Shortly after Charles Dickens's A Christmas Carol was released in 1843, a tradition of adaptation began which has continued seemingly unabated to the present day. Consequently, the tale has become so widely known that one is arguably as likely to have first encountered the iconic miser Scrooge through any number of audio-visual adaptations as through the original work itself. Significant critical attention has been paid to the nature of Scrooge's drastic change from miser to philanthropist. Many would argue that the change, happening both literally and figuratively overnight, is not representative of a genuine psychological transformation. On Christmas day, 2010, Stephen Moffat, Show-runner of the popular sci-fi series Doctor Who, became the latest adapter of the classic tale, with a Christmas themed episode of the series titled Doctor Who: A Christmas Carol. This paper addresses the Scrooge Problem, or the debated legitimacy of Scrooge's transformation. A study of A Christmas Carol and Doctor Who: A Christmas Carol reveals that Dickens in fact represents a genuine transformation based on one primary concept, time as a cyclical journey. This concept accommodates Dickens's belief in the transformative power of childhood memory and the nature of sympathy. Scrooge's transformation is brought to pass in part through his evolving understanding of the nature of time, a phenomenon which becomes even more apparent in Doctor Who: A Christmas Carol.

Background: Errors related to patient safety are a major contributor to adverse incidents and preventable deaths. Interventions aimed at changing team behaviour and implementing World Health Organisation Safe Surgical Checklists (WHO SSCL) have been associated with improved outcomes. We required a cost- and timeefficient vehicle to address low adoption rates of the WHO SSCL, barriers to interdisciplinary teamwork, and inadequate attention to patient safety. Method: We aimed to test the feasibility and efficacy of a simulation-based intervention to improve behaviour influencing patient safety in operating theatres. We performed a prospective cohort study using survey tools for attendee feedback immediately after the event and at 6 weeks. We report feasibility and efficacy data plus qualitative feedback from the education team describing the advantages of this instructional design. The intervention was a 2-stage simulation. First, learners watched a 5-minute film, set in the operating theatre, depicting an error-filled WHO SSCL timeout. Second, learners entered a simulated operating theatre environment with multiple errors and risks to patient safety. Learners identified errors and prioritised them in order of importance. Their observations were discussed in a small group debrief session facilitated by novice debriefers before a whole group plenary discussion. Results: One hundred and three health workers attended the education event and 77 (75%) responded to the Immediate Questionnaire. Surgeons (27), Anaesthetists (18) and Scrub Nurses (12) made up the majority of respondents. Sixty-seven (87%) participants agreed or strongly agreed that they “now have an increased awareness of patient safety”, while 75 (97%) agreed or strongly agreed that they “feel more committed to ensuring a team approach to patient safety”. Thirty (29%) attendees responded to the Delayed Questionnaire distributed via email 6 weeks after the event. Twenty-eight (93%) agreed or strongly agreed that they felt more committed to ensuring a team approach to patient safety. Conclusion: The total cost of the event was low. Faculty reported that the instructional design afforded deliberate targeting of the importance of multi-disciplinary teamwork in patient safety. The simulation event was feasible at low monetary, time, and human resource costs. This approach offers a scalable instructional design that targets inter-professional learning.

Bakgrund: Agenda 2030 har som delmål 3.4 en strävan att främja hälsoarbetet och välmåendet för alla oavsett ålder eller förutsättningar. År 2020 gjordes en enkät där endast 66% nådde upp till WHO’s rekommendationer av fysisk aktivitet. Rekommendationerna gäller även personer med en funktionsvariation. TBI är en av den vanligaste neurologiska funktionsvariationen, där fysioterapeuterna som jobbar med fysisk aktivitet under rehabiliteringen har en viktig roll. Syfte: Syftet med denna studie är att undersöka hur fysioterapeuter inom rehabilitering för personer med TBI använder fysisk aktivitet samt hur arbetet fungerar i hänsyn till de förutsättningar som finns för personalen. Metod: Studien genomfördes med semi- strukturerade intervjuer via digitala mötesrum, där tre kvinnliga fysioterapeuter intervjuades. Sedan gjordes det en summativ innehållsanalys av den insamlade datan. Resultat: Fysisk aktivitet under rehabiliteringen användes med fokus på att patienterna skulle återfå vardagsfunktion. Personalen ansåg att förutsättningarna till att kunna använda fysisk aktivitet var bra, men att det fanns brist på personal och utrustning. Slutsats: Slutsatsen är att fysisk aktivitet inom rehabilitering för personer med TBI individanpassas och används med fokus på att återfå vardagsfunktion, men att de fysiska resurserna utifrån de förutsättningar som fanns för dessa fysioterpeuterna var begränsade.

Cities are facing a major demographic change where the proportion of older people isexpected to increase. This has drawn attention to the need to make cities more age-friendly,and thus promote health, independence and the active lives of the elderly. In 2010, theWorld Health Organization (WHO) created a global network for age-friendly cities andcommunities with the aim of spreading knowledge and information about how to betteradapt cities for older people. Stockholm is one of many cities that have now joined thenetwork and thus committed to making the city more age-friendly. The aim of this thesis hastherefore been to investigate how Stockholm can plan to become an age-friendly city basedon the WHO guidelines and the age-friendly planning processes in other cities.First, a literature study of articles concerning other cities’ age-friendly work was made.Based on this literature study, a theoretical framework was developed around the themesthat emerged as particular important regarding age-friendly planning. The theories werecollaborative planning, institutional capacity and integrated planning. Furthermore, studiesof documents dealing with the future development of Stockholm City were conducted toexamine the elderly perspective in these. Finally, interviews with municipal officials andpoliticians were made to get a deeper understanding of how the cities age-friendly planninglooks today.The study’s results indicate that Stockholm has good opportunities to plan for an agefriendlycity, while there are still several obstacles to overcome. The city’s strengths are thedesire to become more age-friendly, which is evidenced by political support and a givenbudget, as well as the recognition of the importance of including the urban planning office.However, some of the obstacles that remain are the lack of cross-sectorial collaboration(between the urban planning office and the elderly administration office), that the elderlyadministration office comes in too late in urban planning processes, and that the needs ofthe elderly have long been adopted through the accessibility perspective only. The studyends with a number of solutions to help overcome these obstacles. / Världens städer står inför en stor demografisk förändring där andelen äldre människorförväntas öka. Detta har uppmärksammat ett behov av att göra städer mer äldrevänliga, föratt på så sätt främja de äldres hälsa, självständighet och aktiva liv. År 2010 skapadeVärldshälsoorganisationen (WHO) ett globalt nätverk för äldrevänliga städer och kommunermed syftet att sprida information och kunskap om hur man bättre kan anpassa städer föräldre människor. Stockholm är en av många städer som nu har gått med i nätverket ochdärmed åtagit sig att göra staden mer äldrevänlig. Syftet med detta arbete har därför varitatt med hjälp av WHO:s riktlinjer och andra städers äldrevänliga planeringsprocesser,undersöka hur Stockholm kan planera för att bli en mer äldrevänlig stad.Först gjordes en litteraturstudie av artiklar där man forskat om städers äldrevänliga arbeten.Baserat på denna litteraturstudie togs ett teoretiskt ramverk fram kring de teman somframkommit som särskilt viktiga angående en äldrevänlig planering. Teorierna som använtsär kollaborativ planering, institutionell kapacitet samt integrerad planering. Vidaregenomfördes studier av dokument som behandlar Stockholms stads framtida utveckling föratt undersöka äldreperspektivet i dessa. Till sist genomfördes även intervjuer medförvaltningsanställda och politiker inom stadsbyggnad och äldrefrågor för att få en djupareförståelse för hur stadens äldrevänliga planering ser ut idag.Studiens resultat tyder på att det idag finns bra förutsättningar för Stockholm att kunnaplanera för en äldrevänligare stad, samtidigt som det återstår ett antal hinder för arbetet. Destyrkor som staden visar idag är viljan att bli mer äldrevänlig, något som framgår genompolitiskt stöd och en avsatt budget för arbetet, samtidigt som man inser den viktiga roll somstadsbyggnadskontoret kan bidra med. Några av de hinder som dock återstår är bristen påsektorsövergripande samverkan (mellan stadsbyggnadskontoret och äldreförvaltningen), attäldreförvaltningen kommer in för sent i stadsplaneringsprocesser, och att äldres behov längehar antagits tillgodoses genom tillgänglighetsperspektivet. Studien avslutas med ett antalförslag på lösningar för att överkomma dessa hinder.

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The current opioid epidemic has had grave financial and mortal costs for our nation, and the numbers continue to climb despite our best efforts. In spite of attempts to limit the prescription of opioids and implementation of harm reduction strategies, it is clear that we are not doing enough for people struggling with drug addiction. There are many voices present in the war on drugs, however one that is noticeably absent from the conversation is that of people who inject drugs. It is clearly time to try something new which requires a fresh approach and a new point of view. Confronting the current crisis using a public health approach addresses the associated moral challenges faced in the past and provides a new lens to view potential challenges and solutions. With this new approach arises the need for a public health ethical framework to make ethically informed, community engaging, evidence based decisions on a societal, public health, and everyday level. In addition to this new public health ethics framework, the engagement of the community of people who inject drugs is no longer negotiable in order to develop more effective harm reduction interventions and policies. / Urban Bioethics

This study compares anthropometry of rural Indian schoolchildren using national and international reference values, and explores association between demographic and socioeconomic variables and growth measures among rural children. A cross-sectional survey of height, weight, and BMI was conducted among schoolchildren (5-16 years) in Gujarat, where there were pre-established contacts who could facilitate access to schools and data collection for this study. Gender- and age-specific Z-scores were obtained for 519 children (234 girls, 285 boys) based on Indian reference values (Khadilkar et al., 2009) using an Excel® macro. Percentages of children stunted (height-for-age less than or equal to -2SD), underweight (weight-for-age less than or equal to -2SD), and wasted (BMI-for-age less than or equal to -2SD) were obtained (Khadilkar & Khadilkar, 2011). Children falling between adult Indian BMI levels 23 and 28 kg/m2 were considered overweight, and those above 28 kg/m2 were considered obese. Those stunted (height-for-age + 1SD), and obese (BMI > +2SD) were generated similarly using the WHO International Growth Standards (WHO, 2015). Regression analyses were conducted to model the relationship between growth measures, determined using national references, and predictor variables: age, gender, school, and caste. 21%, 23.1%, 8.9%, 2.7% and 0.2% of children were respectively stunted, underweight, wasted, overweight and obese based on Indian References and recommendations, and 27 %, 8.7%, 6.4% and 2.7 % respectively stunted, wasted, overweight and obese based on WHO Standards and recommendations. School was found to have significant interaction with all growth measures (P <.0001) and age had a significant interaction with height-for-age (P = 0.05). The current level of undernutrition, and emerging problems of overnutrition, in this study highlight a need to concentrate efforts to improve nutrition of Indian schoolchildren in rural areas. / Public Health