Astrobiology and Society in Europe Today

This book describes the state of astrobiology in Europe today and its relation to the European society at large. With contributions from authors in more than 20 countries and over 30 scientific institutions worldwide, the document illustrates the societal implications of astrobiology and the positive contribution that astrobiology can make to European society. The book has two main objectives: 1. It recommends the establishment of a European Astrobiology Institute (EAI) as an answer to a series of challenges relating to astrobiology but also European research, education, and society at large. 2. It also acknowledges the societal implications of astrobiology, and thus the role of the social sciences and humanities in optimizing the positive contribution that astrobiology can make to the lives of the people of Europe and the challenges they face

A refamilialized system? An analysis of recent developments of personal assistance in Sweden

The Swedish system of disability support is often praised for its comparably well-developed Personal Assistance (PA) scheme. PA is formally prescribed as a social right for disabled people with comprehensive support needs in the Act Concerning Support and Services to Persons with Certain Functional Impairments (LSS). In the decade following the introduction of LSS in 1994, the PA-scheme expanded steadily to accommodate the support needs of more and more disabled people. It is commonly believed that the expansion of PA has substantially boosted the agency of both disabled people and their relatives. This article critically discusses in what direction the Swedish system of disability support has moved in the past decade. Is the common image of a system moving towards an ever increasing defamilialization of disability support still accurate? Or are there signs of stagnation, or even reversal towards refamilialization? What are the possible consequences of the more recent developments for disabled people and their relatives in terms of agency and equality? These questions will be discussed with the help of an analysis of the regulatory framework of disability support, statistical data and findings from public reports

Implementing a continuum of care model for older people—results from a Swedish case study

Introduction: There is a need for integrated care and smooth collaboration between care-providing organisations and professions to create a continuum of care for frail older people. However, collaboration between organisations and professions is often problematic. The aim of this study was to examine the process of implementing a new continuum of care model in a complex organisational context, and illuminate some of the challenges involved. The introduced model strived to connect three organisations responsible for delivering health and social care to older people: the regional hospital, primary health care and municipal eldercare.Methods: The actions of the actors involved in the process of implementing the model were understood to be shaped by the actors' understanding, commitment and ability. This article is based on 44 qualitative interviews performed on four occasions with 26 key actors at three organisational levels within these three organisations.Results and conclusions: The results point to the importance of paying regard to the different cultures of the organisations when implementing a new model. The role of upper management emerged as very important. Furthermore, to be accepted, the model has to be experienced as effectively dealing with real problems in the everyday practice of the actors in the organisations, from the bottom to the top

How Will the Emerging Plurality of Lives Change How We Conceive of and Relate to Life?

The project “A Plurality of Lives” was funded and hosted by the Pufendorf Institute for Advanced Studies at Lund University, Sweden. The aim of the project was to better understand how a second origin of life, either in the form of a discovery of extraterrestrial life, life developed in a laboratory, or machines equipped with abilities previously only ascribed to living beings, will change how we understand and relate to life. Because of the inherently interdisciplinary nature of the project aim, the project took an interdisciplinary approach with a research group made up of 12 senior researchers representing 12 different disciplines. The project resulted in a joint volume, an international symposium, several new projects, and a network of researchers in the field, all continuing to communicate about and advance the aim of the project

Fidelity and moderating factors in complex interventions: a case study of a continuum of care program for frail elderly people in health and social care

<p>Abstract</p> <p>Background</p> <p>Prior studies measuring fidelity of complex interventions have mainly evaluated adherence, and not taken factors affecting adherence into consideration. A need for studies that clarify the concept of fidelity and the function of factors moderating fidelity has been emphasized. The aim of the study was to systematically evaluate implementation fidelity and possible factors influencing fidelity of a complex care continuum intervention for frail elderly people.</p> <p>Methods</p> <p>The intervention was a systematization of the collaboration between a nurse with geriatric expertise situated at the emergency department, the hospital ward staff, and a multi-professional team with a case manager in the municipal care services for older people. Implementation was evaluated between September 2008 and May 2010 with observations of work practices, stakeholder interviews, and document analysis according to a modified version of The Conceptual Framework for Implementation Fidelity.</p> <p>Results</p> <p>A total of 16 of the 18 intervention components were to a great extent delivered as planned, while some new components were added to the model. No changes in the frequency or duration of the 18 components were observed, but the dose of the added components varied over time. Changes in fidelity were caused in a complex, interrelated fashion by all the moderating factors in the framework, i.e., context, staff and participant responsiveness, facilitation, recruitment, and complexity.</p> <p>Discussion</p> <p>The Conceptual Framework for Implementation Fidelity was empirically useful and included comprehensive measures of factors affecting fidelity. Future studies should focus on developing the framework with regard to how to investigate relationships between the moderating factors and fidelity over time.</p> <p>Trial registration</p> <p>ClinicalTrials.gov, <a href="http://www.clinicaltrials.gov/ct2/show/NCT01260493">NCT01260493</a>.</p

Elderly persons in the risk zone. Design of a multidimensional, health-promoting, randomised three-armed controlled trial for "prefrail" people of 80+ years living at home

Background The very old (80+) are often described as a "frail" group that is particularly exposed to diseases and functional disability. They are at great risk of losing the ability to manage their activities of daily living independently. A health-promoting intervention programme might prevent or delay dependence in activities of daily life and the development of functional decline. Studies have shown that those who benefit most from a health-promoting and disease-preventive programme are persons with no, or discrete, activity restrictions. The three-armed study "Elderly in the risk zone" is designed to evaluate if multi-dimensional and multi-professional educational senior meetings are more effective than preventive home visits, and if it is possible to prevent or delay deterioration if an intervention is made when the persons are not so frail. In this paper the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants are presented. Methods/Design The study is a randomised three-armed single-blind controlled trial with follow-ups 3 months, 1 and 2 years. The study group should comprise a representative sample of pre-frail 80-year old persons still living at home in two municipalities of Gothenburg. To allow for drop-outs, it was estimated that a total of about 450 persons would need to be included in the study. The participants should live in their ordinary housing and not be dependent on the municipal home help service or care. Further, they should be independent of help from another person in activities of daily living and be cognitively intact, having a score of 25 or higher as assessed with the Mini Mental State Examination (MMSE). Discussion We believe that the design of the study, the randomisation procedure, outcome measurements and the study protocol meetings should ensure the quality of the study. Furthermore, the multi-dimensionality of the intervention, the involvement of both the professionals and the senior citizens in the planning of the intervention should have the potential to effectively target the heterogeneous needs of the elderly. Trial registration ClinicalTrials.gov, NCT0087705

To maintain control: Negotiations in the everyday life of older people who can no longer manage on their own.

The general aim of this thesis is to reach a more insightful understanding of how help is actually worked out in the everyday life of older people when they can no longer manage on their own. The overall research question is how individuals, representing different perspectives in the help arrangement process, think and act in order to organise needed help as well as how they may themselves apprehend the functions of the help. It is a qualitative study, containing four papers looking at this issue from different perspectives: the older persons themselves, their next of kin who provide help and the municipal care managers who make decisions on formal help. The empirical material consists of qualitative interviews and participant observations with care managers, qualitative interviews with older people applying for formal eldercare, follow-up interviews with some of them and qualitative interviews with next of kin who provide help. The analysis of the material adopts an empirically oriented approach, involving several steps from open to focused coding. Earlier research and theory guided the analysis. The results show that older people strive to maintain control over their everyday life (Paper I). When they can no longer manage unaided, they use various strategies to maintain control and the feeling of autonomy. Wellfunctioning formal and informal networks (Paper III) allow individuals to sustain autonomy and control in old age even when they have to depend on help from others. The care managers endeavour to make both ends meet in the decision process (Paper II). They develop various techniques and struck a balance between diverse demands and expectations. Helping an older relative is connected with a multiplicity of motives and experiences (Paper IV). The next of kin act both as bridges and buffers between their older relative and formal eldercare. This thesis emphasises the important functions of both formal and informal help to older people. To outline the working forms and methods of collaboration between older people and their informal and formal support networks is an important challenge that needs further attention

Kollegiegranskning av biståndsbedömningen inom äldreomsorgen

Yrkesgruppen biståndsbedömare är tämligen ny inom äldreomsorgen och tillkom i samband med omorganisationer under främst 1990-talet. Omorganisationerna innebar att bedömning och beslut kring de äldres rätt till bistånd skiljdes från ansvaret för själva utförandet av biståndsinsatserna. De myndighetsutövande arbetsuppgifterna, att bedöma och besluta kring äldre och funktionshindrades rätt till bistånd, har dock funnits alltsedan socialtjänstlagens tillkomst 1982 men då tillsammans med arbetsledaruppgifter och verksamhetsansvar. Tillkomsten av särskilda biståndsbedömare innebar en renodling av arbetsuppgifterna vilket man hoppades skulle föra med sig ”en mer professionell biståndsbedömning”. Yrkesgruppen har stått i fokus sedan dess och önskemål om fortbildning och stöd i yrkesrollen har framförts. Genomförandet av en kollegiegranskning inom området är ett led i det stöd som erbjuds yrkesgruppen genom Äldre Väst Sjuhärad