Övervikt och fetma är ett folkhälsoproblem som ökar i en oroväckande takt både i Sverige och i många andra delar av världen. Fetma räknas som en sjukdom i sig, men är även en riskfaktor för andra icke smittsamma sjukdomar. Våra levnadsvanor grundläggs redan under barndomen och inverkar på hälsan resten av livet. Att satsa på förebyggande åtgärder i tidig ålder kan således vara viktigt för att minska risken att barn senare i livet drabbas av överviktsrelaterade sjukdomar. Syftet med denna studie var att undersöka skolsköterskors och skolors erfarenheter av och förutsättningar för att arbeta med övervikt och fetma bland barn mellan sex och elva år. För att besvara syftet användes en kvalitativ metodansats. Totalt genomfördes sex enskilda semistrukturerade intervjuer med skolsköterskor. Intervjuerna analyserades med en manifest innehållsanalys. I resultatet framkom att övervikt och fetma är vanligt förekommande på skolorna. Övervikt och fetma anses vara ett viktigt, men också svårt, område för skolor att arbeta mot. Skolsköterskorna uppfattar flera hinder i sitt arbete, och önskar att de kunde göra mera för att hjälpa barn som drabbats. Skolsköterskorna har många idéer om hur de och skolorna skulle kunna arbeta förebyggande, men upplever en frustration över de bristande resurserna som ges till det. / Overweight and obesity is a public health problem that is increasing in an alarming rate both in Sweden and in many other parts of the world. Obesity is considered as a disease in itself, but is also a risk factor for other noncommunicable diseases. Our habits are established during childhood and have an impact on our health throughout our lives. Investing in preventive interventions at an early age may therefore be important for reducing the risk of children later in life suffer from obesity-related diseases. The aim of this study was to examine school nurses' and schools’ experiences of and presumptions for working with overweight and obesity among children at primary schools. A qualitative approach was chosen and a total of six individual semi-structured interviews with school nurses were conducted. The interviews were analysed with a manifest content analysis. The result showed that overweight and obesity are common in the primary schools. Overweight and obesity are considered an important, but also difficult, area for schools to work against. The school nurses perceive several obstacles in their work, and wish they could do more to help children who are affected. The school nurses have many ideas about how they and the schools could work preventive, but are frustrated over the lack of resources that are given to it.

På grund av den globala flyktingkrisen har invandringen ökat markant i Sverige (SCB, 2017). Etableringsreformen genomfördes 2010 för att hantera de samhälleliga utmaningar som identifierats och med huvudsyfte att påskynda nyanländas etablering på arbetsmarknaden (lag 2010:197). Ansvaret för nyanländas etablering fördelades på olika aktörer där Arbetsförmedlingen fick det primära ansvaret. Arbetsförmedlingens främsta uppgift är att stödja nyanlända att etableras på arbetsmarknaden, vilket innebar att såväl familje- och barnperspektivet som hälsoperspektivet hamnade i bakgrunden av integrationsarbetet. Etableringsreformen innebar även att det är varje kommun som står för integrationsarbetet, vilket kan se olika ut beroende på intresse och förutsättningar. Vidare arbetar myndigheter i så kallad vertikal samordning, som bland annat innebär att ansvarsfördelning mellan angränsande uppdrag kan bli en utmaning (Bolman & Deal, 2012). Det kan också innebära utmaningar för nyanlända som ofta har flera olika kontakter med myndigheter och andra verksamheter. I kommunen där föreliggande studie är genomförd identifierades ett behov av en länkande funktion mellan verksamheterna och de nyanlända, därav valdes det att anställa personal i uppdrag som denna länk. Kommunen har valt att benämna dem som samhällsvägledare med brobyggarfunktion. Studiens syfte är att undersöka förutsättningarna för integrationsarbetet i kommunen, samt samhällsvägledarnas yrkesroll och utveckling av professionell kunskap i deras hälsofrämjande integrationsarbete. Studien genomfördes med kvalitativ metod där inspiration hämtats från den hermeneutiska ansatsen. Semistrukturerad intervju och dokument utgör empirin där tematisk analys genomförts. Resultatet visar att samhällsvägledarnas arbete i huvudsak sker som möten med enskilda individer som de följer i sina ärenden. Arbetet kräver stor anpassningsförmåga och bred kunskap, då det är tydligt behovsstyrt utifrån de enskilda nyanlända. Detta är möjligt inom ramen för etableringens riktlinjer och att samhällsvägledaren arbetar mellan verksamheterna och nyanlända. Utvecklingen av samhällsvägledarens professionella kunskap sker i det dagliga integrationsarbetet. Exempelvis möter de utmaningar som ger inlärningsmöjligheter vid samtal med nyanlända. Samhällsvägledaren står i kontakt med verksamheter i kommunen och lär sig hur dessa arbetar, vilket underlättar deras arbete när de möter nyanlända med liknande behov. Samhällsvägledarnas egen livserfarenhet och kulturella kunskap utgör en annan förutsättning för integrationsarbetet. Vidare kan arbetet anses som hälsofrämjande insatser, genom att samhällsvägledaren tydliggör funktioner i samhället som att förklara hur Arbetsförmedlingen fungerar eller hänvisa till Försäkringskassan. Nyanlända kommer i kontakt med rätt verksamhet utifrån sitt behov via samhällsvägledaren vilket kan skynda på etableringsprocessen. Yrkesrollen är ny och relativt outforskad, vilket gör att studien bidrar till viktig kunskap för integrationsarbetet, vilka kompetenser som kan stödja arbetet och hur yrkesroller som ingår i detta kan utvecklas. / Because of the global migrant crisis, the immigration to Sweden has increased markedly (SCB, 2017). The Establishment Reform was implemented in 2010 to handle the social challenges that were identified and its main purpose was to accelerate the newly arrived's establishment in the job market (lag 2010:197). The responsibility for handling the establishment of the newly arrived was allocated among different actors, were Arbetsförmedlingen was assigned the main responsibility. The primary task of Arbetsförmedlingen is to support the newly arrived to establish themselves in the job market, which entailed that the family perspective and children perspective, as well as the health perspective ended up in the background of the integration work. The Establishment Reform also meant that each municipality is responsible for the integration work, which may look different depending on interest and preconditions. Furthermore, authorities work in what is called "vertical coordination", meaning, among other things, that the assignment of responsibility between delimited assignment may become a challenge (Bolman & Deal, 2012). It may also mean challenges for the newly arrived, which is often in contact with numerous authorities and other operations. For the municipality were the aforementioned study was carried out, a need was identified for a function which bridged the gap between operations and the newly arrived, hence personel was hired to carry out this function. The municipality choose to denominate these personel as Community Guidance workers with bridging capabilities. The objective of the study was to examine the municipality's integration work preconditions, as well as the Community Guidance worker's profession and the development of professional knowledge for their health promotional integration work. The study was carried out using a quality method, were inspiration was drawn from the hermeneutic approach. Semi-structured interviews and documents constitutes the empirics were thematic analysis were performed. The result of the study shows that the Community Guidance worker's job mainly is carried out as meetings between individuals that they follow in their matters. The work of the Social Guidance worker demands a great ability to adapt and a broad knowledge, as it is distinctively based on the needs of the newly arrived individual. This is possible within the scope of the establishment's guidelines and that the Community Guidance worker works between the operations and the newly arrived. The development of the Community Guidance worker's professional knowledge is formed in the everyday integration work. They will for instance happen upon challenges that will bring about learning possibilities through conversations with the newly arrived. The Community Guidance worker is in contact with the operations in the municipality and will gain knowledge regarding how they work, which in turn will facilitate their own work when the meet newly arrived with similar needs. The Community Guidance worker's own life experiences and cultural understanding constitutes a different prerequisite for the integration work. Further, this work may be seen as health promotional efforts, as the Community Guidance worker clarifies social functions such as explaining how Arbetsförmedlingen works or refer them to Försäkringskassan. The newly arrived will be put I contact with the correct operation based on their need, via the Community Guidance worker, which may accelerate their establishment process. The profession is new and relatively unexplored, which makes this study a valuable contribution to integration work, what expertise will support integrationwork and how the professions that are part of this work may be developed.

Introduktion: Ohälsosamma matvanor är en av de största riskfaktorerna för ohälsa och förekommer oftare i socioekonomiskt svagare grupper. Tillgängligheten av livsmedel påverkar både vilka kostval vi gör och hur mycket vi konsumerar. Marknadsföring påverkar tillgängligheten och används för att styra konsumenternas livsmedelsval. För att främja hälsosamma val behövs stödjande miljöer med tillgängliga, prisvärda och hälsosamma livsmedel. Syfte: Syftet är att undersöka hur hälsosamma livsmedelsval har samband med konsumenters upplevelser av dagligvaruhandelns bidrag till stödjande miljöer för hälsosamma livsmedelsval. Metod: En kvantitativ tvärsnittsdesign tillämpades. Datainsamlingen skedde genom webbenkät vilken länkades till informanter via sociala medier. Deskriptiv analys användes samt positiv oddskvot för att belysa det salutogena perspektivet. Ett p-värde på <0,05 ansågs signifikant. Resultat: Respondenterna (n=346) var kvinnor och män över 21 år. Majoriteten var kvinnor i medelåldern, med högskole- eller universitetsexamen samt medelinkomst. Konsumenter som väljer hälsosamma livsmedel har samband med sinnesstämning, naturliga livsmedel och tillgänglighet. Slutsats: Det är viktigt att hälsofrämjande insatser riktas mot hela samhället och stärker medvetenheten om hälsosam kost. Då studien visade samband mellan konsumenters upplevelser av dagligvaruhandelns stödjande miljöer och hälsosamma livsmedelsval, bör hela livsmedelskedjan medvetandegöras om hur folkhälsan påverkas av stödjande miljöer. / Introduction: Unhealthy eating habits are one of the major risk factors för unhealth and occur more frequently in low socioeconomic areas. The availability of food affects both the dietary choices we make and how much we consume. Marketing affects accessibility and is used to guide consumers' food choices. In order to promote healthy choices, supportive environments with available, affordable and healthy foods are needed. Aim: The aim is to investigate how healthy food choices are linked to consumers' experiences of the grocery retailer's contribution to supportive environments for healthy food choices. Methods: A quantitative cross-sectional design was applied. Data was collected with a web survey. Descriptive analysis applied as well as logistic regression analysis and positive odds ratio was used to illustrate the salutogenic perspective. A p-value of <0.05 was considered significant. Result: The respondents (n = 346) were women and men over 21 years. The majority were middle-aged women, with a college or university degree and middle income. There is an association between consumers who choose healthy foods and mood, natural foods and availability. Conclusion: It is important that health promotion efforts are directed at the entire society and strengthen the awareness of healthy eating. As the study showed a correlation between consumers' experiences of the grocery's supportive environments and healthy food choices, the entire food supply chain should be made aware of how public health is affected by supportive environments.

The modern hospice movement emerged in the 1960s as a grassroots social movement that attempted to restore an holistic and contextualised approach to the care of people at the end of life. This approach embraced the lived experience of the dying person at the centre of care across physical, emotional, social and spiritual domains of life. To achieve this, the care of dying people was largely removed from mainstream health care systems to promote more holistic and socially contextualised dying. In recent decades, the evolution of palliative care demonstrates the gradual return of palliative care services to the mainstream. It has been asserted that, in this process, palliative care services have progressively abandoned the social context of dying people, increasing instead an emphasis on "physical care [while] simultaneously de-emphasizing psychological, social and spiritual care" (Kellehear, 1999a, p.76). Kellehear and others have proposed that the repositioning of palliative care within mainstream health care systems has increased a focus upon illness and disease at the expense of health and wellbeing. Subsequently, conventional palliative care services have been criticised for not adequately locating end of life care within the social contexts in which death and dying take place. In an attempt to address this problem, Australian sociologist Allan Kellehear proposed an approach to end of life care that brought together the core concerns of palliative care with the principles and practices of health promotion (Kellehear, 1999b). Whilst their congruence is not immediately apparent, these two fields have been increasingly examined for their potential benefits in the provision of end of life care. In the current policy climate in Australia, there is an imperative to consider how end of life support services might be improved through adopting a health promoting palliative care approach. The aim of this study has been to investigate the integration of health promotion principles and practice by a selected palliative care service by examining the qualitative impact of this change on the organisation. Specifically, it endeavoured to identify the factors that advanced or impeded this integration by examining how the structures and processes of, and outcomes for, the organisation reflected a health promoting approach. To meet these aims, this study undertook an in-depth examination of the implementation of a health promoting palliative care model by a community based palliative care organisation. Based in a constructionist-interpretivist paradigm, a mixed-method (QUAL+quant), instrumental case study research design was utilised to capture multiple perspectives of the implementation process. Data collection comprised examination of 127 organisational documents, 32 in-depth interviews with staff, volunteers and consumers, 5 focus groups with staff and volunteers, and 25 carer questionnaires. Qualitative data were subject to thematic analysis, with supplementary quantitative data analysed to generate descriptive statistics. The findings demonstrated a large number of complex and interrelated enabling and impeding factors to the implementation in the case study site. These factors have been grouped into four key themes which have been examined in light of the aims of this study and the issues identified in a comprehensive review of the literature. This study found that: ◦ Conceptual congruence between health promotion and palliative care was a fundamental starting point in the implementation of a health promoting palliative care model. ◦ Where conceptual congruence was clear, activities associated with the model that were regarded as beyond conventional approaches to palliative care core business were viewed favourably by stakeholders and were less likely to encounter resistance within the organisation. ◦ When systematic approaches to organisational change, such as quality improvement systems, were rigorously applied, the impact of the transition upon stakeholders was qualitatively less. ◦ Where this transition had been effectively made, consumers, staff, volunteers and members of the wider community were seen to benefit. This study adds to the current discourse regarding the intersection between end of life support and health promotion, and provides insight into how palliative care organisations might undertake the transition from conventional models to a health promoting palliative care approach.