Swedish District Nurses’ Attitudes to Implement Information and Communication Technology in Home Nursing

The use of information and communication technology has increased in the society, and can be useful in nursing care. The aim of this study was to describe district nurses’ attitudes regarding the implementation of information and communication technology in home nursing. The first and third authors performed five focus group discussions with 19 district nurses’ from five primary healthcare centres in northern Sweden. During the focus group discussions, the following topics were discussed: the current and future use of information and communication technology in home nursing; expectations, advantages, disadvantages and hindrances in the use of information and communication technology in home nursing; and the use of information and communication technology from an ethical perspective. The transcribed focus group discussions were analysed using qualitative content analysis. The results showed that district nurses’ attitudes were positive regarding the use of information and communication technology in their work. They also asked for possibilities to influence the design and its introduction. However, the use of information and communication technology in home nursing can be described as a complement to communication that could not replace human physical encounters. Improvements and risks, as well as the importance of physical presence in home nursing were considered vital. The results revealed that the use of information and communication technology requires changes in the district nurses’ work situation

Swedish District Nurses’ Attitudes to Implement Information and Communication Technology in Home Nursing

The use of information and communication technology has increased in the society, and can be useful in nursing care. The aim of this study was to describe district nurses’ attitudes regarding the implementation of information and communication technology in home nursing. The first and third authors performed five focus group discussions with 19 district nurses’ from five primary healthcare centres in northern Sweden. During the focus group discussions, the following topics were discussed: the current and future use of information and communication technology in home nursing; expectations, advantages, disadvantages and hindrances in the use of information and communication technology in home nursing; and the use of information and communication technology from an ethical perspective. The transcribed focus group discussions were analysed using qualitative content analysis. The results showed that district nurses’ attitudes were positive regarding the use of information and communication technology in their work. They also asked for possibilities to influence the design and its introduction. However, the use of information and communication technology in home nursing can be described as a complement to communication that could not replace human physical encounters. Improvements and risks, as well as the importance of physical presence in home nursing were considered vital. The results revealed that the use of information and communication technology requires changes in the district nurses’ work situation

Märkning av importerade, färdigförpackade livsmedel i Malmö stad - Uppfyller butikerna Livsmedelsverkets märkningskrav?

Syftet med detta arbete är att undersöka efterlevnaden av lagen gällande märkning av importerade färdigförpackade livsmedel hos livsmedelsbutiker i Malmö. 20 butiker studerades. Vid besöken granskades dels märkning av ett antal importerade färdigförpackade livsmedel, och dels utfördes enkätundersökning kring butikens livsmedelsmärkning och märkningsrutiner. Enkätundersökningen besvarades vanligtvis av ägare eller butikschef. 80 procent av svarandena uppgav att de kände till Livsmedelsverkets regler kring märkning, men ändå fanns det saknade uppgifter och bristfällig märkning i alla butikerna. De vanligast saknade märkningsuppgifterna var svensk beteckning och den svenska formuleringen "bäst före ...". Svensk beteckning saknades hos 42 procent av produkterna, medan "bäst före ..." saknades hos 40 procent. 27 procent av alla de undersökta produkterna saknade helt svensk märkning. De som i enkätundersökningen uppgav att de alltid hade svensk märkning hade mycket sällan det när man jämförde det med resultaten från märkningsgranskningen. I enkätsvaren fanns svar som speglade många butiksägares inställning att de såg grossisten som ansvarig för märkning, trots att butiksägaren enligt Livsmedelsverkets regler är den ansvarige. De allra flesta uppgav att de hade fått information om märkning från livsmedelsinspektörer, så enbart mer information om märkning hjälper sannolikt inte för att stävja problemet.The purpose of this thesis is to examine the compliance of the labeling law of imported prepackaged foods in grocery stores in Malmö. 20 stores were studied. During the visits the labels of a number of imported pre-packaged foods were examined, and there was also a survey conducted about the store's food labels and their labeling rutines. The survey was usually answered by the owner or store manager. 80 percent of the respondents answered that they knew of the National Food Administration’s rules about labeling, but there were missing information and inadequate labeling in all stores. The most commonly missing labeling information was Swedish designation and the words "best before ..." in Swedish. Swedish designation was missing in 42 percent of the products, while "best before ..." was missing in 40 percent. 27 percent of all the examined products didn’t have any Swedish labels at all. Those in the survey who said that they always had Swedish labels, very rarely had so when reviewing the results of the labeling examination. In the survey responses there were answers which reflected many store owners' attitude that they saw the wholesaler as responsible for the labeling, even though the store owner is the one responsible according to the National Food Administration’s rules. The vast majority answered that they had received information about labeling from food inspectors, so just more information about labeling will unlikely help to curb the problem

Linser, sojabönor och trädgårdsbönor

Linser, sojabönor och trädgårdsbönor var bland de första grödorna som domesticerades när människan övergick till jordbrukssamhälle. Idag odlas växtslagen på vitt skilda platser i världen, med sorter anpassade till helt olika odlingssäsonger och klimatförhållanden. Odling av växtslagen är fullt möjlig i Sydsverige. I dagens Sverige odlas dock enbart ett av dessa växtslag kommersiellt, nämligen trädgårdsbönan (Phaseolus vulgaris), i form av de traditionella bruna bönorna. Denna litteraturstudie undersöker odlingskraven för de valda växtslagen, visar resultat från försöksodlingar på Öland och i grannlandet Danmark, tar upp klimathärdiga sorter som är lämpade för produktion på nordliga breddgrader, samt diskuterar slutligen faktorer som skulle kunna bidra till en framtida svensk odling av linser, sojabönor och fler sorters trädgårdsbönor

Characterization of apple cultivars : for the production of juice and cider

The purpose of this study was to evaluate which apple cultivars are best suited for production of juice and cider. The study was limited to 41 cultivars. Common as well as uncommon apple cultivars were selected from available cultivars in the cold storage at Balsgård, Department of Horticultural Plant Breeding and Biotechnology, SLU. The practical part of the study consisted of the apples being pressed, and then the juice characteristics being assessed by appropriate criteria and methods of analysis. The analyses consisted of measurment of soluble sugars with a refractometer (Brix), titration of total acidity, determination of total phenolic content with a spectrophotometer, estimation of alcohol content by density meters and qualitative taste tests. The study did not account for different maturity of cultivars. Different apple cultivars were pressed on separate occasions, before and after Christmas 2010. Some cultivars may have been at their most appropriate level of maturity, while others may have been less suitable because of low or high maturity. This is one among several factors that likely have influenced the results. Despite this a general result of the study was that the panel gave the highest appreciation for the cultivars that they rated as the sweetest, and the lowest to the cultivars that they rated as most acidic. This was identical in the taste assessments of both juice and cider. The most popular cultivars as juice were Wilhelmine, Kaiser Wilhelm, Schöner aus Nordhausen and Cox's Orange Red. The least popular cultivars as juice were Wellington, Mutsu, East Malling and Adamsparmän. The most popular cultivars as cider were NY 45500-3, Mutsu, McIntosh Cornell and East Malling. The least popular cultivars as cider were Wellington, Queen Cox, Kaiser Wilhelm and John Standish. Apple cultivars varied widely, in both biochemical content and other more qualitative properties. This rich variaton can be used to select cultivars and develop products with different flavor profiles. The results of this study demonstrated that the perception of sweetness and acidity are among the most important characteristics. With the help of a wide range of different cultivars, it is possible to blend juices and ciders that have optimum content of sugars and acids. The taste evaluation showed a wide range of other perceived flavors, including many which were interesting and enjoyable. To get a rich and full-flavoured beverage, it is suitable to blend cultivars with different complementary flavors, so that the final beverage naturally have a wide range of appealing flavors. Swedish apple cultivation, as well as juice and cider making, could benefit from being more observant to consumer preferences and the properties of the different apple cultivars. There is much room for improvement in this field. Many other countries have a cultivation that is much more focused on specific cultivars for different processing purposes. In order to more optimally meet consumer taste preferences, this would also be strived for in Sweden.Syftet med detta arbete var att utvärdera vilka äpplesorter som passar bäst till juice- respektive ciderframställning. För överskådlighet så begränsades undersökningen till 41 sorter. Kända såväl som okända äpplesorter valdes ut från det sorturval som fanns att tillgå i kyllagret på Balsgård, Enheten för Hortikulturell Växtförädling vid Området Växtförädling och Bioteknik, SLU. Den praktiska undersökningen utgjordes av att äpplesorter pressades och att mustens egenskaper sedan bedömdes utifrån lämpliga kriterier och analysmetoder. Analysmetoderna utgjordes av mätning med refraktometer (Brix), titrering (totalsyrahalt), spektrofotometer (totalfenolhalt), alkoholberäkning och kvalitativa smaktester. Studien tog inte hänsyn till sorternas olika mognadstider. Äpplesorterna pressades vid två olika tillfällen, innan och efter jul 2010. Vissa sorter kan då ha varit i allra lämpligast mognadsgrad, medan andra kan ha varit mindre lämpade på grund av låg eller hög mognad. Detta är en faktor som naturligtvis påverkar undersökningens resultat. Dock kan man generellt se att panelen gav högst gillande till den sort som de betygsatt som sötast, samt lägst betyg till den sort som de betygsatt som syrligast. Detta var likadant i smakbedömning av både juice och cider. Mest omtyckta som juice var Wilhelmine, Kaiser Wilhelm, Schöner aus Nordhausen och Röd Cox Orange. Minst omtyckta som juice var Wellington, Mutsu, East Malling och Adamsparmän. Mest omtyckta som cider var NY 45500-3, Mutsu, McIntosh Cornell och East Malling. Minst omtyckta som cider var Wellington, Queen Cox, Kaiser Wilhelm och John Standish. Äpplesorterna varierade stort i såväl innehåll som i andra egenskaper. Den rika variationen kan med fördel användas för att välja ut och tillverka juice och cider med olika smakprofiler. Resultaten från studien visade att upplevelsen av sötma och syrlighet är bland de allra viktigaste egenskaperna. Med hjälp av ett stort urval olika sorter kan man således blanda juice och cider som har optimalt innehåll av socker och syror. I smaktestet kom det dessutom fram en lång rad andra uppfattade aromer, varav vilka många var intressanta och angenäma. För att få en rik och fyllig karaktär är det lämpligt att blanda sorter med olika kompletterande aromer, så att den slutliga drycken naturligt får ett brett spektrum av tilltalande smaker. Svensk äppleodling, samt juice- och cidertillverkning, skulle kunna tjäna på att bli mer uppmärksam på konsumenternas preferenser och de olika äpplesorternas kvaliteter. Här finns det mycket att förbättra. Många andra länder har en odling som är betydligt mer inriktad på specifika sorter för olika vidareförädlingsändamål. För att mer optimalt uppfylla konsumenternas önskemål om smak så är detta önskvärt även i Sverige

Primary healthcare in transition – a qualitative study of how managers perceived a system change

BACKGROUND: Primary healthcare in Sweden has undergone widespread reforms in recent years, including freedom of choice regarding provider, freedom of establishment and increased privatisation. The key aims of the reforms were to strengthen the role of the patient and improve performance in terms of access and responsiveness. The aim of this study was to explore how managers at publicly owned primary healthcare centres perceived the transition of the primary healthcare system and the impact it has had on their work. METHODS: In this qualitative study, 24 managers of publicly owned primary healthcare centres in the metropolitan region of Gothenburg were recruited. Semi-structured interviews were conducted and data were analysed using content analysis inspired by Silverman. RESULTS: The analysis revealed two core themes: The transition is perceived as a rapid change, enforced mainly through financial incentives and Prioritisation conflicts arise between patient groups with different needs, demands and levels of empowerment. The transition has produced powerful and rapid effects that were considered to be both positive and negative. While the new financial incentives were seen as a driving force and a tool for change, they also became a stress factor due to uncertainty, competition with other primary healthcare centres and negative feelings associated with staff cutbacks. The shift in power towards the patient improved access and service but also led to more patients with unreasonable demands. Managers found it difficult to prioritise correctly between patient groups with different needs, demands and levels of empowerment and they were concerned about potentially negative effects on less empowered patients, e.g. multi-morbid patients. Managers also experienced shortcomings in their change management skills. CONCLUSIONS: This qualitative study shows the complexity of the system change and describes the different effects and perceptions of the transition from a manager’s perspective. This suggests a need for improved follow-up and control in order to monitor and govern system changes and ensure development towards a more effective and sustainable primary healthcare system

Prevalence, type, and reasons for missed nursing care in municipality health care in Sweden – A cross sectional study

Background With an ageing population, there is an increasing need for care, both as home care and in nursing homes. However, some needed care is not carried out for different reasons, which can affect patient safety. The aim of the study was to describe prevalence, type, and reasons for missed nursing care in home care and nursing homes, from nurses’ perspective. Methods A cross sectional design with quantitative and qualitative approach. A Swedish version of Basel Extent of Rationing of Nursing Care for nursing homes and 15 study specific questions were answered by 624 registered nurses, enrolled nurses, or nurse assistants. Both descriptive and analytical, independent-samples t-test, analyses were used. Qualitative content analysis was used for the open-ended question. Results The care activity most often missed in home care was: ‘set up or update care plans’ (41.8%), and in nursing homes: ‘scheduled group activity’ (22.8%). Reasons for missed nursing care were lack of preparedness for unexpected situations, obstacles in a deficient work environment, unsatisfactory planning in the organisation, and/or shortcomings related to the individual. Conclusion Not all care activities needed are performed, due to reasons such as lack of time or organisational issues. Missed nursing care can lead to adverse events and affect patient safety. It is important to be aware of missed nursing care and the reasons for it, which gives a possibility to initiate quality improvement work to ensure patient safety.publishedVersio

Comparison of Measurements of Autoantibodies to Glutamic Acid Decarboxylase and Islet Antigen-2 in Whole Blood Eluates from Dried Blood Spots Using the RSR-Enzyme Linked Immunosorbent Assay Kits and In-House Radioimmunoassays

To evaluate the performance of dried blood spots (DBSs) with subsequent analyses of glutamic acid decarboxylase (GADA) and islet antigen-2 (IA-2A) with the RSR-ELISAs, we selected 80 children newly diagnosed with type 1 diabetes and 120 healthy women. DBSs from patients and controls were used for RSR-ELISAs while patients samples were analysed also with in-house RIAs. The RSR-ELISA-GADA performed well with a specificity of 100%, albeit sensitivity (46%) was lower compared to in RIA (56%; P = .008). No prozone effect was observed after dilution of discrepant samples. RSR-ELISA-IA-2A achieved specificity of 69% and sensitivity was lower (59%) compared with RIA (66%; P < .001). Negative or low positive patients and control samples in the RSR-ELISA-IA-2A increased after dilution. Eluates from DBS can readily be used to analyse GADA with the RSR-ELISA, even if low levels of autoantibodies were not detected. Some factor could disturb RSR-ELISA-IA-2A analyses

Prevalence, type, and reasons for missed nursing care in municipality health care in Sweden – A cross sectional study

Background With an ageing population, there is an increasing need for care, both as home care and in nursing homes. However, some needed care is not carried out for different reasons, which can affect patient safety. The aim of the study was to describe prevalence, type, and reasons for missed nursing care in home care and nursing homes, from nurses’ perspective. Methods A cross sectional design with quantitative and qualitative approach. A Swedish version of Basel Extent of Rationing of Nursing Care for nursing homes and 15 study specific questions were answered by 624 registered nurses, enrolled nurses, or nurse assistants. Both descriptive and analytical, independent-samples t-test, analyses were used. Qualitative content analysis was used for the open-ended question. Results The care activity most often missed in home care was: ‘set up or update care plans’ (41.8%), and in nursing homes: ‘scheduled group activity’ (22.8%). Reasons for missed nursing care were lack of preparedness for unexpected situations, obstacles in a deficient work environment, unsatisfactory planning in the organisation, and/or shortcomings related to the individual. Conclusion Not all care activities needed are performed, due to reasons such as lack of time or organisational issues. Missed nursing care can lead to adverse events and affect patient safety. It is important to be aware of missed nursing care and the reasons for it, which gives a possibility to initiate quality improvement work to ensure patient safety.publishedVersio

Two tales of cardiovascular risks – middle-aged women living in Sweden and Scotland – a cross-sectional comparative study.

OBJECTIVES: To compare cardiovascular risk factors as well as rates of cardiovascular diseases in middle-aged women from urban areas in Scotland and Sweden. DESIGN: Comparative cross-sectional study. SETTING: Data from the general population in urban areas of Scotland and the general population in two major Swedish cities in southeast Sweden, south of Stockholm. PARTICIPANTS: Comparable data of middle-aged women (40-65 years) from the Scottish Health Survey (n=6250) and the Swedish QWIN study (n=741) were merged together into a new dataset (n=6991 participants). MAIN OUTCOME MEASURE: We compared middle-aged women in urban areas in Sweden and Scotland regarding risk factors for cardiovascular disease (CVD), CVD diagnosis, anthropometrics, psychological distress and lifestyle. RESULTS: In almost all measurements, there were significant differences between the countries, favouring the Swedish women. Scottish women demonstrated a higher frequency of alcohol consumption, smoking, obesity, low vegetable consumption, a sedentary lifestyle and also more psychological distress. For doctor-diagnosed coronary heart disease, there were also significant differences, with a higher prevalence among the Scottish women. CONCLUSIONS: This is one of the first studies that clearly shows that Scottish middle-aged women are particularly affected by a worse profile of CVD risks. The profound differences in CVD risk and outcome frequency in the two populations are likely to have arisen from differences in the two groups of women's social, cultural, political and economic environments.Funding agencies: Swedish Heart and Lung Association [E136-15/E106/13]; Clinic ALF funds, Region Ostergotland, Sweden [LiO-446241]; Research and PhD studies Committee (FUN), Linkoping University, Sweden [LiU-2014-020251]</p