Publicity for Lawyers

Antalet förstainsatsaktörer i Sverige idag utanför de traditionella (räddningstjänst, polis och ambulans) är få, och lite forskning har förts på området. Det finns dock exempel där räddningstjänsten har anlitat väktarbolag eller utrustat hemtjänstpersonal med pulversläckare. Flertalet av dessa samarbeten är relativt nystartade och få utvärderingar har gjorts som visar de faktiska effekterna av dem. Syftet med denna rapport är att beskriva och kartlägga samhällekonomiska nyttor och kostnader av icke-traditionella förstainsatsaktörer som samarbetar med räddningstjänsten. Studien har genomförts genom fallstudier av två samarbeten; Söderköping räddningstjänst som har ett avtal med LA Jour & Säkerhet AB samt Södertörns brandförsvarsförbund (SBBF) som samarbetar med väktarbolag i Södertälje och Botkyrka. Sju semistrukturerade intervjuer har genomförts med representanter från väktarbolag, räddningstjänst och kommun. Den metod som används vid analysen är nationalekonomisk kostnadsnyttoanalys. De nyttor som har identifierats är att väktarna sparar tid, bidrar med lägesrapporter, stöttar insatserna genom att vara behjälpliga på plats, upptäcker incidenter eller bränder vid rondering. De har god lokalkännedom och kan hjälpa till att låsa upp brandbommar och dörrar, vilket indirekt sparar tid åt räddningstjänsten. Samarbetet bidrar också till att de arbetar preventivt; de pratar med ungdomar och andra grupper i samhället och skapar relationer som på sikt har möjlighet att gagna säkerheten och tryggheten i kommunen. Kostnaderna för att utbilda och utrusta väktarna är idag låga. Däremot har det framkommit att väktarna gärna skulle vilja ha mer utbildning så att de kan rycka ut vid fler typer av larm. Det har även framkommit att bättre kommunikationskanaler skulle kunna bidra till ökade möjligheter att åka på fler larm och att vara bättre förberedda på vad de kan bidra med vid olika typer av larm. Den kvantitativa analysen utförs för samarbetet i Söderköping och visar att detta har en hög utdelning. Varje investerad krona i Söderköping har gett en avkastning på åtta kronor, när värdet av den minskade insatstid som väktarna bidrar med beräknas. Nyttan är dock undervärderad då många nyttor (beskrivna ovan) inte kan värdesättas monetärt. Det som har begränsat den kvantitativa analysen är det faktum att väktarnas rapportering i Botkyrka och Södertälje inte särskiljer räddningstjänstsuppdrag från övriga uppdrag. Detta hade möjliggjort en kvantitativ analys även för samarbetet med Södertörn, vilket hade kunnat bidra till att resultaten blivit applicerbara på fler kommuner. Emellertid finns inget som indikerar att andra kommuner inte kommer att erfara samma effekter eller kostnader som de undersökta samarbetena har lett till. Däremot bör kommuner analysera behov och förutsättningar i sin kommun för samarbeten av det här slaget innan de inför dem med tanke på att det uppstår kostnader, om än låga

Vårdskador vid omvårdnad : en studie av patienters, anhörigas och vårdgivares anmälningar

Background: Patient safety has, over the last decades, been increasingly established as an important global issue. Patient safety is jeopardized by for example adverse events and most of the current evidence on adverse events originates from hospitals, but many adverse events also happen in nursing homes. It is clear that adverse events occur in nursing care and can cause suffering and even death, which could have been avoided if adequate actions had been taken. While the literature on improving patient safety is extensive, there is a dearth of studies from the perspectives of patients and their relatives. Aim: To gain new insights about adverse events in nursing care from the perspective of patients and their relatives as well as health care providers, and describe contributing factors to serious adverse events. The specific aim in paper I was to examine adverse events in nursing care as they are experienced by patients and relatives. In paper II the aim was to identify the most common serious adverse events that occur in nursing homes, and their most frequent contributing factors, in order to contribute to the improvement of safe nursing care. Methods: The design was descriptive, based on a total sample of data collected from national registries in Sweden. The method was content analysis with both a qualitative and a quantitative approach. Results: The findings in study I showed that experiences of adverse events in nursing care, reported by patients and relatives, included suffering from both physical and mental injuries caused by the nursing care. Lack of participation caused negative consequences for patients or relatives, as well as physical adverse events. The findings from study II showed that medication errors, falls, delayed or inappropriate interventions and missed nursing care caused the vast majority of the serious adverse events in nursing homes. The most common contributing factors to serious adverse events were 1) lack of competence 2) incomplete, or lack of documentation 3) teamwork failure 4) and inadequate communication. A comparison of the results of studies I and II showed that there were discrepancies between the adverse events reported by patients and their relatives and the serious adverse events reported by health care providers. Conclusion: Carers, as well as leaders in health care, can learn from patients’ and relatives’ experiences of adverse events in nursing care in order to improve the quality of nursing care. The contributing factors to serious adverse events frequently interacted, yet they varied between different groups of serious adverse events. A holistic approach to improve safe care in nursing homes requires competence of the staff, safe environments as well as resident’s and relative’s participation

Genetic control of disease in an experimental model for Sjögren's syndrome

Sjögren's syndrome is an autoimmune disease with a complex etiology depending on hereditary and environmental factors. The disease is characterized by lymphocytic infiltration and inflammation in the salivary and lacrimal glands, leading to oral and ocular dryness. To understand the genetic susceptibility in Sjögren's syndrome, studies of disease phenotypes have been performed in the non-obese diabetic (NOD) mouse. By the identification of genetic regions controlling development of autoimmune exocrinopathy in the NOD mouse and by reducing one of these regions considerably, Nguyen et al. in a recent issue of Arthritis Research and Therapy propose candidate genes for development of Sjögren's syndrome

Characterization of first ever stroke patients : functional status with special reference to risk of falls and fracture.

Introduction. The costs for falling accidents in Sweden are very high. There is now evidence that assessments and intervention programmes are effective in reducing the risk of falling. It is important to identify which patients have a risk of falling and therefore would benefit most from fall prevention measures. Patients with stroke have a high risk of falling. The falls may result in fear of falling again and fractures. Hip fractures constitute one of the most serious ones. Compared with the general population, stroke survivors have an increased risk of hip fracture. The risk is up to four times higher than for age-matched control subjects. The most likely explanations are an increased risk of falling and reduced bone density. Aims. Our aims in the present study were to determine if certain test instruments can identify fallers and predict hip fractures, determine the relationship between fear of falling and functional characteristics, describe the circumstances that prevailed when the patients sustained their hip fractures, compare bone mineral density in patients with stroke and hip fracture and to investigate side differences in bone mineral density in patients with stroke alone. Methods. Patients with first ever stroke treated in the stroke unit at Örebro University Hospital during one year were included in the present study. One hundred and sixty-two of the 218 patients who were included participated in the follow-up after six or twelve months. Nine of the patients fractured their hip within two years after stroke. Bone mineral density was measured in eight of them, as well as in 76 control subjects. Results. The results of Berg Balance Scale (BBS), Stops Walking When Talking (SWWT) and Timed Up & Go (TUG) differed between fallers and non-fallers. Previous falls as well as using sedatives and impaired vision was associated with falling. Impaired physical function was significantly associated with scoring low fall-related self-efficacy, both for fallers and non-fallers. All patients who subsequently sustained hip fracture had their fractures indoors when they were performing everyday activities. Hip fracture was associated with previous fractures, impaired vision and impaired cognition. Bone mineral density in patients with hip fracture tended to be lower whether they had a stroke or not. Side differences may occur even in patients who can walk independently at stroke onset and all patients who fractured their hip did not have osteoporosis. Conclusions. BBS, SWWT, TUG and Falls Efficacy Scale - Swedish version could add useful information in a multidisciplinary fall risk analysis. The same factors were associated with an increased risk of falling and having a hip fracture in patients with stroke as for people in general. For a frail, elderly person who already has very small margins, the onset of stroke may mean the difference between falling or not falling, having a hip fracture or not

NOVA VREMENA, NOVI IZAZOVI I NOVE METODE

We live in changing and challenging times. Many countries in Europe are making plans on how to improve their competitive advantage in order to match the current global challenges in the best ways. In many countries the focus is on how to meet the global challenges with the support from the educational sector. In Finland education has been an important part of building the Finnish economy. When the tough times continue in the economy it is still good news to see how the educational sector and business life still continue to support each other through continuous exchange. One of the educational aims in the country is to continue to learn new things through your whole life – this is one of the key stones upon which the society is built. This is also one way to continue to improve your competitive advantage in the country. According to the last statistics from July 2015 the Vaasa region and the region where the capital of Finland is situated belongs to the most successful ones when it comes to competitive advantage. This is where Novia University of Applied Sciences is situated with one of several campuses. Among the success factors are educational level, innovation, company dynamics, and productivity. Cross sectional knowledge exchange is prioritized in society and therefore research and projects in this area receive high attention and also funding. In comparison with many countries Finland is also a very open and transparent society. This supports the knowledge exchange between business and educational sector. The paper is based on the results from one of the cross border projects where new teaching methods in entrepreneurial education in four countries were documented and took place in Croatia, Slovenia, Portugal and Finland. The results showed that the project and the methods were successful in using new methods within business education in these countries.Živimo u promjenjivim i izazovnim vremenima. Mnoge zemlje u Europi izrađuju planove o tome kako poboljšati svoju konkurentsku prednost kako bi najbolje udovoljile trenutnim globalnim izazovima. U mnogim je zemljama fokus na tome kako zadovoljiti globalne izazove uz podršku obrazovnog sektora. U Finskoj obrazovanje čini važan dio u izgradnji finskog gospodarstva. Kada se teška vremena u gospodarstvu nastave, dobra je vijest ta što se obrazovni sektor i poslovni život nastavljaju podržavati i dalje kroz kontinuiranu razmjenu. Jedan od obrazovnih ciljeva u zemlji je učiti nove stvari kroz cijeli život – to je jedan od temelja na kojem se gradi društvo. To je također način da se poboljša konkurentna prednost u zemlji. Prema posljednjim statističkim podacima iz srpnja 2015. regija Vaasa i regija gdje se nalazi glavni grad Finske pripadaju najuspješnijim regijama kada je u pitanju konkurentna prednost. Tu se također nalazi Veleučilište Novia u jednom od nekoliko kampusa. Među faktorima uspjeha su stupanj obrazovanja, inovacije, dinamika tvrtke i produktivnost. Poprečna razmjena znanja je prioritet u društvu, stoga istraživanja i projekti na ovom području dobivaju veliku pažnju te novčanu potporu. U usporedbi s mnogim zemljama finsko društvo je vrlo otvoreno i transparentno. To podupire razmjenu znanja između poslovnog i obrazovnog sektora. Rad se temelji na rezultatima iz jednog od međunarodnih projekata u kojima su dokumentirane nove metode poučavanja u poduzetničkom obrazovanju u četiri zemlje: Hrvatskoj, Sloveniji, Portugalu i Finskoj. Rezultati su pokazali da su projekt i metode bili uspješni u korištenju novih metoda unutar poslovnog obrazovanja u tim zemljama

Manipulation of medicines, necessary in everyday practice for individualised doses in paediatric care

Introduction: Manipulation of medicines is often necessary in the paediatric setting due to lack of medicines suitable for paediatric patients. There are previous short-term frequency studies in different paediatric settings, but no long-term studies and no comparison between two different years in the same setting. In 2007 the Paediatric Regulation was implemented in Europe to stimulate drug companies to develop more information around medicines for children and new dosage forms suitable for paediatric patients. An alternative to manipulation of medicines is to use extemporaneous preparations in correct strengths. Aim: The overall research aim of this thesis was to study how and to what extent manipulation of medicines is being done and its effect on dosing accuracy in paediatric care. A specific aim was to compare the use of extemporaneous preparations in two different years. Methods: The setting for three of the four studies was a large paediatric university hospital in Sweden, and the fourth study was performed at a hospital pharmacy. Data for paper I and IV were extracted from a large registry containing material regarding patient data, care, and medicines from the hospital electronic health record, TakeCare. In Paper I data regarding all solid oral and rectal administrations where a part of a solid dosage form needed to be administered were counted. Comparisons were then made between the included study years 2009 and 2019 and between inpatients and patients at the emergency department. Semi-structured interviews with registered nurses and pharmacists were performed in Paper II. All interviews were audio recorded, transcribed verbatim, and analysed qualitatively using content analysis. In Paper III five different brands of tablets were split into halves and quarters. The resulting parts were then weighed and compared with expected weight, according to criteria in the European Pharmacopoeia and the United States Pharmacopoeia. The frequency of patients with at least one oral extemporaneous preparation was counted from the registry data and compared for inpatients in 2009 and 2019 in Paper IV. Results: There was no difference in the frequency of inpatients with manipulated oral medicines, when comparing data from 2009 and 2019. For manipulations of rectal medicines there was a statistically significant decrease for both inpatients and patients at the emergency department, as well as for manipulations of oral medicines to patients at the emergency department. Registered nurses and pharmacists state that manipulation of medicines to paediatric patients is frequent, and forces both professions to work outside the box. Splitting of tablets into halves results in more correct parts than splitting further into quarters. The frequency of patients with extemporaneous preparations increased between the study years. Conclusion: There is still a lack of suitable dosage forms and strengths of medicines to paediatric patients in 2019 which leads to manipulation of medicines, or the use of extemporaneous preparations. For individual substances the introduction of a dosage form suitable for paediatric use, decreases, or even erases the need to manipulate or use extemporaneous preparations. Pharmacists are valued members in the ward team, contributing with specific knowledge around medicines

NOVA VREMENA, NOVI IZAZOVI I NOVE METODE

We live in changing and challenging times. Many countries in Europe are making plans on how to improve their competitive advantage in order to match the current global challenges in the best ways. In many countries the focus is on how to meet the global challenges with the support from the educational sector. In Finland education has been an important part of building the Finnish economy. When the tough times continue in the economy it is still good news to see how the educational sector and business life still continue to support each other through continuous exchange. One of the educational aims in the country is to continue to learn new things through your whole life – this is one of the key stones upon which the society is built. This is also one way to continue to improve your competitive advantage in the country. According to the last statistics from July 2015 the Vaasa region and the region where the capital of Finland is situated belongs to the most successful ones when it comes to competitive advantage. This is where Novia University of Applied Sciences is situated with one of several campuses. Among the success factors are educational level, innovation, company dynamics, and productivity. Cross sectional knowledge exchange is prioritized in society and therefore research and projects in this area receive high attention and also funding. In comparison with many countries Finland is also a very open and transparent society. This supports the knowledge exchange between business and educational sector. The paper is based on the results from one of the cross border projects where new teaching methods in entrepreneurial education in four countries were documented and took place in Croatia, Slovenia, Portugal and Finland. The results showed that the project and the methods were successful in using new methods within business education in these countries.Živimo u promjenjivim i izazovnim vremenima. Mnoge zemlje u Europi izrađuju planove o tome kako poboljšati svoju konkurentsku prednost kako bi najbolje udovoljile trenutnim globalnim izazovima. U mnogim je zemljama fokus na tome kako zadovoljiti globalne izazove uz podršku obrazovnog sektora. U Finskoj obrazovanje čini važan dio u izgradnji finskog gospodarstva. Kada se teška vremena u gospodarstvu nastave, dobra je vijest ta što se obrazovni sektor i poslovni život nastavljaju podržavati i dalje kroz kontinuiranu razmjenu. Jedan od obrazovnih ciljeva u zemlji je učiti nove stvari kroz cijeli život – to je jedan od temelja na kojem se gradi društvo. To je također način da se poboljša konkurentna prednost u zemlji. Prema posljednjim statističkim podacima iz srpnja 2015. regija Vaasa i regija gdje se nalazi glavni grad Finske pripadaju najuspješnijim regijama kada je u pitanju konkurentna prednost. Tu se također nalazi Veleučilište Novia u jednom od nekoliko kampusa. Među faktorima uspjeha su stupanj obrazovanja, inovacije, dinamika tvrtke i produktivnost. Poprečna razmjena znanja je prioritet u društvu, stoga istraživanja i projekti na ovom području dobivaju veliku pažnju te novčanu potporu. U usporedbi s mnogim zemljama finsko društvo je vrlo otvoreno i transparentno. To podupire razmjenu znanja između poslovnog i obrazovnog sektora. Rad se temelji na rezultatima iz jednog od međunarodnih projekata u kojima su dokumentirane nove metode poučavanja u poduzetničkom obrazovanju u četiri zemlje: Hrvatskoj, Sloveniji, Portugalu i Finskoj. Rezultati su pokazali da su projekt i metode bili uspješni u korištenju novih metoda unutar poslovnog obrazovanja u tim zemljama

A study of the proactive occupational safety and health work in a Swedish construction company - the example of vibration exposure

Exposure to vibrations from tools and machines used in construction work can induce damages to the human body. One of the most frequent symptoms is the hand-arm vibration syndrome commonly known as white fingers. The proportions of the international workforce exposed to vibrations are high and dominating sectors are construction, agriculture, forestry, and transport. Particularly exposed construction occupational groups include machine operators and drivers of vehicles. In 2005, the Swedish Work Environment Authority introduced a new guideline on the topic of preventing vibration exposure risks (AFS 2005:15) based on the European union 2002/44/EC directive on workers’ exposure to vibration. It includes raised demands on estimating vibration exposure, and clearly stated responsibilities and rights of employers and employees. However, in 2011 the Swedish Work Environment Authority’s inspections showed that many employers belonging to sectors such as building and construction, transport, and mining industry did not have any satisfactory proactive risk management work concerning vibration exposure. This paper reports on a pilot study performed in a large Swedish construction company with the aim to yield more knowledge about factors affecting the implementation of the guidelines and to suggest actions for improvement. A total of 31 construction workers and supervisors were interviewed at nine construction sites in southern Sweden. Interview results demonstrated a lack of knowledge in estimating vibration exposure; the incorporation of the Work Environment Authority’s directions had not been accomplished; driving forces for improving the proactive health and safety work and specifically vibration exposure management was weak on all organisational levels; important factors affecting the implementation of vibration exposure regulations are the psychosocial work environment at construction sites as well as company safety culture; a large proportion of the interviewed construction workers was judged to be at risk for developing vibration injuries if the exposure was not decreased; management, supervisory, and production levels need increased knowledge about vibration exposure and vibration injuries; and methods and tools for easy estimation of vibration exposure needs to be developed

Flow situations during everyday practice in a medical hospital ward. Results from a study based on experience sampling method

Nursing is a constant balance between strain and stimulation and work and health research with a positive reference point has been recommended. A health-promoting circumstance for subjective experience is flow, which is a psychological state, when individuals concurrently experience happiness, motivation and cognitive efficiency. Flow situations can be identified through individuals' estimates of perceived challenge and skills. There is, to the best of our knowledge, no published study of flow among health care staff. The aim of this study was to identify flow-situations and study work-related activities and individual factors associated with flow situations, during everyday practice at a medical emergency ward in Sweden, in order to increase the knowledge on salutogenic health-promoting factors.The respondents consisted of 17 assistant nurses and 14 registered nurses, who randomly and repeatedly answered a small questionnaire, through an experience sampling method, during everyday nursing practice. The study resulted in 497 observations. Flow situations were defined as an exact match between a high challenge and skill estimation and logistic regression models were used to study different variables association to flow situations.The health care staff spent most of its working time in individual nursing care and administrative and communicative duties. The assistant nurses were more often occupied in individual nursing care, while the registered nurses were more involved in medical care and administrative and communicative duties. The study resulted in 11.5% observations of flow situations but the relative number of flow situations varied between none to 55% among the participants. Flow situations were positively related to medical care activities and individual cognitive resources. Taking a break was also positively associated with flow situations among the assistant nurses.The result showed opportunities for work-related interventions, with an adherent increase in flow situations, opportunity for experience of flow and work-related health among the nursing staff in general and among the assistant nurses in particular

Tillfredsställande och likvärdigt skydd mot olyckor - En jämförelse mellan de nationella, regionala och kommunala synsätten

This thesis is an exploratory study with the aim to identify and analyze similarities and differences between different actors perspective on adequate and equal protection against accidents. The study shows that no common understanding of the meaning of the terms adequate and equal has been reached since the Civil Protection Act (LSO) was taken into use. This has caused a non-homogenous perspective on the meaning of the terms and the methods to achieve such protection, which in turn could cause differences in the protection against accidents throughout the country. Based on the study it is recommended that a common meaning of the terms be established, and more guidelines and elaboration in regards to how to achieve an adequate and equal protection be given. Several people whose work is affected by the Civil Protection Act share this opinion. However, it is important that these operational definitions and guidelines do not become too detailed, or the purpose of the law change will be lost