Background During pregnancy, a healthy diet is beneficial for the expecting mother and her fetus. Midwives in antenatal care have an ideal position for promoting a healthy diet and thereby help women to not only lower the risks of pregnancy complications and adverse birth outcomes, but improve maternal health. The overall aim of this thesis was to describe diet and dietary changes during pregnancy from the women’s and the midwives’ perspectives with a focus on dietary counseling. The thesis comprises four studies. The specific aims in the respective studies were to: I) Describe pregnant women’s attitudes to and experiences of dietary information and advice, as well as dietary management during pregnancy. II) Explore midwives’ strategies in challenging dietary counseling situations. III) Describe how midwives’ perceive their role and their significance in dietary counseling of pregnant women.  IV) Describe women’s food habits during pregnancy and up to six months postpartum. Methods Studies I-III were qualitative. Study I included focus group interviews with 23 pregnant women. Study II included telephone interviews with 17 experienced midwives working in Swedish antenatal health care. Study III included the same 17 interviews from study II and supplemented them with four face-to-face-interviews. Qualitative content analysis was performed in all three studies. Study IV was a longitudinal study including a quantitative analysis of a questionnaire, which was given to women at five occasions during and after pregnancy. It concerned their food habits and it was answered by 163 women. The quantitative data was analyzed using comparative and descriptive statistics. Results The overall findings of the thesis were summarized as the main theme “Pregnant women and midwives are not in tune with each other about dietary counseling”. The main theme included the two themes ‘Pregnant women are concerned about risks for their child but fail to change to healthier dietary habits over time’, and ‘Midwives view themselves as authorities, though questioned ones’. In subthemes it was highlighted that pregnant women are well informed and interested in risk reduction for their child’s best and that they try to do their best to improve their diet during pregnancy. However, their diet did not reach levels of healthy eating recommendations and became even unhealthier after pregnancy. It was also highlighted that midwives experienced insufficient knowledge in dietary issues and related risks and that they had difficulties to give dietary support to pregnant women. Midwives were found to mainly focus on giving information and they lacked sufficient competence for challenging counseling. Conclusion Pregnant women, on the one hand, experience a lack of support from the midwives when dealing with dietary changes. The midwives, on the other hand, feel exposed and express a need for both further education in dietary issues and training in counseling. Women’s food habits during, but in particular after pregnancy need improvement, and dietary counseling could be more focused on healthy eating in a long-term perspective. / <p>Felaktigt ISSN angivet i avhandlingen och på spikbladet.</p>

Background: Food nourishes us, sustains us, and has the potential to both heal us and make us sick. Among many Indigenous cultures, traditional activities, ceremonies, events and practices often involve or use food, grounding Indigenous peoples within the context of their local, natural surroundings. This suggests that food is important not only for physical health, but also emotional, mental and spiritual health. The relationships that Indigenous peoples have with food can help us to understand the health of individuals, and the communities in which they live. Purpose: The following qualitative study explores how three generations of adults who live in one Labrador Inuit-Metis community experience and understand their relationships to food in a context of global change. Theoretical Orientation: The research is guided by Two-Eyed Seeing. Two-Eyed Seeing acknowledges that there are many different ways of seeing and understanding the world, some of which can be encompassed through a ‘Western eye’ and some through an ‘Indigenous eye.’ If we learn to see through both eyes, we can gain a perspective that looks very different than if we only view the world through a single lens. Methods: For the study, twenty-four people from the south-eastern Labrador community of St. Lewis participated in individual and joint story-telling sessions. A group story-telling session also took place where community members could share their stories with one another. During many of the story-telling sessions, participants shared photographs, which helped to illustrate their relationships to food. Findings/Discussion: Historically, the people of St. Lewis relied almost entirely upon their own wherewithal for food, with few, if any, government services available and very little assistance from the market economy. This fostered and upheld an Inuit-Metis culture that promoted sharing, reciprocity and respect for the natural world. Currently, greater access to government services and the market economy has led to the creation of certain policies and programs that undermine or ignore established social and cultural norms in the community. Conclusions: Existing Inuit-Metis knowledge should work alongside non-Indigenous approaches to policy and program development. This would serve to protect and promote the health of both individuals and communities.

This thesis is about medical doctors with immigrant backgrounds who work in Sweden. Based on 15 qualitative interviews with medical doctors with immigrant backgrounds, this thesis explores the medical doctors’ feeling of professional belonging and boundary work. This thesis focuses mainly on the doctors’ experiences of being part of the Swedish medical profession while, at the same time, being regarded as ‘different’ from their Swedish medical counterparts. It starts off with the idea that medical doctors with immigrant backgrounds may have, or could be regarded as having, contradictory social positions. By virtue of being part of the Swedish medical profession, they belong to one of the most privileged groups in Swedish society. However, due to their immigrant background these doctors do not necessarily occupy a privileged position either within their profession or in society in general. This thesis shows that doctors with immigrant backgrounds feel that they are not perceived as full-fledged doctors, which seem related to how they are somewhat ‘othered'. The results show that these doctors cope with being seen as different from doctor with non-immigrant backgrounds, by using the notion of ‘migranthood’ as a resource in negotiations in everyday work life but they also do what they can to overcome the boundaries of ‘Swedishness’. Belonging should therefore be seen as having a formal and an informal side, as getting a Swedish license does not automatically mean that you feel belonging to, in this case, the Swedish medical profession. This seems to put doctors with immigrant backgrounds in a somewhat outsider within position, which seems having to do with boundaries between who is included in the ‘us’ and in the ‘them’. Lastly, these findings indicate that sociologists need to expand the understanding of professional groups to also include boundary work within these groups. In order to do so, this thesis argues that sociological theory on professional groups could be combined with sociological theory about social positions as that is one way to understand the outsider-within position that these doctors (and presumably other skilled migrants) have to cope with.

Australia�s policy on Quality Use of Medicines (QUM) aims to achieve appropriate use of medicines and improved health outcomes. Drug and Therapeutics Committees (DTCs) are educators, policy makers as well as financial gatekeepers in matters relating to medicine use. Increasingly, DTCs are also involved in risk management and clinical governance. As such, DTCs could be considered to be QUM advocates in the institutions in which they function. In a health care arena where there are escalating demands on high standards of clinical practice, quality assessment and improvement is essential in ensuring safe and effective patient care. Given the role DTCs play in safeguarding the interests of the stakeholders of the health care system, research into ways in which DTC performance could be enhanced is required. Although indicators specific to DTCs exist, the literature does not seem to provide straightforward answers to the question of what is currently being done in terms of quality assessment and quality improvement of DTCs. In the absence of such data, an opportunity for research is clearly identified. The first aim of this research project was to gain insight into the current activities undertaken by, and challenges facing Australian DTCs. Following this, the second aim was to explore ways in which DTC performance could be augmented. In addressing the first aim of this project, a national survey of Australian DTCs was conducted. These findings reinforce the evidence in the literature about the roles, structure and stakeholder expectations of DTCs. Our research also documents DTCs� quality improvement initiatives and barriers to DTC activities. It appears that there is little support available to Australian DTCs. Further, a case study was undertaken in order to gain an understanding of the depth and detail of DTC operations. An audit of a DTC in an Australian hospital was conducted. This study revealed that DTC decisions are being implemented in an ad hoc manner. In fact, there were no strategies (or action) planned to implement the majority of their decisions. This could have an impact on DTC performance. In view of this finding, qualitative methods were used to explore stakeholder opinions regarding the implementation of DTC decisions and policies. Stakeholders believed that strategies used to implement DTC policies should be targeted (to the audience as well as the type of decision/policy being implemented), timely, and delivered at the point of care. Face-to-face strategies were perceived to be more effective than printed materials, particularly when an influence on clinical practice was desired. Stakeholders also felt that the lack of resources was a significant barrier to DTC performance augmentation. This probably contributed to a lack of follow-up (or review) of implemented policies. According to stakeholders, other barriers to policy implementation include a lack of ownership of policies, low DTC profile, and an over-reliance on pharmacy to implement DTC decisions. Stakeholders felt one of the ways in which DTC performance could be improved was to prioritise DTC decisions for implementation. In pursuit of a method to prioritise DTC decisions, a survey was conducted. Stakeholders identified patient safety, cost, and the practice of evidence-based medicine as domains of important DTC decisions. The results also suggest that stakeholders recognise the need for the prioritisation of DTC decisions for implementation. Stakeholders implied that higher priority would be assigned to DTC decisions considered to be important. In a follow-up survey, stakeholders (including doctors, nurses, pharmacists, and DTC members) seemed to have agreement of the primary domains of DTC decisions. Higher levels of importance and higher priority were assigned to decisions involving the primary domains of patient safety and cost. However, level of importance and priority assignment were not consistently correlated. The work presented in this thesis suggests that there are ways to improve DTC performance. Although conducted primarily on hospital-based DTCs, it is anticipated that the lessons learnt could be applied to state-based, or even, Area Health-based DTCs. In conclusion, this research found that there was a range of views regarding �importance� and prioritisation for implementation. Social, organisational, as well as environmental factors may contribute to this. Future research should examine other possible factors contributing to the importance and priority of DTC decisions, so that DTC policy could be appropriately implemented into practice.

Since its invention nearly 150 years ago, margarine has proven itself adaptable to multiple ingredients and techniques whilst continuing to mimic the fatty tastes familiar to eaters in Northern Europe. In this thesis I argue that it this malleability that makes margarine a useful subject with which to explore constructions of eating-well. This thesis examines the ways in which margarine is done, why it is done in the ways that it is, and explores how such doings frame possibilities for eating-together-well. Eating-well has become something of a social obsession in the UK in recent years. Individual eating practices have become framed as a responsibility of care for personal and societal health, for agricultural workers, animal welfare and for the future of the planet. Nonetheless, it is commonly believed that although deeply personal, food habits are culturally and socially engrained, and as such are hard to change. This empirically led thesis, examines the knowledges and practices of producers and consumers, and establishes habit formation as a typical response by both producers and consumers to becoming overwhelmed with incompatible knowledges and information, compelling them to choose, prioritise and juggle ‘moral’ values. Yet, I demonstrate that such habits only remain stable until disrupted by an event which overflows and troubles this settlement. Building on this, this thesis then examines the possibilities offered by the creation of micro-events for encountering, knowing, and relating with, margarine matters anew. In this way, this thesis investigates the values, norms and power relations entangled with the presentation and enactment of margarine and its constituent parts as ‘good’ or ‘bad’ foods, examining both what these framings do, and how they are maintained. In approaching margarine matters in this way, this thesis offers three key contributions to the area of food geographies. Firstly, I demonstrate how commodity frameworks shift political problems in to a technical and administrative realm and close down spaces of critical thought and political intervention. Secondly, I establish that ‘strange encounters’ are events which can add to understandings of the more-than human world-making of food knowledges, practices, and habits. Thirdly, I determine that the novel methodological approach of ‘playing with our food’ is a productive technique with which to prefigure and rehearse more nuanced ethical understandings of eating-well as a relational doing that is excessive to consuming-well.

Bakgrund : Sjuksköterskans roll i omvårdnad inom rättspsykiatrin är komplex. Detta på grund av att utöver omvårdnaden, skall även en säker miljö upprätthållas. Tvångsåtgärder kanske också måste utföras, vilket kan påverka sjuksköterskans etiska och moraliska principer. Den mest framträdande uppgiften sjuksköterskan har är dock att genom en sjuksköterska-patient relation skapa hälsa och välbefinnande samt ge patienter en chans till att växa och utveckla sina beteende. Syfte: Syftet med studien var att beskriva aktuell forskning om sjuksköterskans attityder inom den rättspsykiatriska omvårdnaden. Metod: Litteraturöversikt som inkluderar elva kvalitativa studier. Studierna som tagits fram har analyserats och teman identifierats. Databassökningar har genomförts i PubMed, CINAHL, SveMed+ och PsycINFO. Resultat: Tre huvudteman och två subteman identifierades. Första huvudtemat var sjuksköterskans roll med subteman relationens faser och säkerhet och tvångsåtgärder. De andra två huvudteman som identifierades var maskulinitet och copingstrategier. Slutsats : De affektiva attityderna som sjuksköterskan upplever kan styra mycket av de beslut och handlingar som utförs. Detta kan påverka patienters hälsa, välbefinnande och utvecklande. Män ansåg sig själva att genom handlingskomponenten bidra till en trygg och säker miljö. / Background: The nurse has a complex role of nursing care in a forensic care setting. This due to in addition to nursing care, also a safe environment should be preserved. Coercive measures may also have to be carried out, which can affect nurse´s ethical and moral principles. The most prominent task the nurse has are however to create health and wellbeing through nurse-patient relation as well as to offer the patient an opportunity to grow and to develop his behavior. Aim: The aim with this study was to describe current research of the nurse’s attitudes about nursing care in forensic care settings Method: Literature review including eleven qualitative studies. The studies have been analyzed and themes has identified. Database searches are made in PubMed, CINAHL, SveMed+ and PsycINFO. Results: Three main themes and two sub themes were identified. The first main theme was the nurse role with the sub themes the phases of a relationship and safety and coercive measures. The two other main themes that were identified are masculinity and coping strategies. Conclusion: The affective attitudes that the nurse experiences can control much of the decisions and actions that are performed. This can affect patients' health, well-being and development. Men considered themselves to contribute, through the action component, to a safe and secure environment.

This thesis is about medical doctors with immigrant backgrounds who work in Sweden. Based on 15 qualitative interviews with medical doctors with immigrant backgrounds, this thesis explores the medical doctors’ feeling of professional belonging and boundary work. This thesis focuses mainly on the doctors’ experiences of being part of the Swedish medical profession while, at the same time, being regarded as ‘different’ from their Swedish medical counterparts. It starts off with the idea that medical doctors with immigrant backgrounds may have, or could be regarded as having, contradictory social positions. By virtue of being part of the Swedish medical profession, they belong to one of the most privileged groups in Swedish society. However, due to their immigrant background these doctors do not necessarily occupy a privileged position either within their profession or in society in general. This thesis shows that doctors with immigrant backgrounds feel that they are not perceived as full-fledged doctors, which seem related to how they are somewhat ‘othered'. The results show that these doctors cope with being seen as different from doctor with non-immigrant backgrounds, by using the notion of ‘migranthood’ as a resource in negotiations in everyday work life but they also do what they can to overcome the boundaries of ‘Swedishness’. Belonging should therefore be seen as having a formal and an informal side, as getting a Swedish license does not automatically mean that you feel belonging to, in this case, the Swedish medical profession. This seems to put doctors with immigrant backgrounds in a somewhat outsider within position, which seems having to do with boundaries between who is included in the ‘us’ and in the ‘them’. Lastly, these findings indicate that sociologists need to expand the understanding of professional groups to also include boundary work within these groups. In order to do so, this thesis argues that sociological theory on professional groups could be combined with sociological theory about social positions as that is one way to understand the outsider-within position that these doctors (and presumably other skilled migrants) have to cope with.

Smart home technology and IoT is rapidly gaining popularity, and many systems use mobile applications to control the hardware in the homes of the owners. Connective created by Indentive is one such system, which allows users to control things like the temperature in their homes via their smartphones. However, the usability of applications such as this one can be limited, which leads to frustration and even loss of interest for the users. This can result in critical implications for the company producing such a system – both economically and in regards to popularity. It is therefore important for companies to detect issues with their systems early on in order to address these issues and prevent negative implications. Connective was thus tested in a qualitative study using contextual inquiries with 7 participants. The data from the inquiries was then structured through thematic analysis, and the usability of the application was also tested using SUS-evaluation. Wireframe suggestions for changes to the application were then brainstormed with the thematic analysis and the result of the SUS in mind. Major issues that were addressed were access to help, information, the layout, the handling of errors, and feedback. Future studies should include further, more in-depth qualitative studies, perhaps in combination with quantitative data, to further improve and develop the wireframe-suggestions into working prototypes that can then be user tested.

Twenty five years after AIDS was first scientifically described, the disease continues to take its toll on the human population. HIV/AIDS disproportionately affects marginalized groups such as poor, underserved, minority populations. In the United States, Blacks become infected with and die from HIV/AIDS more than any other ethnic or racial group. Despite a vast body of literature on HIV/AIDS, little research has focused on black heterosexual men and even fewer studies have explored the context of risk among subgroups of black men. Using qualitative research methods and a socio-ecological framework, this study explored the intrapersonal, socio-cultural, and behavioral factors that influence sexual behaviors in ethnic subgroups of black men who identify as heterosexual. Further, the study examined black women's perceptions of the sexual behaviors of black men. Conducted in a metropolitan area in Southwest Florida, the study consisted of two phases: 1) semi-structured in-depth interviews were conducted among U.S.-born (N=15) and Haitian-born (N=14) heterosexual men who are 18 years and older and have lived in the U.S. for at least 3 years. 2) Using focus group methodology, phase 2 explored black women's (N=23) perceptions of black male sexual behaviors. Study findings have significant implications for public health education, research and practice. Findings reveal that while Haitian-born and U.S.-born men have high levels of knowledge about HIV, they also ascribe to HIV conspiracy beliefs and practice high risk sexual behaviors such as unprotected sex and partner concurrency. Results show that black men's sexual behaviors are influenced by socio-ecological factors such as family norms, hip-hop culture and religious beliefs. Female study participants perceived factors such as masculine ideologies, socialization, and the male-to-female ratio imbalance as critical influences on male sexual behaviors. While intrapersonal approaches are important to address HIV risk behaviors, ecological frameworks are necessary to inform the development of HIV prevention programs that address the socio-ecological factors that create an environment of risk. This inquiry underscores cultural and gender differences in the conceptualization of HIV/AIDS. Findings have implications for HIV prevention and demonstrate the need for gender-specific and culturally relevant HIV prevention approaches for U.S.-born and Haitian-born blacks.

In a time where competition for software services is big and the time to market crucial, speed and productivity is the key to competing with other organizations. One of the competitors is Spotify, who provide an audio streaming platform to 286 million monthly active users around the world. Due to the number of users, a disturbance in the service has a great impact. In order to avoid disturbances, the back-end developers have to locate and solve the issue fast. To be able to identify user problems and frustrations with a troubleshooting tool, fifteen interviews and five observations were conducted. The resulting data, combined with the five-step Design Thinking model, resulted in the two defined problems: finding specific information and narrowing the problem space. Furthermore, a search feature and a feature to customize the view, were tested on a middle-fidelity prototype to investigate the impact on troubleshooting and the usability of the tool.