Japan is facing a great demographic shift, where by 2050 more than 40% of it's inhabitants will be over the age of 65 years. The womens emencipation from the role of stay at home mothers has allowed them to have careers of their own, although a good thing it does not leave a lot of room for starting a family in Japan's hard working climate. This new cultural norm has collided with the the long tradition of family care and Japan is now facing a large cultural collision, where there is a great lack of working solutions for child and senior care. The project suggests a prototypical intergenerational day care center for elderly and children in Tokyos dense now-rise residential neighborhoods. This form of care started being built in America during the 90's and has prooven to provide some of the best care availible for elderly and children. / Japan möter i dagsläget ett stort demografiskt skifte, till år 2050 kommer mer än 40% av befolkningen att vara över 65 år gamla. Kvinnornas frigörelse från hemmet har tillåtit dem att påbörja egna arbetsliv och karriärer, vilket inte lämnar mycket rum för att starta egen familj i Japans hårda arbetsklimat. Denna nya kulturella norm har kolliderat med den traditionella familjevården och Japan står idag utan en bra lösning för barn- och äldrevård. Det föreslagna projektet är ett prototypiskt intergenerationellt dagvårdscenter för barn och seniorer i Tokyos täta lågbebyggda bostadsområden. Intergenerationell vård började byggas under 90-talet i USA och har visat sig ge bland den bästa vården tillgänglig för barn och äldre.

Förekomsten av urininkontinens ökar med åldern. Fler blir idag äldre än förut vilket tyder på att urininkontinens är ett växande problem. Inkontinensskydd är oftast den mest prioriterade åtgärder vilket medför ökade samhällskostnader och ökad klimatpåverkan. Distriktssköterskor inom hemsjukvård bör vid utredning, åtgärd och behandling av urininkontinens sträva efter ett hållbart och hälsofrämjande arbetssätt.   Syftet var att undersöka distriktssköterskors upplevelser gällande utredningar, behandlingar och åtgärder av äldre personers urininkontinens i hemsjukvård. Kvalitativ metod och innehållsanalys med induktiv ansats användes. Semi-strukturerade enskilda och fokusgruppsintervju utfördes. 16 kvinnliga distriktssköterskor (eller sjuksköterskor med förskrivningsrätt) från 11 kommuner inom södra Sverige deltog.   Resultatet visade att utredning av urininkontinens inte upplevdes tillhöra hemsjukvårdens uppdrag.  Ålder samt tids- och personalbrist beskrevs utgöra ett hinder för erbjudande om andra åtgärder och behandlingar än förskrivning av inkontinensskydd. Utprovning av inkontinensskydd skedde utifrån andrahandsinformation vilket gav distriktssköterskor en känsla av att gissa vid ordination av inkontinensskydd.   Individuellt utprovade inkontinensskydd var önskvärt och kunde minska belastningen för miljö och ekonomi. Distriktssköterskorna hanterade äldres urininkontinens genom förskrivning av inkontinensskydd. För att kunna erbjuda utredning samt andra åtgärder och behandlingar än förskrivning behövs resurser i form av mer tid och personal. / The incidence of urinary incontinence increases with age. More people gets older than before, which indicates that urinary incontinence is a growing problem. Incontinence protection is often the most prioritized action, which entails increased societal costs and climate impact.  District nurses within home healthcare should strive for sustainable and health-promoting efforts during management of urinary incontinence.   The purpose was to investigate district nurses' experiences regarding management of older people's urinary incontinence in home healthcare. Qualitative method and content analysis with an inductive approach were used. Semi-structured individual and focus group interview were conducted. 16 female district nurses (or nurses with prescribing rights) from 11 municipalities in southern Sweden participated.   Investigation of urinary incontinence was not felt to be part of the mission of home healthcare. Age and resource shortages were described as an obstacle to offering other management than prescribing incontinence protection. Trial of incontinence protection consisted of secondary information, which gave a sense of guesswork when prescribing incontinence protection.    Individually customized incontinence protection was desirable and could reduce the burden on the environment and economy. The elderly´s incontinence was managed by prescribing incontinence protection. To offer investigation, actions and treatments, other than prescription, more resources are needed.

<p>Two main goals of geriatric rehabilitation are to re-establish ability for physical function in order to facilitate independence in activities of daily living (ADL), and to promote an optimal degree of well-being, i.e. life satisfaction, in the individual. In this research a new scale, the General Motor Function assessment scale (GMF), was developed and evaluated. Subsequently, factors perceived as important for the life satisfaction of people undergoing geriatric rehabilitation were investigated. </p><p>The GMF includes both mobility and upper limb functions and comprises three subscales covering different aspects of functioning, namely performance-related Dependence, Pain and Insecurity. The clinical practicality of the GMF was evaluated by a field test. Its psychometric properties were analysed in both hospital and community-based settings of geriatric rehabilitation, using non-parametric statistical methods. The results indicated that the GMF is clinically adequate, possesses good reliability and is sensitive enough to demonstrate changes from pre- to post-intervention in different forms of geriatric rehabilitation. </p><p>For investigation of perceptions of life satisfaction, individual qualitative interviews were conducted with old (80+) care recipients and with their significant others, who had a helping relationship with them. The results revealed that habitual activity, independence and adaptation were generally considered to be important for the life satisfaction of the care recipients. Recalling of pleasant past memories in an effort to achieve current life satisfaction was a commonly used adaptive strategy among the care recipients. This strategy created a temporary sense of life satisfaction, with a potential for concealing dissatisfaction with conditions that might otherwise be correctable. From the perspective of the significant others, protection of the continuity of the care recipients’ self was seen as vital for the latter's life satisfaction, and was thus an underlying general purpose of the informal caregiving. </p>

<p>Congestive heart failure (CHF) is a major cause of morbidity and mortality and the identification of modifiable risk factors is crucial in order to diminish suffering of this common disease. </p><p>The primary aim of this thesis was to investigate novel metabolic risk factors for CHF, with a focus on insulin resistance and inflammation. The secondary aim was to examine the validity of the CHF diagnosis in the Swedish hospital discharge register.</p><p>This thesis was based on the Uppsala Longitudinal Study of Adult Men (ULSAM) cohort, a community-based prospective study started in 1970. The participants were examined at age 50 and 70 and the data was completed with annual updates on mortality and in-hospital morbidity using national registers. </p><p>We showed that insulin resistance predicts CHF incidence independently of established risk factors in both middle-aged and elderly men. The previously described association between obesity and subsequent CHF may be mediated partly by insulin resistance. Moreover, it was established that inflammation, measured as erythrocyte sedimentation rate is a significant predictor of CHF, independent of established risk factors including an interim myocardial infarction. Furthermore, a low beta-carotene level, as well as an increased apolipoprotein B/A-I-ratio was found to predict CHF independently of established risk factors.</p><p>We also showed that the validity of the CHF diagnosis in the Swedish hospital discharge register appears less precise than for other recently investigated cardiovascular diagnoses. However, when including only cases from selected clinics or cases with a primary diagnosis of CHF, the validity is comparable to the above diagnoses. </p><p>In conclusion, insulin resistance and inflammation are strong independent risk factors for the development of CHF, and seem to be involved in the early process leading to CHF. If confirmed, our observations could have large clinical implications as they may offer new approaches in the prevention of CHF.</p>

Two main goals of geriatric rehabilitation are to re-establish ability for physical function in order to facilitate independence in activities of daily living (ADL), and to promote an optimal degree of well-being, i.e. life satisfaction, in the individual. In this research a new scale, the General Motor Function assessment scale (GMF), was developed and evaluated. Subsequently, factors perceived as important for the life satisfaction of people undergoing geriatric rehabilitation were investigated. The GMF includes both mobility and upper limb functions and comprises three subscales covering different aspects of functioning, namely performance-related Dependence, Pain and Insecurity. The clinical practicality of the GMF was evaluated by a field test. Its psychometric properties were analysed in both hospital and community-based settings of geriatric rehabilitation, using non-parametric statistical methods. The results indicated that the GMF is clinically adequate, possesses good reliability and is sensitive enough to demonstrate changes from pre- to post-intervention in different forms of geriatric rehabilitation. For investigation of perceptions of life satisfaction, individual qualitative interviews were conducted with old (80+) care recipients and with their significant others, who had a helping relationship with them. The results revealed that habitual activity, independence and adaptation were generally considered to be important for the life satisfaction of the care recipients. Recalling of pleasant past memories in an effort to achieve current life satisfaction was a commonly used adaptive strategy among the care recipients. This strategy created a temporary sense of life satisfaction, with a potential for concealing dissatisfaction with conditions that might otherwise be correctable. From the perspective of the significant others, protection of the continuity of the care recipients’ self was seen as vital for the latter's life satisfaction, and was thus an underlying general purpose of the informal caregiving.

Congestive heart failure (CHF) is a major cause of morbidity and mortality and the identification of modifiable risk factors is crucial in order to diminish suffering of this common disease. The primary aim of this thesis was to investigate novel metabolic risk factors for CHF, with a focus on insulin resistance and inflammation. The secondary aim was to examine the validity of the CHF diagnosis in the Swedish hospital discharge register. This thesis was based on the Uppsala Longitudinal Study of Adult Men (ULSAM) cohort, a community-based prospective study started in 1970. The participants were examined at age 50 and 70 and the data was completed with annual updates on mortality and in-hospital morbidity using national registers. We showed that insulin resistance predicts CHF incidence independently of established risk factors in both middle-aged and elderly men. The previously described association between obesity and subsequent CHF may be mediated partly by insulin resistance. Moreover, it was established that inflammation, measured as erythrocyte sedimentation rate is a significant predictor of CHF, independent of established risk factors including an interim myocardial infarction. Furthermore, a low beta-carotene level, as well as an increased apolipoprotein B/A-I-ratio was found to predict CHF independently of established risk factors. We also showed that the validity of the CHF diagnosis in the Swedish hospital discharge register appears less precise than for other recently investigated cardiovascular diagnoses. However, when including only cases from selected clinics or cases with a primary diagnosis of CHF, the validity is comparable to the above diagnoses. In conclusion, insulin resistance and inflammation are strong independent risk factors for the development of CHF, and seem to be involved in the early process leading to CHF. If confirmed, our observations could have large clinical implications as they may offer new approaches in the prevention of CHF.

Sammanfattning Syfte och frågeställningar Syftet med studien var att få kunskap om äldres fysiska, psykiska och sociala välbefinnande har påverkats av att besöka Träffpunkten Allén i Sundbyberg. Träffpunkten är en öppen verksamhet som vänder sig mot personer över 65 år. Träffpunkten bidrar till att upprätthålla funktionsförmåga, skapa sociala kontakter samt bryta isolering genom olika aktiviteter. Studien har utgått från följande frågeställningar: (1) På vilket sätt har seniorernas psykiska, fysiska och sociala välbefinnande eventuellt förändrats av att besöka Träffpunkten? (2) Vad finner seniorerna värdefullt med att besöka Träffpunkten? (3) Vad upplever seniorerna att Träffpunkten medför till deras vardag? Metod För att uppnå studiens syfte genomfördes intervjuer med sju ålderspensionärer i åldersspannet 67–84 år. Respondenterna som deltog i studien är alla besökare hos Träffpunkten Allén. Det genomfördes semistrukturerade intervjuer utifrån en genomarbetad intervjuguide. Intervjuerna spelades in, transkriberades och analyserades på ett tolkande tillvägagångssätt genom en innehållsanalys. Kategorier skapades genom att studera de gemensamma nämnarna som författarna tagit fram från kondensering och meningsbärande enheter. Resultat Resultatet gav följande kategorier: upplevd hälsa, fysisk hälsa, sociala interaktioner samt meningsfullhet. Genom att studera och analysera kategorierna skapades tre teman: välbefinnande, gemenskap och betydelsefullt. Resultaten visade att seniorerna besöker Träffpunkten Allén för att upprätthålla sociala relationer samt att vara fysiskt aktiva. Detta medför att seniorerna upplever en bättre fysisk, psykisk och social hälsa samt en meningsfullhet genom att besöka Träffpunkten Allén. Slutsats Denna studie har visat att de aktiviteter som Träffpunkten erbjuder stärker den upplevda hälsan och den sociala gemenskapen. Genom detta skapas en självständighet samt ett starkare välbefinnande för verksamhetens besökare. Förhoppningsvis kan resultatet användas som underlag vid skapande av fler träffpunkter och mötesplatser för äldre.

Introduction: The aim of this thesis is to investigate the factors that lead to the creation of meaning for Jewish genealogists. Research on the creation of meaning in genealogy has been carried out in the past, but not for this particular group. Method: The grounded theory process of textual coding was conducted on so called success stories in connection to two different databases with access to Holocaust related records. A group of genealogists without connections to the Holocaust serve as comparison. Analysis: Three phases in the genealogical process appear. The first is a practical phase. The second is a personal engagement phase. The last phase is emotional. The attributes and categories from the coding procedure are selected and placed into the most suitable phase. A perspective of archival pedagogy is incorporated. A discussion that ends with the final grounded theory follows. Results: The components that create meaning in the Jewish groups research are information gathering, conclusion, participation, inclusiveness, creation of identity and highlighting. The main differences between the two groups of genealogists are the event of the Holocaust. Conclusion: The genealogical research and its meaningful and creative processes are overall the same in the Jewish as in the other group. The Holocaust is however unavoidably affecting all the processes for the Jewish genealogists. This is a two years master’s thesis in Archival Science.

Denna studie hade som syfte att beskriva hur vårdbiträden inom äldreboende och hemtjänst upplever sin psykosociala arbetsmiljö under coronapandemin. Detta genom frågeställningarna: Hur upplever vårdbiträden att deras arbetsinnehåll har påverkats av pandemin? Hur har vårdbiträdenas samarbete påverkats av pandemin? Vilka andra faktorer i den psykosociala arbetsmiljön har vårdbiträdena uppmärksammat i samband med pandemin? Studien genomfördes med en kvalitativ ansats och semistrukturerade intervjuer med fyra vårdbiträden inom äldreomsorgen. Som analysverktyg användes Karasek och Theorells (1990) krav-kontroll-stödmodell. I resultatet framkom att den största inverkan på vårdbiträdenas psykosociala arbetsmiljö under pandemin var samhällets förändrade rekommendationer och restriktioner avseende skyddsutrustning och att förhindra smittspridning. Detta påverkade hela deras arbetssituation på flera olika sätt genom högre krav och mindre kontroll i arbetet. Stödet i arbetet i form av kollegialt stöd, visade sig vara betydelsefullt för den psykosociala arbetsmiljön under pandemin.

The aim of this study is to describe situations that nurses experience as strenuous in their work with elders in institutional environment. The study focuses on the content and structure of the situations, meanings the nurses put in the situations and how they manage to handle the situations. The approach was to have a phenomenological perspective and a theoretical frame of reference in the CPT model  (CognitivePhenomenological-Transactional view) from Lazarus and Manet as well as inAntonovsky's discussion about the importance of general resistance resources against stressful events. The study is based on observations and interviews with five nurses working in three different institutions and in five different wards. The thesis states that factors in the work organisation such as lack of a common caring philosophy, ignorance of the nurses' role and function, communication problems with other organisations, imbalance between demands and resources are experienced as strenuous. Situations with pain and pain relieving, constant shouting from patients and  severe confusion were pointed out as particularly stressful in the interaction with patients. The nurses use a number of strategies in order to handle these strains, such as seeking social support, planned problemsolving, positive reappraisal and sometimes distancing. From an immediate perspective these strategi.es were efficient and the nurses were satisfied with their work.