Göteborg och maktlandskapet - höghus som symbol och medel i en global konkurrens

This Bachelor thesis aims to analyse how the city of Gothenburg can be seen as a landscape of power and how this landscape might change due to the construction of the new CBD area called RegionCity, located just behind the central station. From the end of the 1970s, the city has developed from being an industrial city to become a post-industrial city. This has led to a new planning discourse characterized by place branding and a for the historical city unfamiliar construction of skyscrapers. The RegionCity development is called a ‘kick start’ for the new economic growth Gothenburg ‘must’ achieve to become an attractive destination for international businesses. This change the spatial power relations that characterizes the city centre today and both Jernhusen, the project developer, and the city of Gothenburg sees this as a symbol for a new epoch. Hence, RegionCity will change the urban landscape, as it expresses, represents and is used as an instrument for a new kind of economic and political aim to become a global competitive city

Sjuksköterskor och drogmissbrukande patienter : En litteraturöversikt om sjuksköterskors attityder och upplevelser

Bakgrund: År 2010 uppskattades nära 300 miljoner människor testat narkotika. I Sverige ökar tillgängligheten stadigt och cannabis anges vara den vanligaste drogen. Hälsoproblem relaterade till drogmissbruket är vanligt, exempelvis infektionssjukdomar förekommer. Drogmissbrukande patienter önskar få vård på samma villkor som andra patienter men möts istället ofta av misstro och oförstående sjuksköterskor. Syfte: Syftet var att belysa allmänsjuksköterskors attityder till och upplevelser av drogmissbrukande patienter. Metod: Vetenskapliga artiklar söktes i databaserna Cinahl, Pubmed och PsycINFO. Sökningarna gjordes med vedertagna söktermer och femton vetenskapliga artiklar, varav fem kvalitativa och tio kvantitativa artiklar, inkluderades. Dessa artiklar kvalitetsvärderades och analyserades vilket resulterade i två huvudrubriker samt fyra underrubriker. Resultat: Huvudresultatet visade att sjuksköterskornas attityder till och upplevelser av drogmissbrukare generellt sett var negativa. I resultatet framkom det att attityderna och upplevelserna påverkade både bemötandet av drogmissbrukaren och dennes omvårdnad. Diskussion: Upplevelserna och attityderna påverkades av sjuksköterskornas erfarenheter och utbildning. Sjuksköterskornas attityder och rädslor resulterade i att drogmissbrukarna blev frustrerade och våldsamma. Detta skulle enligt Travelbees omvårdnadsteori kunnat avhjälpas om sjuksköterskorna lyssnade på och bekräftade patienterna. Slutsats: Då drogmissbruket växer måste problemen relaterat till drogmissbrukarna lyftas fram och utbildning inom området krävs för att förbättra attityderna

Analysis of ICT use in the Barents region : research findings from logistics service providers and forest industry

Efficient logistics is a major aspect in the competitiveness of the companies in the Barents Region because their customers are typically located far away from the region. This study focuses on the Logistics Service Provider (LSP) and the forest industries in the Barents region. The LSPs are important facilitators of trade whose role has increased with the prevailing outsourcing trends of the industries. The appropriate use of Information and Communication Technologies (ICT) provides one means to support the competitive strategies of the LSPs in the Barents region, where the sector is typically composed of small and medium-sized LSPs. To date, the role and competitive developing processes of small and medium-sized LSPs have not been extensively studied and there is very little information on the ICT capabilities and practices in the sector. The research provides general information on the types of LSPs that are found in the Barents region (number of companies, industry trends, company cooperation practices etc.) and studies the current status of ICT implementation in the industry. In particular, the perceived motivators and barriers for ICT implementation are of interest. A survey is conducted in Barents area Finland, Norway, and Sweden, resulting in a total of 168 responses. The results indicate that majority of the LSPs are familiar with computer technology and have some ICT tools available. The surveyed Norwegian LSPs are most “technology-oriented” overall, but the conclusion does not hold for all technology tools. In order to better understand the ICT implementation from the supply chain management perspective, the Russian forest sector is studied in more detail. A total of 9 qualitative interviews are conducted with companies in or related to the Russian forest industry. Overall, the ICT implementation is in a very incipience stage in forestry in Russia. Nonunderstanding of benefits that could be obtained using ICT was mentioned as the main barrier for development of ICT competence. The lack of IT-skilled specialists in Kostomuksha, where majority of the interviews took place, was mentioned as one of the obstacles for a more wide-spread use of ICT in forestry.Godkänd; 2005; 20061117 (ysko

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine