Exploring practices and perceptions of alcohol use during pregnancy in England and Sweden through a cross-cultural lens.

Background: Qualitative studies have aimed to understand why some women continue to drink during pregnancy; however, there is a lack of comparative cross-cultural research. We aimed to explore perceptions and practices of alcohol use during pregnancy in England and Sweden. Methods: Semi-structured interviews were conducted with 21 parents in Merseyside, England and 22 parents in Örebro County, Sweden. Interviews were audio recorded, transcribed verbatim and translated. Data were analyzed using thematic analysis. Results: The majority of women in both countries abstained from alcohol when they found out they were pregnant, despite alcohol being part of many social contexts before pregnancy. Nine of the seventeen English women drank at some point during pregnancy, typically on special occasions. Most parents felt women should modify their alcohol intake when they become mothers, though several English parents argued that responsible motherhood did not necessarily equate to abstinence. Swedish parents held strong opinions against drinking during pregnancy and argued that any amount of alcohol could harm the foetus. English parents' opinions were divided; some were skeptical of whether low to moderate drinking was associated with risks. Conclusions: Practices and attitudes towards alcohol use during pregnancy and views on foetal rights and responsibilities of pregnant women differed in England and Sweden. Shared social norms around drinking may be shaped within the policy context of pregnancy drinking guidelines, determining whether women consume alcohol or not

Surveillance of compliance with tobacco regulations in Örebro County, Sweden: a mixed methods study after the ban of test purchases

<p>Abstract</p> <p>Background</p> <p>Tobacco has long been known to be one of the most common reasons for sickness and premature deaths in the world. An important aspect of tobacco use is the youth's access to tobacco, and surveillance visits are one way to make sure how retailers are complying with age limit in the tobacco law. In Örebro County, Sweden, a project to reinforce the tobacco legislation was carried out in 2009-2010. One part of the project was surveillance visits that were done according to three different themes, called thematic surveillance.</p> <p>Methods</p> <p>This study is an evaluation of the results from thematic surveillance and has a mixed methods approach. The quantitative analyses concerns protocols from 217 surveillance visits, where questions were asked about three themes (self-monitoring programs; marketing; labeling of products and pricing). In addition, questionnaires filled out by six tobacco administrators who worked within the project were analyzed qualitatively by content analysis in order to study their perceptions and opinions of the project.</p> <p>Results</p> <p>This study shows that half of the visited retailers had self-monitoring programs. Lack of self-monitoring programs was significantly more common in smaller stores/kiosks and at restaurants. Further, the tobacco administrators who worked within the project perceived thematic surveillance as a good method for accomplishing better structure in surveillance work, but not as effective as purchase attempts (mystery shopping).</p> <p>Conclusions</p> <p>Thematic surveillance was perceived as positive and the method was also regarded to be a good way to work with surveillance. However, the method could be developed further for optimal use and better effect at the retailers. It is clear that people who work with tobacco prevention at the local level in Örebro County want to use purchase attempts as a surveillance method, and that they believe that purchase attempts is the best way to make sure if store comply with the tobacco law.</p

One Uniform Welfare State or a Multitude of Welfare Municipalities? The Evolution of Local Variation in Swedish Elder Care

The Nordic welfare states, including Sweden, have an inbuilt dilemma between two mainprinciples: universalism and local autonomy. The concept of ‘welfare municipalities’ has been usedto characterize the social policy construction of independent local authorities implementing nationalwelfare policies. The aim of the article is to study the evolution of the balance between universal,centralized versus local, decentralized principles in Swedish welfare services, using elder care as acase. The article follows up previous studies on the extensive diversity and the local path dependencyin the distribution of elder-care services in Sweden. A predominant impression from the presentexploration is that the pattern has changed in many aspects during the first decade of the newmillennium, and in a complex way. The coverage of home help and residential care has become lessgenerous, a sign of weaker universalism. On the other hand, the decentralization tendencies havedecreased, the earlier reported geographical disparity appears to have been reduced and the municipalitiesare increasingly adjusting to the national average. Also, the earlier strong local pathdependency has faded out and therefore the concepts ‘welfare municipality’ and ‘local social policy’appear to be less accurate than heretofore when describing the Swedish model of elder care.</p

Marketisation policies in different contexts: Consequences for home-care workers in Germany, Japan and Sweden

Market-oriented restructurings of long-term care policies contribute significantly to the aggravation of care workers’ situations. This article focuses on the effects of broader long-term care policy developments on market-oriented reforms. Germany, Japan and Sweden are three countries that have introduced market-oriented reforms into home-based care provision embedded in distinct long-term care policy developments. Conceptually, this article draws on comparative research on care to define the institutional dimensions of long-term care policies. Empirically, the research is based on policy analyses, as well as on national statistics and a comparative research project on home-care workers in the aforementioned countries. The findings reveal the mediating impact of the extension and decline of long-term public care support and the corresponding development of the care infrastructure on both the restructuring of care work and the assessments of the care workers themselves.</p