Att nyanlända till landsbygden

De senaste åren har många flyktingar kommit till Sverige och en del av dem som får uppe-hållstillstånd, i den här uppsatsen benämnda nyanlända, placeras ut i mindre orter på lands-bygden. Syftet med studien är att undersöka hur det är att komma som nyanländ till en lands-bygdsort i Sverige och vilka möjligheter och svårigheter man möter där den första tiden. Det är en kvalitativ studie som bygger på fenomenologiska intervjuer med nyanlända, deras fadd-rar och integrationssamordnaren i Mörbylånga kommun på Öland. De nyanlända har av olika anledningar begränsade möjligheter att påverka vart i Sverige de blir bosatta vilket upplevs som problematiskt. De upplever också fysisk, social och språklig isolering som blir extra stor i landsbygdens specifika kontext. Stor medial uppmärksamhet på flyktingsituationen gör att flyktingskapet blir ett stigma som påverkar relationen mellan nyanlända och andra, vilket syns särskilt tydligt i fadderrelationen. Tillsammans kan de ovanstående faktorerna bidra till en känsla av liminality, mellanrum i tillvaron, där de nyanlända ännu inte är framme utan på olika sätt fortsätter att vara flyktingar och vara på väg.During the last years many refugees has come to Sweden and some of them who get residence permit, in this thesis called “new arrivals”, end up in rural areas. The aim of this study is to look into how “new arrivals” experience their first time in rural areas and what difficulties and possibilities they meet there. The thesis is qualitative and based on phenomenological inter-views with “new arrivals”, locals involved in the welcome and the integration coordinator in Mörbylånga municipality on Öland. Due to different reasons the “new arrivals” experience limited possibilities to influence where in Sweden they will settle which is considered problematic. They also experience physical, social and language orientated isolation that is amplified in the specific rural context. Big media attention on refugees creates a stigma that complicates the relation between “new arrivals” and other locals. All together the circumstances mentioned above result can contribute to a feeling of liminality - being in between different parts of life. In some ways the “new arrivals” remain “new arrivals” who not yet reached their final destination

Water, an unlimited resource? : a study of municipal collaboration around water access in river catchments

Vatten är en livsviktig resurs som vi i Sverige har relativt mycket av men under 2016 och 2017 var låga vattennivåer ett bekymmer i stora delar av landet. Pågående klimatförändringar kan medföra att perioder med vattenbrist blir vanligare i framtiden vilket pekar på behov av god planering och förvaltning av resursen. En viktig aktör i det arbetet är kommunerna som ansvarar för större delen av befolkningens dricksvattenförsörjning och planerar för hur mark- och vatten ska användas. Men vattnet rör sig över kommungränser och kommunerna behöver därför samverka med varandra för att säkra tillgången till vatten för sina kommuninvånare. Syftet med den här studien är att undersöka kommuners möjligheter att samverka över geografiska och organisatoriska gränser för att säkra tillgången till vatten. Genom intervjuer med kommuntjänstemän har samverkan mellan och inom nio kommuner i två avrinningsområden i sydöstra Sverige undersökts. I båda avrinningsområdena finns en organisation för samverkan mellan kommuner och andra aktörer. En av organisationerna har mer resurser än den andra och anställd personal och därav större möjligheter att genomföra viktiga åtgärder, samtidigt som kommuntjänstemännens delaktighet är mindre. I båda organisationerna deltar också andra aktörer som kraftverk, industrier och lantbrukare. Genom tillstånd för reglering och vattenuttag har näringsidkarna lika stort inflytande över vattnet som kommunerna, vilket kan försvåra kommunernas arbete med att säkra tillgången till dricksvatten för kommuninvånarna. Trots de båda samverkansorganisationerna samverkar flera av tjänstemännen i studien mer med andra kommuner i samma län än i samma avrinningsområde. Det krävs också samverkan mellan olika avdelningar inom kommunerna som hanterar vattenfrågor för att hindra att de faller mellan stolarna, framförallt i större kommuner. Studien visar också att ett stort hinder för samverkan är att de kostar mycket tid och kommunerna behöver fundera över hur mycket tid som behöver investeras för att säkra tillgången till vatten i framtiden.Water is a vital resource, in Sweden often taken for granted but in 2016 and 2017, low water levels became a concern in some parts of the country. Ongoing climate change may lead to more frequent periods of water scarcity in the future, which calls for good planning and management of the water resource. In this work the municipalities play an important role as responsible for most of the population's drinking water supply, land use and water planning. However, water does not follow municipal boundaries, and municipalities need to collaborate with each other to ensure access to water for their residents. The purpose of this study is to investigate the ability of municipalities to collaborate across geographical and organizational boundaries to ensure access to water. In this study collaboration between and within nine municipalities in two river catchments in southeast Sweden is investigated through interviews with municipal officials. In both river catchments there are an organization for collaboration among municipalities and other parties. One of the organizations has more resources than the other and also employed staff. Hence, they can carry out more activities but at the same time the involvement of municipal officials is lower than in the other organization. In both organizations, other parties than municipalities like power plants, industries and farmers participate. With permits for regulation and water withdrawals, they have as much influence over the water as municipalities, which can complicate municipalities' efforts to secure access to drinking water for municipal residents. Despite the two collaborative organizations, several of the officials in the study cooperate more with other municipalities in the same county than in the same river basin. There is also a need for collaboration between different departments within the municipalities working with water issues, to prevent them from being overlooked, especially in larger municipalities. A major barrier to cooperation is that it is time consuming and the municipalities need to consider how much time they want to invest in collaboration to ensure access to water in the future

Reactions of Persons with Dementia to Caregivers Singing in Morning Care Situations

’Music therapeutic caregiving’, when caregivers sing for or together with persons with severe dementia during care situations, has been suggested as a way to reduce problematic behaviors in dementia care. The present study implemented this technique as an intervention in dementia care. Six caregivers participated in group interviews about their experiences of morning care situations without and with’Music therapeutic caregiving’. Through a qualitative content analysis two themes emerged.’Being in a different reality’ was based on’usual’ morning care situations. The caregivers’ experienced the persons with dementia as absent-minded; communication and cooperation were difficult. The second theme,’Being present’, was based on morning care situations with the intervention. The caregivers described communication as enhanced; the persons with dementia expressed themselves more appropriately, making cooperation possible. The results indicate that’Music therapeutic caregiving’ might lead to a more positive experience of the person with dementia and seems to increase receptivity to caregiving

Producing Feedstock for Biofuels: Land-Use and Local Environmental Impacts

This report covers Chalmers responsibilities for subtask 1.3 - land-use patterns as well as parts of subtask 3.4 – data for other environmental impacts, in the EU Biofuel Baseline projec

Associations between sleep quality and biomarkers for neurodegeneration - A longitudinal one-year case-control study of patients with bipolar disorder and healthy control individuals

Disturbed sleep during affective episodes may impact levels of cerebrospinal fluid (CSF)-amyloid-beta (Aβ)42 and other biomarkers of neurodegeneration in patients with bipolar disorder (BD). The study aimed to investigate the correlations between sleep and biomarkers for Alzheimer's disease (AD) and neurodegeneration in BD and healthy controls (HC). We present a prospective, longitudinal case-control study of euthymic patients with BD (N ​= ​86) and HC (N ​= ​44). All participants were evaluated with clinical assessments at baseline, and after a year. The patients’ affective states were recorded weekly as euthymic, subthreshold level, major depression, or (hypo)mania. Patients were re-assessed during and after an episode if it occurred during follow-up. Total sleep scores based on three Hamilton-17 Depression Scale items were analyzed in relation to concentrations of CSF-Aβ42, CSF-Aβ40, CSF-Aβ38, CSF-Aβ42/40 and 42/38 ratios, CSF-soluble amyloid-precursor proteins α+β, plasma-Aβ42, plasma-Aβ40, CSF-phosphorylated-tau, CSF-total-tau, plasma-total-tau, CSF-neurofilament-light, plasma-neurofilament-light, CSF-neurogranin, serum-S100B, CSF-8-oxo-7,8-dihydro-guanosine, CSF-8-oxo-7,8-dihydro-2′-deoxyguanosine, urine-8-oxo-7,8-dihydro-guanosine, and urine-8-oxo-7,8-dihydro-2′-deoxyguanosine. The primary outcome was the association between total sleep scores and levels of CSF-Aβ42 at baseline and follow-up estimated by the regression coefficient in a linear mixed model. We found no statistically significant associations between sleep and CSF-Aβ42 (−2.307 ​pg/ml (95% CI: -9.525–4.911; p ​= ​0.523)) or any other biomarkers. However, higher sleep scores appeared to be associated with higher CSF-Aβ42/40 and CSF-Aβ42/38 ratios, and lower CSF-total-tau concentration, but were not statistically significant after correction for multiple testing. In conclusion attenuated sleep during an affective episode was not associated with changes in biomarkers for AD and neurodegeneration in BD, but larger prospective studies are needed

High prevalence of neurodevelopmental problems in adolescents eligible for bariatric surgery for severe obesity.

AIM: To assess the prevalence of neurodevelopmental problems in adolescents with severe obesity and their associations with binge eating and depression. METHODS: Data were collected at inclusion in a randomised study of bariatric surgery in 48 adolescents (73% girls; mean age 15.7 ± 1.0 years; mean body mass index 42.6 ± 5.2 kg/m2 ). Parents completed questionnaires assessing their adolescents' symptoms of attention-deficit/hyperactivity disorder and autism spectrum disorder and reported earlier diagnoses. Patients answered self-report questionnaires on binge eating and depressive symptoms. RESULTS: The parents of 26/48 adolescents (54%) reported scores above cut-off for symptoms of the targeted disorders in their adolescents, but only 15% reported a diagnosis, 32% of adolescents reported binge eating, and 20% reported symptoms of clinical depression. No significant associations were found between neurodevelopmental problems and binge eating or depressive symptoms. Only a third of the adolescents reported no problems in either area. CONCLUSION: Two thirds of adolescents seeking surgical weight loss presented with substantial mental health problems (reported by themselves or their parents). This illustrates the importance of a multi-professional approach and the need to screen for and treat mental health disorders in adolescents with obesity

Effects of supervision on tax compliance:Evidence from a field experiment in Austria

We conduct a field experiment on tax compliance, focusing on newly founded firms. As a novelty the effect of tax authorities’ supervision on timely tax payments is examined. Interestingly, results show no positive overall effect of close supervision on tax compliance

A randomized controlled trial comparing intensive non-surgical treatment with bariatric surgery in adolescents aged 13-16 years (AMOS2): Rationale, study design, and patient recruitment.

BACKGROUND: Previous non-randomized studies show similar outcomes in adolescents and adults after bariatric surgery. We describe the study protocol, recruitment, and selected baseline data of patients in a randomized multi-center study, the Adolescent Morbid Obesity Surgery 2 (AMOS2). METHODS: Three clinics in Sweden collaborated in designing the study and recruitment of patients from August 1, 2014 to June 30, 2017. Patients were selected among adolescents 13-16 years of age attending third-level obesity care for at least one year. Patients were randomized 1:1 to bariatric surgery (predominantly Roux-en-Y gastric bypass) or intensive non-surgical treatment starting with an eight-week low-calorie-diet. RESULTS: Fifty adolescents (37 girls) were randomized, 25 (19 girls) to bariatric surgery. Mean age was 15.7 years (range 13.3-16.9), weight 122.6 kg (range 95-183.3), Body Mass Index (BMI) 42.6 kg/m2 (range 35.7-54.9) and BMI-SDS 3.45 (range 2.9-4.1). One patient had type 2 diabetes mellitus, and 12/45 (27%) had elevated liver enzymes. There were no significant differences between the groups. For the 39 eligible patients who were offered but declined inclusion, BMI was not different from included patients. However, patients who declined were younger, 15.2 years (p = 0.021). A sex difference was also noted with more of eligible girls, 37/53 (69.8%), than boys, 13/36 (36.1%), wanting to participate in the study (p = 0.002). CONCLUSIONS: This clinical trial, randomizing adolescents with severe obesity to bariatric surgery or intensive non-surgical treatment, aims at informing about whether it is beneficial to undergo bariatric surgery in early adolescence. It will also enlighten the outcome of comprehensive non-surgical treatment. The study was registered at www.clinicalTrials.gov number NCT02378259

Serum perfluoroalkyl substances in residents following long-term drinking water contamination from firefighting foam in Ronneby, Sweden.

BACKGROUND: In December 2013, it was discovered that drinking water supplied to one third of the households in Ronneby, southern Sweden, was highly contaminated by PFAS (sum level >10,000 ng/L) originated from firefighting foams used at a nearby military airport. OBJECTIVES: To report serum PFAS levels of Ronneby residents participating in a biomonitoring program, and to describe the variation by age, sex and calendar period for residential exposure. In addition, a reference group living in a neighboring municipality without PFAS contaminated drinking water was examined. METHODS: Blood samples and demographic data were collected for 3297 Ronneby residents and 226 individuals from the reference group. Yearly residence addresses were available for 3086 Ronneby residents from the national population registry. Serum concentrations of PFHxS, PFOS and PFOA were determined in all participants, with additional PFHpA, PFNA and PFDA in subsets of the participants. RESULTS: The population geometric means for serum PFHxS, PFOS and PFOA were 114, 135 and 6.8 ng/mL for all Ronneby residents, i.e.135, 35 and 4.5 times higher than for the reference group. Ronneby residents who resided in the area with contaminated water supply during 2005-2013 showed much higher PFAS levels in 2014 than those exposed only before 2005. Ronneby residents who never resided in the area with contaminated water supply also had higher serum PFAS levels than the reference group. All three PFAS were highly correlated (rs > 0.9 for each pair). Serum PFAS levels were lowest in teenage years and then increased with age. Adult females had lower PFAS levels on average than males under the age of 60 but higher above 60. DISCUSSION: The results reveal high serum PFAS levels dominated by PFHxS and PFOS in the Ronneby residents highly exposed to PFAS originated from firefighting foams. The PFAS exposure in Ronneby permits studies of associations to a range of health parameters, as well as studies of the toxicokinetics of PFAS exposure

Simplified routines in prescribing physical activity can increase the amount of prescriptions by doctors, more than economic incentives only: an observational intervention study

<p>Abstract</p> <p>Background</p> <p>Physical inactivity is one well-known risk factor related to disease. Physical activity on prescription (PAP) has been shown in some studies to be a successful intervention for increasing physical activity among patients with a sedentary lifestyle. The method involves motivational counselling that can be time-consuming for the prescribing doctor and might be a reason why physical activity on prescription is not used more frequently. This study might show a way to make the method of prescribing physical activity more user-friendly. The purpose is to determine whether a change in procedures increases the use of physical activity on prescription, and thus the aim of this study is to describe the methodology used.</p> <p>Results</p> <p>The observational intervention study included an intervention group consisting of one Primary Health Care (PHC) clinic and a control group consisting of six PHC clinics serving 149,400 inhabitants in the County of Blekinge, Sweden.</p> <p>An economic incentive was introduced in both groups when prescribing physical activity on prescription. In the intervention group, a change was made to the process of prescribing physical activity, together with information and guidance to the personnel working at the clinics. Physical therapists were used in the process of carrying out the prescription, conducting the motivational interview and counselling the patient. This methodology was used to minimise the workload of the physician. The chi-2 test was used for studying differences between the two groups. PAP prescribed by doctors increased eightfold in the intervention group compared to the control group. The greatest increase of PAP was seen among physicians in the intervention group as compared to all other professionals in the control group. The economic incentive gave a significant but smaller increase of PAP by doctors.</p> <p>Conclusion</p> <p>By simplifying and developing PAP, this study has shown a concrete way to increase the implementation of physical activity on prescription in general practice, as opposed to what can be gained by an economic bonus system alone. This study indicates that a bonus system may not be enough to implement an evidence-based method.</p