Sömnstörningar och förskrivning av sömnläkemedel är ett ökande problem i världen och Sverige. Arbetet visar på att prevalensen av användning av sömnläkemedel i Sverige har ökat under åren 2006 till 2019. Från 10,3 % hos kvinnor och 5,9% hos män till 11,1% respektive 6,7 %. I Sverige finns det inga nationella riktlinjer för behandling av sömnstörningar, utan bara på regional nivå. Gemensamt för de regionala rekommendationerna är att kognitiv behandlingsterapi alltid ska testas innan läkemedelsbehandling sätts in. Läkemedelsrekommendationerna skiljer sig något åt mellan regionerna, där melatonin tillkommit de senaste åren hos flertalet regioner. En ökning av antalet patienter som använder melatonin sågs också i arbetet från 2015 till 2019, där den största ökningen var hos de unga vuxna. Godkända indikationer för melatonin är dock bara behandling av sömnstörningar hos ungdomar och vuxna 55+ samt kortvarig behandling av jetlag hos vuxna. Därför är Region Stockholms rekommendation 2020 överraskande. Melatonin är förstahandsval till alla åldrar vid farmakologisk behandling av sömnstörningar.  Bensodiazepinder och Bensodiazepinliknadande läkemedel tillhör de narkotikaklassade sömnläkemedel, vilka medför en ökad risk för att utveckla läkemedelsberoende hos patienterna. Bensodiazepinliknande läkemedel har under många år ökat i Sverige, men i detta arbete tyder det på att den trenden har brutits. Användningen och nyförskrivning av de narkotikaklassade läkemedel har minskat från 2015 till 2019. Incidensen för alla narkotikaklassade sömnläkemedel har minskat, från 8,4% hos kvinnor och 6,4% hos män till 4,2% respektive 3,6%.  För att besvara arbetes syfte, ” hur ser nyförskrivning av sömnläkemedel ut till vuxna människor i Sverige under åren 2015 till 2019” samt ” tidstrender i användningen av sömnläkemedel under åren 2006–2019” gjordes en kvantitativ deskriptiv kohortstudie baserad på olika register. Barn och ungdomar under 18 år exkluderades då de farmakologiska rekommendationerna för barn och ungdomar skiljer sig från de vuxna. Även äldre vuxna över 64 år exkluderades från studien då sömnsvårigheter ökar med åldern och det finns ökad bakomliggande sjuklighet.  De sömnläkemedel som har en ökad risk för att utveckla läkemedelsberoende minskar i förskrivning. Dock undersöktes inte långtidsanvändningen av dessa läkemedel, vilket är viktigt för framtida forskning. / Background: Sleep disorders are an increasing problem in the world, and due to this, prescription of hypnotics is also increasing. Patients who are prescribed benzodiazepines and non-benzodiazepines have a high risk of developing drug-dependency. Aim: To study the incidence in new prescriptions of hypnotics to adults in Sweden during 2015-2019, in relation to gender, age, region, season, prescriber, and comorbidity. Also, to study trends in the use of hypnotics during 2006-2019. Methods: A quantitative descriptive cohort-study based on national registers on in- and outpatient specialist care, and dispensed prescription drugs held by the National Board of Health and Welfare and the Swedish eHealth Agency.  Adults between 18-64 years who had received a new prescription of hypnotics were included. Results:  The prevalence of use of hypnotics has increased during 2006-2019 from 10.3% and 5.9% to 11.1% and 6.7% for women and men, respectively. In contrast, the incidence of newly prescribed benzodiazepines and nonbenzodiazepines has instead decreased during 2015-2019 from 8.4% and 6.4% to 4.2% and 3.6% for women and men, respectively. The proportion dispensed hypnotics increases with rising age, except in the case of melatonin, which is more common among younger patients. Conclusions: The incidence in prescription of benzodiazepines and other sedatives with a high risk of causing drugdependency, has been declining in the latest years. Interestingly, melatonin increases mostly in younger adults, even though melatonin is only indicated for sleep disorders in adults aged 55 years and older, and short time treatment of jetlag in adults.

Introduktion: Migration har alltid förekommit i större delar av världen, men har under de senaste 25 åren ökat. Enligt World Migration Report fanns det över 280 miljoner migranter under 2020, varav 90 miljoner befaras vara flyktingar eller asylsökande. Att integrera i ett nytt land kan vara svårt och många migranter möter både interna och externa barriärer vid den vidare bosättningen. För migranten är den digitala utvecklingen vital och kan på många sätt underlätta integrationen i samhället. Syfte: Syftet med studien är att undersöka vilka digitala möjligheter och utmaningar migranter ställs inför i ett nytt land.  Metod: Den metod som applicerades var en strukturerad litteraturstudie, där artiklar samlades in i databaserna CINAHL, Scopus och Web of Science. 11 artiklar inkluderades, och analyserades genom en tematisk analys med induktiv ansats. Resultat: Den tematiska analysen resulterade i identifierandet av sju teman, samt 14 underrubriker. Resultatet påvisade en komplex relation mellan migranters digitala möjligheter och utmaningar. Digitala medel kan gynna integration i samhället, men är också en risk för socialt utanförskap. Slutsats: Digitala möjligheter reflekteras genom olika aspekter som underlättar integrationen i samhället. Likväl, är dessa möjligheter endast befintliga för de individer som har tillgång och kunskap att bruka digitala medel. / Introduction: Migration has always occurred around most parts of the world, but has increased in the past 25 years. According to the World Migration Report there was over 280 million migrants during 2020, which of 90 million was refugees or asylum seekers. To integrate in a new country can be challenging and many migrants face both internal and external barriers during their settlement. For the migrant, the digital development is vital and can aid the integration in the new society. Aim: The aim of this study is to examine what digital opportunities and challenges migrants face when settling in a new location.  Methods: The applied method was a structured literature review, where articles were gathered from the databases CINAHL, Scopus and Web of Science. 11 articles were included and analysed through thematic analysis with an inductive approach. Results: The thematic analysis resulted in the identification of seven themes, and 14 subcategories. The result demonstrated a complex relation between migrants’ digital opportunities and challenges. Digital means can help integration in society, but also pose as a risk for social exclusion.  Conclusion: Digital opportunities is reflected through several aspects which facilitates integration in society. Yet, these are possibilities only for the individuals who has access and knowledge on how to use digital means.

Bakgrund: Arbetsmiljö och delaktighet anses vara viktiga faktorer för individens hälsa. Över tid har sjuksköterskors och undersköterskors arbetsmiljö förändrats vilket gett upphov till mindre delaktighet på arbetet och mindre förtroende för organisationen.   Syfte: Syftet är att undersöka delaktighet på arbetsplatser bland sjuksköterskor och undersköterskor som arbetar på sjukhus. Studien avser även undersöka om det finns några skillnader mellan sjuksköterskors och undersköterskors delaktighet.   Metod: I denna studie användes en kvantitativ metod med tvärsnittsdesign där data samlades in genom en digital enkät. Urvalet bestod av cirka 300 medarbetare på sjukhus och 76 deltog i undersökningen genom att besvara enkäten. Data analyserades i SPSS genom frekvenstabeller och skillnader fastställdes genom Chi-2-test.    Huvudresultat: Både undersköterskor och sjuksköterskor upplevde delaktighet på sina arbetsplatser. Resultatet visade även att undersköterskor upplevde mer delaktighet än sjuksköterskor. Dock saknade resultatet statistisk signifikans.   Slutsatser: I föreliggande studie har det framkommit att delaktighet på arbetsplatser upplevs positivt för målgruppen. Det som däremot var märkbart var att både sjuksköterskor och undersköterskor i högre grad upplevde att de inte kunde påverka arbetstempot. Vidare upplevde undersköterskor en mer rättvis fördelning av arbetsuppgifter i jämförelse med sjuksköterskor och hälften av båda yrkeskategorierna ville ha mer inflytande på arbetsuppgifterna. / Background: Work environment and participation are considered important factors for the individual's health. Over time, nurses' and assistant nurses' work environment has changed, which has given rise to less participation in the work and less trust in the organization. Aim: The purpose is to investigate workplace participation among nurses and assistant nurses who work in hospitals. The study also aims to investigate whether there are any differences between the participation of nurses and assistant nurses. Method: This study used a quantitative method with a cross-sectional design where data was collected using a digital survey. The sample consisted of approximately 300 hospital employees and 76 participated in the survey by answering the questionnaire. Data were analyzed in SPSS by frequency tables and differences were determined by Chi-2 test. Main results: Both assistant nurses and nurses experienced participation in workplaces. The results also showed that assistant nurses experienced more participation than nurses. However, the result lacked statistical significance. Conclusions: In the present study, it has emerged that participation in workplaces is experienced positively by the target group. What was noticeable, however, was that both nurses and assistant nurses felt to a greater degree that they could not influence the pace of work. Furthermore, assistant nurses experienced a fairer distribution of tasks compared to nurses, and half of both professional categories wanted to have more influence on tasks.

Bakgrund: Nyexaminerade sjuksköterskor kan uppleva en omfattande och påfrestande förändring när de äntrar arbetslivet. Övergångsprocessen från student till yrkesverksam kan vara nästintill chockartad på grund av psykosociala faktorer, och påverka hälsan negativt. Ur ett folkhälsovetenskapligt perspektiv bör problemet undersökas med anledningen att bidra till mer kunskap inom området. Syfte: Syftet med uppsatsen är att undersöka nyexaminerade sjuksköterskors upplevelser och erfarenheter av övergången från student till yrkesverksam i relation till den psykosociala hälsan.   Metod: En kvalitativ metod tillämpades med ett målinriktat- snöbollsurval. Sex informanter inkluderades, samtliga hade genomgått övergången från sjuksköterskestudent till yrkesverksam sjuksköterska. Individuella semistrukturerade intervjuer valdes som intervjuform, och en manifest innehållsanalys användes som analysmetod. Resultat: Uppsatsens resultat består av två huvudkategorier. Den första är tidens betydelse på den psykosociala hälsan. Brist på arbetslivserfarenhet kan upplevas som en osäkerhet i yrkesrollen vilket kan påverka den psykosociala hälsan negativt. Däremot med mer arbetslivserfarenhet utvecklades ett självförtroende i yrkesrollen, som i sin tur främjade den psykosociala hälsan. Den andra huvudkategorin är resursers betydelse på den psykosociala hälsan. Interna och externa resurser underlättade övergången, och bidrog till ett positivt psykosocialt mående. Medan brist på resurser försvårade övergången och välmåendet. Slutsats: Faktorerna tid och resurser påverkade övergången och den psykosociala hälsan. Det framkom även att nyexaminerade sjuksköterskor inte är tillräckligt yrkesförberedda och att förbättringar bör ske inom utbildningen och på arbetsplatsen för att underlätta övergången. Utöver det hade även Antonovskys teori om känsla av sammanhang, betydelse. Teorins tre komponenter, hanterbarhet, begriplighet och meningsfullhet var centrala vid övergången. / Background: Newly graduated nurses can experience a challenging time when they enter work life. The transition process from student to professional can almost be shocking due to psychosocial factors, which in addition can affect the health negatively. From a public health science perspective, the problem should be investigated with the aim of contributing to more knowledge in the field. Aim: The aim of this study is to examine newly graduated nurse’s experiences of the transition from student to registered nurse in relation to the psychosocial health. Method: A qualitative method was applied with a purposive-snowball sampling. Six informants were included, all of whom had undergone the transition from nursing student to professional nurse. Individual semi-structured interviews were chosen as the interview form, and a manifest content analysis was used as the analysis method. Result: The study’s results consist of two categories. The first category is the importance of time on the psychosocial health. Lack of work experience can be felt as an initial insecurity in the professional role as a registered nurse, which can negatively affect the psychosocial health. However, with more work experience a self-confidence in the professional role as a nurse developed which in turn promoted the psychosocial health. The second category is the importance of resources on the psychosocial health. Internal abilities and external support facilitated the transition, and contributed to a positive psychosocial well-being, while a lack of resources made the transition more difficult. Conclusions: The factors time and resources had an impact on the transition and on the psychosocial health. It also emerged that newly graduated nurses are not sufficiently prepared and that improvements should be implied in the education and in the workplace to facilitate the transition. In addition to that had also Antonovsky’s theory sense of coherences an impact on the transition. The theory’s three components, manageability, comprehensibility, and meaningfulness where central for the transition.

Background: In 1946, a proposal was made for a law on national pensions with the aim of reforming the pension system and giving pensioners better finances, which later was implemented at 1948. The theory of the social determinants of health suggests that income is an important factor that has an impact on health. The study aim was therefore to investigate whether the general pension reform implemented in 1948 could account for any differences in death rates for those aged 67 and older, and the research question was to examine if there was change in death rates for those aged 67 and older after 1948 that could be explained by an increase in income from the pension reform  Method: The study design was a quantitative inductive method. Data used in the study was death rates for those aged 67-90 years in Sweden between 1933-1962, as well as statistics from the Statistical Yearbook for Sweden to obtain data on income from the pension system. To investigate whether the pension reform has had any significant effects on the health of people of old ages, an interrupted time series analysis was used to measure changes in death rates for those aged 67-90 years between 1933 and 1962 in Sweden.  Results and conclusion: The results showed that there was an increase in the average pension by 461% for men and 442% for women between the years of 1947 and 1948. The study suggests that for women there was a significant change in death rates since the reform started, but that the reform of 1948 might not have had a significant effect on men’s death rates. Overall my study indicates that the changes in death rates for women in the pension age in 1948 and after could be explained by an increase in income from the pension reform, and that the pension reform seems to be a sustained policy effect that have accumulated over time.

This study aims to discover how self-supported elderly in Finland experience the move towards a digital society and how this change affects their daily lives. As the proportion of the elderly compared to younger generations changes, so does the need for digital services catering to this population group. At the same time, society is digitalising at an accelerated pace, and this growing populace will face a very different society than the one they grew up in. Conducting 11 personal interviews in Tampere, Finland, and phone interviews around Finland, this study presents the elderly in a more nuanced and personal light. Modified Van Kaam analysis brings a comprehensive picture of the emotions and experiences surrounding digitalisation. This study showed that the elderly in the study are managing the use of digital services but were concerned about the skills and coping of others. Lifelong learning is discussed in connection with the results, as is the need for unlearning old habits. Results show that society’s shift into remote healthcare access and limited on-location services cause the elderly concern and uncertainty, decreasing their quality of life. The elderly want to live high-quality life and have an active role in society. This study showed the elderly as quality conscious populace with digital solutions. The inclusivity of the services is essential as the digital society cannot be wholly avoided in modern life. As the study sample is limited to a broad scope, the study’s results guide future research towards more focused research.

Background Each year almost 1 in 3 (27%) of women (15-49y) worldwide experience lifetime physical and/or sexual domestic violence by their husbands/partners; that is almost 736 million women worldwide. According to the PDHS 2017-18, the prevalence of DV is 24% in Pakistan. The higher education level of the husband/partner in Pakistan might act as a protective factor against DV in women. Therefore, this study aimed to explore the association between the husband/partner's level of education and lifetime physical domestic violence against women. Method This quantitative cross-sectional study was based on the secondary data from Pakistan demographic health survey (PDHS) 2017-2018. The Woman's Questionnaire was used for the Data collection, and women (n = 3959) aged 30-49 in Pakistan were included. Descriptive analysis, crosstab chi-squared tests, and logistic regression analyses were performed to describe the background characteristics of the sample and evaluate the association between exposure and outcome of interest.    Results Almost 24% of the women aged 15-49 have experienced lifetime physical domestic violence by their husbands/partners. In addition, 34% of the husbands/partner had secondary education. A secondary education level lowers the odds of physical domestic violence against women (OR=0.65, CI=0.54-0.77).   Conclusion The association between the husband/partner's level of education and lifetime physical domestic violence against women was established in this study. However, improving the husband/partner’s education level might contribute to eradicating DV against women.

Background Diarrhea is a common diseases and each year around 5 billion children suffer from this diseases globally. According to BDHS 2017-18, 21% mothers had no education. Moreover, maternal education might consider to be one of the important aspect which plays a great role to diarrheal incidence. So the aim of this study is to explore the association between level of maternal education and recent episode of diarrhea among under five children in Bangladesh. Method The quantitative cross-sectional study utilized the secondary data from Bangladesh Demography and Health Survey (BDHS) 2017.Data was collected from Women’s Questionnaire and total 8398 mothers having  children aged 0-59 months were selected. Descriptive analysis, crosstab chi-squared tests, and logistic regression analyses were conducted to describe the background characteristics of the participants and explore the association between exposure and outcome of interest. Result Approximately 5% of the children had diarrhea and 17% of the mothers had higher level of education. Children whose mother had higher education had 30% lower risk of having diarrhea (OR=0.70, CI 0.44-1.13) compared to the children having uneducated mother. However, findings revealed that there is no significant association between maternal education and the incidence of diarrhea in the study population.  Conclusion  Based on this study, maternal education has no association with diarrhea among under five children. However, there might be several other factors responsible for the reduction of diarrheal diseases other than maternal education.

The aim of the study was to investigate the perceived factors influencing the possibilities of engaging more children and youth in organized physical activity during their leisure time within the current IOP project. The studys method used semi-structured interviews for data collection. Conventional content analysis was used for data analysis. The results indicate that resources, organizationalstructure and activites, and the interest of children and youth have the greatest impact on their level of engagement in physical activity. Girls, children from different ethnic backgrounds, and those lacking adult role models were considered more challenging to reach. The informants unanimously emphasized the importance of increased collaboration. The conclusion drawn is that access to economic resources, visible organizations, and children and youth's own interest are crucial in promoting their physical activity. The lack of these factors was found to be a hindrance. Challenges were identified in reaching girls, children from different ethnic backgrounds, and those lacking adult role models. The informants emphasized the significance of increased collaboration for promoting physical activity among children and youth.

Introduction: Organized recess activities which stimulate to physical activity are important for developing social skills, academic performance, and creating a positive attitude towards physical activity. The aim of the study is to investigate key people's perceptions towards the implementation of organized recess activities, with an enforcement on physical activities in primary and secondary schools. Method: An exploratory study design with an inductive approach has been used. Five semi-structured interviews were performed to collect data based on the purpose and questions of the study. A purposive sampling has been performed to provide experienced and additional informative respondents. Collected data has been analysed with a qualitative content analysis within a manifest approach. Findings shows an active work and interest in organized recess activities. The importance of having secure adults at break times was reported by all respondents in this study. Perceptions is that recess does not receive the same priority as other subjects within schools. General barriers for the implementation of organized recess activities were lack of commitment, knowledge, planning time and staff resources. Conclusion: Additional knowledge about recess may be a prerequisite for whether schools choose to develop the work with organized recess activities with an enforcement on physical activities. / Introduktion: Organiserade rastaktiviteter som stimulerar till fysisk aktivitet är viktiga för att utveckla sociala färdigheter, förbättra skolprestationer och skapa en positiv inställning till fysisk aktivitet. Syftet med studien är att undersöka nyckelpersoners uppfattningar till implementering av organiserade rastaktiviteter, med fokus på fysiska aktiviteter på låg och mellanstadiet. Metod: En explorativ studiedesign med induktiv ansats har använts som metod. Fem semistrukturerade intervjuer har genomförts för att samla in data om studiens syfte och frågeställningar. Ett strategiskt urval har vidtagits för att tillhandahålla erfarna och informationsrika respondenter. Insamlade data har analyserats med en kvalitativ innehållsanalys med fokuset på det manifesta innehållet. Resultatet visar ett aktivt arbete och intresse för organiserade rastaktiviteter med fokus på fysiska aktiviteter. Betydelsen av att det skall finnas trygga vuxna ute på rasten rapporterades av samtliga respondenter i denna studie. Generella uppfattningar förelåg om att rasten inte blir lika högt prioriterad som andra ämnen i skolan. Utmaningar för implementering av organiserade rastaktiviteter var brist på engagemang, kunskap planeringstid och personal. Slutsats: Ytterligare kunskap om rasten kan sannolikt vara en förutsättning för huruvida skolor väljer att utöka arbetet med organiserade rastaktiviteter med fokus på fysiska aktiviteter.