless, Paul is using the exact same model for unity - κοινωνία - that was the tradition of the ancient Hellenistic-Roman context. Throughout this essay, I will try to describe for the view of difficulties within a Christian context and how this unity is expressed in the community of Corinth in the light of the secular surroundings.